Filed under: Safety
Stimulants can be dangerous to your health, especially in large quantities, but they’re what give energy drinks their “punch.” You may already know caffeine is a major stimulant found in energy drinks. But do you know that energy drinks often contain other stimulants? These can include “hidden sources” of caffeine (such as guarana, green coffee bean, green tea, and yerba mate), yohimbe, and synephrine (bitter orange).
Many energy drinks, however, aren’t labeled with the amounts of caffeine or other stimulants in them. Some or all of these ingredients are often part of “proprietary blends,” so it’s impossible to determine from the label the exact amount of each ingredient you would be taking. Furthermore, energy drinks might be mislabeled or marketed as sports drinks, causing even more confusion.
Remember, stimulants come in many different forms, so Operation Supplement Safety (OPSS) put together a list of stimulants found in dietary supplements to help you identify these potentially harmful ingredients. And to help you understand what’s in your energy drink, check out the OPSS infosheet on energy drink labels, which includes helpful notes about ingredients.
It’s the peak of summer, which means barbeques, picnics, and other food-filled events. But especially in summer’s heat, don’t forget about food safety, or it might just spoil your fun. Let the good times roll this summer with these food safety tips:
- Wash your hands. Washing your hands often is one of the best ways to prevent the spread of bacteria. Remember to use warm water and soap, and wash your hands for at least 20 seconds.
- Marinate meat safely. Marinate your food in the refrigerator, and keep it there until you’re ready to cook it. If you want to use the marinade as a sauce, set aside a portion before adding your raw meat or poultry, and don’t reuse marinade.
- Cook food thoroughly.Use a thermometer to ensure your food is cooked to the right minimum internal temperature:
- Steaks and pork—145°F
- Hamburgers and sausages—160°F
- Keep cold food cold. Don’t let your cold dishes sit out on a counter for more than 2 hours, or one hour outdoors when temperature is above 90°F. Otherwise, keep it chilled at 40°F or less in a cooler or place directly on ice.
Always remember: “When in doubt, throw it out.” A foodborne illness is not worth the risk. For more information on food safety during the summer, visit “Summer and Vacations” at Foodsafety.gov.
Skin cancer is a major public health issue, but with proper precautions you can decrease your risk considerably. Ultraviolet radiation (UVR) is the most important risk factor for both melanoma and non-melanoma skin cancer. Exposure to these rays also can result in deeper facial wrinkles, skin discoloration, burn, and skin aging.
Athletes who practice outdoor sports are especially at risk for skin cancer. Sweating increases the skin’s sensitivity to the sun’s rays, magnifying the risk of sunburn and skin damage.
Remember: The weather does not have to be sunny and hot for you to get sun damage! Whether you’re training for the PRT, patrolling, road marching, or participating in a summer league softball game, follow these tips to stay safe during all outdoor activities.
- Avoid burning
- As little as a single sunburn can increase your risk for developing skin cancer. Getting burned 5 or more times doubles the risk over your lifetime.
- Apply sunscreen
- Use water-resistant, broad-spectrum (UVA/UVB) sunscreen, with SPF 15 or higher, every day. Apply it 15–30 minutes before you’re exposed to the sun to give it time to absorb. Also, reapply sunscreen after swimming, sweating, or toweling off. Be sure to check out the FDA regulations regarding sunscreens and their effectiveness.
- Seek shade
- Whenever possible, stay in the shade under a tree or tent. Especially try to avoid sun exposure during midday (11 a.m. to 3 p.m.), when the rays are strongest.
- Cover up
- Wear protective clothing—including hats, long-sleeved shirts, and pants—when you go outdoors. Keep in mind, though, that protection decreases when clothes are wet.
- Use extra caution…
- …near water, snow, and sand. Ultraviolet rays can reflect off these and other surfaces, increasing your chance of sun exposure and skin damage.
- Wear sunglasses
- Protect your eyes when you work, drive, participate in sports, take a walk, or run an errand. Solar ultraviolet B radiation can increased your risk of cataracts and cancer of the skin around eyes without proper cover.
Service members should be careful about taking dietary supplements because many of these products contain hidden active ingredients that can result in harmful effects.
The most common types of dietary supplements found to contain “undeclared” ingredients (that is, substances not listed on the label) are those marketed for weight loss, sexual enhancement, and bodybuilding. The Food and Drug Administration (FDA) has identified over 600 tainted dietary supplements. FDA specifically warns against the use of products that claim to be “alternatives” to FDA-approved drugs or “legal” alternatives to anabolic steroids.
Dietary supplements don’t require approval by FDA before being put on the market, and without laboratory testing there is no way to know the contents of a product. If you’re considering a dietary supplement, be sure to check the label to see if the product has been evaluated by an independent third-party organization.
For more information, please visit Operation Supplement Safety (OPSS), including the OPSS High-Risk Supplement List.
An “adverse event” can occur as a result of taking some dietary supplements. Learn how to identify an adverse event from the Operation Supplement Safety (OPSS) FAQ, and find out where you can go to report one. And for healthcare providers, HPRC has a helpful video, “How to probe for dietary supplement use and report adverse events.” (Click on the “Video” tab to access the link.) Documenting adverse events is an essential part of how the Food and Drug Administration (FDA) evaluates potentially dangerous dietary supplements, so it’s very important to report potential problems.
Service members and their families relocate a lot, and moving to a new home is hard enough without adding injury. Here are some tips on how to properly handle heavy objects such as moving boxes and furniture, and how to take care of yourself if you do sustain an injury:
- Wear less-restrictive clothing such as looser-fitting pants or workout clothes.
- Wear closed-toe shoes.
- Take breaks when necessary. Stretching and reassessing your mechanics can help you maintain proper posture when lifting. HPRC has tips on how to maintain flexibility and remove tension in your body.
- The U.S. Army has fact sheets on Lifting Techniques for handling heavy objects and How to Safely Perform Pushing and Pulling Tasks.
- Remember to keep your core tight, and use your leg muscles rather than your back to lift heavy objects.
The best way to prevent back injury is to strengthen your back and core muscles. The National Institutes of Health (NIH) has suggestions and exercises to help build your back.
If you’re sore from all the lifting or think you may have pulled something, you can treat the pain with ice and rest—and perhaps an over-the-counter pain reliever—for the first 48 hours. Follow NIH guidelines on how to further treat your back pain if it’s acute. However, if the pain persists, consult your doctor to rule out a more serious back problem or injury before you do any more heavy lifting. If all seems well, consider core-strengthening exercises to support your back. Another option is a yoga class to relieve your pain, build your muscles, and return your back to normal function.
For more about how to protect your back, please visit HPRC’s Injury Prevention Series. Good luck with your PCS!
BMPEA is an unapproved amphetamine-like substance that has been appearing in some dietary supplement products. BMPEA (also known as β-methylphenylethylamine, R-beta methylphenylethylamine, beta-methylphenethylamine, and others) was first made in the 1930s as a possible replacement to amphetamine (a central nervous system stimulant), although it never became a drug because human studies on safety were not performed.
The Food and Drug Administration (FDA) tested 21 supplement products with the ingredient Acacia rigidula listed on the label and found that 9 of the 21 products were found to contain BMPEA, which is not derived from the plant Acacia rigidula. Some dietary supplement products actually list BMPEA on their labels. FDA recently issued a warning stating, “…BMPEA does not meet the statutory definition of a dietary ingredient.” Therefore, dietary supplement products with BMPEA are misbranded and cannot be sold as dietary supplements.
The World Anti-Doping Agency has banned BMPEA. For more answers to questions we’ve received about ingredients in dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.
Bitter orange is an extract from the immature green fruit of the Citrus aurantium plant, also known as Seville orange. It is sometimes used in small amounts in food as a flavorant and often used in weight-loss supplements. The terms “bitter orange,” “bitter orange extract,” or “Citrus aurantium” are often used interchangeably with the ingredient name “synephrine,” but bitter orange (the extract from Citrus aurantium fruit) is actually a complex mixture of many compounds, including synephrine and octopamine. Although both synephrine and octopamine occur naturally in the Citrus aurantium plant, they also can be made in a laboratory.
Many safety concerns have been raised with regard to synephrine and octopamine, which are both stimulants. The National Collegiate Athletic Association (NCAA) bans both of them, but the World Anti-Doping Agency (WADA) bans only octopamine. Bitter orange is frequently used in "ephedra-free" products since 2004, when the Food and Drug Administration (FDA) banned ephedra for its association with serious adverse cardiovascular effects. Combinations of stimulants—such as bitter orange and caffeine, commonly found together in weight-loss and bodybuilding products—can cause hypertension and increase heart rate in otherwise healthy adults. A major concern with products that list bitter orange (or synephrine, or octopamine) on the label is that the amount of stimulants in the product is sometimes very difficult—if not impossible—to determine. Service members should exercise extreme caution when considering whether to use supplements containing bitter orange.
No conclusive, peer-reviewed, scientific evidence clearly establishes that bitter orange is any safer than ephedra. For more information on bitter orange and ephedra, read the monographs in HPRC’s Dietary Supplement Classification System series.
For more answers to common questions we’ve received about dietary supplements, please visit our Operation Supplement Safety (OPSS) FAQs.
Lately, HPRC has been receiving a lot of questions about the use of banned supplements in the military, but the fact is: There isn’t a list of banned dietary supplements currently available. It isn’t always easy to determine whether a dietary supplement product is safe or not, so the Department of Defense (DoD), together with HPRC, provides helpful resources on the Operation Supplement Safety (OPSS) website to help you choose supplements wisely. With regard to the military’s stance on supplements in general, please see the OPSS FAQ about a "banned list," which is pertinent to all service branches.
Some dietary supplements, including ones sold on military installations, contain potentially harmful and problematic ingredients. For some tips about how to avoid these, read the OPSS infosheet “Red Flags—What You Need to Know.” In addition, some other potentially dangerous ingredients include prescription drug ingredients and their analogs, drugs banned by FDA for safety reasons, controlled substances (such as anabolic steroids), and untested/unstudied new active drug ingredients, which may not be listed on the product label.
One way to ensure that a dietary supplement product is safe is to see if it is third-party verified. Third-party certification organizations have developed criteria for evaluating and authenticating the quality of a supplement—the ingredients, the dosage levels, the level of contaminants, the label claims, and whether the manufacturing facilities follow Good Manufacturing Practices (GMP).
The Natural Medicines Comprehensive Database (NMCD) is the gold standard for evidence-based information on dietary supplement products and ingredients and is an HPRC partner. (Subscription is free if you have a “.mil” email address; visit the OPSS FAQ for more information.) NMCD rates products on a scale of 1 to 10 based on safety and effectiveness. We encourage you to consider only using products rated 8 or above.
To avoid potential problems, talk with your healthcare provider or dietitian before using dietary supplements. Also, see FDA’s list of tainted bodybuilding products, which includes important public notifications.
In a new Operation Supplement Safety (OPSS) PSA video, Gold Star mother Ms. Terri Bellamy-Coleman urges service members to seek out information and guidance on dietary supplements from the appropriate sources before taking them. Ms. Bellamy-Coleman’s son, who was attending the NCO (Noncommissioned Officer Academy, WLC (Warrior Leadership Course) in Fort Benning, GA at the time of his death, had been taking dietary supplements when he exerted himself during physical training, suffered a heart arrhythmia, and died. He had the sickle-cell trait, which may have aggravated the situation. She wants others to be aware of the possible risks associated with dietary supplements, especially when certain medical conditions are present, and urges service members to seek information to help prevent possible harmful health effects. Please watch the video, “A Mother’s Plea."