Objective: The aim of this study was to carry out an epidemiological analysis of metabolic syndrome among Brazilian Army soldiers. Subjects and methods: Two thousand seven hundred and nineteen male soldiers of the Brazilian Army were evaluated from 2014 to 2016. Characteristics: age = 27.77 (± 8.59) years and BMI = 25.15 (± 3.41) kg/m 2. Blood tests and anthropometric measures were performed following the criteria of the International Diabetes Federation Task Force on MS Epidemiology and Prevention, 2009. The epidemiological analysis was based on Odds ratio (OR) with confidence interval (CI). Results: The prevalence of MS found was 12.21%. Both WC and BMI proved to be good predictors of changes in MS physiological markers. Increased WC and BMI were strongly associated with all physiological markers. Soldiers with WC ≥ 90 were more likely to present MS with OR = 33.37 (24.37-45.7). Soldiers with WC ≥ 90 also presented high risk of: high triglycerides with OR = 5.98 (4.69-7.61); low HLD-c with OR = 1.78 (1.47-2.16); and increased systolic blood pressure OR = 3.10 (2.55-3.76). Soldiers with BMI ≥ 30 had a high risk of: increased glucose with OR = 2.69 (1.93-3.75); and increased diastolic blood pressure with OR = 3.02 (2.22-4.10). Conclusion: Both WC and BMI can be considered as good predictors of changes in MS physiological markers. We believe that WC and BMI should be used as screening tools to indicate the soldiers that must undergo blood tests to monitor MS prevalence.

Introduction: Adipocyte volume (fat accumulation) in different parts of the body may play different roles in the metabolism and in the appearance of cardiovascular risk factors. Most studies indicate that the regional distribution of body fat seems to be more important than excess adiposity per se. High levels of physical activity are associated with lower total and visceral body fat levels. Military physical training is of paramount importance for the health and performance of soldiers in the Brazilian Army. In this context, physical evaluation will provide data on the main physical benefits involved in military tasks. Objective: Verify the relationship between visceral fat (VF), physical performance and biochemical markers of soldiers in the Brazilian Army. Methods: The sample consisted of 41 (38.9 ± 2.2 years) Brazilian male military personnel. VF was obtained with a Dual Energy X-Ray Absorptiometry densitometry device. The biochemical analysis included fasting glycemia, triglycerides (TG) and HDL-C levels. Physical performance was evaluated through two tests (12-min run and pull-ups). The Shapiro-Wilk test confirmed the normality of the variables. Pearson's correlation test was then applied, with a p-value of <0.05. Results: Significant negative correlations of VF were found with the results of both physical tests (Pull-ups r = −0.59; 12-min r = −0.61). The only biochemical variable that had a significant positive correlation with VF was TG (r = 0.44). Conclusion: The results of this study showed a significant negative association between VF and physical tests. A significant positive association between VF and TG was also found. Level of Evidence I; Diagnostic studies - Investigation of a diagnostic test.

Introduction: Since 1965, the Brazilian Army (BA) has participated in peacekeeping missions of the United Nations (UN), sending large contingents to various parts of the world, such as Angola, Mozambique, East Timor and Haiti. To do so, the military must be in a minimum physical condition to face any obstacles in the course of action in the theater of operations. Objective: To verify the effects of Military Physical Training (MPT) on muscular strength of upper limbs, anthropometric variables and body composition of Brazilian military personnel of the 24th UN peacekeeping mission in Haiti. Methods: The sample consisted of 192 male soldiers with mean age of 23.2 ± 3 6 years. They observed a weekday residential regime, with a defined schedule of meals and activities and time off on weekends. The MPT was applied four times a week, 90 minutes long for 14 weeks and involved aerobic and resisted exercises. In the pre-and post-MPT period, body mass (MC), height, waist circumference (WC) and abdomen circumference (AC) were measured to calculate body mass index (BMI) and fat percentage (%F) through the protocol of Salem.. In addition, 12-minute run tests, push-ups, pull up and abdominal flexions were performed to calculate the Rogers Index (RI). Results: When comparing pre-and post-MPT, a significant difference was observed in all anthropometric variables and body composition (BM, BMI and %F) and in the RI for the upper limb muscle strength. Conclusion: The 14-week MPT indicates an improvement in the anthropometric and body composition variables, as well as an increase in upper limb muscular strength in Brazilian soldiers of the UN peacekeeping contingents in Haiti. This study concluded that RI could be an effective tool for assessing military muscular strength. Level of Evidence II; Therapeutic studies -Investigating the results of treatment.

Introduction It has been suggested that visceral adipose tissue (VAT) is associated with several non-communicable chronic diseases, but measuring it is difficult. Thus, anthropometry could be used because is easily applied in clinical practice. Objectives The present study aimed to develop and validate VAT estimation equations (Eq) in military men. Methods The sample consisted of 409 (mean age, 36.5 ± 6.7 years) military men in the Brazilian Army (BA) divided into an equation group (EG) ( n = 270; mean age, 37.0 ± 6.3 years) and a validation group (VG) ( n =139; mean age, 36.0 ± 7.2 years). Anthropometric, hemodynamic and DXA body composition evaluations ( GE iLunar ) were performed. The Student’s t test, Pearson’s correlation, and stepwise general linear regression were applied. Bland-Altman graphics were used to assess the concordance between VAT by Eq and by DXA. The level of significance was 95% ( p < 0.05). Results Age, waist circumference (WC), hip circumference and body mass index presented the main significant positive correlations with the VAT-DXA. Four Eq were created Eq1 ( r 2 = 0.793), Eq2 ( r 2 = 0.810), Eq3 ( r 2 = 0.817), and Eq 4 ( r 2 = 0.823) ( p < 0.05). No differences were observed between VAT by DXA and VAT by Eq ( p = 0.982, p = 0.970, p = 0.495 and p = 0.698). Bland-Altman analysis also presented good concordance as the bias was close to zero and was not statistically significant. Conclusion Eq2 (age*13.0 + WC*60.0 - 4975,.5) was more suitable because it is easier to apply, has a higher predictive power (81.0%), less bias (1.86) and validation yielded average VAT values close to those found in DXA. It may still be considered a valuable tool for other extensive epidemiological studies in military men in the BA and can be used in adult men. Evidence Level I: Development of diagnostic criteria on consecutive patients (with universally applied reference ‘‘gold’’ standard).

Visceral adipose tissue (VAT) has high metabolic activity and secretes a larger number of adipokines that are related to the inflammatory process. Quantifying VAT could estimate the risk of developing Metabolic Syndrome (MetS). This study was designed to determine the VAT cut-off points assessed by DXA associated with MetS in military men. In total, 270 (37.5 ± 6.9 years) military men from the Brazilian Army (BA) participated in the study. Anthropometric measurements, assessment of body composition by dual X-ray absorptiometry (DXA), hemodynamics and biochemical tests were performed. The Student’s t test, independent samples, Person’s correlation, ROC curve, Youden Index and positive (PPV) and negative predictive value (NPV) were used. The MetS prevalence was 27.4%, which means that 74 (38.0 ± 7.3 years) military men had at least three risk factors of MetS present. The cutoff point of VAT with the highest balance between sensitivity (77.0%) and specificity (69.9%) was 1025.0 cm3 (1086.0 g). An area on the ROC curve was 0.801 (p < 0.000), which was very good precision. VAT ≥ 1025.0 cm3 (1086.0 g) is associated with the risk factors of MetS and is, therefore, a predictor of the disease with good indicators of sensitivity and specificity and a robust indicator of MetS.

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Introduction: The Brazilian Army (BA) considers Military Physical Training (MPT) essential for the development of physical conditioning and general health, including prevention of chronic noncommunicable diseases (CNCDs), including metabolic syndrome (MS) risk factors. The evaluation of body composition using dual-emission x-ray absorptiometry (DXA) quantifies the visceral fat responsible for several types of disease. Objective: To verify the behavior among the body composition, anthropometric, hemodynamic and biochemical variables by means of the physical performance of military personnel with MS (W/MS) and without MS (NO/MS). Methods: The sample consisted of 41 (38.9 ± 2.3 years, 177.8 ± 6.4 cm, 91.5 ± 11.9 kg) military personnel, with 28 individuals diagnosed as W/MS and 13 individuals as NO/MS. Data collection was divided into three days. An anthropometric assessment was performed on the first day. On the second day, the subjects underwent biochemical tests of MS markers, blood pressure (BP) checks, and DXA examinations. On the third day, a physical assessment was applied according to the requirements of the BA (12-minute run, pushups and pullups). Results: There was a significant difference between W/MS and NO/MS subjects in the variables of HDL-C, Diastolic BP, Systolic BP and Waist Circumference. None of the physical variables presented a significant difference. There was also a significant difference between groups for all body composition and anthropometric variables. Conclusion: NO/MS subjects have better mean body composition, BP and anthropometric values than W/MS subjects, which may indicate that they are at less risk of CNCDs. The fact that the military subject is or is not a carrier of MS did not influence the performance of the tests applied. Level of Evidence I; Diagnostic studies - Investigation of a diagnostic test.

Following the increase in the employment of women in conflicts around the world, the federal government of Brazil enacted a law which determines the participation of women in the military. The aim of this study was to analyze the effect of six months of physical training (PT) on the physical fitness of young Brazilian Army cadets to carry out the physical assessments provided in military training. Sixty-eight members of the (19.4 ± 1.0 years) military from the Brazilian Army (BA), with BMI of (23.61 ± 2.17/21.81 ± 2.26) respectively and divided in two groups (men/women) participated in the study. PT was conducted by Manual EB20-MC10.350. Anthropometric measurements and assessment of body composition by dual X-ray absorptiometry were performed. The Student’s t test, percentage evolution equation, and Levene test were used. Results showeda significant increase in anthropometric variables and cardiorespiratory fitness in both groups. Bone health variables and visceral fat presented a significant increase in the malegroup. In terms of muscle fitness (handgrip and isometric strength of the legs and push-up and pull-up), there was no significant variation between thegroups. Percentage evolution was greater in female group. The conclusion shows PT was able to cause beneficial changes, promoting positive improvement in bone health, especially in women. Also, PT was shown to enhance cardiorespiratory capacity, and muscle fitness of the upper limbs in all participants.