Medical Service Corps, Army, Department of Health Policy, Yale School of Public Health, New Haven, CT 06520, USA.
Associate Dean of Research and Professor of Epidemiology, Yale School of Public Health, New Haven, CT 06520, USA.
Mil Med. 2021 Nov 2;186(11-12):1093-1099. doi: 10.1093/milmed/usab012.
Since the beginning of overseas contingency operations, the percent of service members who are considered overweight or obese has tripled to 15% for men and 20% for women. This has implications for national security if the country is unable to staff its military with fit-to-fight individuals. The purpose of this systematic review is to move policy efforts forward by illuminating the efficacy of several lifestyle interventions for active duty service members since 2001. It aims to both identify common aspects of successful interventions and also identify interventions without success so DoD leaders may replace those initiatives.
The electronic database PubMed was searched from September 11, 2001 to May 15, 2020. Studies were included if the target population was United States active duty service members from any branch, the study included an intervention, and the measured outcome was weight loss. Seven studies met final inclusion criteria.
Interventions with corresponding weight loss data are summarized in Table III. This review found that there is not a sufficient body of evidence to determine if interventions to aid active duty service members in losing weight are effective.
However, as a collection, the studies could support the notion that military members get the best results when interventions are convenient, modern, personalized, and accessible. More studies are needed, and future studies with larger sample sizes and longer durations would be valuable in determining efficacy of weight loss interventions. Undoubtedly, enrollment and compliance is difficult with military member moves and competing mission requirements. Ideally, the DoD should work to aggregate the efforts in this field, as many initiatives are not captured, shared, and utilized by other installations or other services. Data silos and unpublished or underdeveloped research reactively addresses issues and does not proactively address them. Policy change will need to be nested in further research, as well as consider the food environment on bases and possible prevention efforts.
自海外应急行动开始以来,军人中超重或肥胖的比例已从 2001 年的男性 5%和女性 10%增加到男性 15%和女性 20%。如果国家无法让适合战斗的个人入伍,这将对国家安全产生影响。本系统评价的目的是通过阐明自 2001 年以来针对现役军人的几种生活方式干预措施的效果,推动政策努力向前发展。它旨在确定成功干预的共同方面,同时确定不成功的干预措施,以便国防部领导层可以取代这些举措。
从 2001 年 9 月 11 日至 2020 年 5 月 15 日,在电子数据库 PubMed 中进行了搜索。如果目标人群是来自任何分支机构的美国现役军人,研究包括干预措施,并且测量结果是体重减轻,则纳入研究。共有 7 项研究符合最终纳入标准。
表 III 总结了具有相应体重减轻数据的干预措施。本综述发现,没有足够的证据来确定干预措施是否有效,以帮助现役军人减轻体重。
然而,作为一个集合,这些研究可以支持这样一种观点,即当干预措施方便、现代、个性化和可及时,军事人员会得到最好的结果。需要更多的研究,未来具有更大样本量和更长时间的研究将有助于确定减肥干预措施的效果。毫无疑问,随着军人的调动和竞争任务的要求,入伍和遵守规定是困难的。理想情况下,国防部应该努力整合这一领域的努力,因为许多举措都没有被其他设施或其他服务部门捕获、共享和利用。数据孤岛和未发表或欠发达的研究是在问题发生后做出反应,而不是主动解决问题。政策变化需要在进一步的研究中得到嵌套,并考虑基地的食物环境和可能的预防措施。