Abstract
BackgroundCardiometabolic disease risk in US military recruits and the effects of military training have not been determined. This study examined lifestyle factors and biomarkers associated with cardiometabolic risk in US Army recruits (209; 118 male, 91 female, 23±5 yr) before, during, and after basic combat training (BCT).Methodology/Principal FindingsAnthropometrics; fasting total (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol; triglycerides (TG); glucose; and insulin were measured at baseline and every 3 wks during the 10 wk BCT course. At baseline, 14% of recruits were obese (BMI>30 kg/m2), 27% were cigarette smokers, 37% were sedentary, and 34% reported a family history of cardiometabolic disease. TC was above recommended levels in 8%, LDL in 39%, TG in 5%, and glucose in 8% of recruits, and HDL was below recommended levels in 33% of recruits at baseline. By week 9, TC decreased 8%, LDL 10%, TG 13%, glucose 6% and homeostasis model assessment of insulin resistance (HOMA-IR) 40% in men (P<0.05). In women, TC, LDL, glucose and HOMA-IR were decreased from baseline at weeks 3 and 6 (P<0.05), but were not different from baseline levels at week 9. During BCT, body weight declined in men but not women, while body fat percentage declined in both men and women (P<0.05).Conclusions/SignificanceAt the start of military service, the prevalence of cardiometabolic risk in US military recruits is comparable to that reported in similar, college-aged populations. Military training appears to be an effective strategy that may mitigate risk in young people through improvements in lipid profiles and glycemic control.
Highlights
Cardiovascular and metabolic diseases remain leading causes of morbidity and mortality in the United States [1,2]
As lifestyle behaviors adopted early in life may increase the risk of developing cardiometabolic disease in adulthood, risk factor identification and management in young adults should be a primary focus of long-term disease prevention
Similar to the corresponding civilian demographic, health-risk behaviors and cardiometabolic risk factors were evident in US Army recruits before starting basic combat training (BCT)
Summary
Cardiovascular and metabolic diseases remain leading causes of morbidity and mortality in the United States [1,2]. Studies investigating primary and secondary cardiometabolic disease prevention strategies have traditionally focused on modifying health risk behaviors in older adults [8,9,10,11]. As exposure to cardiometabolic risk factors in childhood and adolescence is associated with disease development in adulthood [20,21,22] and health-risk behaviors are often established early in life, identifying strategies that deter the adoption and continuation of health risk behaviors in younger adults is essential for long-term primary prevention of cardiometabolic disease. Evidence suggests that biomarkers and health-risk behaviors associated with cardiometabolic disease in military personnel may be similar to that observed in civilians [25,26], with the rate of military personnel with a body mass index (BMI) exceeding 25 kg/m2 at 62% and the prevalence of dyslipidemia [26] and smoking [27] at approximately 30%. This study examined lifestyle factors and biomarkers associated with cardiometabolic risk in US Army recruits (209; 118 male, 91 female, 2365 yr) before, during, and after basic combat training (BCT)
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