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Objective Examine associations between soldiers’ eating behaviors, compliance with body composition and fitness standards, and physical performance. Design Cross-sectional study. Setting Eight Army installations. Participants US Army Soldiers (n = 1,591; 84% male). Main Outcome Measures Characteristics, eating behaviors, compliance with body composition and physical fitness standards, and fitness level were assessed via questionnaire. Analysis Bivariate and multivariable logistic regression. Results Eating mostly at a dining facility was associated with lower odds of body composition failure (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.26–0.73); whereas, eating at a fast rate (OR, 1.51; 95% CI, 1.05–2.17) or often/always ignoring satiety cues (OR, 2.12; 95% CI, 1.06–4.27) was associated with higher odds of body composition failure. Eating mostly fast-food/convenience meals (OR, 1.75; 95% CI, 1.19–2.59) and eating at a fast rate (OR, 1.42; 95% CI, 1.04–1.93) was associated with higher odds of physical fitness failure. Skipping breakfast was associated with lower odds of high physical performance (OR, 0.41; 95% CI, 0.23–0.74); whereas, nutrition education was associated with higher odds of high physical performance (OR, 1.02; 95% CI, 1.01–1.04). Conclusions and Implications As eating behaviors are modifiable, findings suggest opportunities for improving the specificity of Army health promotion and education programs.

Objective To describe the Military Eating Behavior Survey (MEBS), developed, and validated for use in military populations. Design Questionnaire development using a 6-phase approach that included item generation, subject matter expert review, cognitive interviewing, factor analysis, test-retest reliability testing, and parallel forms testing. Setting US Army soldiers were surveyed at 8 military bases from 2016 to 2019 (n = 1,561). Main Outcome Measure Content, face, and construct validity and reliability of the MEBS. Analysis Item variability, internal consistency, and exploratory factor analysis using principal coordinates analysis, orthogonal varimax rotation, and scree test (correlation coefficient and Cronbach alpha), as well as consistency and agreement (intraclass correlation coefficient) of test-retest reliability and parallel forms reliability. Results Over 6 phases of testing, a comprehensive tool to examine military eating habits and mediators of eating behavior was developed. Questionnaire length was reduced from 277 items to 133 items (43 eating habits; 90 mediating behaviors). Factor analysis identified 14 eating habit scales (hunger, satiety, food craving, meal pattern, restraint, diet rigidity, emotional eating, fast/slow eating rate, environmental triggers, situational eating, supplement use, and food choice) and 8 mediating factor scales (body composition strategy, perceived stress, food access, sleep habits, military fitness, physical activity, military body image, and nutrition knowledge). Conclusions and Implications The MEBS provides a new approach for assessing eating behavior in military personnel and may be used to inform and evaluate health promotion interventions related to weight management, performance optimization, and military readiness and resiliency.

In civilians, overweight and obesity are associated with emotional eating behaviors such as eating in response to stress, but this association has not been examined in Soldiers, a population with unique stressors. This cross-sectional study examined the relationship between perceived stress (PS), emotional eating (EE), and outcomes of body mass index (BMI), and failing Army body composition (BC) standards among Soldiers.Soldiers (N = 1460, 83% male, 23.5 ± 5.2 years old) completed validated surveys on PS, EE, and adherence with military BC standards. Conditional process models and mediation models tested gender as a moderator and EE as a mediator of associations between PS and BMI and PS and BC failure, respectively.Higher PS was associated with more frequent self-reported EE behaviors (p 0.001), higher BMI (p 0.001), and BC failure (p 0.001). BMI significantly increased with frequency of reported EE behaviors (p 0.001). Gender was not a statistically significant moderator in the relationship between PS, EE, and, BMI (p = 0.83) or BC failure (p = 0.57). PS appears to affect BMI indirectly through EE behaviors (c' = 0.03, 95% CI: 0.02, 0.04). PS may affect BC failure directly (c' = 1.04, 95% CI: 1.01, 1.08) and indirectly (ab = 1.02, 95% CI: 1.01, 1.03) through EE as a mediator.EE behaviors may mediate the positive association between PS, BMI, and BC failure. Prospective investigation is warranted to better understand the role of EE in health-related outcomes among Soldiers and populations in high stress professions.