{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:11:22Z","timestamp":1778022682624,"version":"3.51.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"5-6","funder":[{"DOI":"10.13039\/100009898","name":"Defense Health Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009898","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Glucose dysregulation is a significant obesity-related comorbidity known to impair both mental and physical performance. Glycated hemoglobin (HbA1c), a measure of average glucose regulation over 2-3 months, is elevated in over a third of American adults, indicating prediabetes (5.7-6.4%) or type 2 diabetes mellitus (\u2265 6.5%). However, the \u2018fit-fat\u2019 concept suggests that physical activity may mitigate the adverse effects of adiposity on metabolic health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This study investigated the relationship between relative body fat (%BF), HbA1c, and maximal oxygen uptake (V.O2max) as a surrogate measure of physical activity, in 216 physically active military personnel (188 men, 28 women).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In men, fat mass (FM) was significantly, but weakly, inversely associated with HbA1c (\u03b2 = \u22120.008, 95% CI [\u22120.015 to 0.000], SE\u2009=\u20090.004, P\u2009=\u20090.048), a finding that warrants further investigation. Maximal oxygen uptake was not significantly associated with HbA1c in either men or women. The variance explained by these models was low. Cluster analysis identified 3 distinct clusters with differing profiles of adiposity and fitness, but no significant differences in HbA1c were observed between them (F(2, 213) = 0.72, P\u2009=\u20090.488).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this physically active military population, normal mean HbA1c levels (5.2%) suggest that regular physical activity may mitigate the adverse effects of adiposity on glucose homeostasis. These findings support the \u2018fit-fat\u2019 concept and suggest that current fitness standards may be sufficient to maintain metabolic health. Therefore, inclusion of HbA1c testing in annual physical readiness standards may not be warranted in young, physically active service members.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf512","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T17:38:40Z","timestamp":1763055520000},"page":"e1012-e1019","source":"Crossref","is-referenced-by-count":1,"title":["Glucose Homeostasis Remains Normal in a Physically Active Military Population"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4980-8353","authenticated-orcid":false,"given":"Adam W","family":"Potter","sequence":"first","affiliation":[{"name":"US Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliette I","family":"Jacques","sequence":"additional","affiliation":[{"name":"US Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["United States"]},{"name":"Oak Ridge Institute for Science and Education , Oak Ridge, TN 37830,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-9356","authenticated-orcid":false,"given":"Christopher L","family":"Chapman","sequence":"additional","affiliation":[{"name":"US Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["United States"]},{"name":"Oak Ridge Institute for Science and Education , Oak Ridge, TN 37830,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4882-0011","authenticated-orcid":false,"given":"William J","family":"Tharion","sequence":"additional","affiliation":[{"name":"US Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["United States"]},{"name":"Oak Ridge Institute for Science and Education , Oak Ridge, TN 37830,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7878-0092","authenticated-orcid":false,"given":"David P","family":"Looney","sequence":"additional","affiliation":[{"name":"US Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["United States"]},{"name":"Maximize Human Performance, LLC , Westwood, MA 02090,","place":["United States"]},{"name":"CoachMePlus , Buffalo, NY 14203,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3134-8427","authenticated-orcid":false,"given":"Karl E","family":"Friedl","sequence":"additional","affiliation":[{"name":"US Army Research Institute of Environmental Medicine , Natick, MA 01760,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"2026050517483187600_usaf512-B1","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1111\/j.1467-789X.2007.00311.x","article-title":"Health risks associated with overweight and obesity","volume":"8","author":"Kopelman","year":"2007","journal-title":"Obes Rev"},{"key":"2026050517483187600_usaf512-B2","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1158\/1055-9965.EPI-13-0330","article-title":"Metabolic dysregulation of the insulin-glucose axis and risk of obesity-related cancers in the framingham heart study-offspring cohort (1971-2008)","volume":"22","author":"Parekh","year":"2013","journal-title":"Cancer Epidemiol Biomarkers Prev."},{"key":"2026050517483187600_usaf512-B3","doi-asserted-by":"publisher","first-page":"1192602","DOI":"10.3389\/fendo.2023.1192602","article-title":"Cognitive dysfunction in diabetes: abnormal glucose metabolic regulation in the brain","volume":"14","author":"Zhang","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026050517483187600_usaf512-B4","doi-asserted-by":"publisher","first-page":"30","DOI":"10.3390\/diabetology3010003","article-title":"Type 2 diabetes and impaired physical function: a growing problem","volume":"3","author":"Ahmad","year":"2022","journal-title":"Diabetology (Basel)"},{"key":"2026050517483187600_usaf512-B5","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s11892-016-0775-x","article-title":"Diabetes and cognitive impairment","volume":"16","author":"Zilliox","year":"2016","journal-title":"Curr Diab Rep"},{"key":"2026050517483187600_usaf512-B6","first-page":"1522","article-title":"Glycated hemoglobin","volume":"83","author":"Chandalia","year":"2002","journal-title":"Curr Sci"},{"key":"2026050517483187600_usaf512-B7","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1210\/jcem-44-5-859","article-title":"Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus","volume":"44","author":"Gabbay","year":"1977","journal-title":"J Clin Endocrinol Metab"},{"key":"2026050517483187600_usaf512-B8","doi-asserted-by":"publisher","first-page":"95","DOI":"10.4137\/BMI.S38440","article-title":"Significance of HbA1c test in diagnosis and prognosis of diabetic patients","volume":"11","author":"Sherwani","year":"2016","journal-title":"Biomark Insights"},{"key":"2026050517483187600_usaf512-B9","doi-asserted-by":"publisher","first-page":"2596","DOI":"10.1210\/jc.2010-1698","article-title":"Role of glycated hemoglobin in the prediction of future risk of T2DM","volume":"96","author":"Abdul-Ghani","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2026050517483187600_usaf512-B10","doi-asserted-by":"publisher","first-page":"111022","DOI":"10.1016\/j.diabres.2023.111022","article-title":"Trends and risk factors of diabetes and prediabetes in US adolescents, 1999-2020","volume":"207","author":"Ouyang","year":"2024","journal-title":"Diabetes Res Clin Pract"},{"key":"2026050517483187600_usaf512-B11","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1001\/jama.2015.10029","article-title":"Prevalence of and trends in diabetes among adults in the United States, 1988-2012","volume":"314","author":"Menke","year":"2015","journal-title":"JAMA"},{"key":"2026050517483187600_usaf512-B12","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1001\/jama.2023.4063","article-title":"Diagnosis and management of prediabetes: a review","volume":"329","author":"Echouffo-Tcheugui","year":"2023","journal-title":"JAMA"},{"key":"2026050517483187600_usaf512-B13","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1001\/jama.1996.03540030039029","article-title":"Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women","volume":"276","author":"Blair","year":"1996","journal-title":"JAMA"},{"key":"2026050517483187600_usaf512-B14","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1001\/jama.292.10.1232","article-title":"The fitness, obesity, and health equation: is physical activity the common denominator?","volume":"292","author":"Blair","year":"2004","journal-title":"JAMA"},{"key":"2026050517483187600_usaf512-B15","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1136\/bjsports-2016-097400","article-title":"The fat but fit paradox: what we know and don\u2019t know about it","volume":"52","author":"Ortega","year":"2018","journal-title":"Br J Sports Med"},{"key":"2026050517483187600_usaf512-B16","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1136\/military-2022-002189","article-title":"Body composition of extreme performers in the US marine corps","volume":"170","author":"Potter","year":"2024","journal-title":"BMJ Mil Health"},{"key":"2026050517483187600_usaf512-B17","first-page":"T23","volume-title":"US Marine Corps Body Composition and Military Appearance Program (BCMAP) Study","author":"Potter","year":"2022"},{"key":"2026050517483187600_usaf512-B18","doi-asserted-by":"publisher","first-page":"e1103","DOI":"10.1210\/clinem\/dgae341","article-title":"Defining overweight and obesity by percent body fat instead of body mass index","volume":"110","author":"Potter","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"key":"2026050517483187600_usaf512-B19","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1089\/dia.2004.6.732","article-title":"Can you be large and not obese? The distinction between body weight, body fat, and abdominal fat in occupational standards","volume":"6","author":"Friedl","year":"2004","journal-title":"Diabetes Technol Ther"},{"key":"2026050517483187600_usaf512-B20","doi-asserted-by":"publisher","first-page":"S87","DOI":"10.1519\/JSC.0b013e31825ced6c","article-title":"Body composition and military performance\u2014many things to many people","volume":"26","author":"Friedl","year":"2012","journal-title":"J Strength Cond Res."},{"key":"2026050517483187600_usaf512-B21","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1007\/s12265-020-10057-w","article-title":"Modulation of insulin sensitivity by exercise training: implications for cardiovascular prevention","volume":"14","author":"Iaccarino","year":"2021","journal-title":"J Cardiovasc Transl Res"},{"key":"2026050517483187600_usaf512-B22","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.3389\/fphys.2018.01307","article-title":"Physical exercise-induced myokines and muscle-adipose tissue crosstalk: a review of current knowledge and the implications for health and metabolic diseases","volume":"9","author":"Leal","year":"2018","journal-title":"Front Physiol"},{"key":"2026050517483187600_usaf512-B23","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1111\/eci.12781","article-title":"Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease","volume":"47","author":"Pedersen","year":"2017","journal-title":"Eur J Clin Invest"},{"key":"2026050517483187600_usaf512-B24","volume-title":"Physical Activity Guidelines for Americans: Be Active, Healthy, and Happy!","author":"US Department of Health and Human Services","year":"2008"},{"key":"2026050517483187600_usaf512-B25","doi-asserted-by":"publisher","first-page":"1491931","DOI":"10.3389\/fnut.2024.1491931","article-title":"Reliability, biological variability, and accuracy of multi-frequency bioelectrical impedance analysis for measuring body composition components","volume":"11","author":"Looney","year":"2024","journal-title":"Front Nutr"},{"key":"2026050517483187600_usaf512-B26","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-025-01664-4","article-title":"Real-world assessment of multi-frequency bioelectrical impedance analysis (MFBIA) for measuring body composition in healthy physically active populations","author":"Potter","year":"2025","journal-title":"Eur J Clin Nutr"},{"key":"2026050517483187600_usaf512-B27","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1519\/1533-4287(1988)002&lt;0009:RBATMR&gt;2.3.CO;2","article-title":"Relationship between a two mile run for time and maximal oxygen uptake","volume":"2","author":"Mello","year":"1988","journal-title":"J Strength Cond Res"},{"key":"2026050517483187600_usaf512-B28","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1136\/bmjnph-2023-000757","article-title":"Physical performance and body composition reference values for modern US Marine Corps women","volume":"6","author":"Potter","year":"2023","journal-title":"BMJ Nutr Prev Health"},{"key":"2026050517483187600_usaf512-B29","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/978-3-319-24277-4_9","volume-title":"Ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2016"},{"key":"2026050517483187600_usaf512-B30","article-title":"A grammar of data manipulation","volume":"1","author":"Wickham","year":"2023","journal-title":"R Package Version"},{"key":"2026050517483187600_usaf512-B31","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1467-9868.2010.00749.x","article-title":"Fast stable restricted maximum likelihood and marginal likelihood estimation of semiparametric generalized linear models","volume":"73","author":"Wood","year":"2011","journal-title":"J R Stat Soc Series B Stat Methodol"},{"key":"2026050517483187600_usaf512-B32","volume-title":"An R Companion to Applied Regression","author":"Fox","year":"2018"},{"key":"2026050517483187600_usaf512-B33","first-page":"7","article-title":"Cluster: cluster analysis basics and extensions","volume":"20","author":"Maechler","year":"2018","journal-title":"R Package Version"},{"key":"2026050517483187600_usaf512-B34","volume-title":"Factoextra: Extract and Visualize the Results of Multivariate Data Analyses","author":"Kassambara","year":"2016"},{"key":"2026050517483187600_usaf512-B35","doi-asserted-by":"publisher","first-page":"665","DOI":"10.5351\/CSAM.2015.22.6.665","article-title":"Package \u2018Ppcor\u2019","volume":"22","author":"Kim","year":"2015","journal-title":"Commun Stat Appl Methods"},{"key":"2026050517483187600_usaf512-B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2025.07.023","article-title":"Cross-sectional analysis of visceral adipose tissue associations with obesity-related disease","author":"Potter","year":"2025","journal-title":"Am J Clin Nutr"},{"key":"2026050517483187600_usaf512-B37","doi-asserted-by":"publisher","first-page":"e139","DOI":"10.1093\/milmed\/usy207","article-title":"Identifying a potential screening tool for prediabetes: the association of hemoglobin A1c and a test of physical fitness","volume":"184","author":"Timboe","year":"2019","journal-title":"Mil Med"},{"key":"2026050517483187600_usaf512-B38","doi-asserted-by":"publisher","DOI":"10.1109\/JBHI.2025.3614093","article-title":"Estimating visceral adiposity from Wrist-Worn accelerometry","author":"Williamson","year":"2025","journal-title":"IEEE J Biomed Health Inform"},{"key":"2026050517483187600_usaf512-B39","doi-asserted-by":"publisher","first-page":"e1948","DOI":"10.1093\/milmed\/usac074","article-title":"Dose of exercise therapy among active duty soldiers with chronic pain is associated with lower risk of long-term adverse outcomes after linking to the Veterans Health Administration","volume":"188","author":"Meerwijk","year":"2023","journal-title":"Mil Med"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/5-6\/e1012\/65285099\/usaf512.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/5-6\/e1012\/65285099\/usaf512.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T22:20:35Z","timestamp":1778019635000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/5-6\/e1012\/8322468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,16]]},"references-count":39,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2026,4,16]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaf512","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,4,16]]}}}