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HPRC Fitness Arena: Dietary Supplements
The purpose of the 2011 Department of Defense Health Related Behaviors Survey of Active Duty Military Personnel (HRB) is to assess the health practices of active-duty service members. Substance abuse, mental and physical health, and lifestyle choices are important matters, especially when you need to be at your best for the demands of military life. Certain areas of this study directly affect human performance, and results (as reported in the Executive Summary) show that health behaviors vary between services.
Physical Activity/Body composition
Here are some figures from the Physical Activity/Body Composition portion:
- Overall, service members have lower rates of obesity (as defined by BMI) compared to the general public.
- More than one-third of active-duty service members age 20 and older were considered to be at a healthy weight, which exceeds the Healthy People goal as well as civilian population estimates.
- 75% of active-duty members practiced moderate to vigorous physical activity in the 30 days prior to the survey, with Army and Navy personnel having the highest rates.
- Almost half of service members do strength training three or more days a week.
Physical health and fitness are key components to optimal fitness. While these numbers are encouraging, there is no doubt that a larger portion of the military should be at a healthy weight and fit enough to fight. Make fitness and weight management your priority for performance.
- Only 40% of all active-duty personnel surveyed get the recommended seven to eight hours of sleep per night.
Sleep is an important factor in recovery. Poor sleep habits can take a physical and mental toll on your health, your relationships, and your performance.
Tobacco and alcohol
One area where the military could improve is in the use of tobacco products and alcohol:
- Almost one-quarter of service members reported smoking a cigarette in the 30 days prior to taking the survey, which is higher than the civilian population and the Healthy People objective.
- Smokeless tobacco use is also prevalent in the military with 12.8% of all service members using smokeless tobacco in the month leading up to the survey.
- Rates of binge drinking were higher in the military than in the civilian population and more prevalent in the Marine Corps than in any other branch.
Tobacco in any form is detrimental to your health. If you’re thinking about quitting smoking or would like to talk to someone about your alcohol use, there are lots of resources and professionals that can help you achieve your goal.
Stress and mental health
After more than a decade of ongoing war, troops have—and will continue to experience—significant mental stress as a result of their service. In general, 5-20% of service members reported high rates of anxiety, depression, PTSD, and/or other mental health concerns.
- The most common military-related sources of stress were being away from family and friends and changes in workload but included financial problems and family members’ health problems.
- Women reported experiencing personal sources of stress more often than men did.
- Those who drank heavily were more likely to report problems with money and relationships.
Drinking, smoking, overeating, and even attempted suicide are all negative coping factors when dealing with stress. The survey found that the most effective methods of coping were planning to solve problems and talking with friends or family members. Find out how to use productive and effective methods for coping with stress and mental health.
Nutrition and dietary supplements
Being fueled to fight is an important component for anyone in the military. Proper nutrition requires consuming healthy—and avoiding bad and potentially harmful—foods and beverages.
- According to the survey, active-duty personnel eat too many unhealthy foods such as snacks, sweets, and sugary drinks and not enough of the recommended servings of fruits and vegetables.
- More than one-third of personnel reported daily dietary supplement use.
What you decide to put in your body now may affect your performance and your career later. For more information on nutrition for combat effectiveness, read Chapter 15 of the Warfighter Nutrition Guide. And make sure you know what you’re putting into your body. Dietary supplements are not subject to pre-market approval by the FDA, and there are many ingredients that may do more harm than help. You can learn more about dietary supplements at Operation Supplement Safety. And for more information about the Health Related Behavior Survey, visit TRICARE’s webpage.
Since we first posted our list of DMAA-containing dietary supplement products in December 2011, and especially since FDA’s announcement in April 2013, the number of products being manufactured with this ingredient has continued to decline. Our search does still occasionally turn up products with DMAA that were not on our previous lists: just six new products have been added since our last update in April 2013. Despite these additions, this update shows that about 80 dietary supplement products are apparently still being manufactured with DMAA, but note that many are by non-U.S. sources. Over the lifetime of this list 125 products have been discontinued or reformulated to exclude DMAA, including some of the most well-known ones. To the best of our knowledge and searching, 68 of these no longer appear for sale, even from distributor stock. You'll find our updated list of products containing DMAA here.
Dendrobium is being used as a dietary supplement ingredient in some pre-workout products marketed to enhance physical or athletic performance. What is it? And is it effective? Read this OPSS FAQ about dendrobium to find out. Be sure to check back often, as we add answers to other questions about ingredients in performance and weight-loss supplements and how to choose supplements safely.
If you have more questions about a particular dietary supplement ingredient or product, please use our “Ask the Expert” button located on the OPSS home page.
The annual Army “Strong B.A.N.D.S.” campaign is set to launch for another year beginning in May. Strong B.A.N.D.S. promotes physical fitness, nutrition, optimal health, and resilience by focusing on Balance, Activity, Nutrition, Determination, and Strength—forming the acronym B.A.N.D.S. The campaign has activities at numerous garrisons to help educate soldiers, their families, and civilians. Strong B.A.N.D.S. is a campaign of the U.S. Army Installation Management Command Family and Morale, Welfare and Recreation directorate and is “designed to energize and inspire community members to live a healthy lifestyle.”
Check out the website for detailed information and to see if there is a Strong B.A.N.D.S. activity near you.
Carnitine is a naturally occurring substance in the human body that helps cells use fat for energy. The liver and kidneys can produce carnitine from amino acids provided by the diet, but carnitine also comes from many foods, especially red meat, and is an ingredient in many dietary supplements and energy drinks.
Sometimes doctors use carnitine to treat certain heart conditions. Recent clinical trials suggest that carnitine supplements may help reduce many of the complications associated with heart attacks, such as chest pain and irregular heart rhythms.
But new research suggests that long-term consumption of dietary carnitine also may play a role in the development of atherosclerosis—“hardening of the arteries”—especially in people who eat red meat regularly. So what’s the bottom line? More research is needed to determine the risks and benefits associated with carnitine.
You can learn more about carnitine in HPRC’s Dietary Supplement Classification System.
DMAA, which the Food and Drug Administration (FDA) announced illegal in dietary supplements on 11 April 2013, has been used in many weight-loss, bodybuilding, and performance-enhancement products. HPRC has received many questions about it use by military personnel. To help answer questions about DMAA in general, we put together an Operation Supplement Safety (OPSS) FAQ. OPSS also has FAQs about Jack3d and OxyElite Pro, two popular dietary supplement products. Be sure to check back often as we add answers to other questions about ingredients in performance-enhancing and weight-loss supplements and how to choose supplements safely.
The Food and Drug Administration (FDA) has issued a Consumer Update warning of the potential dangers of DMAA, which was announced illegal in dietary supplements on 11 April 2013. DMAA is also referred to as dimethylamylamine and other names. This dietary supplement product ingredient has been used in many weight-loss, bodybuilding, and performance-enhancement products. FDA received numerous reports of illnesses and death from the use of products containing DMAA; commonly reported reactions include heart and nervous system problems as well as psychiatric disorders. DMAA has been the focus of conflicting information regarding whether or not it is a natural extract from geranium. FDA has now found “the information insufficient to defend the use of DMAA as an ingredient in dietary supplements.” Online, FDA also stated, "Dietary supplements containing DMAA are illegal and FDA is doing everything within its authority to remove these products from the market."
For more information, read the FDA Q&A on DMAA here.
Energy drinks have been in the news lately, mostly due to media reporting on a group (doctors, researchers, scientists, and politicians) writing to the Food and Drug Administration (FDA) to express concern over the use of these drinks by adolescents. Much of the concern has to do with the amounts of caffeine in these drinks, among other issues. Energy drinks also may contain large amounts of other stimulants, including guarana, yohimbe, yerba mate, kola nut, methylsynephrine, Citrus aurantium (Bitter Orange), and Ma Huang (ephedra). Although listing the total amount of caffeine on the label would help, consumers should be aware that there are often other stimulants in energy drinks.
The American Academy of Pediatrics has written several articles over the last year about the potential risks associated with the adolescent population using energy drinks. One very recent article outlines the harmful effects of energy drinks on adolescents, including increased heart rate, high blood pressure, anxiety, digestive problems, sleep disturbances, and dehydration. The withdrawal effects after habitually consuming energy drinks is also an issue, as it can lead to headaches and attention problems. Also, the ingestion of energy drinks by adolescents who take prescription drugs for Attention Deficit Hyperactivity Disorder (ADHD) or who have eating disorders or diabetes is another topic of concern.
The amount of caffeine contained in energy drinks is not regulated, as the FDA does not regulate caffeine in foods or beverages, except that the maximum concentration for caffeine in cola beverages is 71 mg per 12 oz. The amount of caffeine in energy drinks ranges from 50 to more than 500 mg per can or bottle. The American Academy of Pediatrics recommends that children and teens drink no more than 100 mg of caffeine per day. To put that in perspective, an eight-ounce cup of coffee typically contains about 100 mg of caffeine (or more), and the most popular caffeine-containing sodas contain around 30 to 55 mg in a 12 oz. can. Not knowing how much caffeine and other stimulants are contained in energy drinks is a potential health threat.
Furthermore, the caffeine and other stimulants contained in the energy drinks, when combined with alcohol, can mask the symptoms of alcohol intoxication, potentially leading to risky behavior. The American Academy of Pediatrics advises parents and doctors to talk to children about the dangers of mixing alcohol and energy drinks, and the Centers for Disease Control and Prevention has a fact sheet on the potential risks.
Parents, educators, and healthcare professionals need to focus on educating adolescents about potential problems associated with consuming these high-stimulant products. Companies are heavily marketing their products by featuring athletic superstars, which causes children and adolescents to confuse energy drinks with sports drinks. Generally speaking, adolescents don’t need energy drinks, and they should be made aware of the potential dangers. It’s definitely a case of “buyer beware.”
Visit HPRC’s Operation Supplement Safety (OPSS) to access resources on the informed use of dietary supplements.
Raspberry ketone, touted to be an effective fat-loss and weight-loss supplement, occurs naturally in various red raspberries. The raspberry ketone in supplements is probably produced in the laboratory, as it would be too expensive to extract it from real raspberries. FDA recognizes that raspberry ketone as a food additive is “Generally Recognized as Safe” (GRAS) to consume in small amounts. However, the long-term effects in humans who consume it as a supplement are unknown. For more information, read HPRC’s InfoReveal on “Raspberry ketone.”
Be extra cautious when taking dietary supplements before and after surgical procedures; some products can have serious negative effects on surgical procedures. For instance, certain supplements prevent certain blood cells (platelets) from clumping, resulting in excessive bleeding during surgery. Some of the ingredients commonly found in supplements that hinder platelet aggregation are ginko biloba, saw palmetto, glucosamine, black tea, fish oil, and garlic. If you are having a surgical operation, consider abstaining from these items or consume these items in moderation a few weeks before and after the procedure. For more a complete list of products and additional information, including other surgical risks associated with dietary supplements, read this web page from the Natural Medicines Comprehensive Database. And always read product labels carefully; many include warnings of potential medical risks, including the length of time prior to surgery that you should discontinue use.