Does the US Air Force have a fitness problem? It depends

How can the U.S. Air Force be physically fit – and not physically fit – at the same time? The answer depends on how you measure fitness. By some metrics, Air Force personnel are unfit and obese. Yet other measurements indicate that the Air Force is in good shape.

Just as in the civilian world, the problem is Body Mass Index (BMI). For years, BMI – which combines height and weight – has been used to calculate whether someone is obese. However, there has been increasing criticism that BMI is not an accurate indicator of fitness.

“Using only BMI, we would conclude that airmen appear to be generally unfit and have been for more than a decade,” according to a new study by the RAND Corporation, a think tank.

“However, when we examine muscular fitness, cardiorespiratory fitness, and alternative measures of body composition, we conclude that USAF fitness, on average, has been improving over time,” the study adds.

Judged solely by BMI, America needs to go on a diet. In 2018, 42 percent of U.S. adults were obese, according to Centers for Disease Control (CDC) standards. “CDC categories indicate that more than 50 percent of today’s airmen are overweight or obese,” RAND said.

This results in bizarre statistical findings, such as Air Force commandos being the least physically fit.

“Strikingly, the Special Warfare career group contained the greatest percentage of officers classified as overweight based on BMI (69 percent), but it contained the lowest percentage of officers classified as overweight based on waist-to-height ratio (15 percent),” the study noted.

In 2010, the Air Force received a special Department of Defense exemption to replace BMI with abdominal circumference, or AC, which measures fat around the waist. Many experts believe that AC is a better indicator of fitness and a better predictor of future health problems such as heart disease.

Related: What does a former Navy SEAL think of the Garmin fitness smartwatch?

Becoming fly-worthy

Replacing BMI with other indicators produced radically different results. For example, in the Air Operation career field, 58 percent of personnel were classified as overweight. But using the weight-to-height ratio measurement (WHtR), that figure plunged by more than half, to 28 percent.

Yet even these correlations aren’t completely straightforward. Replacing BMI with AC and WHtR means that fewer servicemembers are classified as overweight – but those who are overweight appear to face more severe health risks.

The most dangerous combination is when a person fails BMI, AC, and WHtR.

“These findings strongly suggest that there is value in using multiple measures of body composition, both because different measures are correlated with different health outcomes and because failing to meet the cutoffs of multiple measures is a clear cause for concern, more so than failing to meet the cutoffs of only one,” the RAND study notes.

For now, the military and civilian worlds still tend to use BMI as a general fitness indicator. RAND doesn’t recommend that BMI be discarded; rather, that it should only be used as part of a package of measurements.

“We recommend that USAF continues to use AC in combination with other body composition metrics, such as WHtR and BMI,” the study concluded. “Given CDC caveats, documented criticism, and evidence from our analyses, we recommend that BMI should not be used alone as a diagnostic tool to indicate health risk or to report on the health of the force.”

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