By AMERICAN HEART ASSOCIATION NEWS

Obesity and physical inactivity aren’t just health issues for our country. They’re a threat to national security.

That’s the contention of a new study in the Journal of Public Health Management and Practice, and potentially, a way to focus more attention on the need to improve diet and fitness.

“Maybe you don’t care about public health or the cost of treating diseases,” said Dr. Daniel Bornstein, an exercise scientist and lead author of the study. “But if you care about military readiness and national security, you have to care about fitness.”

Bornstein, assistant professor in the Department of Health, Exercise and Sport Science at The Citadel in Charleston, South Carolina, compared fitness levels of U.S. Army recruits from each of the 50 states and the District of Columbia – based on their times completing a 2-mile run – with their rates of injuries during basic training.

“As we expected, the correlation was quite high,” he said. “Recruits from states that have been producing worse fitness outcomes were more likely to become injured in basic training.”

At the top of the list in both categories were states in the American South, a swath stretching from Texas to Florida.

Southern states often rate poorly in health statistics such as obesity, cardiovascular disease and diabetes, and experts point to factors including poverty, poor diet, less access to health care, sedentary lifestyles and a tradition of fried foods. The study, Bornstein said, indicates that the same states “that are disproportionately burdensome for public health are also burdensome for our military.”

The burdens, he said, stem both from the cost of treating those injuries and the challenge of producing an effective fighting force. It’s even worse, he said, because a significant percentage of young Americans aren’t fit enough even to try to qualify for the military — a common career path for young people in the South — which could hurt communities in those states.

“We owe it to our military not only to give them weapons, but a good pool of candidates,” Bornstein said. “It’s society’s problem to solve. It’s too easy to point to the individual and say, ‘You need to be more physically active.’ We must undertake policies that will create environments that will allow more people to become more physically fit.”

Those range from more physical education in schools and safer neighborhoods that encourage walking and biking to workplaces that encourage physical activity. Bornstein said he doesn’t doubt that nutrition is a key factor as well, but that was not a focus of the study.

The study only examined U.S. Army recruits, he said, because the Army had the best system of tracking training-related injuries. Bornstein said he hopes to include other military branches in future research. Among the other authors of the study was Dr. Laurie Whitsel, director of policy research at the American Heart Association.

The AHA’s chief medical officer for prevention, Dr. Eduardo Sanchez, said, “The strength of our nation is dependent, in part, on the fitness and military readiness of the men and women who protect our nation every day.

“We must continue to build communities and schools that give all children the opportunity to grow up healthy and active, not just for their hearts and brains, but for our national security,” he said.

Lackluster fitness results in southern states don’t surprise Dr. Arie Szatkowski, a Memphis cardiologist on a crusade to improve cardiovascular health in the South. His medical group works in Tennessee, Arkansas and Mississippi, and he’s active in educational outreach, community health screenings and lobbying efforts.

“We know that the southern states, compared to other regions of the USA, would gain the greatest percentage of decline in deaths and complications from cardiovascular disease if strong policy changes were enacted that would directly reduce the behaviors that lead to increased risk,” he said.

The new study underscores that point, Szatkowski said. But he would like to see more research to assess more factors than just a 2-mile run, and to gauge the eventual success of recruits who do suffer training-related injuries.

Nevertheless, Szatkowski said, another argument for the need for public policy changes is always welcome.

“It seems that the impetus to improve health and reduce health care costs by creating and passing transformational legislation is not enough for our government leaders,” he said. “If the threat to national security is what it takes to galvanize our policymakers to create laws that lead to improved health and fitness, I’ll take it.”

Bornstein has the same hope. “We know poor fitness is problematic for public health in the long term,” he said. “In the short term it’s problematic for national security. So if you believe in a strong military, you have to believe in improving the fitness of your population.”

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