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Military Health System

TFF: A holistic approach to health and performance

Image of Silhouette of man climbing a hill. Air Force Senior Airman Erick Requadt climbs a dirt incline during the 2019 Moody Mud Run in Ray City, Ga. For service members to meet and excel in their performance, it’s important for them to pay attention to all eight life domains, including physical fitness. (Photo by Air Force Airman 1st Class Eugene Oliver.)

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What does it take to reach and sustain an optimal level of military fitness, health, and performance?

As with any journey, a roadmap can point out the best path. Total Force Fitness provides the military community with that roadmap to reach their peak performance.

Introduced to the Department of Defense in 2009, Total Force Fitness is a framework that helps warfighters, their family members, and military units reach and sustain optimal, holistic health and performance in a way that aligns with their mission, culture, and identity. By taking a holistic approach to improving warfighter performance, Total Force Fitness also serves as the Military Health System’s connection to first line of effort in the current National Defense Strategy – building a more lethal force.

“The DOD is increasingly recognizing that people represent our greatest asset, and the human weapon system is the priority investment to ensure readiness, said retired Army Col. (Dr.) Francis O’Connor, professor in the Department of Military and Emergency Medicine at the Uniformed Services University and the medical director of the Consortium for Health and Military Performance. “Total Force Fitness is the framework that links the vision with practical implementation.”

Total Force Fitness suggests you reconsider what it means to be healthy beyond just physical fitness by focusing on your whole self and those life domains that are key to holistic military wellness. Your total fitness includes eight domains: social, physical, environmental, medical and dental preventive care, ideological and spiritual, nutritional, psychological, and financial health.

In any given situation, you may draw on each Total Force Fitness domain to perform well. For example, if you’re getting ready to take your physical fitness and physical readiness tests, the emphasis is on your muscular strength and cardiovascular endurance. However, many other things — such as the quality of your sleep, what you’re eating, and reactions to any supplements you might be taking—can impact your performance. Your mental focus, environment, and support system of training partners play a role too.

“Total Force Fitness has become a priority across the DOD because leaders understand the importance of looking at our people as the greatest asset,” said Dr. Patricia Deuster, professor at the Uniformed Services University and executive director of the Consortium for Health and Military Performance (CHAMP). “That means taking care of them in every domain of TFF – from nutritional and physical fitness to social and spiritual fitness – as they service and sacrifice for our country.”   

Total Force Fitness gets away from a one-size-fits-all model for health and performance. It allows your identity, culture, and mission to shape your quest for total fitness. Everyone’s mission demands, occupational risks, culture, and mission-essential skills are different, so their approaches to sustaining health and performance need to be different.

"For service members to meet and excel in their performance, it’s important for them to pay attention to all eight life domains. Understanding the intersection of the Total Force Fitness domains is crucial to optimizing performance and readiness,” said O’Connor. “For example, it’s possible to assist in the management of depression by leveraging your social relationships, changing your diet, and getting more exercise. In addition, your mental health can boost your cardiovascular health and physical fitness—mental imagery can help.”

The Human Performance Resources by CHAMP (HPRC), at the Uniformed Service University of Health Sciences in Bethesda, Maryland, is one great resource for TFF information. Its website is there to support your fitness needs, and even boasts an “Ask the Expert” feature if you don’t find answers to your question right away.

As a warfighter, participating in your own total fitness contributes to your readiness and helps achieve Total Force Fitness. You’ll know you’ve reached peak performance when you’re performing at your best and thriving in all aspects of your life. When you have great relationships with the people around you, and you feel happy and fulfilled.

And when you’re physically healthy and fit, you feel a sense of purpose in the things you do, and you’re able to bounce back and grow from the curve balls life throws at you.

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Last Updated: January 29, 2021
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