When Military Fitness Standards No Longer Apply: The High Prevalence of Metabolic Syndrome in Recent Air Force Retirees

• Published in: Military medicine 2017-07, Vol.182 (7), p.e1780-e1786
• Main Authors: Cranston, Marcus M, True, Mark W, Wardian, Jana L, Carriere, Rishawn M, Sauerwein, Tom J
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Age; Armed forces; Blood pressure; Body Mass Index; Body Weight Maintenance; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cholesterol; Cohort Studies; Diabetes; Disease prevention; Ethnicity; Exercise; Female; Health promotion; Health risk assessment; Heart; Humans; Hyperglycemia; Hypertension; Logistic Models; Male; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - epidemiology; Middle Aged; Military Personnel - statistics & numerical data; Nutrition research; Obesity; Odds Ratio; Population; Prevalence; Retirees; Retirement; Retirement - statistics & numerical data; Risk Factors; Sex Factors; United States - epidemiology; Veterans; Weight control
• ISSN: 0026-4075; 1930-613X
• DOI: 10.7205/MILMED-D-16-00253

Metabolic syndrome (MetS) is strongly associated with cardiovascular disease. With MetS prevalence rates increasing in the U.S. population, prevention efforts have largely focused on diet and exercise interventions. Before retirement, military service members have met fitness requirements for at least 20 years, and have lower MetS rates compared to age-matched U.S. population controls (23.4% vs. 39.0%), which suggests a protective effect of the lifestyle associated with military service. However, MetS rates in military retirees have not been previously reported, so it is unknown whether this protective effect extends beyond military service. The purpose of this study was to examine the prevalence of MetS and individual diagnostic criteria in a population of recent U.S. Air Force (USAF) retirees. We obtained institutional review board approval for all participating sites at Wilford Hall Ambulatory Surgical Center. From December 2011 to May 2013, USAF retirees within 8 years of their date of retirement were recruited at five USAF bases. Consenting subjects underwent examination and laboratory studies to assess the five diagnostic criteria measures for MetS. We used binary logistic regression to examine the relationship between various factors and the presence of MetS. The study population (n = 381) was primarily male (81.9%), enlisted (71.1%) and had a mean age of 48.2 years. When applying the American Heart Association MetS diagnostic criteria to this population, the MetS prevalence was 37.2%. When using alternative diagnostic criteria found in other published studies that did not include the use of cholesterol medications, the MetS prevalence was 33.6%. Per American Heart Association criteria, the prevalence of each of the MetS diagnostic criteria was as follows: central obesity, 39.8%; elevated fasting glucose, 32.4%; high blood pressure, 56.8%; low-high-density lipoproteins cholesterol, 33.3%; and elevated triglycerides, 42.7%. MetS was more common among males (odds ratio [OR] = 4.05; confidence interval [CI] = 1.94, 8.48) and enlisted (OR = 2.23; CI = 1.24, 4.01). It was also strongly associated with a history of participating in the Air Force Weight Management Program (OR = 2.82; CI = 1.41, 5.63) and increased weight since retirement (OR = 4.00; CI = 1.84, 8.70). However, the study did not find an association between the presence of MetS and time since retirement or self-reported diet and exercise changes since retirement. The MetS prevalence among rec