蜜桃APP

Researchers at 蜜桃APP鈥檚 Pennington Biomedical Research Center (PBRC) are putting 20 years of knowledge from working with soldiers into a new app for everyone, a one-stop shop for body and mind health. It鈥檚 called Z!G and although powered by artificial intelligence, it鈥檚 not looking for perfection.

Baton Rouge鈥擮ver the past 30 years, scientists at PBRC have fundamentally changed how American soldiers eat. As the number-one provider of nutrition science for the U.S. Department of Defense (DOD), PBRC researchers are helping to secure the nation by making sure soldiers get the food and drink they need to optimize their performance and protect against injury.

The work impacts every branch of the military鈥擜rmy, Navy, Air Force, etc. And by leveraging technology, the researchers are putting science to work in the hands of men and women on active duty, as well as their families. A prime example is through the Army H.E.A.L.T.H. (Healthy Eating, Activity, Lifestyle Training Headquarters) app, which more than 15,000 U.S. soldiers have used so far, with regular users improving their performance on physical fitness tests and meeting military weight standards. Unlike most other lifestyle apps where the focus might be on either weight-loss or mental wellness, Army H.E.A.L.T.H. takes a more integrated, whole-health approach, incorporating tools related to weight, nutrition, and fitness鈥攁ll integrated with sleep and stress management and mood and mindfulness support. The app offers personalized tools to help users reach specific goals, or just do and feel better on a day-to-day basis.

The Army is now talking with PBRC about making the app available DOD-wide through its own secure 鈥渁pp store.鈥� To date, the DOD has invested $18 million over 15 years in the development of this program. Meanwhile, the researchers are taking everything they鈥檝e learned from working with soldiers and many of the best parts of Army H.E.A.L.T.H. and retooling them into a new app called Z!G for the general population, which is struggling with many of the same challenges as active-duty soldiers. This includes first responders and frontline medical professionals, but also anyone who lives with high amounts of stress and uncertainty, which might be most of us.

鈥淲orking with the Louisiana National Guard has prepared us exceptionally well to be able to offer an effective tool for the general population.鈥�

Tiffany Stewart, clinical psychologist and director of the Behavior Technology Laboratory at Pennington Biomedical

Through collaboration with the Louisiana National Guard (LANG), a customized version of the app has already been tested by a majority of the state鈥檚 soldiers and their family members, in all 64 Louisiana parishes. (The LANG maintains a total of 183 units in 44 parishes.)

鈥淲orking with the Louisiana National Guard has prepared us exceptionally well to be able to offer an effective tool for the general population,鈥� said Tiffany Stewart, a clinical psychologist, director of the Behavior Technology Laboratory at Pennington Biomedical, and faculty lead for Army H.E.A.L.T.H. and Z!G. 鈥淎lthough they鈥檙e soldiers, national guard soldiers live among us as civilians. Besides being deployed overseas, they are often called in for domestic deployments on a moment鈥檚 notice, including for search and rescue during hurricanes, COVID-19, and so on鈥攂ut they鈥檙e also driving kids to school, live in food deserts, and might struggle to get to the gym, same as we are.鈥�

The retooled app includes custom workout generators, meal planning tools (complete with grocery lists), and interactive trackers that encourage incremental changes (鈥測ou鈥檙e on your way鈥�) rather than piecemeal progress toward distant goals (鈥測ou鈥檙e not there yet鈥�). The researchers have also recently added an artificial intelligence component, so the app can learn about its user and become more responsive to needs and preferences over time. The app was designed to be like a quiet, supportive coach in everyone鈥檚 pocket.

鈥淲hen we first started talking with the Army about a program like this back in 2003, people thought we were crazy,鈥� Stewart said. 鈥淎n anonymous, Internet-based program? 鈥楴obody would use it,鈥� and, 鈥楬ow ridiculous.鈥� But it worked because it was anonymous and automated. It took away the stigma of needing or asking for help鈥攏obody had to know you were struggling.鈥�
 
鈥淎lso, this was the first tool soldiers and their families could use independently鈥攁nytime and anywhere鈥攖o sustain health, readiness, and performance on a year-round basis,鈥� Stewart added. 鈥淭he Army had never had programming like this before.鈥�

鈥淭he Army had never had programming like this before.鈥�

鈥擳iffany Stewart

One of the main motivations behind Army H.E.A.L.T.H. came with the realization in the early 2000s (post-9/11 and the beginning of the War on Terror) that the need for soldiers was increasing while the recruiting pool was shrinking. Today, roughly 70% of possible Army recruits are ineligible for service due to many reasons, with overweight and obesity at the forefront.

鈥淎lso, it became obvious that our active-duty soldiers were not immune to weight creep and the obesity epidemic,鈥� Stewart explained. 鈥淲hat we were seeing in the general population was true in the Army as well. Soldiers were struggling to stay under established weight-height thresholds, battling diabetes and cardiovascular disease. And while we intended Army H.E.A.L.T.H. as a prevention tool, it鈥檚 often used for intervention.鈥�

Captain Michael Switzer with the LANG is the soldier perhaps most familiar with the 蜜桃APP/Pennington-developed health app. Not only did he help design the app, but he and his wife have both used it, whether he鈥檚 home in Denham Springs (which hasn鈥檛 been a lot lately) or deployed. They鈥檝e used the app to stay connected, work together toward shared goals, and鈥攐n occasion鈥攃ompete with each other. Back in 2005, Switzer lost four men in his unit, including his best friend, during a deployment to Baghdad. He says the app鈥檚 mental health and mindfulness tools played an important role in his recovery from those losses combined with daily challenges.

鈥淚've always been physically fit, that鈥檚 never been much of a struggle for me, but coming from three deployments, I was choking up a little bit,鈥� Switzer said. 鈥淭he mindfulness techniques in the program were really beneficial to me, especially coming home and transitioning back. If you don鈥檛 have tools for mental management, anxiety and depression can easily become obstacles for nutrition, fitness, and sleep, so it all goes together.鈥�

More recently, Switzer has been deployed in Louisiana to help stage COVID-19 testing and vaccine sites, do emergency supply runs during storms, clear roads, and rebuild infrastructure. He spends most nights on a cot in his office.

鈥淲hile the Army values military family time both here and overseas, at high op-tempo times, we don鈥檛 get to spend much time with our families,鈥� Switzer said. 鈥淪leeping is sometimes not even an option, so the best you can do is breathe and try to keep yourself calm.鈥�

As a leader in charge of others, it鈥檚 not lost on Switzer that have been increasing. The National Guard is not immune to this trend. During Hurricane Ida, the LANG鈥攐ne of the most deployed in the nation鈥攍ost at least one soldier to suicide. Dealing with that and general mental health management can be especially hard when you don鈥檛 have specialized mental health training, which is commonplace, Switzer said:

鈥淭he app has been a very good tool for me in my life, personally, but it鈥檚 also a great leadership tool. It鈥檚 helped me be a better resource for others.鈥�

Captain Michael Switzer, Louisiana National Guard

鈥淭he app has been a very good tool for me in my life, personally, but it鈥檚 also a great leadership tool. It鈥檚 helped me be a better resource for others. You want to be able to counsel your subordinate soldiers and veterans in a positive way, and the app is something I can put in their hands and into the hands of younger leaders who are put in charge of soldiers.鈥�

The latest version of the Army H.E.A.L.T.H. app can also help fresh recruits as well as experienced soldiers prepare for the new combat fitness test, which is replacing the older physical fitness test the Army was using since the 1980s (sit-ups, push-ups, and a two-mile run). The new test is designed as a better measurement of soldiers鈥� readiness on the battlefield and includes lifting, dragging, and carrying. All soldiers are required to pass the test and stay within a certain weight range.

Switzer values how the app has helped the LANG retain soldiers on all levels.

鈥淲hen a soldier doesn鈥檛 meet weight standards or pass physical fitness tests, they can鈥檛 get promoted鈥攊nstead, they lose many of the benefits you get from being in the military,鈥� Switzer said. 鈥淪ometimes they become ineligible for bonuses, and, in the worst-case scenario, they may even be discharged. In the military, you must meet standards in order to be successful. So, the app is a tool that helps us with retention, which has become even more important as our recruiting pool is shrinking. It puts an evidence-based tool directly into the hands of the soldiers who need it the most.

In 2013, the first female U.S. Army surgeon general, Patricia D. Horoho, recognized the importance of treating soldiers holistically and more as equivalent to athletes. It was after Horoho endorsed the 蜜桃APP-PBRC Army H.E.A.L.T.H. tool that the researchers were able to pilot it Army-wide.

鈥淲e鈥檝e been in protracted wartime since 9/11, and our military needs its soldiers鈥攖hey can鈥檛 just discharge them when they鈥檙e struggling to meet standards, because we desperately need to retain our fighting force,鈥� Stewart said. 鈥淭hat鈥檚 one of the reasons our lab develops technologies to help people change their behaviors and realize that small steps can lead to big change. It鈥檚 hard to make habit changes in the context of chaos鈥攚hether that鈥檚 in the middle of a war or a pandemic or a hurricane, when you鈥檙e worried that you or people you care about could be hurt or die鈥攂ut we want to show that you can do tiny things every day, in the context of real life, that build up to something meaningful.鈥�

Jennifer Rood鈥檚 lab, meanwhile, has been working on biomarkers in soldiers鈥� blood that can help predict鈥攁nd therefore prevent鈥攊njury, among other things. One of her recent studies showed that male soldiers who maintain normal testosterone levels can retain and even gain muscle mass while losing weight from fat stores during high-stress times, when they鈥檙e often not eating or sleeping enough. The U.S. Army Research Institute for Environmental Medicine has already invested tens of millions in her work, contributing to the more than $100 million the DOD has dedicated to research at PBRC over the past 30 years.

鈥淚t鈥檚 hard to make habit changes in the context of chaos鈥攚hether that鈥檚 in the middle of a war or a pandemic or a hurricane, when you鈥檙e worried that you or people you care about could be hurt or die鈥攂ut we want to show that you can do tiny things every day, in the context of real life, that build up to something meaningful.鈥�

Tiffany Stewart

While Rood鈥檚 research is making an impact on every branch of the U.S. military鈥攚orld-wide鈥攕he personally cares more about the effect her work is having on specific people, closer to home.

鈥淵ou might talk to other scientists, and they鈥檒l say, 鈥業 discovered this,鈥� or 鈥業 put this new technique on the map,鈥� but for me, it鈥檚 more personal,鈥� Rood said.

When she and her husband were finally able to go to an in-person 蜜桃APP Tigers football game this season, a young man walked up to her and tapped her on the shoulder.

鈥淚 couldn鈥檛 place him at first,鈥� Rood remembered. 鈥淏ut then I remembered him from one of our studies, and he told me how much he鈥檇 learned from it and the difference it鈥檇 made for him in his life. If you look at the big picture of the discoveries we鈥檝e made, it鈥檚 probably a much bigger accomplishment, but for me, walking the streets of Baton Rouge and having people come up to me and tell me how they鈥檝e been able to keep their cholesterol down, or get their diabetes in check, keep the weight off, or get on a new life-changing medication because of our research鈥攖hat鈥檚 really powerful.鈥�

鈥淔or the past three decades, the Pennington Biomedical Research Center and their expert staff have been key partners to the Army and Department of Defense in nutrition research. Together, we have made significant discoveries, which have resulted in improved health and performance of the modern Warfighter.鈥�

James McClung, Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine (USARIEM)

The development of the Z!G app for the general population was supported by a 2021 LIFT2 (Leveraging Innovation for Technology Transfer) grant from the 蜜桃APP Board of Supervisors.

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