Performance Triad and Health of the Force

In this changing world, one constant is the requirement for our Soldiers to remain healthy and ready to achieve Force dominance. In its 6th annual installment, the 2020 Health of the Force report documents conditions that influence the health and medical readiness of the U.S. Army Active Component (AC) Soldier population. Leaders can use Health of the Force to optimize health promotion measures and effect culture changes that influence both individual Soldiers and Army institutions. Health of the Force presents Army-wide and installation-level demographics and data for more than 20 health, wellness, and environmental indicators at more than 40 installations worldwide. Installations included in Health of the Force are those where the AC population exceeds 1,000 Soldiers. Data presented in this report reflect status for the prior year (i.e., the 2020 report reflects calendar year 2019 data).

Please click here to view the 2020 Health of the Force - Performance Triad Executive Summary.

Please click here  to view the full 2020 Health of the Force report.

Sleep, activity, and nutrition (SAN), also known as the Performance Triad (P3), work together as the pillars of optimal physical, behavioral, and emotional health. Neglect of any single SAN domain can lead to suboptimal performance and, in some cases, injury. The interrelationships between SAN domains are critical for maximizing Soldier performance—Soldiers need to have balanced nutrients to fuel their physical activity, and physical activity can impact the amount and quality of sleep. To address those deficiencies, Leaders and Soldiers need information about the SAN targets that Soldiers do not meet. 

THE American Academy of Sleep Medicine and Sleep Research Society recommends that adults 18–64 years old get 7 or more hours of sleep per night. Poor sleep can result in fatigue, which can contribute to factors influencing injury risk, such as reduced proprioceptive ability (i.e., the body’s ability to perceive its own position), changes in gait and balance, ligament laxity, and alterations in muscle activity. Soldiers who slept less than 8 hours per night were 1.2 to 2.4 times more likely to experience a musculoskeletal injury.

Overall, a smaller proportion of Soldiers reported meeting the sleep target of 7 or more hours of sleep during work/duty weeks. During work/duty weeks, over one-third of Soldiers (37%) reported obtaining 7 or more hours of sleep. During weekends/days off, the majority of Soldiers (70%) reported obtaining 7 or more hours of sleep.

The CDC recommends two physical activity targets (CDC 2020d). The first is attaining 2 or more days per week of resistance training. The second is attaining adequate aerobic activity. The amount of activity can be attained in one of three ways:

- 150 minutes a week of moderate-intensity aerobic activity, or

- 75 minutes a week of vigorous-intensity aerobic activity, or

- an equivalent combination of moderate- and vigorous-intensity aerobic activity.

Overall, the majority of Soldiers met the activity targets. The majority of Soldiers (84%) engaged in resistance training 2 or more days per week. Most Soldiers (90%) achieved adequate moderate/vigorous aerobic activity targets.

Most Soldiers’ fruit consumption ranged from 3 to 6 servings per week to 2 to 3 servings per day. Vegetable consumption was a bit higher, with more Soldiers reporting multiple servings per day. The nutrition targets used for the purposes of this report were informed using recommendations provided by the U.S. Department of Agriculture (USDA 2019) two or more servings of fruits and two or more servings of vegetables per day.

Overall, less than half of Soldiers met the nutrition targets. Nearly one-third of Soldiers (33%) met the target of two or more

servings of fruits per day. Less than half of Soldiers (42%) met the target of two or more servings of vegetables per day.

Health Of The Force Online is a digital platform that allows users to access detailed population health data by installation and command. Through this suite of tools, leaders can inform health promotion and prevention, drive cultural and programmatic changes, and meet the emerging health needs of the U.S. Army AC Soldier population. From a CAC-enabled device, visit the Health of the Force homepage  and select “Online Data”.