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Body Mass Index at Accession and Incident Cardiometabolic Risk Factors in US Army Soldiers, 2001–2011

Journal Article · · PLoS ONE
 [1];  [2];  [3];  [2];  [4];  [4];  [4];  [5]
  1. US Army Research Institute of Environmental Medicine, Natick, MA (United States). Military Nutrition Div.; Tufts Univ., Medford, MA (United States). Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging; DOE/OSTI
  2. US Army Research Institute of Environmental Medicine, Natick, MA (United States). Military Performance Div.; Health Readiness Center of Excellence, Fort Sam, Houston, TX (United States). U.S. Army Medical Department Center and School
  3. US Army Research Institute of Environmental Medicine, Natick, MA (United States). Military Performance Div.
  4. US Army Research Institute of Environmental Medicine, Natick, MA (United States). Military Nutrition Div.
  5. Dasman Diabetes Institute, (Kuwait)

Individuals entering US Army service are generally young and healthy, but many are overweight, which may impact cardiometabolic risk despite physical activity and fitness requirements. This analysis examines the association between Soldiers’ BMI at accession and incident cardiometabolic risk factors (CRF) using longitudinal data from 731,014 Soldiers (17.0% female; age: 21.6 [3.9] years; BMI: 24.7 [3.8] kg/m2) who were assessed at Army accession, 2001–2011. CRF were defined as incident diagnoses through 2011, by ICD-9 code, of metabolic syndrome, glucose/insulin disorder, hypertension, dyslipidemia, or overweight/obesity (in those not initially overweight/obese). Multivariable-adjusted proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between BMI categories at accession and CRF. Initially underweight (BMI<18.5 kg/m2) were 2.4% of Soldiers, 53.5% were normal weight (18.5-<25), 34.2% were overweight (25-<30), and 10.0% were obese (≥30). Mean age range at CRF diagnosis was 24–29 years old, with generally low CRF incidence: 228 with metabolic syndrome, 3,880 with a glucose/insulin disorder, 26,373 with hypertension, and 13,404 with dyslipidemia. Of the Soldiers who were not overweight or obese at accession, 5,361 were eventually diagnosed as overweight or obese. Relative to Soldiers who were normal weight at accession, those who were overweight or obese, respectively, had significantly higher risk of developing each CRF after multivariable adjustment (HR [95% CI]: metabolic syndrome: 4.13 [2.87–5.94], 13.36 [9.00–19.83]; glucose/insulin disorder: 1.39 [1.30–1.50], 2.76 [2.52–3.04]; hypertension: 1.85 [1.80–1.90], 3.31 [3.20–3.42]; dyslipidemia: 1.81 [1.75–1.89], 3.19 [3.04–3.35]). Risk of hypertension, dyslipidemia, and overweight/obesity in initially underweight Soldiers was 40%, 31%, and 79% lower, respectively, versus normal-weight Soldiers. BMI in early adulthood has important implications for cardiometabolic health, even within young, physically active populations.

Research Organization:
Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
Sponsoring Organization:
USDOE
Grant/Contract Number:
SC0014664
OSTI ID:
1627816
Journal Information:
PLoS ONE, Journal Name: PLoS ONE Journal Issue: 1 Vol. 12; ISSN 1932-6203
Publisher:
Public Library of ScienceCopyright Statement
Country of Publication:
United States
Language:
English

References (38)

Cardiorespiratory Fitness in Young Adulthood and the Development of Cardiovascular Disease Risk Factors journal December 2003
Association of Fitness in Young Adulthood With Survival and Cardiovascular Risk: The Coronary Artery Risk Development in Young Adults (CARDIA) Study journal January 2016
Trends in overweight and obesity in soldiers entering the USArmy, 1989-2012 journal January 2015
BMI and Lower Extremity Injury in U.S. Army Soldiers, 2001–2011 journal June 2016
Fitness vs. Fatness on All-Cause Mortality: A Meta-Analysis journal January 2014
Role of Fitness in the Metabolically Healthy but Obese Phenotype: A Review and Update journal July 2015
Can You Be Large and Not Obese? The Distinction Between Body Weight, Body Fat, and Abdominal Fat in Occupational Standards journal October 2004
Cardiorespiratory Fitness, Body Mass Index, and Heart Failure Mortality in Men: Cooper Center Longitudinal Study journal September 2013
Physical Fitness and Body Composition after a 9-Month Deployment to Afghanistan journal January 2008
Cardiometabolic Risk in US Army Recruits and the Effects of Basic Combat Training journal February 2012
Association of 20-Year Changes in Cardiorespiratory Fitness With Incident Type 2 Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) fitness study journal March 2009
Correlates of Age Onset of Type 2 Diabetes Among Relatively Young Black and White Adults in a Community: The Bogalusa Heart Study journal March 2012
Effect of a 13-Month Deployment to Iraq on Physical Fitness and Body Composition journal June 2010
Prevalence of Abnormal Serum Lipids Among Overweight and Obese Soldiers journal October 2013
Effects of Age and Military Service on Strength and Physiological Characteristics of U.S. Army Soldiers journal February 2016
Prevalence of and Risk Factors for Autopsy-Determined Atherosclerosis Among US Service Members, 2001-2011 journal December 2012
The progression of cardiometabolic disease: Validation of a new cardiometabolic disease staging system applicable to obesity: CMDS Risk Staging System journal September 2013
Excess body mass index- and waist circumference-years and incident cardiovascular disease: The CARDIA study: Excess Adiposity and Cardiovascular Disease journal March 2015
Lifestyle and weight predictors of a healthy overweight profile over a 20-year follow-up: Metabolic Status over a 20-Year Follow-Up journal May 2015
Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants journal March 2014
Overweight and Obesity Trends Among Active Duty Military Personnel journal February 2015
Developing and validating a diabetes database in a large health system journal March 2007
Incidence of Metabolic Risk Factors Among Healthy Obese Adults journal August 2015
Healthy obese versus unhealthy lean: the obesity paradox journal September 2014
Cardiometabolic Risks and Severity of Obesity in Children and Young Adults journal October 2015
Assessing Validity of ICD-9-CM and ICD-10 Administrative Data in Recording Clinical Conditions in a Unique Dually Coded Database: Assessing Validity of ICD-9-CM and ICD-10 journal January 2008
BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants journal May 2016
Cardiorespiratory Fitness, Body Mass Index, and Heart Failure Mortality in Men: Cooper Center Longitudinal Study journal September 2013
Coding of obesity in administrative hospital discharge abstract data: accuracy and impact for future research studies journal February 2014
Effects of Age and Military Service on Strength and Physiological Characteristics of US Army Soldiers: 1584 Board #5 May 28, 1 00 PM - 3 00 PM journal January 2015
Physical Fitness and Body Composition after a 9-Month Deployment to Afghanistan journal January 2008
Body Composition and Military Performance—Many Things to Many People journal January 2012
Rarer Than a Blue Moon: The use of a diagnostic code for the metabolic syndrome in the U.S. journal June 2005
BMI and all cause mortality: systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. journal May 2016
Body mass index, medical qualification status, and discharge during the first year of US Army service journal January 2011
Effect of a 13-Month Deployment to Iraq on Physical Fitness and Body Composition journal June 2010
Prevalence of Abnormal Serum Lipids Among Overweight and Obese Soldiers journal October 2013
Effects of Age and Military Service on Strength and Physiological Characteristics of U.S. Army Soldiers journal February 2016

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