Obesity is a National Security Issue: Lieutenant General Mark Hertling at TEDxMidAtlantic

Lieutenant General Mark Hertling is General Commander of the US Army in Europe and the Seventh Army. His talk entitled "Obesity as a National Security Issue" focuses on the fact that obesity is the leading medical reason why applicants fail to qualify for military service in the US. Lieutenant General Mark Hertling provides an insight into the steps taken by the US Army to ensure that its pool of recruit will not deplete.

Hello, my name's Hertling

and I'm a soldier and

-- you probably could tell that.

I've been in the military for 38 years.

I'm thinking of making it a career.

I have seen -- (Laughter) --

I have seen and studied and analysed

all types of security threats.

I've fought in several wars

but there's an emerging threat
that we're seeing

and I'd like to talk a little bit
about today

that I think will have an effect
on our future,

our economy,

our youth

and our economic system.

It is an emerging threat

that concerns me significantly

and it's represented in this picture.

Now you might think,

why is a soldier talking about

a young man who is obviously inactive

and perhaps is a little bit overweight?

And it's because of some things I've seen

in the last several years

and I'd like to talk a little bit about those today

and related to how I believe

it could be a national security threat

within the next 20 to 30 years.

First of all, in 1983,

the Army sent me on something

called a broadening experience.

I was asked to go graduate school

at Indiana University.

I had studied as an undergraduate
in International Relations

but they said, "Hey we want you to go

and get a Master's degree
in Exercise Physiology

and then teach PE at West Point."

So I said, "Okay, sounds like a great idea.

It's broadening to be sure."

And I went out there -- (Laugther) --

I went to Indiana University

and my first class was an anatomy class

and I had an anatomy lab.

I walked into the classroom

and they issued me a cadaver.

As they did everyone else in the class.

And the cadaver I had,
came with a medical history

The professor told us,
"In order to respect

the people who have given
their bodies to science

we'd ask you to respect them,
too, and you perhaps

wanna name them to remind yourself

that they were once a person

although we don't wanna give you
their real name."

So I named mine Charlie.

Charlie had a medical history.

He had been a two-pack-a-day smoker.

Charlie had not exercised in the last 20 years.

Charlie was extremely overweight

and Charlie had died of a cardiovascular disease

and he was 46 years old.

When we pulled him up and we began,

the various students in the room began

our disection of these bodies

I had a lot of a tougher time

than some of the other students

because I had to cut through

several layers of adipose.

When I got to the internal body cavities

it was amazing to me

comparing Charlie's organs

to some of the organs of
the other students in the class.

The heart was surrounded by fat

several inches.

One of the tricks our instructors taught us was,

you know, we had to through these labs

where we had to name what vein was which

and what artery was which,

and the professor said, "If you pull

on an artery, it's like a rubber band.

If you pull on a vein, it's like
a guitar string and it'll twang."

When I pulled on Charlie's arteries and veins

they broke off into my hand.

So I finished grad school

and went to teach at West Point for 3 years

from '83 to '86

and then after that assignment

I went back to the operational Army

and did things that all soldiers do:

commanded organizations,

trained, went into combat several times,

and then coming out of combat

as a Division Commander in 2009

the Army decided they wanted to promote me

to three-star General

I think because they wanted to prove

they have a sense of humor.

They then sent me to be the Commander of

Initial Military Training.

My job was to train
the 160,000 or so soldiers

or correction: civilians,

that would come into the Army every year

and turn them into soldiers.

What I found when I reported to that assignment

disturbed me.

Several facts came to my attention.

First of all, 75% or more

a little bit more actually

of the civilians who wanted to join the Army

were not qualified to do so.

75% of the 17-24 year olds
who wanted to join the Army

were not qualified

and the number one reason

was because they were obese.

Of the 25% that could join the Army

what we found on the first day of basic training

was that about 60% of them

could not pass the PT test

that we gave on the first day.

And that was:
one minute of push-ups,

one minute of sit-ups and
a one-mile run.

Now, that's not a difficult test.

But we were finding that

a great majority of our new soldiers

coming off the civilian environment,

could not pass that test.

I couldn't understand what had happened.

This was not what I had left

studying physical education in 1986.

As we did some analyses

I realized that a couple of things had changed.

First of all, number one
and the primary reason was

starting in the late '90s

the majority of our elementary
and high schools

stopped teaching PE,

and in fact, only five states

of the 50 of our country right now

have mandatory requirements
for physical education

between K and 12th grade today.

Five out of 50.

Now, you say,
"Okay, well that's interesting,

but what does the Army care about that?"

Well, we're getting the product of that

but in addition to second and third order effects

were young people that were joining our service

could not run, dodge, jump, tumble, roll

the kinds of things you expect soldiers to do

if they're in combat.

The second thing we found

or that I found or realized was

that our diet had changed radically

in the last 15 years.

We were supersizing everything.

Having been stationed overseas in Germany,

that's not the case there,

but they were supersizing --

if you want a large fries

you can get extra large
and extra-extra large.

You couldn't just get a 16 oz drink,

you could get a 24, 42, 64 oz soda.

And that was having a deleterious effect.

It was fascinating to me

that we were also seeing,

a scientist told me,

that in the last 15 years

from the time I left West Point until today

Americans eat about 30% more calories a day

than they had in 1983

and about 15 lbs more of sugar a year.

Phenomenal statistics.

But the combination
of a lack of physical education

and an increase of poor nutrition

was causing secondary effects.

This is the "O" food group, by the way.

I started calling it the "O" food group

because anything that ends in an "O"

is probably not good for you.

(Laugther)

I haven't found anything
that ended in "O" yet

that was actually very nutritious in nature.

But what we started to do was

we saw some second and third order effects

and this is one of them

this is at one of our training bases

and we have five in the United States Army.

We were seeing a malady called

femoral neck stress injuries,

and what that means is that

the tip of the pelvis would crack

and it wouldn't be a clean break

but it would be a stress fracture

that would cause significant problems

and you can see starting in 2000
that we were beginning to see this

and this is because the people
we were recruiting were just coming of age

and many of them had not had PE

and they had started to have the bad nutrition.

But by 2009 when our new recruits

were 18 or 19 years old

they had gone through their entire life

without having a PE class
and dependent on bad nutrition.

Those 135 that we had at one training base

are significant injuries because

in order to fix it

it costs anywhere between
USD 100,000 and USD 300,000.

So this is an economic issue.

This isn't just a soldier health issue.

For me this was an economic issue.

The third reason, and I'll say this

then move quickly on.

The third reason we saw

was an increase in technology.

Now, I'm a big fan of technology,

but the researchers had told me

that we now watch as a nation

about 150 hours of television a month.

That's five hours a day.

In 2009, when we started this study

we were seeing anywhere
from 30 to 40 on average

hours of internet searches

by adult male Americans per month.

That's between one and two hours a day.

Gaming was off the charts.

In 2009, and it's increased since then

the average teenager was playing

thirteen hours of video games per week.

Now all those hours in front of a tube

were replacing the play time

and that's significant.

In addition to that,

the final one, number four:

We're terrible examples to our children.

We're in too much of a rush.

We're eating poorly

we're eating fast foods

we're relaxing in front of the television
at the end of the day.

We also are relying on technology

instead of play

and we're not balancing our lives.

My wife has a stitchery in our house

as we've raised two children

and now a couple of grandchildren

that says, "Your children are watching you."

What you do speaks louder
than anything you can say.

We were not doing the right things
for our children.

So in typical army fashion

I said, "We've got to address
these issues with our new recruits."

And we changed several things.

We began something we called

the Soldier Athlete Initiative

because you can't just say
to a bunch of 18 year olds,

"We're going to get you all in shape

and stop feeding you cheeseburgers."

You have to give kind of a sexy title

to it so we called it

Soldier Athlete Initiative.

If you're going to perform on the battle field,

you have got to train like a champion.

And what we did was,
we completely changed

well, it's a three-legged stool

we completely changed the way
we were training

to compensate for things
that were not going on

in grade school and high school.

We assigned physical terapists

and athletic trainers
to every organization

because we wanted
to prevent the injuries

and treat them before they turned into

those USD 100,000 bone stress fractures.

We wanted to fix them
as they became visible.

And then the third thing
and probably the most important was

we changed the way
we feed food in the mess halls

the dining facilities.

We called it "Fueling the Soldier."

You can't just say,
"Hey, have a salad."

We instead say -- (Laugther) --

you've got to advertise with soldiers

so we said,
"Hey, we're going to fuel you

for maximum performance."

This is what sports teams are doing.

This is what NFL, major league baseball

they know they've got to eat right

in order to perform at their maximum.

Okay, I'm not going to dwell...

Within the first year, we saw

some unbelievably strong statistics

that shows this was working:

reduction in injuries,

we saved about USD 30 million the first year

just in treatment of injuries.

30 million in the army.

Just on injury prevention

And we began to see weight loss

and improved... or we reduced
the number of

overweight soldiers we have in the Army.

We still have a way to go.

We've advanced this "Fueling the Soldier"

to "Fueling the Teams"

and in fact we've redirected

to the Department of Defense Schools

for our young people
and we're calling it

"Fueling the future."

So we fixed it!
Or we're on our way to fix it.

What's interesting about this

is your Army combined with your Navy,
your Marine Corps

you Air Force and your Coast Guard

makes up less than 1%
of the American population.

So my concern is:

What's going on with the other 99%?

And this gets me back to my issue of this

being a national security concern.

I'm going to show you

one area and that's just levels of obesity.

This was a chart that represents

the number of states in the Union

that were below 20% obesity rates

on average from a child of 14 to 19 years old.

This was in 1985.

Watch what happens.

As you can see

in 2009, it's significantly worse.

The predictions for 2030

are these:

You can see the number of states

that have greater than 65% children obese.

This is not overweight, this is obese.

Now, the related issues

that I told you the issue with our injury rates

and how much we were paying to fix people

is significant.

We spend estimated

the Department of Health and Education

both determined that we spend

on average today between
USD 150 to USD 200 billion per year

treating the results of childhood obesity.

We're seeing an increase in diabetes.

We estimate that we will have

a 40% cardiovascular disease rate
by the year 2030.

This is significant.

This is a health care issue.

An economic issue.

A readiness issue for me because

I've seen my pool of recruits deplete

based on this.

I can't pull them in in order to fix them.

And it's just a competition issue.

There's other studies
that show what obesity

and lack of activity do to young people.

So I believe this is certainly

a national security concern.

There are several organizations
who are attempting to approach this.

You may have heard of
Mayor Bloomberg in New York

who has banned all sugary drinks

above 16 oz in schools and public restaurants
in New York City

and he took a lot of heat for that.

Nike, Blue Cross Blue Shield and Subway

are all using overweight actors in their adds

to pattern behavior

and perhaps to turn this thing around.

Nickelodeon in last year's
Worldwide Day of Play

decided to put their screens black

as opposed to showing programming

in order to get children outside and play.

And of course our First Lady

over the last several years

has been attempting to do "Let's Move!"

and the counter obesity measures.

This concerns me.

This concerns me greatly.

Again as I said

my name is Hertling,
I am a soldier.

I've been a soldier for 38 years.

This is not something the Army can fix.

This is not something you can put
a yellow ribbon on

and say, "Let somebody else take care of it".

This is not something

that we can rely on governments

or organizations to do.

Be fearless in terms of writing your schools.

Be fearless in trying to get nutrition

back in restaurants.

Be fearless in balancing your lives

and getting out to exercise.

Be fearless in modelling your behavior

for young people.

That will prevent

a whole lot of Charlies in the future.

Thank you very much.

(Applause)