Could military use of dietary supplements pose a threat to military readiness? Dietary supplements are readily available at retail stores on military bases, niche stores near military bases, and on the Internet. But few people realize that many of these supplements contain ingredients that could make them dangerous to the military we depend on to keep our country safe.
The use of dietary supplements is considerably higher in the US Armed Forces than in civilian populations, with more than two-thirds of service members using them weekly or more often, compared to 50% of the general population. Strength, energy, or pre-workout and weight loss supplements are commonly used by military personnel, likely due to their unique job requirements and body composition requirements. However, predatory marketing strategies targeting service members likely also influence their high usage rates.
Dietary supplements can be dangerous when they contain adulterants or contaminants, such as steroids, stimulants, prescription drugs, or heavy metals, or when they contain multiple ingredients with unknown interactions. Also, due to potential interactions, it is risky to take dietary supplements containing multiple stimulants or to use multiple dietary supplements while taking prescription or over-the-counter medications. What types of supplements have been found to most often carry these risks? Exactly the types that service members are particularly likely to use: those sold for bodybuilding, energy, or pre-workout and weight loss.
More than a decade ago, a series of devastating injuries to service members caused by dietary supplements – called adverse events by the Food and Drug Administration – pushed the Department of Defense to establish Operation Supplement Safety as a “go-to” resource for military personnel and their healthcare providers. OPSS’s goal is to provide the tools and resources to help users make informed decisions about dietary supplements to reduce potential health and career risks.
Now an established program, OPSS provides service members with a trusted resource to ask questions through an Ask-the-Expert portal, learn about dietary supplements, and use the OPSS Risk Assessment Dashboard when they are considering using dietary supplements. OPSS also maintains a continuously updated list of prohibited ingredients on its website which is publicly available for military and civilians.
Despite the threat that dietary supplements pose to the readiness of the nation’s military, there is no system in place to track adverse events experienced by military members as a result of supplements. It is estimated that less than 2% of adverse events are reported to the FDA or other appropriate systems, such as health departments. Without a centralized reporting system in the military for adverse events caused by dietary supplements, the Department of Defense lacked the vital data needed to quickly identify at-risk products and intervene to prevent injury or illness. preventable in the military. But that could soon change. The National Defense Authorization Act of 2022, signed into law by President Joe Biden on December 27, 2021, and for the first time includes report language from Senate and House committees urging the Department of Defense to fill the discrepancy in reporting dietary supplement-associated adverse events.
The reporting language of the two committees is a huge step forward in the effort to have an internal Department of Defense reporting system that has not been realized to date, despite a recommendation from the Institute of Medicine in 2008. Adverse Event Reporting of Dietary Supplements in the Department of Defense would inform both the military health system and the FDA of potential health risks, which would have a beneficial impact on patient care, public safety and mission readiness.
OPSS is a program of the Consortium for Military Health and Performance at the Uniformed Services University of the Health Sciences.
Melissa Givens, MD, MPH, is executive director of the Consortium for Health and Military Performance, a DoD Center of Excellence at Uniformed Services University.
Andrea T. Lindsey, MS is Director of Operational Supplement Safety and Senior Nutrition Scientist for The Henry M. Jackson Foundation for Advancing Military Medicine, in support of the Military Health and Performance Consortium.
Allison Ivie, MPP, MA, is the Vice President of Center Road Solutions, LLC
S. Bryn Austin, ScD, is a professor at Harvard TH Chan School of Public Health and Boston Children’s Hospital and founding director of the Strategic Training Initiative for the Prevention of Eating Disorders, or STRIPED.
Patricia A. Deuster, PhD, MPH, FACSM, is a professor at Uniformed Services University and scientific director of the Consortium for Health and Military Performance.
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