MOPs & MOEs

In 2016 the American Heart Association called for Cardiorespiratory Fitness (CRF), generally measured using VO2max, to be included as a vital sign. They said:“The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk.”In this episode we discuss the arguments made and evidence cited in that statement, as well the update published in 2024.If you're the type to want follow up citations/further readings, here are a few that we found interesting (but you can find many more cited in the two statements linked above):People over 60 can still improve their VO2 by just as much as young people, relative to their baseline.Here's where you'll find the normative values from the Fitness Registry and the Importance of Exercise National Database (FRIEND) that we discussed.And before you ask, we also briefly address the classic "strength vs cardio" debate. Here are some studies we used to support it:Association of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality (yes, we understand that CVD is probably not the right place to look for strength training benefits)Optimum dosing of resistance training for health and longevity

This episode is all about identifying the right approach to endurance training for different types of athletes. Some people are genetically predisposed to strength and power, while others are built for stamina. While most of us fall somewhere on a spectrum between the two, knowing your athlete archetype can help you determine your optimal approach to training. This episode is built on Drew's blog post from a month ago, so if you need some written examples of what we discuss you can refer to that.Some key topics we address:Strength and power adaptations are largely neurological, while endurance adaptations are largely physiological. As a result, intensity is the key training variable for strength and power, while volume if the key to endurance.We return to a frequent topic on this podcast, which is the energy systems model routinely found in strength and conditioning education classes.Zone 2, who it's appropriate for, and when. Alternate cardio modalities (like biking, rowing, and swimming) and how they fit into training when the primary focus is often running.The classic "training residuals" chart that appears in so many textbooks, and just a few of the reasons it's probably not accurate for most people.

The human performance community often focuses on physical fitness at the expense of other domains. Recent holistic approaches have improved the ways we address other domains, especially nutrition, mental health, and spiritual fitness. A weak area in many of these programs is financial fitness, and Life Skills for Soldiers is working to fix that. Financial fitness is a dedicated domain in the DoD's Total Force Fitness model, but it's often treated as separate from the "performance" focused domains. Our guest on this week's episode is Brendan Duebner, a former artillery officer who served at Fort Bragg, North Carolina, and deployed to the Middle East. He served as a headquarters and HIMARS platoon leader and as a liaison officer to the Kuwaiti Artillery forces.During his last year in the Army he started Life Skills for Soldiers, a 501(c)(3) nonprofit whose mission is to improve service members lives through life skills education. Through this organization he has led a team of over 25 and raised over $150,000 including donations from companies like Nike and Google.After leaving active duty he completed his MBA at Wharton where he focused on Entrepreneurship and Finance, and he still serves as a member of the Army Reserve's 75th Innovation Command. In the spirit of measuring effectiveness, Brendan's team also publishes impact assessments from their pilot programs.

This episode covers a lot of ground. On the heels of last week's episode where we had to edit out our discussion of women in special operations, that's exactly where our conversation this week starts. We originally connected with our guest because of his LinkedIn post about a woman in her senior year at the Naval Academy who has been selected to attend BUD/S, but we quickly move on to focus on how mindfulness fits into human performance. Jon Macaskill is a retired Navy SEAL Commander turned consultant and mindfulness and meditation teacher. He was born in South Africa but grew up in Ruston, Louisiana.After graduating high school, he served briefly as an enlisted sailor in the US Navy before receiving an appointment to the US Naval Academy and graduating from there with a BS in mathematics 4 years later. He also has a Master’s degree in Operations Research from the Naval Postgraduate School.During his 24-year Navy career Jon served in Iraq, Afghanistan, off the coast of Somalia, and in Panama.After retiring, he served briefly as the Deputy Executive Director for the veteran nonprofit, Veteran’s PATH. He now runs a podcast called Men Talking Mindfulness; does keynote speaking engagements on developing leadership, grit, and resilience; and owns his own consulting company, Frogman Mindfulness. In all three roles, his desire is to improve cultures and individuals through mindfulness, meditation, vulnerability, and compassion.Jon’s wife, Beka, also served in the Navy and is now a civilian Orthopedic Physician Assistant. Together, they are the proud parents of three children, and after an adventurous 6 months as a family in an RV, they have settled on a small farm in Colorado Springs.

CSM JoAnn Naumann planned on serving one enlistment in the Army to get a clearance and learn a language so she would be competitive for the Foreign Service. 28 years and 14 deployments later she's now the USASOC Command Sergeant Major.We originally got in touch because she appreciated our episode with Alyssa Clark where we talked about ultra marathon running. CSM Naumann recently completed her first fifty miler at fifty years old (at a pace faster than she's required to run on the ACFT two mile, according to the Army). In addition to hearing about her approach to training, we also discussed her experience with embedded human performance teams in special operations, including the challenges around integrating human performance professionals while preserving NCOs' role in physical training leadership. She joined the special operations community before POTFF was established and has watched it evolve over the course of her career.

In this episode we look at a few pieces of recent research that focus on how knowledgeable both health and fitness professionals and average gym goers are on a variety of topics. We break down the results, but we also challenge the quality of questions the researchers asked in their assessments.We spend the bulk of the time on this survey by researchers from the University of Klagenfurt's (Austria) Institute of Sports Science.We compare it to research done by another Austrian team where they instead focus on health professionals (physical therapists, sports scientists, and coaches).Finally, we discussed a similar study among American health and fitness professionals looking at exercise prescription across a wide range of experience and education levels. We get pretty deep in the weeds in this episode, so tune in if some research discussion is up your alley!

After they complete initial entry training all soldiers are entitled to Basic Allowance for Subsistence (BAS) to help pay for food, but many of them have most of it deducted to pay for meals provided in dining facilities (DFACs). Recent investigative reporting by our guest, Steve Beynon, has revealed striking inconsistencies between how much money is taken from soldiers in the form of BAS deductions and how much money is spent on providing those soldiers with the meals they're entitled to. At many of the Army's largest installations more than half of those funds seem to be getting reallocated, and the Army can't even explain where. From "smoke pit conspiracy" to congressional inquiry, this is a problem that many soldiers have talked about for years, but is just now breaking into mainstream media coverage thanks to Steve's work. He joined us on the podcast to discuss what he's found, and we may have even identified more problems live on air...Steve Beynon is a reporter for Military.com based out of the Washington, D.C., area whose detailed investigations have covered urgent issues impacting soldiers. A veteran of the Afghanistan war with over a decade of experience as a cavalry scout, Steve leverages his firsthand military experience to deliver authoritative journalism. In 2023, Military Veterans in Journalism honored him as one of the top veterans in media for exposing a cult scheme that defrauded veterans of their benefits, one of the largest scams ever to target the military community. This accolade includes recipients from the New York Times and Associated Press. The cult's churches were eventually raided by the FBI. His byline has appeared in Politico, Stars and Stripes, Military Times, American Legion Magazine, National Guard Magazine, Fox 19, Cincinnati City Beat, and the Cincinnati Enquirer. He studied journalism and environmental policy at the University of Cincinnati on a GI Bill scholarship.Steve's original story breaking this news published last month in Military.com21 Senators and Members of Congress signed this letter to the Secretary of Defense demanding answers about this situationSteve published a follow up piece discussing the reaction from Congress and some of the feedback from inside the pentagonHere's the DoD's page about BASWe discussed the Army's budget estimates towards the end of the episode, the military personnel (MILPERS) portion of which can be found hereWe also referenced the DoD's Financial Management Regulation, and the subsistence portion is found in Volume 7A, Chapter 25We also referenced two GAO reports:The first was "DOD Should Formalize Its Process for Revising Food Ingredients and Better Track Dining Facility Use and Costs"The second was "Additional Actions Needed to Implement, Oversee, and Evaluate Nutrition Efforts for Service Members"The law that guides most of this is 37 USC 402And finally, the DoD's overarching guidance is found in DoD Directive 1418.05

In this engaging discussion, Chris Meyering, a board-certified Primary Care Sports Medicine physician and retired U.S. Army officer, sheds light on the often opaque military entrance physical process. He explains the high disqualification rates of applicants and the frequent need for waivers, especially concerning mental health issues. He also tackles the evolving standards for mental health diagnostics and discusses the impact of socioeconomic factors on recruitment. Meyering's insights provide a necessary perspective on military readiness and the complexities of health evaluations.

How much do we really know about injury risk and prevention? Our guest this week argues it's less than most people think, so we dive into the state of the research to figure out why. There aren't many people as qualified as Dr. Dan Rhon to discuss the problem of musculoskeletal injuries in the military. He has a bachelors in applied health, a masters in physical therapy, and THREE doctorates: one in physical therapy, one in orthopedic physical therapy, and one in physiotherapy.All of those degrees are a bit ironic because he originally enlisted as an infantry marine because he didn't really think school was for him. That led him to going through marine corps infantry school, the scout swimmers course, the scout sniper course, SERE, and the special purpose recon and surveillance course. So he has military chops beyond his extensive medical qualifications. He's been a hospital staff physical therapist, brigade combat team physical therapist while deployed to Iraq, research center director, USARIEM research fellow, and various faculty and professor positions across a few university and clinical settings.He also lists 174 peer reviewed publications, well over 100 national and international presentations, and $35 million in total funding for projects where he was the primary investigator.

Why are there more MRI machines in Massachusetts than in all of Canada? Why is healthy food getting more expensive faster than processed food? Why does our medical system prioritize providing treatments over improving health outcomes?Our guest this week answers all of these and more, and he's among the most qualified people in the world to take on these questions.Dr. David Cutler is an American economist who is the Otto Eckstein Professor of Applied Economics at Harvard University. He holds a joint appointment in the economics department and at Harvard Kennedy School and the Harvard School of Public Health, is a faculty member for the Harvard Center for Population and Development Studies, and serves as commissioner on the Massachusetts Health Policy Commission.Cutler graduated summa cum laude from Harvard College with a degree in economics, and then joined the Harvard faculty after receiving his Ph.D. in economics from the Massachusetts Institute of Technology in 1991. He has served in the administration of two presidents. His book Your Money or Your Life gives an introduction on the US health care system or you can find a discussion of it in the New York Times Magazine article, "The Quality Cure" Cutler's 2003 study "Why have Americans become more obese?" discusses rising obesity as an outcome of the revolution in mass food packaging.You can find links to his peer reviewed publications hereYou can find links to much of his editorial work here