Health assessment of U.S. Army Rangers

Military Medicine, Jan 2003 by Deuster, Patricia A

Purpose: Assess the health behaviors of U.S. Army Rangers, including their diet and physical activity patterns, and their use of alcohol, tobacco, and nutritional supplements. Methods: Army Rangers (N = 38) completed selected self-report and food frequency questionnaires, and anthropometric measures (height, weight, circumferences) were taken. Results: Dietary patterns were collected from questionnaires that asked respondents to report the frequency of usual consumption from a list of foods over a period of I year. The data collected indicated a diet high in fat (38.0% of energy) and low in carbohydrates (41.90. Protein intake (17.9% of energy) was consistent with recommendations for endurance and strength training athletes. Hours engaged in physical activity averaged 12 per week. Overall, 76% of the volunteers reported using alcohol on a regular basis, and 52.6% used some form of tobacco: 50% reported using either snuff or chewing tobacco. The use of supplements was high with 13% taking creatine and ephedrine products on a regular basis. Conclusion: Although physical activity patterns indicated a high level of activity, dietary and other health behaviors, such as smoking, alcohol use, and patterns of supplement use, suggest that health education programs may be important in this select Army population.

Introduction

Health assessments of various groups have been conducted over the years to document particular lifestyle patterns that may affect overall health. Numerous studies have shown the importance of nutrition and other health behaviors for reducing the morbidity and mortality of the general population. For example, a diet that meets energy requirements and is low in fat has been associated with a reduced risk of developing various chronic diseases.1,2 In addition, combining a good diet with physical exercise and other positive health behaviors (nonsmoking, limiting alcohol intake) can substantially reduce the risk of chronic disease and morbidity.1-3

U.S. citizens also believe that taking dietary supplements may reduce the risk of chronic disease and improve overall health.4-7 Although the role of nutritional supplements in reducing chronic diseases is unknown, the use of nutritional supplements is prevalent.4,6-8 This is particularly true among athletes with various reports indicating that 39% to 100% use supplements on a regular basis.4,8-12 Over the past several years, the use of supplements within both the military and civilian populations has become a concern, because adverse events associated with selected supplements, in particular ephedrine-containing products, have been reported.13 Thus, the health behavior of supplement users must also be considered as a component of a health assessment.

The U.S. military is interested in the overall health and wellness of the war fighter. In particular, the military leadership has become increasingly concerned with the role of health behaviors in various aspects of military training. Dietary and physical activity patterns, supplement use, and alcohol and tobacco use are behaviors of interest. One group of military personnel whose health behaviors are of interest is the U.S. Army Rangers. This elite group of men undergoes rigorous physical and psychological training just to join this prestigious fighting organization. To date, no information regarding the health habits of Rangers has been reported, although health and nutritional surveys of other military populations, such as high ranking military officers,14 the Navy SEALS,15 new recruits,4 and Navy divers,16 have been conducted. Because Rangers routinely undergo rigorous physical training and experience high levels of stress, their nutrition and health behaviors would be important for formulating recommendations regarding short- and long-term health objectives.

The goal of this study was to conduct a health assessment of the U.S. Army Rangers. The overall information derived can be used by health care professionals for making recommendations about future desirable health behaviors. To that end, U.S. Army Rangers were provided a questionnaire to assess the weekly amount of aerobic and anaerobic exercise performed, nicotine and daily caffeine intake, alcohol habits, use of supplements, and dietary patterns, including the intake of fat, carbohydrates, and protein. Specific questions to be answered by the study include the following: (1) Do intakes of carbohydrates, fat, and protein meet the Dietary Guidelines for Americans, 2000 (DGA)17 and the Military Dietary References Intakes?18 (2) Do dietary patterns of the trainees conform to recommendations for endurance athletes? (3) What are their health behaviors in terms of nutritional supplement patterns, use of caffeine, alcohol and tobacco, and levels of daily physical activity?

Methods

The 38 subjects who volunteered for this study were all qualified Ranger graduates assigned to Fort Benning, Georgia. The study was part of another study to examine the effects of creatine on military performance. Many subjects were briefed on the study, and then those interested in participating reported the next morning to the gymnasium for the Rangers. At that time, informed consent was obtained from each individual. All the participants came from similar military training. The study was approved by the Institutional Review Boards at the Uniformed Services University of the Health Sciences in Bethesda, Maryland and the Eisenhower Army Medical Center in Augusta, Georgia.