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News | May 6, 2021

Travis embraces approach to health care looking at Airmen’s lifestyles

TRAVIS AIR FORCE BASE, Calif. — In an effort to help Airmen live happier, healthier lives, Travis Air Force Base, California, is one of several bases trying a Lifestyle and Performance Medical Clinic approach to health care.

The program takes a patient-centered, evidence-based method to preventing, treating and potentially reversing the effects of diseases by looking at the entirety of an Airman’s health and how various aspects such as diet, sleep, physical wellness and emotional health are intertwined.

"What we wanted to do in the Air Force is ensure we're looking at the entire person and root causes," said Lt. Col. Jennifer Harward, 60th Medical Diagnostics and Therapeutics Squadron nutritional medicine flight commander.

The program is built upon six pillars: nutrition, physical activity, sleep, decreased use of risky substances, social connection and stress management.

Col. Daniel Murray, 60th Operational Medical Readiness Squadron master clinician and the program’s physical fitness expert, said that all of the pillars feed off of each other. For example, when physical health decreases, that impacts mental health as well. When sleep is disrupted, mood is affected. When someone is depressed, it may make them less inclined to exercise.

“That’s what I think is different about all of this,” Murray said. “It gives us the mechanisms to get after things we talk about all of the time – obesity, depression, suicide problems. This is a way to comprehensively address all of that. We’re not trying to fix your run. Yeah, it will fix your run, but you’ll also eat better and sleep better. We’re doing it holistically rather than poking at these problems one at a time, which primarily is what I think makes this very different.”

In terms of nutrition, the program emphasizes a plant-focused diet that favors minimally processed, whole foods. It also emphasizes decreasing the use of risky substances, which involves curtailing the intake of products such as tobacco, alcohol, caffeine and energy drinks.

Thus far, the benefits for individuals who participate has been measured through weight loss and laboratory test results. Participants from the first seven-week course saw a 4.9% reduction in their weight, as well as blood-level reductions in cholesterol (5.5%), triglycerides (14.85%) and low-density lipoproteins (16.15%), according to data provided by Sahra Pak, 60th Medical Diagnostics and Therapeutics Squadron dietitian and the developer of Travis’ LPMC program.

At Travis AFB, the program, which started fall 2020, has been deployed as a pair of courses lasting approximately a month and a half. Other facilities, Harward said, attempting to implement a similar program include Whiteman AFB, Missouri; Wright-Patterson AFB, Ohio; and the Air Force Academy in Colorado Springs, Colorado.

When the Air Force prioritizes the health and wellness of its Airmen, the hope is other benefits will accumulate downstream, such as cost savings in terms of health care needs and on-the-job efficiency, Pak said.

However, the results of the program aren’t aimed simply at benefiting the broader service, but also on an individual level. The program strives to put Airmen on a path “for lifelong success when it comes to health, longevity and resilience,” said Col. Zachery B. Jiron, 60th Air Mobility Wing vice commander.

“Throughout my career, I’ve found that the Air Force brings relatively healthy members into the force, but then does not provide them with current, expert-informed information on optimizing diet, nutrition, sleep, etc., so they can live their best lives and, most importantly for the Air Force, be fully combat-ready for what the nation expects of them,” Jiron said. “I want Airmen to be at peak fitness during their time in service while developing the mindset and habits that will ensure they live long, healthy lives well beyond their Air Force careers. The LPMC program underpins both of these.”

Lt. Col. Joe Sky, 60th Surgical Operations Squadron associate chief of medical staff and a cardiologist, echoed Jiron’s observations, saying he has been an advocate for this style of health care for years.

"The goal is to show we can improve readiness, to show we have more (physical training) passes, that we're making a difference in people's lives," Sky said. "I don't tell people, 'I'm going to put you on a different diet.' I tell people to think about what your goals are for how you're going to eat."

Sky said both private and public-sector health care providers are embracing this approach, although results tend to come in the longer term, making the program difficult to institute. That’s where he and Pak agreed leadership-level support has been vital. In addition to Jiron’s backing, Pak said she recently briefed Chief Master Sergeant of the Air Force JoAnne Bass on the program during her visit to Travis AFB.

“From the top of the Air Force, we’re really trying to change the culture of fitness and what that means,” Pak said. “It’s about changing the culture, changing the mindset. It’s not a temporary fix to pass a PT test, but it’s about long-term health.”

Sky talked about the “80/20 concept,” a notion that health care providers are just one component of a person’s health care, with 80% of health based on the choices patients make for themselves while just 20% comes from health care professionals.

"Medical doctors have known for years that we don’t provide everything that matters," Sky said. "This is an attempt to bring evidence-based science to providing our patients with the best options to control the components of health care that they can control."

Harward said giving patients that control isn’t beneficial to just individuals, but also to the broader Air Force.

“People don’t correlate the lifestyle behaviors that they do day to day to how they’re performing throughout the day, right?” Harward said. “So, if you’re not eating well, not taking care of yourself, you start performing not very well and that impacts the mission. … If we can make better choices throughout the day, we are going to be a much happier person, have more energy and be able to perform more throughout the day compared to if we were to make the bad choices.”

To participate in the program’s next course, which Pak said is expected to launch in mid-May, active-duty members can self-refer or talk to their doctor about being enrolled in the program.

Also connected to the program are multiple, recurring fitness training sessions each week, which its coordinators call “Yoda’s Performance Clinic.” The sessions include, but are not limited to participants in the Lifestyle Medicine program. The running group, organized by Murray, meets at 9 a.m. on Saturdays at the red track (formerly the blue track), by the Duck Pond. The strength training conditioning group, which is run by others, meets at 8 a.m. and 4:30 p.m. Tuesdays and Thursdays at the Nose Dock Gym.
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