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HPRC Fitness Arena: Dietary Supplements
The Food and Drug Administration (FDA) has issued warning letters to 15 companies regarding illegally marketed diabetes products that are in violation of federal law. These products are either dietary supplement products or unapproved prescription drugs with claims that they “prevent and treat diabetes” and “can replace medicine in the treatment of diabetes.”
FDA is warning consumers to stop using these products since they may harmful, and their use may interfere with receiving the necessary medical treatment for diabetes. More information is provided in FDA’s “Illegally Sold Diabetes Treatments,” which includes the news release, warning letters issued, and a consumer update.
The dietary supplement and fitness industries are filled with sport drinks, powders, bars, pills, gels, footwear, clothing, and an array of devices all claiming to provide you with a competitive advantage, whether it be improved performance or enhanced recovery. With the ever-growing popularity of team and individual sports, professional and recreational athletes of all ages are an easy target for these claims. But how many of these claims are backed by evidence-based research?
A recent report now reviews the quality of evidence behind the claims of improved sports performance made by advertisers for a wide range of sports-related products, including sport drinks, supplements, footwear, and clothing. The team identified 431 performance-enhancing claims for 104 products advertised in more than 100 general, sport, and fitness magazines in the UK and U.S. for a single month in 2012. They found that more than half of the advertisements and their associated websites provided no evidence to support the claims of enhanced sports performance. Only 146 references were found, and only 74 of these met basic criteria for research quality and almost all of the 74 were found likely to be biased or lacking scientific objectivity. Only three studies were rated as “high” quality and probably unbiased. Such lack of evidence makes it very difficult for consumers to make well-informed decisions about using performance-enhancing sports products.
This review makes it clear that many of the claims made for sports and fitness products lack reliable evidence to support them and that more and better studies are needed to help inform consumers. In the meantime, consumers should be cautious when reading claims of enhanced performance and recovery and always remember that “true” evidence-based results mean that a substantial number of independent research studies have been performed, with findings that clearly support the claims made by advertisers. Presently, there is still no substitute for sound physical conditioning and nutrition practices.
For more information on dietary supplements and how to choose supplements safely, please visit Operation Supplement Safety (OPSS). For information on physical fitness and conditioning, please explore HPRC’s Physical Fitness domain. The original British Medical Journal open-access article is available online.
Tribulus terrestris is used as an ingredient in some dietary supplement products marketed as testosterone “boosters” and/or to enhance muscle strength. What is it and does it work? Read this OPSS FAQ about Tribulus terrestris to find out. Also, be sure to check the OPSS section often, as we add answers to other questions about ingredients in performance-enhancing and bodybuilding supplements. OPSS can help you learn how to choose supplements safely.
If you have a question about a particular dietary supplement ingredient or product, and you can’t find the answer on our website, please use our “Ask the Expert” button located on the OPSS home page.
Operation Live Well is a new wellness campaign by the Department of Defense that aims to make healthy living the easy choice and the norm for service members, retirees, DoD civilians, and their families. They point out resources for how to eat better, stay physically active, quit or avoid tobacco, and stay mentally fit. The educational, outreach, and behavior-change initiatives provide tools and resources to help you learn about healthy lifestyles. You’ll also be able to develop your own personalized health plan via the Operation Live Well website soon.
A second part of Operation Live Well is their Healthy Base Initiative (HBI), which aims to help the defense community reach or maintain a healthy weight and avoid tobacco use. Scheduled for launch during the summer of 2013 at 13 military installations and DoD sites worldwide, HBI will offer a range of installation-tailored, health-related programs that will be measured for their effectiveness. The programs that are most successful will eventually be expanded to other installations.
For more information on Operation Live Well, visit militaryonesource.mil/olw.
Cheeba Chews are marketed as chocolate taffy, but they actually contain an illegal substance. Read the Operation Supplement Safety (OPSS) FAQ to find out more about these products and whether they are legal for members of the military community to consume. Be sure to check back often as we add answers to other questions and topics in the OPSS section of HPRC’s website.
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.