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Metabolic Syndrome in Military Personnel Post-Retirement

Contributing factors like weight, exercise, and caloric intake are explored

by Bianca Garilli, ND, USMC Veteran

Military ranks are full of healthy men and women participating in regular physical fitness routines comprised of cardiovascular fitness, strength training, and flexibility exercises all designed to keep the warfighter in tip top condition, ready to deploy and engage at a moment’s notice.

In fact, due to the sharp focus on exercise and weight standards of the US Armed Forces, active duty troops are much healthier than their civilian counterparts. For example, rates of metabolic syndrome (MetSyn) in military service members is 23.4%, much lower than their age-matched peers whose MetSyn rate is 39%.1,2

Frequent and challenging fitness sessions are key to the US military achieving higher health status, as well as a critical component for military members to maintain standards of body composition and exercise capacity. Military fitness levels are typically measured biannually throughout the various branches of the service, with each organization having their own specific standards. For instance, the Marine Corps requires Marines to demonstrate their fitness in three areas including a timed 3 mile run, pull-ups, and crunches; the Air Force assessment is completed utilizing push-ups, sit-ups, and a timed 1.5 mile run; the other branches also have their own set of requirements.3,4

To learn more about whether maintaining such rigorous exercise habits and physical fitness standards over a 20+ year career in the military would continue to deliver health benefits post-retirement, a study reviewing health-related behaviors and health status of 381 retired military Air Force personnel was conducted and published in Military Medicine.5

Individuals participating in the study had a mean age of 48.2 years and were within 8 years of their date of retirement from the US Air Force (USAF).5 Approximately 82% of participants were male, and 71% had been enlisted; all individuals underwent examination and various laboratory tests to determine presence of MetSyn.5 Anthropometric and health-related behavioral information was also collected, including information on their current weight, caloric intake, and exercise levels compared to when they were active duty (i.e., decreased, same, increased).5

The following prevalence data was observed for MetSyn criteria in the USAF retirees:5

  • Central obesity: 39.8%
  • Elevated fasting glucose: 32.4%
  • High blood pressure: 56.8%
  • Low HDL cholesterol: 33.3%
  • Elevated triglycerides: 42.7%

Overall, MetSyn was found to be more common in retired males and retired enlisted personnel (compared to females and officers, respectively).5 Further results from this study demonstrated that within 8 years of retirement, 37.2% of the studied individuals met criteria for MetSyn, with the prevalence of this cardiometabolic condition peaking in 6-8 years post-retirement.5

Interestingly, if the individual had participated in the Air Force Weight Management Program while on active duty, they had an increased prevalence of weight gain post-retirement and were nearly 3x more likely to meet MetSyn criteria (61.4% of previous participants in the program had MetSyn within 8 years of retirement) than their fellow service members who had not participated in the program while on active duty.5 The Air Force Weight Management Program was created to improve overall fitness in Air Force personnel who fail to meet minimum requirements of the annual fitness tests and physical fitness standards.5

Similar MetSyn rates were seen in both USAF retirees and the general public: 37.2% in Air Force retirees compared to 39% in age-matched US general population.5

This study was the first of its kind to investigate whether long-term physical fitness requirements, such as those implemented by active duty Air Force personnel, for a period of 20+ years would confer beneficial effects after retirement. The concluding results indicate that an increase in weight; a maintenance or increased caloric intake; or a reduction in regular exercise habits, may lead to factors associated with MetSyn risk and eventually diagnosis.5 Researchers found that the weight gain in particular, not the individual contributors (such as less exercise and increased caloric intake), was the most important determinant of whether a USAF retiree would go on to develop MetSyn.5

Why is this Clinically Relevant?

  • MetSyn is a precursor to various chronic disease, including cardiovascular disease and diabetes; reducing risk of MetSyn is an important step to long term health in military veterans
  • Long-term, regular exercise and maintenance of a healthy weight during active duty does not continue to offer protection against MetSyn if significant weight gain is experienced in post-retirement individuals
  • When transitioning from active duty to retiree status it is important to educate individuals on the necessity of maintaining a healthy weight through continued regular exercise and moderation of caloric intake post-retirement
  • Within 8 years of retirement from service, retirees of active duty military (in this case, Air Force) have a similar prevalence of MetSyn as the general US population
  • Veteran healthcare administration and local community healthcare providers giving care to veterans and retirees should monitor MetSyn markers, weight, waist circumference, and BMI and create actionable health and wellness plans aimed at maintaining optimal weight control in this population

Link to abstract

Citations

  1. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States. Natl Health Stat Report. 2009;13:1-8.
  2. Herzog CM, Chao SY, Eilerman PA, Luce BK, Carnahan DH. Metabolic syndrome in the military health system based on electronic health data, 2009-2012. Mil Med. 2015;180(1):83-90.
  3. Marines. Marine Corps Physical Fitness. https://www.fitness.marines.mil/PFT-CFT_Standards17/. Accessed November 1, 2018
  4. Air Force PT Standards. https://airforce-pt.com/. Accessed November 1, 2018.
  5. Cranston MM, True MW, Wardian JL, Carriere RM, Sauerwein TJ. When military fitness standards no longer apply: the high prevalence of metabolic syndrome in recent Air Force retirees. Mil Med. 2017;182(7):1780-1786.

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