Healthy Eating Scores Are Positively Associated With Physical Fitness in Military Personnel

Diet quality, as measured by the Healthy Eating Index, is positively associated with physical performance and fitness in elite U.S. Army Soldiers. Whether the Healthy Eating Score (HES-7), which was recently developed as an expedient proxy for determining adherence to dietary guidelines among military personnel, is also associated with physical fitness is unclear. The objective of this study was to determine the association between HES-7, eating style, physical activity, and physical fitness as measured by the Army Combat Fitness Test (ACFT) among U.S. Army Soldiers.

In this cross-sectional observational study, 483 active duty Soldiers and Cadets (75% enlisted, 87% male, 26 ± 6 years) from three Army installations completed the Military Eating Behavior Survey (MEBS). Healthy Eating Score-7 (range: 0-35), 6-event ACFT (range: 0-600), eating style, and physical activity were determined from MEBS responses. Physical fitness was defined as the aggregate score from all ACFT events, which collectively assess both aerobic and anaerobic fitness.

The average ACFT score and HES-7 were 496 ± 61 and 18 ± 5, respectively. In a multivariate-adjusted linear regression model, each one-point increase in HES-7 was associated with a 2-point increase in ACFT score (P < .001). Compared to those with the highest quartile of HES-7 (23-34), those in the two lowest quartiles (HES-7: first quartile = 0-14, second quartile = 15-18), reported 30 (P < .001) and 19 point (P = .004) lower ACFT scores, respectively. High protein eating style was significantly associated with a 16 point (P = .01) increase in ACFT score and a balanced diet or high protein diet was associated with a 4-point higher HES-7 (P < .05) compared to those who reported -following no specific style.

A higher HES-7 and a high protein eating style were positively associated with physical fitness in this sample of Soldiers. Findings support the potential importance of diet quality and specific eating styles in physical performance of military service members.