title: Physical Performance and Attrition Among U.S. Air Force Trainees Participating in the Basic Military Training Fueling Initiative.
abstract: Dietary intake of military initial entry trainees is often inadequate because of the structured food environment, lack of snacking, and limited time for meals. Inadequate intake during training increases risk for injury, poor performance, and attrition from training. A performance nutrition initiative was implemented at Joint Base San Antonio Lackland to mitigate this inadequacy in Air Force trainees and better reflect recommendations for active populations and mitigate nutritional inadequacy.
  
  
  
  Trainees (N = 867) in two squadrons either received a nutrition bar before bed (snack squadron n = 423) or did not (standard squadron n = 444). This study retrospectively compared trainees' attrition and fitness measures as recorded in the Basic Military Training (BMT) Surveillance database.
  
  
  
  Both groups had similar rates of attrition and graduation at the end of 8 weeks (p = 0.23). At the start of training, only one out of four trainees in either Squadron passed the Physical Fitness Assessment (PFA). Although both squadrons' fitness measures improved as a result of the effects of training, the snack squadron had a significantly greater percent improvement in all PFA categories (p < 0.001), as represented by improved muscular fitness measures (p < 0.001), decreased median run time (p = 0.001), and greater improvement in scaled run scores (p = 0.013) as compared to the standard squadron. Those who received the snack were 1.62 (confidence interval: 1.2-2.2) times more likely to pass the PFA at 4 weeks than those who did not receive the snack.
  
  
  
  This study shows that military trainees' fitness improves with a modest nutritional supplement and suggests that optimizing overall nutrition benefits trainees. Attrition from BMT costs the U.S. Air Force up to $22,000 per trainee lost. In contrast, a trainee could receive one nutrition bar per day during BMT for $34. As the nutrition bar initiative improves fitness as well as costs less than recruiting and medically treating trainees whom ultimately attrite from training, the snack intervention was beneficial. Future studies of strategic nutrition interventions in military training populations can help trainees to better meet their macronutrient and micronutrient needs and further optimize training performance.
authors.affiliation: U.S. Military Baylor Graduate Program in Nutrition, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234.
authors.forename: Carrissa G
authors.initials: CG
authors.lastname: Bartlett
authors.affiliation: U.S. Military Baylor Graduate Program in Nutrition, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234.
authors.forename: Susan
authors.initials: S
authors.lastname: Stankorb
mesh_terms: D000293:Adolescent; D004032:Diet / Q000592:standards* / Q000706:statistics & numerical data; D004493:Education / Q000592:standards* / Q000706:statistics & numerical data; D015444:Exercise; D005080:Exercise Test / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D009752:Nutritional Status; D015397:Program Evaluation / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States; D055815:Young Adult