Substantiation Of An Algorithm For The Correction Of Metabolic Disorders And Evaluation Of Its Effectiveness In Military Personnel With Obesity And Insulin Resistance

Background: Obesity and insulin resistance undermine health and readiness in military populations. Early, evidence-based interventions are needed to prevent cardiometabolic decline in servicemembers. Objective: To develop and validate a practical algorithm for identifying and correcting metabolic disorders in obese, insulin-resistant military personnel. Methods: A prospective cohort or pilot RCT will enroll active-duty members (n~100) aged 21–40 with BMI≥25 or central obesity. Baseline measures include anthropometry, fasting labs (glucose, insulin, HOMA-IR, HbA1c, lipids, ALT/AST), 25(OH)D, serum Mg, 24-hour BP monitoring, and fitness testing. ROC analysis will define risk cut-offs for performance decline. Participants will be risk-stratified and managed via diet, exercise, sleep optimization, and supplements (vitamin D, Mg) per thresholds (e.g. 25(OH)D<20 ng/mL, Mg<0.75 mmol/L). Follow-ups at 3, 6, 12 months will assess changes. Primary outcomes: HOMA-IR, weight, BP patterns. Secondary: lipid profile, liver enzymes, fitness scores. Statistical analyses include paired tests, regression and intention-to-treat comparisons. Results (expected): We anticipate that the algorithm-guided intervention will significantly reduce insulin resistance (ΔHOMA-IR ~–1.5), body weight (~–6–8%), and normalize BP dipping, with p<0.001 vs baseline. We expect >50% of high-risk subjects to improve to moderate/low risk. Power calculations indicate the sample size is adequate to detect such effect sizes. Conclusions: A stepwise metabolic screening-and-correction program in military settings is feasible and likely effective. Integrating micronutrient repletion and lifestyle measures can restore metabolic balance and preserve operational performance. This model can inform military health policy on cardiometabolic prevention.

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