Linear regression correlation of health behaviour factors and tness skills in the Hungarian Defence Forces


 BackgroundThe observance of health behaviour recommendations is particularly important in the armed forces where about a certain level of the different physical abilities has to be given account of regularly during work too. The aim of the research is to analyse certain areas of the soldiers’ lifestyle how much they influence the reached scores on the physical tests used by the Hungarian Defence Forces.Sample and MethodDuring examination we compared the results of the prevention data sheet of the soldiers (n=490) appeared on the annual health screening in 2015 against their points obtained on the annual physical fitness test (PFT). The average age of the sample test was 34,1 years (+ 6,91 years) and the proportion of the women was 13,5%. In the test our participants’ average height was 177,64 cm (+7,49 cm), the average weight was 78,94 kg (+12,07 kg). According to the prevention data sheet we analysed the eating habits, frequency of psychosomatic waist pain, body mass index (BMI), the relationship between age and smoking status in relation to scores obtained by stamina and strength endurance practices. To assess the physical fitness of the cardio-vascular endurance we used the results of the 3200 m flat race and for the strength endurance survey we used the results of the scores from lying on the back sit-up with bent legs and arm bending in push-up performed within 2 minutes in a maximum repeat number.ResultsThe growth of the body mass index with 0,1 meant 2 points loss. Regarding the frequency of vegetable-, fruit-, cereal-, and dairy product consumption we found a significant difference (p <0,05) in correlation of the obtained scores on the PFT. The back pain as a symptom appearing monthly meant an advantage on the strength endurance tests, as for smoking on the physical fitness tests. Age did not influence the results of the physical tests significantly. ConclusionThe detection of the connection between certain health behaviour factors and the physical parameters can be one of the strategic tasks of the military supply service.


Abstract Background
The observance of health behaviour recommendations is particularly important in the armed forces where about a certain level of the different physical abilities has to be given account of regularly during work too. The aim of the research is to analyse certain areas of the soldiers' lifestyle how much they in uence the reached scores on the physical tests used by the Hungarian Defence Forces.

Sample and Method
During examination we compared the results of the prevention data sheet of the soldiers (n=490) appeared on the annual health screening in 2015 against their points obtained on the annual physical tness test (PFT). The average age of the sample test was 34,1 years (+ 6,91 years) and the proportion of the women was 13,5%. In the test our participants' average height was 177,64 cm (+7,49 cm), the average weight was 78,94 kg (+12,07 kg). According to the prevention data sheet we analysed the eating habits, frequency of psychosomatic waist pain, body mass index (BMI), the relationship between age and smoking status in relation to scores obtained by stamina and strength endurance practices. To assess the physical tness of the cardio-vascular endurance we used the results of the 3200 m at race and for the strength endurance survey we used the results of the scores from lying on the back sit-up with bent legs and arm bending in push-up performed within 2 minutes in a maximum repeat number.

Results
The growth of the body mass index with 0,1 meant 2 points loss. Regarding the frequency of vegetable-, fruit-, cereal-, and dairy product consumption we found a signi cant difference (p <0,05) in correlation of the obtained scores on the PFT. The back pain as a symptom appearing monthly meant an advantage on the strength endurance tests, as for smoking on the physical tness tests. Age did not in uence the results of the physical tests signi cantly.

Conclusion
The detection of the connection between certain health behaviour factors and the physical parameters can be one of the strategic tasks of the military supply service.

Background
The observance of health behaviour recommendations is particularly important in the armed forces where about a certain level of the different physical abilities has to be given account of regularly during work too. Health is the symbol of certain jobs and professions, and as such, the social picture, opinion is formed accordingly in the thinking of a nation, state. These jobs require a certain level of the different physical abilities which has to be given account of regularly during work too. Thanks to this it can be said that both domestic and internationally, the health and physical condition of service beginners exceeds the status of the civil society's members with similar parameters. 1,2 The occupational health professionals who are responsible for ensuring the physically t workforce, use the physical tness tests to assess the physical tness of the army. The most bene cial tests are those which are related closely to the critical tasks from the perspective of general work. 3 In the Hungarian Defence Forces (HDF) also -such as in other nation's army -the proper general physical state has been determined as selection criteria and it has been checked yearly, assuming that these abilities -cardiovascular physical tness as well as the trunk-, shoulder-, arm muscle strength endurance -are required not only for maintaining health but also for singularity of military service's supply. The quantitative and qualitative indicators of the nutrition, the smoking habits, the psychosomatic burden are critical elements of the soldiers' health and e ciency. The occurrence of a risk factor is related to a statistically signi cant decrease in performance. 4,5 In addition, it can be detected that the appearance of health risk is associated with the reduction of physical tness. 6 The military appropriateness has rigorous physical stature standards, but the lowest guidelines are applied with respect of health risk thresholds, the appropriate level of the physical performance closely related to this is placed between the two poles. 7 The correct eating habits are strongly related to medical condition, physical tness as well as every dimension of psychosocial status to support mental and physical performance, allowing to reach the military standby. 8 The energy imbalance by this the change of the body shape -body fat mass growth in most cases -spoil the soldier's physical load capacity. 9,10 The domestic studies show that people who possess the normal body mass index (20-25 BMI) reach the highest tness level regardless of the age group. 10 It can be stated that health behaviour habits closely related to physical activity -e.g.: sport activities -improve the physical tness of the armed forces. 11,12,13 It is also clear that the eating habits connect to the soldiers' physical condition. 14,15 Our goal was to reveal the relationships between the physical skills necessary for military service and some of the health behaviour factors and also to identify those non-physical lifestyle parameters which could in uence the cardio-, vascular training rates, as well as the muscle strength endurance of arm and trunk muscles.

Sample And Method
To create our database, we have made a cross-sectional analysis in the circle of those professional and contractual staff members of the HDF who appeared on health screening in 2015, lled in the health screening form (HSF) completely and their screening data have been xed electronically in an assessed and usable manner. During statistical analysis we included only those questionnaires, which the test person gave a written consent to use the data for statistical purposes and the examined variables were lled in completely. We put a big emphasis on following the ethics rules in relation to data collection and analysis (informed consent form, analysis inadequate for personal identi cation), the results will be communicated with the compliance of ethics rules hereinafter. According to HSF we analysed our samples regarding to eating habits -frequency of consumption of vegetable, fruit, cereal, dairy productfrequency of the occurrence of psychosomatic waist pain, smoking habits and the effect of body mass index (BMI). We have used 7-degree scale regarding the consumption of vegetable, fruit, cereal and dairy product as for psychosomatic back pain 5-degree Likert-scale. In the former case it could be chosen among never, less than a week, 2-4 times a week, 4-5 times a week, every day or more than once daily regarding consumption. In the latter case daily, more than once a week, on a weekly basis, monthly or more infrequently occurring symptoms have been recorded.
Furthermore, the corrected points according to age groups have been got into the analysed variables which can be obtained on the yearly physical survey (PCS) -which contain the tests regarding the heartvascular system physical tness survey like running as well as the trunk-, shoulder-and arm muscles strength endurance survey from push-up arm bending and from lying on the back sit-up tests -carried out compulsory under the age of 50. The goal was to assess the physical tness of the heart-vascular endurance with completion of the 3200 m at race within a shorter time. The obtained results were recorded according to a point system appropriate for sex and age group. The obtainable score could spread from 0 to 160 points. During the strength endurance survey the obtained scores are normally from lying on the back sit-up with bent legs and arm bending in push-up performed within 2 minutes in a maximum repeat number. The obtainable score spread from 0 to 200 points.
In our statistical procedure -we used R-studio program in R environment -we created a multiple linear regression model. The 0,05 value of the signi cance level was determined. A graphical tting test (QQplot) was performed for the validity of the model (1., 2., 3. diagram)

Results
Regarding to vegetable consumption compared to those who have almost never consumed vegetables each category meant additional points in respect the total score (1. Table). Referable to fruit consumption we compared the other categories to less than a week consumer. Accordingly, the results came out similarly like regarding vegetable consumption, the more frequent fruit consumption resulted in extra points on the PCS (1. table). In relation to cereal consumption those people, who almost entirely ignored cereals from their diet, were taken as benchmark. In our research we didn't nd a signi cant correlation between the frequency of cereal consumption and the total score obtained on the physical tness test.
With regard to dairy products similar results came out as far as the cereal consumption was concerned. The almost never consumers were taken as benchmark. In this case we didn't nd a signi cant correlation between the frequency of dairy product consumption and the total score obtained on the physical tness test also.
Referring to psychosomatic back pain the following results were obtained in relation to daily appearing symptoms. The several times a week appearing symptom meant 4 points, and the weekly regularity meant 8 points in respect the loss of the total score. The monthly appearing symptom possessed more than 21 points and the more infrequently appearing back pain 10 points, however the differences did not exceed the signi cance level speci ed by us.
Considering smoking compared to those who do not smoke and have not smoked at all we correlated to those who have already quit smoking and smoke currently. Accordingly, in the model almost any kind of difference was not observed among those who have already quit smoking and have never smoked in relation to the total score. Referring to age every single year meant about half point plus, but this result was not signi cant. The increase of the body mass index with 0.1 brought almost two points loss (1 .  table). The reliability of the correlation between the above mentioned examined variables and the total scores obtained by PFT is presented to Fig. 1. by QQ plot.

Stamina pattern
In our research we didn't nd a signi cant correlation between the frequency of vegetable consumption and the total score obtained on the physical tness test.
Referable to fruit consumption we compared the other categories to less than a week consumer. The more frequent fruit consumption resulted in extra points (2 . table). Surprisingly in the model compared to those who almost entirely ignored cereals from their diet, got less points than every other more frequent consumer category (2 . table).
With regard to dairy products the almost never consumers taken as benchmark the increase of the score could be observed with the increase of the frequency (2 . table).
Referring to psychosomatic back pain we didn't get a signi cant difference in relation to changes of the frequency factors and the total score obtained on the physical tness test. Between smoking status and the obtained score on the heart-vascular endurance test we found that no smoking meant less points in the model than quit smoking more than 1 and active smoking more than 5 points (2. Referable to fruit consumption we compared the other categories to less than a week consumer. The more frequent fruit consumption resulted in extra points regarding the total score obtained on the strength endurance test (3. table).
In our research we didn't nd a signi cant correlation between the frequency of cereal consumption and the total score obtained on the strength endurance test.
With regard to dairy products' consumption the almost never consumers taken as benchmark the decrease of the strength endurance score could be observed with the increase of frequency.
Referring to psychosomatic back pain we analysed the results in relation to daily appearing symptom. We found a signi cant difference in relation to monthly appearing symptom regarding the strength endurance scores (3. table).
In respect of smoking status, age and the body mass index we didn't nd a signi cant correlation in relation to scores on the strength endurance test. The reliability of the correlation between the above mentioned examined variables and the scores obtained by one of the part of PFT (cardio-vascular) is presented to Fig. 3. by QQ plot.

Discussion
The soldiers' lifestyle in uences the scores obtained on the physical tests strongly. The results of the U.S.
Army's longitudinal follow-up analyses showed that the service beginners in the armed forces can be said to be especially healthy and t thanks to relevant screening tests and regulations. 1 The health behaviour researches completed in the HDF showed, -similarly to U.S. Army -that the health status of the service beginners was higher than the status of the average population thanks to the selection of the aptitude test system. 2,16 By favour of the physical aptitude tests the tness indicators represent a higher level of quality than average, which continue to rise after the training. However, after the termination of the service, work the positive yield of the health status reduces and they are in even worse health than the members of the civil society. The veterans' health behaviour is worse than the civils, they will smoke more likely, they will eat unhealthier and move less, their health and physical condition is poorer than average. 17,18 Previous researches carried out on sportsmen -not on soldiers -have found a health protective effect in many cases in the circle of the younger smokers on both levels, domestic and international. 19,20,21 In the research samples -unexpectedly -the runtime results came out signi cantly better in the circle of smokers. Despite the fact, that smoking had advantages according to our results based on this sample regarding the scores obtainable on the endurance test, we recommend giving it up rather.
To explain this, further testing is necessary, similarly to the results obtained by the strength endurance pattern in connection to dairy product consumption. The increase of the frequency of dairy product consumption meant signi cantly less points regarding the total score obtained on the strength endurance test.
Our previously performed research has shown that the frequency of back pain as a psychosomatic symptom is closely related to the chance of the appearance of non-infectious diseases. 22 One of the results of our recent study was that the frequency of psychosomatic back pain was related not only to scores obtained on the strength endurance test but also to the chance of the appearance of chronic noninfectious diseases. The advantage of the monthly psychosomatic back pain regarding the strength endurance pattern can be justi ed by the participants' relatively young average age and by this the frequency of higher military physical ability. The proper nutrition is closely related to physical tness and military standby. 18,23 Therefore, there is no question that the actual nutritionists have an important aim to de ne the qualitative and quantitative indicators. In our analysis it was con rmed -in accordance to earlier studies -that maintaining of the normal body weight (BMI 20-25 kg/m2) is essential to achieve the appropriate military physical skills. 10 The ideal frequency of vegetable and fruit consumption has been identi ed, which can be the highest score available with, regarding the scores obtainable on the endurance as well as strength endurance tests. Age has not meant a signi cant difference in the correlation of the test variables thanks to the scoring system differentiated by age groups.

Conclusions
The food specialists of the armed forces can help with the logistics in their work by the compiling of the temporary food plan supported by research results. These results may facilitate the connection to healthy eating identity, this require making a strategy to be devised, which can increase the accuracy of the health promotion campaigns aiming to improve nutrition. The soldier's term of service has to be used for in uencing to make efforts for a healthy lifestyle.

Declarations
Ethics approval and consent to participate: The HDF MC DHP reviewed protocol EFO 5/7-198874/2015 and determined it was exempt from IRB oversight. We obtained only deidenti ed data.
Consent for publication: Our manuscript was approved for publication by our public affairs o cer.
Availability of data and materials: Not applicable.