Airmen prepare for glory

  • Published
  • By Lt. Col. Ronnie Collins
  • 189th Airlift Wing Medical Group
For as long as civilizations have organized militaries, physical wellness and strength have played an integral role in the establishment of those forces. In the Old Testament book of 1 Chronicles, chapter 7 records the "mighty men of valor" who served in the army of Israel - men "fit to go out for war and battle." In ancient Greece, Pheidippides ran 150 miles in two days to request the help of the Spartans in the battle of Marathon. The following day, he ran the 25 miles from Marathon to Athens to announce the Greek victory and immediately thereafter collapsed, a story that spawned the modern-day marathon. In modern times, the stereotypical member of any branch of the US military is that of a lean, fit and well-trained warrior. It's for that reason that the people we work with in our civilian jobs think that on drill weekends we are all running covert ops into the mountains of Afghanistan.
Unfortunately, the shape of America, and its military, has changed in recent years. As of April 2012, 35.7% of the US civilian adult population was obese. It is well-documented that increased food consumption with concomitant decreased physical activity levels have been the leading causes of the "obesity epidemic." Our military services have not been immune to the same trends in obesity and decreased fitness. As a result, effective January 1, 2010, the Air Force Chief of Staff approved revitalized fitness standards for Active Duty, Guard, and Reserves personnel. These revised standards have been intended to promote physical fitness and to usher a return to the physical wellness that have characterized military members throughout history. What is the primary vehicle by which those changes are to occur? Exercise.
Most people are well-aware that physical exercise is beneficial, but they don't really understand what exercise actually is. To have a meaningful discussion on the benefits of regular exercise, it is important to have a working definition of what exercise, not physical activity, actually is. Physical activity and exercise are not interchangeable terms. Physical activity is "bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above the basal level." Exercise, on the other hand, is a form of physical activity that is "planned, structured, repetitive, and purposeful with a main objective of improvement or maintenance of one or more components of physical fitness." Endpoints indicative of obtaining an adequate level of exercise include breathlessness, fatigue, and sweating. This is important when it comes to determining the benefits of exercise - if you aren't really exercising, you shouldn't expect the benefits that come with exercise.
Multiple scientific studies have demonstrated the health benefits of engaging in regular exercise. The most extensive body of literature on the health impact of exercise is regarding cardiovascular disease. The institution of a regular exercise program can decrease the blood pressure by as much as 15 mmHg in patients with essential hypertension. It is also associated with improved lipid profiles and a decreased risk of Type 2 diabetes. In a study of over 10,000 Harvard alumni, those who engaged in moderately vigorous sports activity (i.e. brisk walking, recreational cycling or swimming, home repair, and yard work for 30 min/day on most days) had a 23% lower risk of death than those who were less active.
Other than cardiovascular benefits, regular exercise has been shown to decrease the risk of dementia and improve cognitive function in older individuals. The risks of certain types of cancers are reduced. Psychological conditions such as stress, anxiety, and depression are improved. The risk of obesity is greatly decreased, and a host of other conditions are improved, all with the advent of a regular exercise regimen.
While the benefits of exercise are myriad, there are some risks. Though rare, the risk of suffering an acute myocardial infarction (heart attack) is present. It is important to note, however, that the risk of myocardial infarction during exercise is increased most among those who do not exercise routinely. Further, in those patients who have documented coronary artery disease, those patients who exercise regularly are far less likely to suffer a myocardial infarction than those who are inactive. Other risks with the initiation of an exercise regimen include orthopedic injuries, exercise-induced bronchoconstriction (asthma "attack"), and muscle injury. For these reasons, it is important to be evaluated by your primary physician prior to the initiation of any strenuous exercise regimen.
As part of a pre-exercise physical evaluation, the patient should be evaluated for the need for testing for coronary artery disease. Other things that will need to be considered include the age, general physical condition, and exercise history. Orthopedic and musculoskeletal histories and risks will need to be evaluated. Also, all medications must be considered, as they could impact exercise tolerance, or have a negative impact on the body in the setting of dehydration or hyperthermia from exercise. A history of lung disease must be considered. Finally, the anticipated type and level of exercise should be considered.
Once your primary physician has conducted a medical evaluation, you can be provided with an exercise prescription. This is a recommendation as to the intensity and duration of the exercises you anticipate undertaking. There is no single exercise prescription for all individuals. A general weekly goal of at least 150 minutes of moderate intensity aerobic activity or 75 minutes of vigorous intensity activity is ideal for many people. As sedentary lifestyles are associated with health risks and even modest increases in physical activity are associated with improved health outcomes, it is also reasonable to advocate for a modest increase in physical activity even if the specific goals above are not met. The goal is to develop an individualized approach in the development of a specific exercise prescription. Each exercise prescription must take into consideration injury prevention. Further, the prescription should maximize incentives to promote the maintenance of a consistent exercise regimen - the best exercise regimen in the world will not help if you don't want to engage in it.
Our mission in the Medical Group is to promote and ensure the physical wellness of all 189th Airlift Wing personnel so that the missions of the Wing and US Air Force are accomplished. To this end, our medical personnel are available for consultation on appropriate exercise programs and lifestyle modifications. Please feel free to visit us in the clinic.