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Ann Epidemiol. 2019 Nov;39:26-32.e1. doi: 10.1016/j.annepidem.2019.09.001. Epub 2019 Sep 11.

Healthy behaviors and incidence of overweight and obesity in military veterans.

Author information

1
The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD; Westat, Rockville, MD.
2
Leidos, Inc., San Diego, CA; Deployment Health Research Department, Naval Health Research Center, San Diego, CA. Electronic address: bennett.w.porter.ctr@mail.mil.
3
Leidos, Inc., San Diego, CA; Deployment Health Research Department, Naval Health Research Center, San Diego, CA.
4
The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
5
Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA; Department of Epidemiology, University of Washington School of Public Health, Seattle; Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA.
6
Deployment Health Research Department, Naval Health Research Center, San Diego, CA.
7
Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA; Department of Epidemiology, University of Washington School of Public Health, Seattle; Department of Medicine, University of Washington School of Medicine, Seattle.

Abstract

PURPOSE:

Research suggests that U.S. veterans have a higher obesity prevalence than nonveterans and that weight gain is high after military discharge. Few studies have assessed the joint effects of health behaviors on obesity risk.

METHODS:

We prospectively assessed the incidence of overweight and obesity in relation to multiple behaviors among U.S. veterans, with follow-up beginning 2-3 years after military discharge. Self-reported physical activity, sedentary time, fast-food intake, sleep duration, smoking status, and alcohol use were categorized as "healthy" based on recommendations or prior literature. Multivariable Cox models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for overweight/obesity (body mass index [BMI] ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) in relation to healthy behaviors.

RESULTS:

Among 11,025 participants with baseline BMI of 18.5-24.9 kg/m2, those reporting at least five of six healthy behaviors had 36% lower overweight/obesity risk compared with those reporting 0 or one healthy behavior (RR, 0.64; 95% CI, 0.54-0.74). Among 17,583 participants with baseline BMI of 25.0-29.9 kg/m2, obesity risk was 38% lower for those with at least five of six relative to 0 or one healthy behavior (RR, 0.62; 95% CI, 0.54-0.72).

CONCLUSIONS:

Self-reporting multiple healthy behaviors was associated with reduced overweight/obesity rates. Further research is warranted to determine whether interventions targeting several health behaviors may be more effective in reducing obesity among military veterans than interventions targeting one behavior.

KEYWORDS:

Behaviors; Obesity; Veterans

PMID:
31588009
DOI:
10.1016/j.annepidem.2019.09.001
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