title: Nutrition as a component of the performance triad: how healthy eating behaviors contribute to soldier performance and military readiness.
abstract: OBJECTIVE
  Nutrition is a critical element of Soldier health and performance. Food choices, meal timing, and dietary intake behaviors contribute to nutritional fitness. The objectives of this study were to describe Soldier dietary behaviors and quantify the association between healthy eating behaviors and demographic, lifestyle, and psychosocial factors.
  
  
  METHODS
  The Comprehensive Soldier and Family Fitness Global Assessment Tool (GAT) assesses emotional, social, family, and spiritual fitness. In 2012, 57 pilot questions were added to the GAT to create a physical dimension that included nutrition assessments. Participants included 13,858 Active Duty, Reserve, and National Guard Soldiers: 83% male; 85% enlisted; a mean age of 28±9 years. A Healthy Eating Score (HES-5) was calculated from 5 questions assessing frequency of fruit, vegetable, whole grain, dairy, and fish intake (Cronbach α=0.81). Associations between HES-5 and other dietary habits, physical activity patterns, and GAT psychosocial dimension scores were examined.
  
  
  RESULTS
  Soldiers who ate breakfast regularly (6 times/week or more), drank 7 servings or more of water/day, and met weekly exercise recommendations were more likely to be in the highest HES-5 quartile than those who did not. Those who passed their Army Physical Fitness Test (APFT) in the top quartile were also more likely to report high HES-5 scores than those who failed (P<.001). Soldiers with healthy anthropometric measures and the highest emotional, social, family, and spiritual fitness scores were also more likely to be in the top HES-5 quartile than those with unhealthy measures and with the lowest fitness scores (P<.001).
  
  
  CONCLUSIONS
  The HES-5 may be a useful index for characterizing dietary intake behaviors. Healthy dietary intake behaviors are associated with all dimensions of health, physical fitness, and psychosocial status.
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD.
authors.forename: Dianna L
authors.initials: DL
authors.lastname: Purvis
authors.forename: Cynthia V
authors.initials: CV
authors.lastname: Lentino
authors.forename: Theresa K
authors.initials: TK
authors.lastname: Jackson
authors.forename: Kaitlin J
authors.initials: KJ
authors.lastname: Murphy
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Deuster
mesh_terms: D000293:Adolescent; D000328:Adult; D004032:Diet; D004644:Emotions; D005080:Exercise Test; D005190:Family; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008889:Military Personnel; D015596:Nutrition Assessment; D018673:Nutrition Policy; D064797:Physical Conditioning, Human / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D029181:Spirituality; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D014481:United States; D055815:Young Adult