Obesity and health risk factors in Czech artillery soldiers

Abstract: INTRODUCTION: The physical fitness and body composition of soldiers are critical for operational readiness and overall health. Military service demands optimal levels of muscle strength, endurance, and cardiorespiratory fitness, alongside a healthy body fat percentage (%BF). However, unlike in the U.S. Armed Forces, Czech Soldiers are not required to meet specific %BF standards, and the prevalence of excessive fat remains unknown. Dual-energy X-ray absorptiometry (DXA) offers a precise and reliable assessment of body composition, yet its use in European military research remains limited. This study evaluates the body composition of Czech Artillery Soldiers using DXA, focusing on %BF, fat-free mass, visceral adipose tissue (VAT), and bone mineral density (BMD), compares %BF values with U.S. Army and civilian norms, and evaluates the practical implications of these findings for military health policy. MATERIALS AND METHODS: A randomized cross-sectional study was conducted on 209 healthy adult active-duty Czech Artillery Soldiers (189 men, 20 women). Participants underwent a DXA scan to assess body composition using a Hologic Horizon system. Statistical analyses included the Mann-Whitney and Kruskal-Wallis tests, 1-way ANOVA, and generalized linear models (GLM) with age as a covariate. Health classifications were derived using BMI, %BF, and VAT thresholds for cardiometabolic risk and BMD T-scores for osteopenia and osteoporosis. The protocol adhered to the approval granted by the relevant institutional ethics committee (No. 246/2021). RESULTS: Czech Artillery Soldiers and U.S. Soldiers had nearly identical %BF, 24.3% in Czech men vs. 24.3% in U.S. men; 33.8% vs. 33.3% in women, respectively. Overall, excessive %BF (≥25%) was observed in 41.2% of participants. Age group was a significant predictor of VAT (ω2 = 0.20, df = 6, H = 42.51, P < .001) and %BF (ω2 = 0.07, df = 6, H = 18.73, P < .005), with older participants exhibiting higher levels. High prevalence of osteopenia was found, reaching 20% in both sexes. Contrary to expectations, the GLM revealed that there are no significant differences among units of the Czech Artillery Brigade in any measured variable when age is considered. CONCLUSIONS: DXA-measured body composition in Czech Artillery Soldiers closely matches contemporary U.S. Army values. The high prevalence of overweight and osteopenia underscores the need for preventive and educational strategies addressing both metabolic and skeletal health risks. Future research should determine the prevalence of osteopenia and osteoporosis across the Czech Armed Forces to inform appropriate screening practices and targeted interventions.