The Air Force is taking aim at obesity among dependents and retirees through two pilot programs that could eventually go servicewide.

Part of the new Healthcare to Health initiative — H2H for short — the programs target parents of Air Force children as well as spouses and retirees through interactive courses on base, said Kelly Williams, a certified health education specialist who has spent two years developing the initiative.

The first, called 5210 Healthy Military Children, teaches moms and dads how to make consistent, healthy meal and exercise choices at home. The second, Group Lifestyle Balance, focuses on weight management, physical activity and healthy eating for spouses and retirees at risk for weight-related health problems like Type 2 diabetes, sleep apnea, strokes and heart attacks.

The programs are underway at Scott Air Force Base, Illinois, and Mountain Home Air Force Base, Idaho. They'll begin at four more Air Force bases by the end of the fiscal year: MacDill in Florida; Peterson in Colorado; Shaw in South Carolina and Tinker in Oklahoma.

The bases were picked based on the population of dependents — all have at least 10,000 — and what, if any, health programs are already offered at the installations. The Air Force also took into account the number of patients younger than 18 who are classified as obese and the non-active-duty population that met the criteria for metabolic syndrome indicators. Those include weight, blood pressure, cholesterol level, triglyceride and fasting blood glucose levels.

The military health care system promises to be stretched thin as the country faces the impact of more than a decade of war and a swelling retiree population, Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson said in the 2012 Military Health System stakeholders' report.

An added burden: Many retirees are dropping their private insurance to return to the more affordable Tricare.

"We are an organization on the move — from health care to health," Woodson wrote.

"We have to transition from a focus on what we do within the walls of the [medical treatment facility] to taking that out in the community — making the healthy decision the default," Williams said.

Woodson directed the services to look at the two leading causes of preventable death in the U.S. — tobacco use and obesity.

Active-duty airmen are generally healthier than the rest of the population, said Col. John Oh, chief of health promotion for the Air Force Medical Support Agency. That's because of requirements to join the service and physical fitness standards to stay in. But obesity among dependents and retirees reflect that of the rest of the country.

Although there have been no studies of obesity in Air Force children, the numbers are thought to be consistent with the general population, which in 2012 reached 18 percent for children ages 6 to 11. It was 21 percent for 12- to 19-year-olds, according to the Centers for Disease Control and Prevention.

Some have said childhood obesity is threat to national security, Oh said, pointing to 2010 report by a group called Military Leaders for Kids that claimed three-quarters of Americans ages 17 to 24 are unfit for military duty in part because they are overweight.

"Certainly if we have this problem, we are not going to be able to recruit the best adults into service," Oh said. "We've got to be able to turn the corner on this, not just in the Air Force but in the country."

In two, one-hour sessions, 5210 Healthy Military Children teaches parents that children should eat five or more servings of fruits or vegetables every day, spend no more than two hours in front of a screen and at least one hour in active play, and consume zero sugar-sweetened drinks.

"We recognize it's difficult and challenging," said Oh, the father of a 5-year-old. "The TV can be like a babysitter. It's so convenient. But screen time very much correlates with childhood obesity. Once an adult is obese, it's challenging to lose weight and sustain it."

Group Lifestyle Balance targets those adults, who work with a dedicated health coach to learn how to set weight and fitness goals, address barriers, self-monitor eating and exercise habits and solve problems that stand in the way of making healthy choices, Williams said. They learn how to read nutrition labels and track calories when eating out. They build a social support network — all in an effort to sustain the weight loss.

The course meets an hour a week for the first 12 weeks, followed by biweekly and monthly check-ins.

Doctors will refer people to the program who have three or more metabolic syndrome indicators, Williams said. You can also ask your physician for a referral. Williams is working with the six bases to get the word out about the voluntary 5210 program.

The feedback from Scott and Mountain Home so far has been positive, Williams said.

The Air Force will measure the success of the two programs by collecting data from participants, she said. "If we're seeing progress, we'll roll it out to a few more bases, and eventually go enterprisewide."■

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