KIRTLAND AIR FORCE BASE, N.M. --
Dietary supplements (DS) are certainly big business.
For example, in 2014, sales of DS in the U.S. totaled $36.7 billion. In 2015, global sales were estimated to be nearly $100 billion.
Nearly 50 percent of the U.S. civilian population takes at least one DS, and rates of DS use in military populations are even higher (60 to 70 percent).
Last year, a research paper was published in the Journal of Aerospace Medicine and Human Performance describing, for the first time, patterns of DS use in active-duty Air Force personnel. The research was conducted at eight Air Force installations, and collected data from 1,750 members.
According to the report, 68 percent of Air Force personnel use one to two DS at least one time per week. Twenty percent were considered “high utilizers,” and used five DS at least once per week.
Regarding individual products, 45 percent of those in the study used multivitamins or multi-minerals, 33 percent used protein and amino acid supplements, 22 percent used individual vitamins or minerals, 22 percent drugused combination products, 7 percent used herbal supplements and less than 1 percent used products marketed as steroid analogs.
In addition, 23 percent of Airmen in the study reported the use of DS classified as “other.” Supplements classified as “other” included fish oils, DS intended to improve digestive or joint health, and other multicomponent DS.
The average yearly expenditure on DS was nearly $470, and 6 percent of those in the study spent more than $600 annually. Higher dollar amounts spent on DS were seen in personnel greater than 24 years of age, and personnel whose body mass index was greater than 24.
Higher rates of DS use were associated with high-volume exercisers (aerobic and/or strength training), personnel with a history of multiple deployments and former smokers. Airmen with higher levels of education, ranks of E5-E9 and officers, women at least 24 years of age and overweight Airmen were also more likely to exhibit high rates of DS use.
The most common reasons for DS use were to promote general health (52 percent), increasing muscle strength (23 percent), providing more energy (21 percent), enhancing performance (21 percent) and “other” (16 percent).
High rates of DS use by Airmen, as well as other military personnel, have raised concerns regarding potential safety and efficacy due, in part, to numerous reports of DS contamination.
For example, the New York State Attorney General’s office recently conducted tests on top-selling brands of herbal supplements at four major retailers (GNC, Target, Walgreens and Walmart), and found that 80 percent of the products did not contain any of the herbs listed on the labels.
Also, companies that sell DS may misbrand illegal drugs as DS, which could adversely affect service members’ health and performance.
In 2012, the website Bodybuilding.com, plus the former president, vice president, founder and CEO of the company, were fined $8.1 million as the result of an investigation by the Food and Drug Administration. The FDA found five of the company’s products were drugs misbranded as dietary supplements.
These drugs were anabolic steroids or chemical “clones” of anabolic steroids.
An additional concern is mandatory drug-testing requirements. Consumption of some DS may lead to positive drug tests, due to the similarity of some DS to banned substances, or contamination of DS with banned substances.
For this reason, we strongly encourage Airmen to contact us if they have questions.
Earlier this year, an Airman came to us wanting to know if a particular DS was safe. The DS in question turned out to be a selective androgen receptor modulator (SARM).
SARMs are a new class of drugs, none of which has yet been approved by the FDA for human use. Despite this, some SARMs or products advertised as SARMs are marketed as DS, and are already available to the public.
All SARMs are banned by the World Anti-Doping Administration, and are prohibited from athletic competition. In addition, SARMs are listed as banned drugs in a U.S. Special Operations Command policy memorandum released in 2016.
There are also online resources available to assist consumers with purchasing supplements. The U.S. Pharmacopeial Convention (usp.org) and NSF International (nsf.org) conduct quality-control testing on a variety of DS. These websites contain lists of DS that have been tested and certified as free of contaminants or mislabeled drugs.
The certification does not guarantee the listed DS are effective, but it does indicate which are safe.
Another question we are frequently asked is whether DS are effective for improving health, performance and weight loss. Very few meet any of these criteria.
Our view is that DS are the icing on the cake; they’re not the cake. Healthy eating and regular exercise are the cake, and should form the foundation for a healthy lifestyle.
For example, one of the most common DS questions we are asked is whether to use pre-workout supplements. The best pre-workout supplement is a healthy breakfast, such as a whole-grain cereal with milk and fruit, or a healthy snack that contains carbohydrates and protein, such as Greek yogurt, a granola bar or fruit with peanut butter.
This type of “supplement” has actually been shown to improve workout performance, which is not the case with most DS from a bottle. If you want to know how to build your “cake” with the right ingredients, you can contact us at 846-1186 or 846-1483.