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AF Fitness Test and Standards

Science and Rationale

Neal Baumgartner, Ph.D.Exercise Physiology Consultant HQ AF

Program Director Force Fitness HQ AETC

The views expressed in this brief are those of the author, and do not necessarily reflect official US Government, DoD, or USAF positions or policies.

Major

General

Poor Staffer

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Purpose / Overview

• Purpose – informational brief on the current AF Physical Fitness Test and Standards

1. Physical Fitness (PF) Standards Development - Tiered

2. Scientific Rationale - Tier 1

– Aerobic

– Body Composition

– Muscle Fitness

3. Way Ahead - Tier 1 + Tier 2

Health-Fitness Hierarchy

Goal: Improve Health & FitnessCurrent and Future!

Aerobic > Body Comp > Muscle Fitness

Fit & Lean > Fit & Fat > Unfit & Lean > Unfit & Fat

Components of Fitness• Health components of physical fitness

1 Cardiorespiratory Endurance (aerobic)

2 Body Composition

3 Muscular Strength

4 Muscular Endurance

5 Flexibility / (Mobility - Stability)

• Skill componentsAgilityBalanceCoordinationPowerReaction timeSpeed

• Total Physical Fitness = Health + Skill

Tier 1

Tier 2

Magnitude

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PF Standards Development• Military traditional-historical model - use normative data

• Military sample - subjective range from “very poor” to “excellent”

• Limited - only provides rating versus peers

• Not anchored in meaningful criteria - “Shifting sand”

• Not necessarily related to health or mission requirements

• Most Sister Service PF standards are normative

• Previous AF PF standards were arbitrary, not based on recognized science, health, or performance criteria

• We moved beyond traditional-historical model to criterion, science-based standards

• Current AF Fitness Assessment (FA) - health-related PF standards; Tier 1 for all airmen

• Next generation AF FA - Tier 1 for all + Tier 2 performance-related PF by career field for some

Health vs. Performance Standards

Health-based fitness for total force (Tier 1)• Evidence-based

• Occupationally (AFSC) independent

• Gender dependent

• Health standard across fitness components

• Performance-based fitness by career field (Tier 2)• Evidence-based

• Occupationally (AFSC) dependent

• Gender independent

• Performance standard across fitness components

• Allowance for this development in DoD Physical Fitness Instruction

• Next generation effort for AF Fitness

Notional Depiction:Health-Based PF Standard

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AF Specialty Code Groupings

Health Standard - Physical Fitness

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AF Specialty Code Groupings

Performance Standard - Physical Fitness

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Notional Depiction:Performance-Based PF Standard

PF Standard Inherent to the Military Profession

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AF Specialty Code Groupings

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MilitaryProfessional

Standards Development - Tier 1• Well established - physical activity related to health risk

• Strongest relationship - aerobic fitness and health risk

• Abdominal adipose tissue also related to health risk

• Continuous nature; linear early, then curvilinear

• Challenge - develop dichotomous thresholds from continuous line; health risk stratification

• Published science provides basis (49 citations)• Used equations that connect fitness parameter to health outcome

• Aerobic and body composition criterion values

• Critical to set health risk thresholds, then address test methodology and programmatic requirements• Ordered process forms a defensible foundation, avoiding possible

arbitrary selectionsAmerican College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 6th ed. Baltimore: Williams & Wilkins, 2000

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Tier 1 - GAR Approach• Basis = fitness parameter - health outcome relationship• Green-Amber-Red zones – indicate health risk

• Designed to motivate change towards healthy lifestyle behavior• Green = low health risk• Amber = moderate health risk• Red = high health risk

• Amber zone – very important addition• ID “creeping” health problems earlier in service member life cycle• Window for successful intervention / prevention

• Movement from Red to Amber or Amber to Green signifiesan improvement in fitness and a reduction in health risk

Blair SN, et al. Changes in physical fitness and all-cause mortality. JAMA. 1995; 273:1093-1098.Despres JP. Visceral obesity, insulin resistance, and dyslipidemia; contribution of endurance exercise training to the treatment of the plurimetabolic syndrome. In: Holloszy, JO, ed. Exercise and Sport Science Reviews. Baltimore: Williams & Wilkins, 1997; 25:271-300.

Expert Panel. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 1998; 158:1855-1867.

Aerobic Standards Rationale• Researched the aerobic fitness - health risk relationship

• VO2 max - criterion measure of aerobic fitness

• Used published data from The Cooper Institute’s landmark Aerobics Center Longitudinal Study as criteria• Long term (1970 – present) study connects actual PF aerobic test

data (vice physical activity surveys) to health outcomes

• American College of Sports Medicine recognized - gold standard

• The Cooper Institute and AF-specific publications specified aerobic fitness - health risk thresholds

• Further supported by collective body of literature

• Bottom line: Run time → VO2 max → Health Risk• All cause mortality, cardiovascular diseases, diabetes, some cancers

Wilkinson, et al. Physical fitness & health: a comparative review of the USAF fitness program. USAF School of Aerospace Medicine Technical Paper 2000-0001

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Aerobics Center Longitudinal StudyRelative Risk - All-cause Mortality

Male PF Group Mortality Rate (/10k) Relative RiskQuintile 5 (most fit) 18.6 1.00 (referent)

Quintile 4 21.7 1.17Quintile 3 27.1 1.46Quintile 2 25.5 1.37

Quintile 1 (least fit) 64.0 3.44

Female PF Group Mortality Rate (/10k) Relative RiskQuintile 5 (most fit) 8.5 1.00 (referent)

Quintile 4 6.5 0.76

Quintile 3 12.2 1.44

Quintile 2 20.5 2.41

Quintile 1 (least fit) 39.5 4.65

Blair S.N., et al. Physical fitness and all-cause mortality. JAMA. 1989; 262:2395-2401

Fitness Test – Muscle FitnessModified Weighting / Scoring

Return

20‐60‐10‐10Male 30‐39

Run TimePrevious 

Pts New Pts (50%)

New Pts (60%)

≤ 10:37 50 50.0 60.0

10:38 ‐ 11:06 50 49.8 59.7

11:07 ‐ 11:22 47.5 49.5 59.4

11:23 ‐ 11:38 45 49.2 59.0

11:39 ‐ 11:56 43.5 48.8 58.5

11:57 ‐ 12:14 43.5 48.3 58.0

12:15 ‐ 12:33 42 47.8 57.3

12:34 ‐ 12:53 42 47.1 56.5

12:54 ‐ 13:14 40.5 46.4 55.6

13:15 ‐ 13:36 40.5 45.5 54.5

13:37 ‐ 14:00 39 44.4 53.3

14:01 ‐ 14:25 39 43.1 51.8

14:26 ‐ 14:52 37.5 41.6 50.0

14:53 ‐ 15:20 37.5 39.9 47.9

15:21 ‐ 15:50 36 37.8 45.4

15:51 ‐ 16:22 34 35.4 42.4

16:23 ‐ 16:57 34 32.5 39.0

16:58 ‐ 17:34 32 29.0 34.9

17:35 ‐ 18:14 30 25.0 30.0

18:15 ‐ 18:56 27 20.2 24.3

18:57 ‐ 19:43 24 14.6 17.5

19:44 ‐ 20:33 21 7.9 9.5

≥ 20:34 18 0.0 0.0

20:34 ‐ 21:28 18

21:29 ‐ 22:30 15

22:31 ‐ 23:36 12

23:37 ‐ 24:48 9

24:49 ‐ 26:06 6

Aerobic Scoring System - Old vs NewM 50-59

Run Time(mins:secs)

est. VO2 max(ml/kg/min) Health Risk Ratio Health Risk Category Points

≤ 9:12 ≥ 56 0.2 Low-Risk 60.09:13 - 9:34 54-55 0.3 Low-Risk 59.79:35 - 9:45 53 0.3 Low-Risk 59.3

(Male < 30 yrs) ϟ ϟ ϟ ϟ11:57 - 12:14 43 1.3 Low-Risk 50.912:15 - 12:33 42 1.5 Low-Risk 49.212:34 - 12:53 41 1.8 Moderate Risk 47.212:54 - 13:14 40 2.0 Moderate Risk 44.9

13:15 - 13:36 * 39 2.4 Moderate Risk 42.313:37 - 14:00 38 2.7 High Risk 0 (39.3)

14:01 - 14:25 37 3.1 High Risk 0 (35.8)

14:26 - 14:52 36 3.6 High Risk 0 (31.7)

14:53 - 15:20 35 4.2 High Risk 0 (27.1)

15:21 - 15:50 34 4.8 High Risk 0 (21.7)

15:51 - 16:22 33 5.6 High Risk 0 (15.5)

16:23 - 16:57 32 6.5 High Risk 0 (8.3)

≥ 16:58 ≤ 31 7.4 High Risk 0.0

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Run Time(mins:secs)

est. VO2 max(ml/kg/min) Health Risk Ratio Health Risk Category Points

≤ 10:23 ≥ 50 0.1 Low-Risk 60.010:24 - 10:51 48-49 0.1 Low-Risk 59.910:52 - 11:06 47 0.2 Low-Risk 59.5

(Female < 30 yrs) ϟ ϟ ϟ ϟ13:37 - 14:00 38 0.8 Low-Risk 54.214:01 - 14:25 37 1.0 Low-Risk 52.814:26 - 14:52 36 1.2 Low-Risk 51.214:53 - 15:20 35 1.4 Moderate Risk 49.315:21 - 15:50 34 1.7 Moderate Risk 46.9

15:51 - 16:22 * 33 2.1 Moderate Risk 44.116:23 - 16:57 32 2.5 High Risk 0 (40.8)

16:58 - 17:34 31 3.0 High Risk 0 (36.7)

17:35 - 18:14 30 3.7 High Risk 0 (31.8)

18:15 - 18:56 29 4.4 High Risk 0 (25.9)

18:57 - 19:43 28 5.3 High Risk 0 (18.8)

19:44 - 20:33 27 6.4 High Risk 0 (10.3)

≥ 20:34 ≤ 26 7.7 High Risk 0.0

Fitness Test - Aerobic Component

1.5 Mile Run(time)

1.0 Mile Walk

(sex, age, body mass, walk time, end test

heart rate)

VO2 maxAerobic Fitness

LowHealth Risk

ModerateHealth Risk

HighHealth Risk

HighPoints

Lower(Warning)

Points

LowPoints

Boondock AFBFitnessCenter

Aging0-6

FPM

FredFred

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Body Composition• Body composition (BC) a major PF component

• BC measurement necessary for both health and performance

• Overweight and obesity pose health, performance, and cost problems, even in the near term

• Body Weight (Mass) vs Body Fat• Misconception that body weight is more important than body

fatness, i.e., people focus on thinness and lower weight rather than on leanness, the composition of the body weight

• Thin - may be and below ideal body weight but unfit and overfat

• Lean, fit and low in body fat - may be over ideal weight due to higher levels of fat-free mass (primarily muscle and bone mass)

• Therefore, AF no longer uses measures of stature and mass

• Height for weight, and body mass index (BMI) are not BC measures

• May lead to erroneous conclusions regarding levels of fitness, fatness and health risk

Body Mass• Stature and Mass (Height & Weight)

• Measures only stature and body mass, not fat

• Does not provide the type of mass gained or lost, nor corresponding health status

• Obsolete, of little health value• Unfortunately, routine scale readings - ingrained behavior

• Body Mass Index• Correlates to mortality at population level

• Measures only stature and body mass (kg/m2), not fat

• Does not provide the type of mass gained or lost, nor corresponding health status

• Misclassifies individuals with high fat-free mass and low fat mass as overweight or obese

• Fails to identify individuals with low fat-free mass, but high fat mass as at risk

• AF data (n = 5263) show that BMI misclassifies 29.1% of sample

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Body Composition Hierarchy• Relative Body Fat (% Body Fat) - Total Adiposity

• Better measure for health than MAW or BMI as excess levels of total adiposity (fat) place individual at risk

• DoD methodology (2 / 3 point anthropometric taping)

• Does not provide body fat distribution or fat pattern

• Individuals may have the same stature, mass, BMI, and %BF, but different health risk levels due to different fat deposition patterns!

• Regional Fat Pattern / Fat Distribution - Central Adiposity• Distribution of adipose tissue more important than total fat

• Intra-abdominal fat - visceral adipose tissue (VAT)

• Very labile, metabolically active – blood fat

• Significant health risk for myriad cardiometabolic diseases

• Greater health risk than fat in the gluteal-femoral region

• Android “apple” versus gynoid “pear” pattern

• Gender pros and cons

Body Mass and BC Measures1. Stature and Mass - stadiometer and scale (old MAWs)

2. Stature and Mass Index - BMI (kg/m2)---------------------------------------------------------------------------------------------------------------------------------------------------------------

1. Relative Body Fat (% Body Fat) - Total Adiposity• Densitometry (hydrostatic weighing)

• Dual energy x-ray absorptiometry

• Plethysmography

• Bioelectrical impedance analysis

• Near-infrared interactance

• Anthropometric methods - skinfolds, circumferences

2. Regional Fat Pattern / Fat Distribution - Central Adiposity• Computed tomography - intra-abdominal diameters, areas

• Waist-to-hip ratio

• Waist /Abdominal circumference

• Waist-to-height ratio

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Abdominal Fat MeasurementsComputer axial tomography (CAT) scans and magnetic resonance imaging (MRI) can assess intra-abdominal adipose tissue area, but impractical and cost prohibitive for broad application. Related, a recent study (Nutrition Feb 2013) concluded that ultrasonographicmeasurements of VAT were correlated with cardiovascular risk factors, but this association was also demonstrable with AC measurements

Abdominal Circumference• Abdominal circumference (AC) - best simple VAT measure

• Strongly correlated to VAT, independent of BMI

• Superior to BMI and waist-to-hip ratio; stronger predictor of multiple health risks in individuals than BMI

• A single measurement (vice DoD 2/3 taping)

• Highly reproducible - easier to administer than other measures; measurement error reduced with consistent technique and setting

• Unrelated to stature

• Generally age independent – for a given AC, older individuals typically have higher VAT

• Good for assessing fat content before and during fat loss treatment

• Members can easily track their progress

• Practical – most people readily identify with AC, where computation and conceptualization of BMI can be problematic

• Adverse impact of overfat on military bearing largely captured by abdominal circumference measure

AC - Methodology

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Adverse Health Outcomes with Abdominal Obesity

Condition Linkage with Abdominal Obesity

Type II Diabetes Strong association in both gendersand in diverse populations

Impaired Glucose Tolerance Strong association

Hypertension Strong association

Hyperlipidemia Strong association

Myocardial Infarction Strong association

Stroke Probable association

Obstructive Sleep Apnea Strong association

Prostate Cancer or Hyperplasia Significant association

Breast Cancer Probable association

Colon Cancer Probable association

Depression Probable association

BM/BC Health Hierarchy TSgt Smith

68 in 178 lbs

27.1 kg/m2

22 %

39.5 in

1 Ht and Wt• Not body composition

• No health status

2 BMI• Population only trends for

health

• Not body composition

• Misclassifies > 30% of AFAD

3 Percent Body Fat• General adiposity only

• Limited health risk status

4 Abdominal Circumference• Best simple marker of central fat

• Key determinant of health risk

TSgt Jones

70 in 187 lbs

26.8 kg/m2

24 %

37.0 in

Lower

Health Risk

BC Standards Rationale• Rationale paper (2003, 49 citations) provides basis for BC

measurement hierarchy, AC measurement and standards• Introduced AC as a preferred BC measure for fitness and health

following hierarchy - abdominal adiposity > total adiposity

• Went beyond 1998 National Institutes of Health BMI-basedAC thresholds• Male - AC ≥ 102 cm (≥ 40.2 in) / Female - AC ≥ 88 cm (≥ 34.6 in)

• Rather focused on direct relationship between AC and health outcomes, independent of BMI

• Used published (Am J Clin Nutr) equation on AC - health risk relationship and the strong body of literature

Expert Panel. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 1998; 158:1855-1867.

Janssen I, et al. Body mass index, waist circumference, and health risk. Arch Intern Med 2002; 162:2074-2079.Zhu S, et al. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: clinical action thresholds. Am J Clin Nutr 2002; 76:743-749.

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Literature Support• Since 2003 research data reinforce that BMI alone, BMI

coupled with AC, or % BF does not predict health risk as well as AC alone

• For every centimeter increase in AC, one’s health risk increases• Gradual linear fashion at lower AC values, then curvilinear fashion

at higher AC levels

• Challenging, but possible to determine dichotomous AC thresholds for low, moderate, and high health risk • We established thresholds via strong body of literature

• Linear portion of AC - health risk curve = low risk

• Curvilinear portion of AC - health risk curve = moderate to high risk

• Correct to use the collective literature since no singular study pinpoints optimal thresholds

Literature Support• Per literature (34 citations) AC thresholds are (inches):

• Despite a minority view that these thresholds may be too stringent, greater concern that they may be too lenient

• Research data show increased levels of disease risk at levels equal to or lower (AC values) than AF thresholds• Prospective studies, 16 yrs of follow-up, > 43k women - disease risk

(CV disease, cancer, diabetes) increased progressively w increasing AC values from 28 inches to 35 inches even after covariate adjustments, including BMI, i.e., elevated AC is associated w significantly increased disease risk even among normal wt females

• Similarly for males - disease risk (diabetes) increased significantly at AC values above 34 inches, even after adjusting for BMI

Health Risk Male AC (inches) Female AC (inches)

Moderate > 35.0 > 31.5

High > 39.0 > 35.5

Body CompPrevious 

Pts New Pts (30%)

New Pts (20%)

< 32.5 30.00 30.0 20.0

≤ 32.5 28.75 30.0 20.0

33.0 27.50 30.0 20.0

33.5 26.25 30.0 20.0

34.0 25.00 30.0 20.0

34.5 23.75 30.0 20.0

35.0 22.50 30.0 20.0

35.5 22.35 26.4 17.6

36.0 22.20 25.6 17.0

36.5 22.05 24.7 16.4

37.0 21.90 23.7 15.8

37.5 21.75 22.7 15.1

38.0 21.60 21.5 14.4

38.5 21.15 20.3 13.5

39.0 21.30 19.0 12.6

39.5 21.25 17.5 11.7

40.0 21.00 15.9 10.6

40.5 18.00 14.2 9.4

41.0 15.00 12.3 8.2

41.5 12.00 10.2 6.8

42.0 9.00 8.0 5.3

42.5 6.00 5.5 3.7

43.0 3.0 2.9 1.9

≥ 43.5 0.0 0.0 0.0

BC Scoring SystemMales ‐ age independent 

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BC - GAR

• Green - low health risk

• Amber - moderate health risk• “Action Level 1,” first warning• Need to take action to prevent further fat gain

• Red - high health risk• “Action Level 2” second warning• Point requiring fat loss and risk reduction

AC (inches) Health Risk Ratio Health Risk Category Points

≤ 32.5 1.0 Low-Risk 20.033.0 1.1 Low-Risk 20.0

(Male) ϟ ϟ ϟ

34.5 1.4 Low-Risk 20.035.0 1.5 Low-Risk 20.035.5 1.7 Moderate Risk 17.636.0 1.8 Moderate Risk 17.0ϟ ϟ ϟ ϟ

38.5 2.8 Moderate Risk 13.539.0 * 3.0 Moderate Risk 12.639.5 3.3 High Risk 0 (11.7)

40.0 3.6 High Risk 0 (10.6)

40.5 3.9 High Risk 0 (9.4)

41.0 4.2 High Risk 0 (8.2)

41.5 4.6 High Risk 0 (6.8)

42.0 5.0 High Risk 0 (5.3)

42.5 5.5 High Risk 0 (3.7)

43.0 6.0 High Risk 0 (1.9)

≥ 43.5 6.5 High Risk 0.0

AC (inches) Health Risk Ratio Health Risk Category Points

≤ 29.0 1.0 Low-Risk 20.029.5 1.1 Low-Risk 20.0

(Female) ϟ ϟ ϟ

31.0 1.4 Low-Risk 20.031.5 1.5 Low-Risk 20.032.0 1.7 Moderate Risk 17.632.5 1.8 Moderate Risk 17.1ϟ ϟ ϟ ϟ

35.0 2.9 Moderate Risk 13.735.5 * 3.1 Moderate Risk 12.836.0 3.4 High Risk 0 (11.8)

36.5 3.7 High Risk 0 (10.7)

37.0 4.1 High Risk 0 (9.6)

37.5 4.4 High Risk 0 (8.3)

38.0 4.8 High Risk 0 (6.9)

38.5 5.3 High Risk 0 (5.4)

39.0 5.8 High Risk 0 (3.8)

39.5 6.3 High Risk 0 (2.0)

≥ 40.0 6.9 High Risk 0.0

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Muscle Fitness Standards Rationale

• Very limited research on the muscle fitness - health outcome relationship, especially with calisthenic tests

• Normative based data remains as basis

• Muscle fitness standards• Used ACSM recognized normative data – significant

improvement over previous arbitrary standards (2004)

• Refs: ACSM Resource Manual and The Cooper Institute database

• Cross checked with AF data set and sister service standards

• Component minimums set at:

• 60th percentile sit-ups / 50th percentile push-ups

Situps Current  New Pts

≥ 46 10.00 10.0

43 10.00 9.5

42 9.50 9.4

41 9.50 9.2

40 9.00 9.1

39 9.00 9.0

38 8.75 8.8

37 8.75 8.7

36 8.50 8.5

35 8.50 8.0

34 8.25 7.8

33 8.25 7.5

32 8.25 7.3

31 8.00 7.0

30 8.00 6.5

29 7.75 6.3

28 7.75 6.0

27 7.50 5.5

26 7.50 5.0

25 7.40 4.5

24 7.40 4.0

23 7.30 3.8

22 7.30 3.5

21 7.20 3.0

20 7.10 2.5

19 7.10 2.0

18 7.00 1.8

17 7.00 1.5

16 6.00 1.3

15 6.00 1.0

≤ 14 4.00 0.0

13 2.00

12 2.00

<12 0.00

Sit-ups Scoring SystemM 50-59

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Push‐Ups Current  New Pts

≥ 44 10.00 10.0

39 10.00 9.5

38 9.75 9.4

37 9.75 9.4

36 9.50 9.3

35 9.50 9.3

34 9.25 9.2

33 9.25 9.2

32 9.25 9.1

31 9.00 9.1

30 9.00 9.0

29 8.75 8.8

28 8.75 8.5

27 8.75 8.3

26 8.50 8.2

25 8.50 8.0

24 8.25 7.5

23 8.25 7.3

22 8.25 7.2

21 8.00 7.0

20 8.00 6.5

19 7.75 6.0

18 7.75 5.8

17 7.75 5.5

16 7.50 5.3

15 7.50 5.0

14 7.40 4.5

13 7.40 4.0

12 7.30 3.8

11 7.20 3.5

10 7.20 3.0

9 7.10 2.0

8 7.00 1.8

7 7.00 1.5

6 6.00 1.0

≤ 5 5.00 0.0

4 4.00

3 3.00

Push-ups Scoring SystemM 50-59

AF PF Test - Vetted, Reviewed• 2010 aerobic, AC, and MF standards were vetted by:

• Original fitness standards development team of preventive medicine physicians, exercise physiologists

• Separate group - preventive medicine physician, biostatistician, epidemiologist with inputs from senior US Navy BC expert

• AF Blue Team of biomedical experts• The Cooper Institute physicians and exercise physiologists

• Supportive feedback from briefings to: AF Red Team of commanders and first sergeants, AF NCO Academy, CMSAF Summit, MAJCOM/CCs, CSAF, SecAF

• Briefed new program to DoD’s Physical Fitness and Body Fat Programs Working Group; interest in AC measure and standards for potential use in sister services

• Peer-reviewed publication - Baumgartner, N., McSweeny F., Fonseca V. AF PF Test Standards Development. In draft

HQ Staffer

AF Fitness Trainer

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Way Ahead - Tier 1• Review applicable science literature, especially military

populations

• Closely monitor new FA results – fit parameter vshealth risk, illness, injury and related costs and lost duty time

• MF Standards - move from normative to criterion

• New test modalities – close gap in primary movement patterns• Bend and Twist (cross knee crunch)

• Squat (two legged squat)

• Pull (pull-up)

• Reconsider machine-based testing

• “Aerobic Protection” science; integrate into FA scoring

Aerobic Protection• Cardiorespiratory endurance most important for Health-

Fitness; compelling research data show aerobic fitness:• Provides risk protection independent of body mass and total adiposity

• Provides protection not by reducing body mass per se, but by reducing VAT, SAT, and total AT

• Mitigates elevated health risk associated with increases in total AT

• For long term health benefits we should focus on improving fitness by increasing physical activity rather than relying solely on diet for fat (weight) control

• “Aerobic Protection” / “Green - Green” - Tier 1 modification• Potential mod: earn max BC component points (20) only if aerobic

component is low risk (green); requires data analyses

• May carry some extra central adipose tissue if fast run time

• Required run time most likely faster than just lowest green

Fit & Lean > Fit & Fat > Unfit & Lean > Unfit & Fat

BM/BC Health Hierarchy TSgt Smith

68 in 178 lbs

27.1 kg/m2

22 %

1 Ht and Wt

2 BMI

3 Percent Body Fat

4 Abdominal Circumference

TSgt Jones

70 in 187 lbs

26.8 kg/m2

24 %

2nd example: what if………..

35 in 35 in

12:56 11:30

Lower Health Risk

5 Aerobic Protection

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Tier 1 Status

• Culture Change• AF can embrace new AF PF Program with confidence and seize

the opportunity to change AF fitness culture

• Must continue to train, educate, and market

• Advance fitness assessment and program across both:• Tier 1 - health-based tests and standards

• Tier 2 - AFSC-specific, performance-based tests and standards

Goal: Improve Health & FitnessCurrent and Future!

Way Ahead - Tier 2• Conventional PT techniques often contribute to:

• Chronic injury when coupled with high demand work environments

• Cumulative anatomical imbalances - detrimental career effects

• Counter this with Tier 2 development and PT revision

• Perform demand analysis on occupational movement patterns

• Review entry and exit training tests and standards

• Monitor, assess, develop, and terminally guide PT with same due diligence used with operational systems

• Focus on pulling and core fitness versus pushing

• Multiple planes of motion (closed vs open chain movements)

Mercer, G and M Strock. Introduction of Functional Physical Training into Special Operations Units. Journal of Special Operations Medicine. 2005; 5(1) 54-59.

Way Ahead - Tier 2

• Tier 2 R&D - Bona Fide Operational Requirements work

• Develop performance tests, standards and training modes for Aerobic, BC, MF, and PF skill components• Positive HAF support in hi-level briefs (1998 to present)

• Review efforts of sister services and allies

• SF civilian guards - military guards

• Phase 1 - RAND Corp PAF Study (FY12 - prior to WISR)

• Phase 2 - Battlefield Airmen proposals (encompass WISP)

• Near term - functional fitness in AF testing and training• Develop functional tests with normative standards per priority

movement patterns and energy systems (anaerobic metabolism)

• Examples: cross-knee crunch, squat, shuttle run

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Developing Tier 2 PF Standards• Establishing occupationally-specific PF standards:

1. Job analysis or physical demands analysis

2. Employ appropriate types of tests to evaluate work ability; basic ability tests, and work-sample tests

3. Physical test validation

• Public Law 103-160, Sec. 543 Gender-neutral occupational performance standards.“In the case of any military occupational career field that is open to both male and female members of the Armed Forces, the Sec of Def shall ensure that qualification….for, and continuance of members….in, that occupational career field is evaluated on the basis of common, relevant performance standards, …”

Constable S and Palmer B, eds. The Process of Physical Fitness Standards Development. Human Systems Information Analysis Center State of the Art Report. Wright-Patterson Air Force Base, OH., 2000

Fitness Components x Tiers

Fitness Component Tier 1 - Health Tier 2 - Performance

Aerobic Most Important Most Important

Body Comp Very Important Somewhat Important

Muscle Fitness

Somewhat Important Very Important

Flexibility Stability Mobility

Functional Living Very Important

Skill(A-B-C-P-RT-S)

na Very Important

Health: CRF>BC>MF

Performance: Total Fitness in Six Priority Movement Patterns = Run, Bend, Twist, Squat, Pull, Push

Health vs. Performance Standards

Health-based fitness for total force (Tier 1)• Occupationally (AFSC) independent

• Gender dependent

• Health standard across fitness components

• Performance-based fitness by career field (Tier 2)• Occupationally (AFSC) dependent

• Gender independent

• Performance standard across fitness components

• Allowance for this development in DoD PF Instruction

• Next generation effort for AF Fitness

3/13/2013

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AF PF Salient Issues1. Science-based standards (health criterion)

2. Return BC measures to HAWCs / FACs

3. Eliminate use of BMI

4. Incentives

5. Training, Education and Marketing (communication and clarification)

6. Altered test frequency

• Semi-annual / Annual > 90 points

• Random

7. Performance-based (Tier 2) standards development

8. Machine based MF testing

Back-ups

DoD Body Fat Program

If Then

ServiceBMI

(weight/height table)Max Body Fat

Entered into WMP?

Marine Corps

Male > 27.5Female > 25

Male > 18%Female > 26%

add 1% for each of 4 age groups Yes

Army

Male (25 – 27.5)Female (25 – 26)

Varies by age category

Male > 20%Female > 30%

add 2% for each of 4 age groupsYes

NavyMale (26.2 – 27.5) Female (25 – 27.5)

Varies by height category

Male > 22%Female > 33%

add 1% if age over 40Yes