Trends in the evolution of BMI in Belgian army men

Abstract

Objectives: The first aim was to evaluate BMI cross-sectionally over a period of 14 years (1992 to 2005) in 43 343 army men and the second was to compare BMI using the paired data of 1497 army men. The data were analysed as a function of the military ranking system, used as an indicator for socio-economic position. Design: Multiple cross-sectional and longitudinal design. Results: A significant increase of BMI between age categories was detected over the 14-year period; BMI remained stable in each age category. In the paired cohort, median BMI increased during the same period from 23?9 (interquartile range 3?3) kg/m 2 to 24?7 (interquartile range 3?5) kg/m 2 (P , 0?0001). This age-dependent evolution was present in all military rankings. From age 40 years or more, BMI indicated a significant increase in the prevalence of overweight and obesity. Conclusion: For the total cohort, BMI remained stable in each age category. For the paired cohort, BMI increased over time. The military leadership should emphasize prevention in order to reduce the health-care costs and disease burden in this cohort. This emphasis on prevention should target those aged less than 40 years. KeywordsObesity Body mass index Socio-economic position Army EpidemiologyOverweight and obesity are serious, large-scale global public health concerns. Obesity is not only associated with a lack of self-esteem, depression, social and work problems, but also with a range of chronic diseases (1) . Obesity has also been clearly related to socio-economic factors (2) . The prevalence of obesity increases gradually in each 10-year age category in the Flemish and Belgian populations (3,4) .According to Belgian military health recruitment standards, all army men should have a normal BMI at the start of their career (5) . However, Kress and co-workers demonstrated in the US military that decades of active duty does not confer any long-term protection against overweight or obesity (6,7) . Such data are not available for the Belgian army. Therefore, the present study was designed to evaluate the evolution of BMI over 14 years. Second, the influence of socio-economic position was evaluated. MethodsBetween 1 January 1992 and 31 December 2005, the biomedical data of personnel who participated in international peace-keeping missions were registered by the Belgian army. The variables registered at each period were date of birth, self-reported weight and height, sex and military rank.The study population was divided in two samples. The first sample, named the total cohort, included 49 784 male and female military employees who took part in one or more international military peace-keeping missions between 1992 and 2005. Because of the under-representation of women, we studied only the male population (n 48 850). BMI data were incomplete in 5507 cases, leaving a cohort of 43 343 army men. For each of the fourteen years between 1992 and 2005, a mean of 3096 subjects were evaluated. From this cohort, we identified 1497 paired measurements of army men who carried ou...

Prevalence and socio-demographic correlates of obesity in the British Army

“…Across both genders, age represented a clear relationship with obesity and risk to obesity-related diseases. This relationship is generally supported in other studies on the military population (Bray et al, 2009;Helmhout, 2009;Mullie et al, 2008;Napredit et al, 2005;Shaw et al, 2013). Similarly a significant association, 2 (3) ¼ 41.86 (p50.05), was found between age group and BMI classification of UK Royal Navy personnel, whereby participants in the 35-44 and 45 year age group were more likely to be obese in comparison to the younger age groups (Shaw et al, 2013).…”

“…However, the higher levels of obesity that were observed in the LE cohort either became insignificant (female) or reduced in significance (male) and effect size, when the predictor variables were controlled for each other. Two studies on military populations have reported elevated levels of obesity in the soldier populations as opposed to the officer populations (Bray et al, 2009;Mullie et al, 2008). One recent study indicated that a correlation might exist between the hierarchical system of rank employed within the military and 'pay-group', with higher rank commanding higher pay (Sanderson et al, 2011).…”

“…The worrying trend of escalating obesity has prompted some armed forces to replicate these surveys for military personnel, the findings of which have indicated that obesity is also a cause for concern in these specific populations (Bray et al, 2009;Helmhout, 2009;Mullie et al, 2008;Napredit et al, 2005). Where trend data are available, they suggest there has been little change in the level of overweight from 1998 to 2008 (48.8% and 48.6%); however, this level of stability is not replicated within the obese (Body Mass Index (BMI) 30.0 kg/m 2 ) military population, where the prevalence has more than doubled (6.4% to 13.2% in 1998 and 2008, respectively) (Bray et al, 2009).…”

Dietary patterns and socioeconomic position

“…Stratification in normal weight, overweight and obesity did not influence the relation between socioeconomic indicator and dietary pattern. Although socioeconomic differences in prevalence of obesity have been described, that is, higher prevalence for the lowest socioeconomic positions (Mullie et al, 2008), dietary pattern analysis seems not to be able to detect a specific dietary pattern explaining this socioeconomic occurrence of obesity. The positive association between socioeconomic position and dietary pattern has been confirmed by research carried out on different populations, using different indexes or statistical techniques to determine dietary patterns.…”

Relation between dietary pattern analysis (principal component analysis) and body mass index: a 5-year follow-up study in a Belgian military population

“…Hence, testing the weight gain hypothesis in specific populations can help to clarify the relationship with secular BMI increase. An increasing prevalence of adiposity has been described in military populations, which can negatively influence military readiness 17. When relating dietary pattern to weight gain, the clear socioeconomic stratification of a military population can be of added value to investigate the relation between socioeconomic status and nutrition.…”