A recent study on the use of dietary supplements among active-duty U.S. Army soldiers has prompted the U.S. Army to establish a specialized group to deal with nutritional supplements and specific personnel needs.¹ The study, conducted by the U.S. Army Research Institute of Environmental Medicine, assessed the use of dietary supplements (DSs) by 990 randomly selected soldiers at 11 army bases globally. The survey included questions on types of DSs used, frequency of use, reason for use, and money spent on DSs.

So do active-duty army soldiers use more supplements than civilian adults? Results from the survey showed these interesting findings:

• 53.2% of soldiers (similar to 52% of a representative sample of the U.S. population) report taking greater than or equal to 1 DS per week
• As with civilian adults, the most widely used DS type among soldiers was multivitamins
• Also like civilians, users of DSs in the army tended to be older and more highly educated
• The use of DSs by general occupation (combat arms, support, or service) did not differ significantly among army personnel, but persons assigned to an elite unit (Special Forces) reported a nearly 25% higher prevalence of use
• In the army, strength training was highly associated with the reported use of any supplements, multivitamins or minerals, protein and amino acid products, and spending greater than $50 a month on DSs; soldiers who participated in strength training were almost twice as likely to use DSs as soldiers who did not participate in strength training
• Among soldiers, 20.2% of men and 9% of women were taking protein and amino acid supplements; a survey of a representative sample of U.S. men and women 18-44 years old showed only one protein or amino acid supplement in the top 10 nonvitamin herbal supplement category (creatine), which was used by 4% of men but not by many women or older men
• The most common reason that soldiers who were regular DS users reported for taking DSs was to improve general health, which is consistent with the civilian population; however, 31.3% of soldiers took DSs to increase energy, 24.9% of soldiers took DSs to increase muscle strength, and 16.7% of soldiers took DSs to enhance performance - reasons few civilians report for taking DSs

Is there reason for concern?

While the daily use of a multivitamin/mineral is not concerning, the use of multiple DSs, some which lack data on safety and some with possible adverse effects when combined with common medications is worrisome. And over 12% of soldiers in all age groups except those greater than 40 years reported taking greater than or equal to 5 DSs a week. Likewise, weight loss was a fairly common (12.4%) reason soldiers used DSs. Given recent Food and Drug Administration reports that many weight loss DSs that contain drugs could be harmful, especially when combined with common soldier exposures like environmental extremes, intense exercise, and dehydration, this is also very concerning.

Thus, educational interventions to limit the use of DSs may be warranted in the army. Education on topics like eating certain foods to improve performance and the evidence and safety (or lack thereof) of various ergogenic aids and DSs could be very helpful.

¹Lieberman, H.R., Stavinoha, T.B., & McGraw, S.M. (2010). Use of dietary supplements among active-duty us army soldiers. Am J Clin Nutr, 92, 985-995.