A study published in The Journal of Nutrition has found that service members from the Air Force, Army, Marine Corps, and Navy are more likely to use dietary supplements compared with civilians.

Dietary supplements are commercially available products that include vitamins, minerals, herbs, amino acids, and a variety of other products. Marketing claims for dietary supplements include improvements in overall health status, enhancement of cognitive or physical performance, increases in energy, weight loss, pain relief, and other favorable effects. From 2006 to 2011, the use of dietary supplements has increased among Army personnel, but it is not known if this trend has continued or is apparent in the other military services. To address this gap in knowledge, Joseph Knapik (Military Nutrition Division, US Army Research Institute of Environmental Medicine) and colleagues examined current dietary supplement use in a random sample that included all military services.

This investigation involved a cross-sectional survey that was completed by 26,681 US active-duty military service members between December 2018 and August 2019. The questionnaire assessed the prevalence of, and factors associated with dietary supplement use. Overall, 74% reported using >1 dietary supplement/week and 40% of users consumed >5 dietary supplements/week. The most frequently used dietary supplements were multivitamins/multiminerals (45%), combination products that include >2 ingredients (44%), proteins/amino acids (42%), individual vitamins/minerals (31%), herbals (20%), joint health products (9%), and purported prohormones (5%). Factors associated with use of dietary supplements included female gender, older age, higher education level, higher body mass index, more weekly resistance training, smokeless tobacco use, higher alcohol intake, and higher military rank.

When individual supplements were examined, men were more likely to use proteins/amino acids, combination products, and purported prohormones, whereas women were more likely to use multivitamins/multiminerals, herbals, and joint health products. The different branches of service were similar with respect to use of most dietary supplements.

Compared with civilian data assessed in National Health and Nutrition Examination Survey, a nationwide survey conducted in the United States to assess health and nutritional status, service members were more likely to use dietary supplements and to use different types of dietary supplements, especially combination products and proteins/amino acids. Comparisons with previous military data suggest that dietary supplement use has increased over time among service members in all branches.

This study provides information on the prevalence of dietary supplement use by military personnel and how demographic, lifestyle, and military factors affect use. In a companion editorial, Mona Calvo (The Icahn School of Medicine at Mount Sinai) commends this report for revealing important differences between civilian and military population use of dietary supplements. Surveillance of dietary supplement use among active-duty military may provide a better understanding of adverse events that may otherwise go undetected. This information could provide early warning to the FDA and the medical and public health communities, alerting them to dangers associated with unsafe dietary supplements.

References

Joseph J Knapik, Daniel W Trone, Ryan A Steelman, Emily K Farina, Harris R Lieberman, Prevalence of and Factors Associated with Dietary Supplement Use in a Stratified, Random Sample of US Military Personnel: The US Military Dietary Supplement Use Study, The Journal of Nutrition, Volume 151, Issue 11, November 2021, Pages 3495–3506, https://doi.org/10.1093/jn/nxab239.

Mona S Calvo, Expanding Our Understanding of Dietary Supplement Use to Include Both Civilian and Institutionalized Consumers: The US Military Dietary Supplement Use Study, The Journal of Nutrition, Volume 151, Issue 11, November 2021, Pages 3267–3268, https://doi.org/10.1093/jn/nxab319.

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