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Autopsies of war dead suggest today’s troops live healthier lives

A soldiers with the Washington Army National Guard works out in March 2009.

WASHINGTON — They may be fatter, but when it comes to cardio health, today’s troops appear far fitter than their predecessors from earlier wars.

At least, that’s what the autopsies of thousands of war dead stretching back more than 60 years suggest.

In an article published this week in the Journal of the American Medical Association, researchers who compared autopsy data of thousands of American servicemembers killed in Iraq and Afghanistan to data from the Vietnam and Korean wars reported that a key measure of heart disease may have dropped nearly ten-fold.

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For troops who died in the recent wars, they found an overall rate of atherosclerosis — hardening and thickening of major arteries — of 8.5 percent. Autopsy results of Americans who died fighting in Korea suggest 77 percent of troops in the early 1950s conflict had atherosclerosis. In Vietnam, the rate was 45 percent.

The lead author, Dr. Bryant Webber of Uniformed Services University of the Health Sciences in Bethesda, Md., warned that the rates are not directly comparable because diagnosis standards — particularly for mild artery problems — may have changed over the years.

But for simpler-to-diagnose severe atherosclerosis, rates still declined from 15 percent of those studied in Korea to only 2.3 percent of troops killed in Afghanistan and Iraq.

The Defense Department’s chief medical examiner in 2001 ordered postmortem examinations for all troops killed in the wars, a practice that led to advances in protective gear and medical treatment.

 

The findings from earlier wars were key in the recognition by doctors that heart disease begins developing in young people long before it can be diagnosed clinically.

The new findings, Webber said, may be explained partly by an all-volunteer force that is more committed to fitness than the conscripts of the past were.

It also suggests the military is succeeding in encouraging healthier lifestyles, he said,as well as addressing problems like high cholesterol and high blood pressure.

“I think the U.S. military generally has done a good job addressing a lot of the cardiovascular risk factors, particularly smoking, for which rates have dropped 40 percent since 1980,” he said.

But there’s room for further improvement, Webber said. While military heart disease rates have fallen — as they have in the general population — the problems of overweight troops and diabetes are rising in tandem with civilians.

From 1998 to 2010, the number of troops diagnosed as overweight steadily increased, according to a 2011 study by the Armed Forces Health Surveillance Center. It rose particularly quickly from 2003 to 2008 as the demand for troops caused the military to become more hesitant to punish weight-standard violators with expulsion.

But the services have made recent moves to begin enforcing weight standards more strictly, and the Army has separated more than 1,600 soldiers this year for failing to control their weight, according to a recent Washington Post report.

“This should be encouraging that things seem to be moving in the right direction,” Webber said. “For the weight issue, commanders should keep working to improve dietary habits and increase physical activity.”

Carrollc@stripes.osd.mil
Twitter:
@ChrisCarroll_

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