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Is baseline aerobic fitness associated with illness and attrition rate in military training?
  1. Lygeri Dimitriou1,
  2. J Lockey2 and
  3. L Castell2
  1. 1London Sport Institute, Middlesex University, London, UK
  2. 2Green Templeton College, University of Oxford, Oxford, Oxon, UK
  1. Correspondence to Dr Lygeri Dimitriou, London Sport Institute, Middlesex University, London, NW4 1RL, UK; L.Dimitriou{at}


Background Respiratory illnesses are a leading cause of morbidity and medical discharge in the military. This study aimed to investigate the effects of baseline aerobic fitness on haematological, salivary and mood variables, and simultaneously, in a novel approach, to identify factors precipitating illness and attrition rate in recruits during military training.

Methods Thirty-five healthy male recruits from an Army Training Regiment undertaking 12 weeks of training were prospectively investigated. Their 2.4 km run time (RT) was used as a surrogate of baseline aerobic fitness. Saliva and venous blood samples were analysed for secretory IgA, full blood counts and cell cytokine production (interleukin (IL) 6 and IL-8), respectively. Each recruit completed questionnaires on mood profile, and gastrointestinal and upper respiratory tract symptoms (URTS).

Results Significant salivary and haematological perturbations were observed and coincided with increased duration of URTS/week and mood disturbance over this military training period. From Start to End: leucocyte count decreased by 28% (p<0.001); neutrophil percentage (%) decreased by 13% (p<0.01); lymphocyte % increased by 17% (p<0.05); the neutrophil:lymphocyte ratio decreased by 22% (p<0.01); eosinophil% increased by 71% (p<0.01). From Start to Mid to End: monocyte% increased by 68% at Mid (p<0.01) but only by 30% at End (p<0.01); IL-6 increased by 39% at Mid (p<0.01) and a further 61% by End. The 2.4 km RT was significantly associated with URTS duration (p<0.01). In addition, a 1-min increase in 2.4 km RT increased a recruit's risk 9.8-fold of developing URTS lasting, on average, 3.36 days/week. In recruits ranked with high-URTS duration their RT was 48 s slower (p<0.01) than those with low-URTS, and their attrition rate reached 45%.

Conclusions The least fit recruits may have found training more physically demanding as reflected in the higher URTS duration, which may have led to a high attrition rate from the Army. It is worth considering that baseline aerobic fitness might be an important factor in illness development and attrition rate in recruits during this type of military training.

  • Military training
  • Respiratory symptoms
  • Mood states
  • Attrition rate
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  • Contributors LD and LC conceived the idea for the study, prepared the methods, collected the data and drafted the initial version of the manuscript. LD completed both the biochemical and statistical analyses. JL contributed with further critical drafting. All authors critically revised and approved the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval University of Oxford.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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