Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98101, USA.
Int J Obes (Lond). 2013 Feb;37(2):244-53. doi: 10.1038/ijo.2012.46. Epub 2012 Apr 10.
Although overweight and obesity are less prevalent among active-duty military personnel compared with similar persons not serving in the military, no such differences have been observed between veterans and non-veterans.
To assess the magnitude of weight changes before, concurrent with and following discharge from the military, relative to weight during service, and to determine the demographic, service-related and psychological characteristics associated with clinically important weight gain among those who were discharged from military service during follow-up.
Eligible Millennium Cohort Study participants (n=38 686) completed the questionnaires approximately every 3 years (2001, 2004 and 2007) that were used to estimate annual weight changes, as well as the percentage experiencing clinically important weight gain, defined as 10%. Analyses were stratified by sex.
Weight gain was greatest around the time of discharge from service and in the 3 years before discharge (1.0-1.3 kg per year), while it was nearly half as much during service (0.6-0.7 kg per year) and 3 years after service ended (0.7 kg per year). Consequently, 6-year weight gain was over 2 kg greater in those who were discharged compared with those who remained in the military during follow-up (5.7 vs 3.5 kg in men; 6.3 vs 4.0 kg in women). In those who were discharged, younger age, less education, being overweight at baseline, being in the active-duty component (vs Reserve/National Guard) and having experienced deployment with combat exposures (vs non-deployment) were associated with increased risks of clinically important weight gain.
This study provides the first prospectively collected evidence for an increased rate of weight gain around the time of military discharge that may explain previously reported higher rates of obesity in veterans, and identifies characteristics of higher-risk groups. Discharge from military service presents a window of risk and opportunity to prevent unhealthy weight gain in military personnel and veterans.
与未服兵役的相似人群相比，现役军人中超重和肥胖的情况较少，但退伍军人与非退伍军人之间没有观察到这种差异。
评估与服役期间相比，退伍军人在退役前、服役期间和退役后体重的变化幅度，并确定退伍军人在随访期间退役后出现临床显著体重增加的相关人口统计学、服务相关和心理特征。
合格的千禧年队列研究参与者（n=38686）完成了大约每 3 年一次的问卷调查（2001、2004 和 2007 年），这些问卷用于估计每年的体重变化，以及经历临床显著体重增加（定义为增加≥10%）的百分比。分析按性别分层。
退伍前后体重增加最大（每年 1.0-1.3 公斤），而服役期间体重增加几乎减半（每年 0.6-0.7 公斤），退役后 3 年内体重增加（每年 0.7 公斤）。因此，与随访期间留在军队中的人相比，退伍军人的 6 年体重增加超过 2 公斤（男性退伍军人比继续留在军队中的人多 5.7 公斤，女性退伍军人多 6.3 公斤）。在退伍军人中，年龄较小、受教育程度较低、基线时超重、现役（与预备役/国民警卫队相比）和经历过战斗部署（与非部署相比）与临床显著体重增加的风险增加相关。
这项研究首次前瞻性地提供了退伍军人在退伍前后体重增加率增加的证据，这可能解释了之前报告的退伍军人肥胖率较高的原因，并确定了高风险群体的特征。退伍军人从军队退役时是一个存在风险和机会的时期，可以预防军队人员和退伍军人的体重不健康增加。
