title: Use of the stages of change model in improving nutrition and exercise habits in enlisted Air Force men. Efficacy of a meal-replacement program for promoting blood lipid changes and weight and body fat loss in US Army soldiers. Efficacy of orlistat 60 mg on weight loss and body fat mass in US Army soldiers. Association between folate intake from different food sources in Norway and homocysteine status in a dietary intervention among young male adults. Effects of an Eight Week Military Training Program on Aerobic Indices and Psychomotor Function Adherence and weight loss outcomes associated with food-exercise diary preference in a military weight management program. Long-term sustainability of a worksite canteen intervention of serving more fruit and vegetables. The impact of a shipboard weight control program. Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity Effect of an accelerometer on body weight and fitness in overweight and obese active duty soldiers. The efficacy and cost-effectiveness of a community weight management intervention: a randomized controlled trial of the health weight management demonstration. Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members. A pedometer-based intervention to improve physical activity, fitness, and coronary heart disease risk in National Guard personnel. Weight management using the internet a randomized controlled trial. A low-intensity intervention to prevent annual weight gain in active duty Air Force members. A comprehensive weight-loss program for soldiers. Obesity Intervention During a Work Health Promotion: The Obesity Intervention Program of the German Military Forces Economic evaluation of an Internet-based weight management program. Effects of an energy balance educational intervention and the COPE cognitive behavioral therapy intervention for Division I U.S. Air Force Academy female athletes
abstract: Thirty-nine U.S. Air Force enlisted men participated in a r and omized controlled study that evaluated an experimental program design ed to enhance fitness . Subjects were assigned to either a treatment ( access to the program ) or control ( no access to program ) group for 6 months . To improve treatment group fitness ( as measured by VO2 , subjects received individually tailored information ( based on a behavior change model ) via the Internet to encourage adoption of positive diet and exercise behaviors . Results showed no significant effect in improving fitness in treatment . However , significant effects were observed for secondary outcomes such as weight ( controls , + 1.0 kg vs. treatment , -2.2 kg , p < 0.05 ) , body mass index ( + 0.3 kg/m2 vs. -0.7 kg/m2 , p < 0.05 ) , and percent body fat ( + 0.6 % vs. -1.5 % , p < 0.001 ) . The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness . However , the dietary tailored information appears to have encouraged the adoption of more positive nutritional practice s as demonstrated by the beneficial effects reflected in secondary outcomes Excess weight is associated with negative health outcomes . Meal replacements are effective in promoting favorable body composition changes in civilian population s ; however , their efficacy with military service members who have unique lifestyles is unknown . The objective of this r and omized controlled trial was to determine the efficacy of the Army 's education-based weight-management program , " Weigh to Stay , " with and without meal replacements for improving blood lipids , and to promote weight and body fat loss in overweight US Army soldiers . Soldiers ( n=113 ; 76 males/37 females ) attending Weigh to Stay at Fort Bragg , NC , in 2006/2007 were r and omized to Weigh to Stay only or a commercially available meal-replacement program ( two meal replacements per day ) in conjunction with Weigh to Stay , and followed until Army body fat st and ards were met or for 6 months if st and ards were not met . Study completers ( n=46 ) in both treatment groups lost weight ( Weigh to Stay : -2.7+/-4.3 kg ; meal replacers : -3.8+/-3.5 kg ) and fat mass ( Weigh to Stay , -2.7+/-3.2 kg ; meal replacers : -2.9+/-2.5 kg ) , and improved high-density lipoprotein cholesterol concentrations ( Weigh to Stay : 13+/-9 mg/dL [ 0.34+/-0.23 mmol/L ] ; meal replacers : 8+/-7 mg/dL [ 0.21+/-0.18 mmol/L ] ; P<0.05 ) ; however , no between-group differences were observed . Attrition was lower ( P=0.009 ) and success in meeting body fat st and ards tended to be higher ( P=0.06 ) for the meal replacers vs Weigh to Stay participants . Intent-to-treat analysis demonstrated that meal replacers lost more weight ( 1.2+/-0.5 kg ) , percent body fat ( 1.0%+/-0.4 % ) , and fat mass ( 0.8+/-0.4 kg ) compared to Weigh to Stay volunteers ( P<0.05 ) . Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay A higher body mass index is associated with exercise-related injuries and increased risk for musculoskeletal and connective tissue disorders , which are relevant to military personnel . Studies show the efficacy of orlistat 60 mg for promoting weight and body fat loss in civilians ; however , its efficacy among predominantly young , male soldiers is unknown . This study 's objective was to examine the effect of a 6-month , st and ard education-based weight-management program with and without orlistat 60 mg on changes in weight and body fat in overweight soldiers . Data were collected for this r and omized , controlled trial from March 2008 to November 2010 at Fort Bragg , NC . Participants were enrolled in an education-based weight management program ( n=435 ; 75 % men ) and were r and omized to placebo or orlistat 60 mg , three capsules daily with meals . All participants were recommended to maintain a reduced-energy , low-fat diet . Among study completers ( 14 % retention rate ; placebo n=22 , orlistat n=35 ) members of both groups lost significant weight from baseline  ( placebo -3.0±5.2 kg ; orlistat -3.2±4.7 kg ; P<0.01 ) , but only the orlistat group lost fat mass ( -2.5±3.9 kg ; P<0.001 ) , whereas the placebo group lost lean mass ( -1.4±2.7 kg ; P < 0.01 ) . An intent-to-treat analysis ( ? 1 follow-up body weight measure ) demonstrated that the orlistat group lost more fat mass vs the placebo group ( -1.3±2.9 kg vs ? 0.6±1.8 kg , respectively ; P<0.05 ) , but less lean mass ( -0.2±2.0 kg vs -0.8±1.8 kg , respectively ; P<0.01 ) . Orlistat 60 mg may be an effective adjunct to an education-based weight management program in a mostly young , male soldier population The aim of the present investigation was to study the effect of a dietary intervention which combined nutrition information with increased availability of vegetables , fruits and wholegrain bread . The effect of the intervention was determined by changes in the intake of vegetables , fruits , wholegrain bread and estimated nutrients . Furthermore , the study investigated whether changes in relative contribution from different food sources of folate were related to changes in the concentration of plasma total homocysteine ( p-tHcy ) . The 5-month intervention study included 376 male recruits from the Norwegian National Guard , Vaernes ( intervention group ) and 105 male recruits from the Norwegian National Guard , Heggelia ( control group ) . The study result ed in an increase in the total consumption of vegetables , fruits , berries and juice  ( P < 0.001 ) and of  wholegrain bread ( P < 0.001 ) . The participants in the intervention group showed a higher increase in the intake of dietary fibre  ( P < 0.001 ) and  folate  ( P < 0.001 ) compared with the control group . The relative contribution of folate intake from fruits , vegetables and wholegrain bread was higher in the intervention group compared with the control group ( P < 0.001 for all ) . The increased intake of folate from wholegrain bread was inversely associated with a reduced concentration of p-tHcy ( P = 0.017 ) . In summary , the dietary intervention result ed in an increased intake of vegetables , fruits and wholegrain bread and a subsequent increase in folate intake from these food components . Reduction in the concentration of p-tHcy was significantly related to an increased folate intake due to an increased consumption of wholegrain bread This study assessed the effects of eight weeks of military training on aerobic fitness indices , military skills and neuropsychological function . Thirty five ( n=35 ) male Irish Defence Forces personnel , divided into training ( n=20 ) and control ( n=15 ) subgroups , completed tests of military aptitude ( Kim ’s games , judging distance , fire order , map reading , weapon assembly ) and neuropsychological function ( Symbol digit modalities test ( SDMT ) , Trail making test , Stroop test and grooved pegboard test ) pre- and post-intervention . The repeated measures study design sought to account for any learning effect . Participants also completed a 10 km route march , a two mile run and three by 20 m shuttle run tests at both time points to quantify changes in fitness variables . The training sub-group significantly ( P<0.001 ) improved mean 20 m shuttle-run distance and consequently estimated VO2 max pre- to post-intervention ( 49.8±1.0 vs. 52.4±0.9 mL.kg-1.min-1 ) . Two mile run time was not significantly improved . Mean % HRmax during the 10 km route march was significantly higher in both training ( P<0.001 ) and control ( P<0.01 ) sub-groups post-intervention ( 71±1 and 83±1 % ) compared to pre-intervention ( 65±1 and 77±1 % ) . However , the training sub-group conducted the route march at a significantly faster speed on the second occasion . Military training significantly improved performance in 3/18 neuropsychological test components and 2/12 military skills test components . Training significantly improved ability to estimate both short ( error ; 36±6 vs. 12±1 % ) and intermediate ( error ; 72±12 vs. 11±3 % ) distances post-intervention . The training sub-group significantly ( P<0.01 ) improved SDMT score and mean Trail 1 time pre- to post-intervention ( 58.0±2.8 vs. 69.5±3.4 ; 18.1±0.8 vs. 14.4±0.8s , respectively ) . In Part 3 of the Stroop test , time mediated a significant ( P<0.05 ) and selective improvement in the training sub-group ( 51.3±3.2 vs. 63.8±5.4 ) . In conclusion , aerobic fitness and a minority of neuropsychological and military skills tests improved following 8 weeks of military training The more consistently someone records their food intake the more likely they are to lose weight . We hypothesized that subjects who kept track via their preferred method would demonstrate higher adherence and therefore improved outcomes compared to those who used a non-preferred method . Participants were r and omly assigned to use a paper , PDA , or Web-based diary and classified as " Preferred " if they used their preferred method and " Non-Preferred " if they did not . Days adherent to diary use were collected for 12 weeks . Weight , % body fat , waist circumference , and self-efficacy scores were measured at baseline , 6 and 12 weeks . Thirty nine participants completed the 12 week study . Fifty nine percent were male . The mean age was 35 and mean baseline BMI was 33 kg/m(2 ) ( + /-3.5 ) . Forty four % ( n=17 ) used their " Preferred "  diary  method and 56 % ( n=22 ) did not . Participants who used their preferred diary were more adherent to recording both food intake ( 64.2 % vs. 43.4 % , p=.015 ) and exercise ( 60.6 % vs. 31.2 % , p=.001 ) . Though no difference was seen between groups on weight management outcomes , these results suggest that diary preference affects adherence to diary use OBJECTIVE To analyse the 5-year sustainability of a  worksite canteen intervention of serving more fruit and vegetables ( F&V ) . DESIGN Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste . Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline , at end point and at 1-year follow-up . The intervention used a participatory and empowering approach , self-monitoring and networking among the canteen staff , management and a consultant . The method focused on providing ideas for increased F&V for lunch , making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options . SETTING Five Danish worksites serving from 50 to 500 meals a day : a military base , an electronic component distributor , a bank , a town hall and a waste-h and ling facility . SUBJECTS Worksite canteen managers , canteen staff . RESULTS Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day ( 18 , 144 , 66 , 105 and 141 g , respectively ) . On average , the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer . CONCLUSIONS The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach , self-monitoring , environmental change , dialogue with suppliers and networking among worksite canteens are applied OBJECTIVE The specific aim was to determine whether a multifaceted approach to weight loss and physical readiness could be implemented onboard a deployed combatant ship of the U.S. Navy . RESEARCH METHODS AND PROCEDURES Thirty-nine men ( 31+/-6 years old , mean+/-st and ard deviation ) assigned to the USS ENTERPRISE ( CVN 65 ) during a 6-month Mediterranean deployment who had failed their previous Physical Readiness Test due to excessive body weight ( 108+/-11 kg overweight ) were r and omly assigned to nutrition , cognitive-behavioral obesity treatment plus exercise or to the Navy 's usual treatment ( control ) , which is exercise alone . RESULTS Outcomes for the treatment group were significantly better than the controls , with 8.6+/-5.0 vs. 5.0+/-4.1 kg weight loss , 8 % vs. 5 % reduction in original body weight , and body fat loss of 7 % vs. 5 % . Triglycerides declined significantly greater in the treatment group than the controls ( 145 mg/dL to 109 mg/dL vs. 146 mg/dL to 145 mg/dL , p<0.05 ) , whereas depression and eating behaviors significantly improved among treated men . Problematic environmental factors were the limited variety of heart healthy foods in the galley , short meal breaks , and long mess hall lines that led to eating snacks from vending machines and frequent port calls . DISCUSSION Although greater weight loss than would be expected of a Navy usual care group diluted the treatment effect , the treated men still fared significantly better . The physical readiness implication of this research has the potential to impact Navy health promotion programs and policy , the health and well-being of its personnel , and the Navy 's ability to meet mission requirements Objective : To examine whether obesity is associated with increased presenteeism ( health-related limitations at work ) . Methods : R and omly selected manufacturing employees ( n = 341 ) were assessed via height and weight measures , demographic survey , wage data , and the Work Limitations Question naire . The Work Limitations Question naire measures productivity on four dimensions . Analyses of variance and analyses of covariance were computed to identify productivity differences based on body mass index ( BMI ) . Results : Moderately or extremely obese workers ( BMI ≥35 ) experienced the greatest health-related work limitations , specifically regarding time needed to complete tasks and ability to perform physical job dem and s. These workers experienced a 4.2 % health-related loss in productivity , 1.18 % more than all other employees , which equates to an additional $ 506 annually in lost productivity per worker . Conclusions : The relationship between BMI and presenteeism is characterized by a threshold effect , where extremely or moderately obese workers are significantly less productive than mildly obese workers This study evaluated whether using a web-linked accelerometer , plus m and atory physical training , is associated with various weight- and fitness-related outcomes in overweight/obese active duty soldiers . Soldiers who failed the height/weight st and ards of the Army Physical Fitness Test ( APFT ) were r and omized to use a Polar FA20 accelerometer device ( polar accelerometer group [ PA ] , n = 15 ) or usual care ( UC , n = 13 ) for 6 months . Both groups received 1.5 hours of lifestyle instruction . We collected data at baseline , 2 , 4 , and 6 months , and evaluated group differences in temporal changes in study outcomes . At 6 months , 1/28 subjects ( UC ) passed the APFT height/weight st and ards . There were no group differences in changes in weight ( PA : -0.1 kg vs. UC : + 0.3 kg ; p = 0.9 ) , body fat ( PA : -0.9 % vs. UC : -1.1 % ; p = 0.9 ) , systolic blood pressure ( PA : + 1.3 mm Hg vs. UC : -2.1 mm Hg ; p = 0.2 ) , diastolic blood pressure ( PA : + 3.8 mm Hg vs. UC : -2.4 mm Hg ; p = 0.3 ) , or resting heart rate in beats per minute ( bpm ) ( PA : + 7.8 bpm vs. UC : + 0.1 bpm ; p = 0.2 ) . These results suggest that using an accelerometer with web-based feedback capabilities plus m and atory physical training does not assist in significant weight loss or ability to pass the APFT height/weight st and ards among overweight/obese soldiers PURPOSE The study investigated the efficacy and cost-effectiveness of a cognitive-behavioral weight management program , complemented by an interactive Web site and brief telephone/e-mail coaching . METHODS In 2006 - 2007 , 1755 overweight , non-active-duty TRICARE beneficiaries were r and omized to one of three conditions with increasing intervention intensity : written material s and basic Web access ( RCT 1 ) , plus an interactive Web site ( RCT 2 ) , plus brief telephone/e-mail coaching support ( RCT 3 ) . The study assessed changes in weight , blood pressure , and physical activity from baseline to 6 , 12 , and 15 - 18 months . ( Study retention was 31 % at 12 months . ) Average and incremental cost-effectiveness and cost-offset analyses were conducted . RESULTS Participants experienced significant weight loss ( -4.0 % , -4.0 % , and -5.3 % , respectively , in each RCT group after 12 months and -3.5 % , -3.8 % , and -5.1 % , respectively , after 15 to 18 months ) , increased physical activity , and decreased blood pressure . Cost-effectiveness ratios were $ 900 to $ 1100/ quality -adjusted life year ( QALY ) for RCT 1 and RCT 2 and $ 1900/QALY for RCT 3 . The cost recovery period to the government was 3 years for RCTs 1 and 2 and 6 years for RCT 3 . CONCLUSION A relatively inexpensive cognitive-behavioral weight management intervention improved patient outcomes . Extrapolation of savings for the entire TRICARE population would significantly reduce direct medical costs OBJECTIVE To determine whether adoption of dietary patterns consistent with the US Dietary Guidelines for Americans and the Food Guide Pyramid , combined with exercise training , result in significant reductions in cardiovascular risk compared with a regimen of exercise therapy alone . DESIGN A r and omized trial to compare the effects of exercise alone ( n = 17 ) with the effects of exercise and dietary intervention ( n = 15 ) . SETTING McClellan Air Force Base medical clinic ( Sacramento , Calif ) . SUBJECTS Thirty-two members of the Air Force ( 20 men and 12 women ) were recruited at the time they entered a 90-day fitness improvement program . Mean age was 32 years . INTERVENTION All subjects participated in a 90-day fitness program . Half of the group received individualized dietary counseling using the Food Guide Pyramid as a primary educational tool . MAIN OUTCOME MEASURES Changes in body mass index , plasma lipids and lipoprotein levels , aerobic capacity , and dietary intake were selected to evaluate the effectiveness of the intervention . STATISTICAL ANALYSES PERFORMED Outcome measures were evaluated by analysis of variance . A paired t test was performed to compare changes in food-group servings and food-group fat intake from baseline values for the exercise-plus-diet group . RESULTS Percentage of energy from fat decreased from 39 % to 23 % for the exercise-plus-diet group , and servings from each of the food groups changed to reflect current guidelines . This group also had significant reductions in body mass index , total cholesterol level , and low-density lipoprotein level : 2 % ( P = .0001 ) , 9 % ( P = .003 ) , and 13 % ( P = .005 ) , respectively . No change was observed for the exercise-only group . Additionally , a significant improvement in maximum oxygen consumption ( P = .01 ) of 38 % ( vs 14 % for the control group ) was achieved . CONCLUSIONS Dietary modification in accordance with the Food Guide Pyramid and the US Dietary Guidelines results in significant reductions in known cardiovascular risk factors and improves the response to exercise training To compare the effects of a pedometer-based behavioral intervention ( Fitness for Life [ FFL ] program ) and a traditional high-intensity fitness ( TRAD ) program on physical activity ( PA ) , Army  Physical Fitness Test ( APFT ) , and coronary heart disease risk factors in Army National Guard members who failed the APFT 2-mile run . From a pool of 261 Army National Guard , a total of 156 were r and omized to TRAD or FFL for 24 weeks consisting of a 12-week progressive conditioning program followed by 12 weeks of maintenance . For both groups , the total APFT score and 2-mile run time/score improved from baseline to 12 weeks ( FFL : down 7.4 % , p = 0.03 ; TRAD : down 5 % , p = 0.08 ) but at 24 weeks they had regressed toward baseline . PA improved modestly and coronary risk profile changed minimally in both groups . A pedometer-based exercise intervention had results similar to a high-intensity program for improving PA , APFT , and 2-mile run times/score . Neither group sustained the improved run times over the 12 weeks of maintenance BACKGROUND Most weight-loss research targets obese individuals who desire large weight reductions . However , evaluation of weight-gain prevention in overweight individuals is also critical as most Americans become obese as a result of a gradual gain of 1 - 2 pounds per year over many years . METHOD This study evaluated the efficacy of an Internet-based program for  weight-loss and weight-gain prevention with a two-group , prospect i ve , r and omized controlled trial . A military medical research center with a population of 17,000 active-duty military personnel supplied 446 overweight individuals ( 222 men ; 224 women ) with a mean age of 34 years and a mean BMI of 29 . Recruitment and study participation occurred 2003 - 2005 and data were analyzed in 2006 . Participants were r and omly assigned to receive the 6-month behavioral Internet treatment ( BIT , n=227 ) or usual care ( n=224 ) . Change in body weight , BMI , percent body fat , and waist circumference ; presented as group by time interactions , were measured . RESULTS After 6 months , completers who received BIT  lost 1.3 kg while those assigned to usual care  gained 0.6 kg ( F((df=366))=24.17 ; I<0.001 ) . Results were similar for the intention-to-treat model . BIT participants also had significant changes in BMI ( -0.5 vs + 0.2 kg/m(2 ) ; F((df=366))=24.58 ) ; percent body fat ( -0.4 vs + 0.6 % ; F((df=366))=10.45 ) ; and waist circumference ( -2.1 vs -0.4 cm ; F((df=366))=17.09 ) ; p<0.001 for all . CONCLUSIONS Internet-based weight-management interventions result in small amounts of weight loss , prevent weight gain , and have potential for widespread dissemination as a population health approach . TRIAL REGISTRATION NCT00417599 Elevated body weight among active duty Air Force ( ADAF ) members is a substantial and growing problem , and typically results from gaining small amounts of weight each year over many years . We design ed a strategy to prevent annual weight gain in ADAF members using self-directed behavior change booklets followed by weekly e-mails about diet and physical activity for a year . The intervention was universally offered to ADAF members meeting selection criteria at five U.S. Air Force bases ( n = 3,502 ) ; members at 60 other U.S. Air Force bases served as controls ( n = 65,089 ) . The intervention was completely effective at preventing weight gain in a subgroup of men ( those above the lowest three ranks , with baseline weight above maximum allowable ) and in women , while controls continued to gain weight . Since the intervention did not require personalized contact , this approach has promise for large-scale population -based efforts aim ed at preventing weight gain in working adults A weight-loss treatment program for active duty military personnel is discussed and evaluated . The Fat Loss and Exercise Program at U.S. Army Hospital , Bremerhaven , Germany , consisted of a 3-week inpatient treatment program and 6 months of weekly outpatient follow-up . The program combined a multidisciplinary team approach to the treatment of obesity -- psychology , internal medicine , nursing , nutrition care , and physical therapy . Patients showed a significant weight and body fat loss [ F(2,90 ) = 52.91 and 65.85 , p < 0.001 , respectively ] from the initiation of treatment ( mean = 205.9 pounds , 28.91 % ) to the end of the inpatient program ( mean = 192.8 pounds , 25.97 % ) with maintenance over 6 months ( mean = 190.4 pounds , 25.03 % ) . Changes in cholesterol levels by treatment phase are also discussed . Results demonstrate positive increases in high-density lipoprotein at each phase . These results support a comprehensive , multidisciplinary inpatient treatment of obesity within the military Objectives : The aim of the Obesity Intervention Program of the German Army was to enhance physical activity levels , to adjust diet behavior , and to reduce risk factors in out patients over a period of 24 months . Methods : The data of the participants in the outpatient intervention from 2003 till 2011 were analyzed . Results : In total , 665 participants took part . All examined parameters were improved by the intervention , already in the second follow-up , significant for all parameters . A total of 12.2 % of all patients reduced their body weight by 5 % , and 8.4 % by 10 % . Conclusions : A significant improvement in all examined parameters was found . With respect to the fact that the participants of this  Obesity Intervention Program were only military servicemen and servicewomen , it should be tested if the program can be transferred on work health promotions outside the military OBJECTIVE To determine whether a behavioral Internet treatment ( BIT ) program for weight management is a viable , cost-effective option compared with usual care ( UC ) in a diverse sample of overweight ( average body mass index = 29 kg/m2 ) , healthy adults ( mean age = 34 years ) serving in the US Air Force . STUDY DESIGN Two-group parallel r and omized controlled trial . METHODS Participants were r and omly assigned into 2 groups : UC ( n = 215 ) and UC plus BIT ( n = 227 ) . Baseline and 6-month assessment s were included in the analyses . Primary outcome measures ( changes in body weight , percent body fat , and waist circumference ) and secondary outcome measures ( Weight Efficacy Lifestyle [ WEL ] question naire ) were included in an incremental cost-effectiveness analysis ( ICEA ) model . Costs were computed using the perspective of an agency wanting to replicate the intervention . Sensitivity analyses were performed to measure the robustness of models . RESULTS Overall cost for BIT intervention was $ 11,178.40 , or $ 49.24 per BIT participant . Total staff-time cost was $ 14.03 per BIT participant . Intervention cost was $ 25.92 per kilogram of weight loss and $ 28.96 per centimeter of waist-circumference loss . The cost was $ 37.88 for each additional point gained on the WEL subscale , where increasing scores indicate increased confidence in managing social pressures to eat . CONCLUSIONS The BIT program is a cost-effective choice for weight management . It may cost more initially , but it results in long-term cost savings . Such cost-effective , Internet-based behavioral interventions for weight management could provide a valuable tool for preventive care aim ed at improving individual and societal health Background and purpose : Female athletes struggle harder than male athletes to lose body fat and maintain a leaner physique . The purpose of this study was to determine the effects of an educational and cognitive behavioral therapy (CBT)‐based intervention on knowledge , body composition , anxiety , stress , and nutritional intake . Methods : A r and omized controlled trial was conducted with 153 female athletes from the U.S. Air Force Academy ( USAFA ) . Participants were assigned to one of three groups : ( a ) a combined energy balance and CBT‐based intervention ( E1 ) ; ( b ) a CBT‐based intervention alone ( E2 ) ; and ( c ) a control group ( C ) . Main outcomes included a DXA scan for body composition , a knowledge test , the GAD‐7 for anxiety , the brief inventory of perceived stress ( BIPS ) for stress , and a 24‐h food recall . Findings : Significant improvement on knowledge of energy balance occurred in all three groups E1 ( p < .001 ) , E2 , and C ( p < .05 ) . Significant reductions in percentage of body fat occurred in E1 ( p < .001 ) and E2 ( p < .05 ) . There also were significant reductions in the percent of fat consumed by E1 ( p < .05 ) and saturated fat consumed by both E1 and E2 ( p < .05 ) . The control group only demonstrated a significant increase in stress as measured by the BIPS ( p < .05 ) . Conclusions : A combined energy balance and CBT‐based intervention  improves knowledge and body fat . Implication s : The importance to assess knowledge , anxiety , stress , nutrition intake , and percentage of body fat in female athletes and to deliver evidence ‐based interventions to improve their health outcomes
target: Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
  Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
  Dietary interventions can potentially reduce total fat and saturated fat intake .
  Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
  The results regarding military physical fitness interventions were inconclusive .
  Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
background: Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
  The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .