For more than a century the Army has tinkered with ways to make soldiers more fit.

With each passing phase of warfare, leadership sought to get more soldiers ready for battle through a range of physical training exercises.

That’s most evident now in the ongoing debate on the Army Combat Fitness Test, and how best to adjust it across a force with jobs as diverse as deskbound supply sergeants and Rangers in-the-thick of combat.

That’s where the latest shift in PT culture enters, bringing a new approach to tackle aspects of fitness that are not measured with a stopwatch or pushup count — Holistic Health and Fitness, or H2F.

Since the publication of Army Field Manual 7-22 in 2020, leaders at Training and Doctrine Command have unfurled the holistic model that hits on nutrition, sleep, physical, mental and spiritual health.

They’ve embedded teams of physical trainers, occupational and behavioral health specialists, chaplains and nutrition experts within 28 brigades. Those teams will arrive at 12 more brigades next year and 10 more each year after until the Army hits 110 brigades by 2030.

Army Times interviewed key leaders in each H2F core area to see how they’re building a soldier-centered, health-focused system that prepares troops for both the rigors of combat and daily life in a 21st century Army.

H2F director Col. Kevin Bigelman told Army Times that, by decade’s end, the program will mesh within every soldier’s daily life.

“Oh, you’re a soldier? You’ve got to take care of yourself — physically, mentally and spiritually. And how you sleep and how you eat,” Bigelman said. “It’s going to be baked into the culture and fabric of the Army in a few short years.”

The problem and the rollout

The Army began a pilot of the H2F program in 2019, a year before it published the doctrine. And there’s an origin story to it all that involves reducing injuries and increasing readiness.

Then-Army Chief of Staff Gen. Mark Milley pounded the podium hard back in 2015 on the lagging readiness of the force after two decades of fighting counterinsurgency and counterterrorism conflicts. Readiness, he said, went beyond gunnery tables and rifle range scores.

Now chairman of the joint chiefs of staff, Milley had two objectives — build an agile, adaptive Army and take care of troops.

That means more than getting soldiers to run faster.

One significant factor that prevented the readiness leaders wanted was injuries, specifically musculoskeletal injuries.

As recently as early 2020, Bigelman said nearly 60,000 soldiers, or the equivalent of 13 brigade combat teams, were non-deployable due to one or more deficiencies, many of them physical injuries.

Knocking out pushups, sit-ups and a 2-mile run was not preparing soldiers for anything other than their annual PT test. And it wasn’t preventing injuries.

Injuries result from more than a substandard PT program — poor nutrition, bad warmup or cooldown, bad form, inadequate sleep and focus all contribute.

Bigelman said even minor improvements can produce substantial results.

The ACFT has created much debate and even gotten Congress involved in dictating different tests or standards for different jobs. That remains unresolved. But what the ACFT did do, Bigelman said, was expose weaknesses and give commanders a target.

The colonel’s research shows that reducing musculoskeletal injuries by 10% would bring back one full BCT to the Army. Getting 15% more soldiers to pass the ACFT would bring back another brigade.

Some of the attrition of first-term soldiers is centered on injuries and some by overwhelming work stress. Cutting first-term attrition by 20% would keep 12,500 soldiers in the Army. That would save $750 million annually for initial training and another $489 million for first-term assignments, Bigelman said.

They’re already seeing benefits.

Brig. Gen. John Kline, commander of the Center for Initial Military Training, said musculoskeletal injuries in entry-level training are under 6%, down from nearly 12% before H2F.

“That’s real numbers when you’re talking about 70,000 soldiers coming through basic training,” Kline said.

Some of that is due to reversing the approach, he added. By easing new soldiers into physical training before ramping up the intensity, they’re better conditioned.

Those H2F teams in each of the 28 fielded brigades bring collegiate athlete-level precision to well-rounded fitness, he said.

Bigelman’s team visited each brigade over the past seven months, concluding their tour in June to bring back lessons learned and gather best practices.

Here’s how it works. Soldiers meet H2F teams for an initial total body and mind evaluation. That results in a training, nutrition and sleep plan with regular check-ins to follow.

The teams also provide more tools and health tactics for commanders. And the Army’s top enlisted soldier wants them to take advantage of those measures.

Sergeant Major of the Army Michael Grinston challenged unit leaders to adjust their thinking at the April H2F Industry Day conference at Fort Eustis, Va.

Grinston wants unit leaders to reconfigure their days to integrate PT.

“Poor training management means, ‘I have to stick to a 0630 training schedule because I can’t think past tomorrow,” Grinston said.

Even at the brigade level, Bigelman said, if all units are training at the same time of day, it’s challenging for the H2F teams to reach everyone. The typical H2F team has a staff of as many as 35 personnel to assist a brigade of about 5,000 soldiers, so leaders have to be creative and plan ahead of time to craft the right schedule.

“I think brigade commanders are realizing they have a really valuable asset in their formations,” Bigelman said.

Food as fuel

The Army implemented a color-coded system for healthy chow hall choices years ago. But soldiers need to learn to think of food-as-fuel, experts said.

Lt. Col. Brenda Bustillos, TRADOC’s top dietician, and Maj. Jordan DeMay, H2F nutrition domain lead, told Army Times one way to do that is to give soldiers convenient, healthy food sources.

Some brigades have dining facilities that package healthy lunches and dinners troops can take with them after grabbing breakfast. The pre-made meals cut food prep time and put a healthy option in the rucksack.

Food as fuel means more than eating fresh vegetables and lean proteins. Jordan said timing and soldier activity level are crucial.

During arduous training, the soldier needs more calories. For sedentary stretches they’ll need to cut back. A combination of education and flexible food options means they can get the right food in them at the right time.

Within the first week of meeting with their H2F team at entry-level training, Bustillos said, soldiers are given a one-hour block of nutrition instruction. The idea is to embed good nutrition early so that it’s part of soldier thinking.

Those meal prep options are great but not available everywhere yet. Most Army National Guard and Army Reserve soldiers, for example, don’t have such easy access.

For them, and for others interested in learning a do-it-yourself approach, the service has created a series of online videos showing healthy food prep and planning, Bustillos said.

There’s also no one-size-fits-all approach. Bustillos said Army research has to provide detailed data on what works for different populations, specifically variations in diet and calorie needs for male and female soldiers.

The teams have also structured postpartum specific nutrition guidelines to help female soldiers after pregnancy use food to aid their physical recovery.

If you don’t snooze, you lose

Perhaps one of the biggest challenges to improving soldier health is beating back decades of a tough-guy approach to sleep.

It starts with leaders.

“I think commanders are getting the message that the Army believes sleep is important,” Bigelman said. “Our aviators have known this for a long time. We don’t let you get in a cockpit if you’re sleep deprived. So why should we let you get into a Humvee, Bradley Fighting Vehicle or an Abrams?”

One talking point Bigelman’s team has been using is science. Lots of research, he said, shows inadequate sleep lowers testosterone and that combination has a “high correlation” to injury rates.

The holistic part of H2F means a lot and it’s a new approach. But Bigelman has a priority.

“If we had to focus on one domain, it would be the sleep domain,” he said. “Because without sleep, the brain doesn’t recover.”

The service is experimenting with fitness watches and other devices to track and monitor sleep as part of overall fitness indicators.

There are challenges that go beyond old-school culture. Anecdotally, Bigelman sees younger soldiers who have a better grasp on the technology than their older counterparts, they’re also likely staying up later and eating worse, which leaves them dragging the next day.

Mental and spiritual health

Food, physical training and sleep all give soldiers measurable ways to track progress. But without mental wellbeing and a greater understanding of the meaning behind their military service, many struggle, experts said.

CIMT commander Kline said some simple mental health strategies such as positive visualization —picturing yourself completing a challenging task — provides a brain-based simulation. That practice allows soldiers to perform better.

That’s why mental health and spiritual fitness were for the first time added to physical health doctrine, said Maj. Gen. Thomas Solhjem, chief of chaplains.

The Army has more behavioral health assets in the force than ever before. That’s been part of the strategy to combat the ongoing challenge of military suicide.

But, Solhjem said, therapy and medication are not the only answer. And for some dealing with less extreme difficulties, they may not be the right answer.

“H2F has given us an awareness that something that is missing is identity, meaning and purpose, connection,” Solhjem said.

Chaplains now include research by Dr. Lisa Miller, author of “The Awakened Brain” and professor of psychology at Columbia University, in New York City, as science-based backing in their briefings on soldier spiritual health.

The two-star made a clear distinction for skeptical soldiers — spirituality is not religion. Neuroscientific research cited by Miller and others over the past two decades has shown greater overall well-being and goal-driven behavior among those who report a spiritual grounding, or greater sense of meaning and purpose.

“If you’re not religious, there’s still a place for you in the spiritual readiness discussion,” Solhjem said.

That search for meaning is where Solhjem and Army chaplains hope to assist.

“Do I know what my life is about? Do I derive meaning from serving others?” Solhjem said. “When you know these things about people and have it in doctrine, it’s powerful.”

The two-star said the chaplaincy is positioned to help soldiers trying to connect to that larger purpose, the role spirituality may play, and how to incorporate that sense of meaning into their life plan.

“We talk a lot in the military about readiness, these are the types of people who have the character, grit and optimism in their worldview, and they’ll be the kind of people you can depend on,” Solhjem said.

Todd South has written about crime, courts, government and the military for multiple publications since 2004 and was named a 2014 Pulitzer finalist for a co-written project on witness intimidation. Todd is a Marine veteran of the Iraq War.