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Alerts

RegenESlim Appetite Control Capsules voluntarily recalled due to the presence of DMAA.

FDA warns consumers about caffeine powder. 

FDA advises consumers to stop using any supplement products labeled as OxyElite Pro or VERSA-1. Please see the following advisories: FDA -10/08/13, FDA - 10/11/13 and CDC - 10/08/13.

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Announcements

New article on reporting side effects of supplements
Just published in The New England Journal of Medicine: A recent article brings up dietary supplement issues you need to be aware of and discusses how dietary supplement side effects could be monitored better. A PDF of the April 3rd article is available free online.

DMAA list updated for April 2014

Fueling Performance Photo Campaign
Share photos of how you fuel your performance and be featured on our Facebook page!

Dietary supplement module
Earn continuing education credits (if eligible) for this two-hour online module.

Operation LiveWell

Performance Triad

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HPRC Blog

Welcome to the HPRC Blog. We've got lots of information here, from quick tips to in-depth posts about detailed human performance optimization topics.

HPRC Fitness Arena: Total Force Fitness

How families can benefit from the USDA’s switch to MyPlate

The USDA’s new MyPlate program is designed to make learning about and practicing healthy eating habits more appealing and more fun for all members of the family.

The USDA announced on June 2, 2011, that its classic food guide Pyramid is being replaced with the easy-to-understand and interactive MyPlate. Using a “familiar mealtime visual,” MyPlate is intended to remind Americans about balancing meals with the five food groups: fruits, vegetables, grains, protein, and dairy. Based on the 2010 Dietary Guidelines, notable changes to the new guide are the inclusion of more fruits and vegetables, less grains, and the re-categorization of oils as providing “essential nutrients” but not appearing on the plate.

The result is a simple visual graphic of a balanced meal that families can use as a tool to make sure the portions of the major food groups are covered in meals. The simplicity of the graphic helps ALL family members, especially children, become more engaged in what and how much they should be eating. An interactive plate on the MyPlate website allows users to click on each section of the plate, which then displays a page for the selected food group with description, key message, and a list with pictures of single-serving sizes of some common foods in that group. These changes allow families to easily identify what a healthy, balanced meal looks like. Also featured is an Interactive Tools section that enables users to develop personalized plans and learn about specific healthy food choices. When all family members know the basics of healthy eating, mealtime can truly be a shared event.

MyPlate can also encourage family discussions about healthy foods, which can help develop good eating habits by all members of a family. For example, you can find out if there are any particular foods that family members like or dislike, and then find and offer alternatives in the specific food group of a disliked item. This will help eliminate the likelihood that someone will skip the essential healthy components of a meal. Get everyone excited and involved during mealtime! Fun meals shared as a family can promote healthy eating habits for children that they can carry into adulthood and can reinforce family bonding.

Keep in mind that MyPlate isn’t designed as strict rule to be followed—it’s perfectly fine to have dairy products directly on the plate instead of in a cup. Desserts, which are currently placed in the “Empty Calories” section, are okay when consumed in moderation in appropriate portions. You may still have to seek out other sources for how to prepare foods in healthy ways and to determine for the nutrition content of many food items. The information on MyPlate should be used as a tool to build a foundation of knowledge about food choices and help set healthy eating goals for your family. Families should take this change as an opportunity to get the entire family involved in healthy eating.

Sleep Apnea and athletic performance

HPRC Fitness Arena: Mind Tactics, Total Force Fitness
Sleep apnea is a disorder caused by the decrease or pause in the airflow or breathing during sleep. It can lead to daytime sleepiness, fatigue, and cognitive impairment, all side effects that could negatively impact athletic performance.

NBA superstar Shaquille O'Neal recently announced that he will retire from professional basketball after 19 seasons and four championship rings. In addition to that announcement, O'Neal announced via a YouTube video that he, like 12 million other Americans, had been diagnosed with sleep apnea.

According to his girlfriend, the seven-feet-tall, 300-plus-pounds center snored excessively during the night, and she noticed that his chest would often cease movement entirely. After participating in a Harvard University–sponsored sleep study, he was diagnosed with a mild case of sleep apnea and was advised to begin wearing a CPAP (Continuous Positive Airway Pressure) mask, a respiratory ventilation therapy that assists the wearer’s breathing while asleep. O'Neal's story has a happy ending—because of the recent diagnosis and subsequent treatment, O’Neal reports that he feels more energetic and that his overall quality of life has improved. He is also happy and comfortable with the treatment. Other professional athletes suffering from sleep apnea have not been so fortunate. In 2006, Reggie White, defensive end for the Philadelphia Eagles and Green Bay Packers—one of the greatest players in football history—reportedly died from causes related to sleep apnea.

What exactly is sleep apnea? And how does it affect athletic performance? People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. According to the American Sleep Apnea Association, there are three types of apnea: obstructive, central, and mixed. Of the three types, obstructive sleep apnea (OSA) is the most common. Weight can contribute to sleep apnea. In 2009, a study by Sweden's Karolinska Institute showed that overweight and obese men who lost weight during a calorie-restricted diet over nine weeks had major improvements in their sleep apnea symptoms.

Other risk factors for obstructive sleep apnea include certain physical attributes, such as having a thick neck (which describes many athlete body types), deviated septum, receding chin, and enlarged tonsils or adenoids. Allergies or other medical conditions that cause nasal congestion and blockage can also contribute to sleep apnea.

Signs of sleep apnea include loud and chronic snoring, choking, snorting, or gasping during sleep, long pauses in breathing, and daytime sleepiness regardless of how much time you spend sleeping. Other common signs and symptoms of sleep apnea include waking up with a dry mouth or sore throat, morning headaches, restless or fitful sleep, insomnia or nighttime awakenings, going to the bathroom frequently during the night, waking up feeling out of breath, forgetfulness and difficulty concentrating, moodiness, irritability, or depression.

Untreated, sleep apnea can cause high blood pressure and other cardiovascular diseases, memory problems, weight gain, impotency, and headaches. Moreover, left untreated, it may be responsible for job impairment and motor vehicle crashes.

In terms of athletic/sports performance, sleep apnea is a major concern because sleep apnea causes a disruption to healthy sleep patterns, which in turn can affect physical performance. According to a 2007 Stanford University study of sleep and athletic performance, athletes who extend the amount of sleep they get and reduce their sleep debt are more likely to improve their performance. Conversely, if an athlete does not get a good night’s sleep, then the next day he/she is tired, sleepy, or irritable. In such cases, physical performance also is impaired, since there is limited energy reserve due to the lack of adequate or good-quality sleep.  Sleep apnea not only has an impact on athletes—it affects the military, as well.

So what can you do if you suspect that you or your sleep partner has sleep apnea? The only way to be sure is to undergo a sleep test, which is done in a sleep lab where patients sleep in a special bedroom with electrodes and other sensors attached to various parts of the body. There, you will be monitored throughout the night to keep track of whether and how often you stop breathing, how low your O2 sat (oxygen saturation) goes, and what your brainwaves are doing while you're sleeping.

For additional resources on sleep and sleep apnea, please visit the following:

American Sleep Apnea Association

National Sleep Foundation

How Much Sleep does a Warfighter Need?

National Center on Sleep Disorders Research

The Military Family Fitness Model

The Warfighter’s greatest support usually comes from his or her family, yet families also have to deal with the stress of military life. The Joint Services and the DoD have teamed up to develop a framework for additional support and resources to help families cope with the increased pace of deployment.

Since the beginning of Operation Enduring Freedom and Operation Iraqi Freedom, approximately two million U.S. troops have deployed. The operational tempo associated with these conflicts has led to longer and more frequent deployments with fewer rest periods in between. The inevitable stress is a challenge for military and civilian communities, even as families work hard to reintegrate their families and normal routines.

In response to these ongoing demands, the Chairman of the Joint Chiefs of Staff directed the development of the Total Force Fitness (TFF) initiative, a new Department of Defense model that focuses on the health, readiness, and performance of our Warfighters. (See the Total Force Fitness section of HPRC’s website for more information on this initiative.)

Following this initiative, a team of Joint-Service and DoD experts lead by COL Bowles of the Uniformed Services University of the Health Sciences (USUHS) came together to create a model that promotes family fitness, resilience, and optimal well-being for service members and their families. This model, which is still in development, is called The Military Family Fitness Model (MFFM).

The MFFM first examines stress-inducing demands placed on military and civilian families from sudden deployment and the return home. Then, looking to build on the resilience of the family, MFFM provides guidelines, skills, and resources for the individual, family, and community to protect against the negative effects of stress. As sources of stress increase, certain behaviors indicate the need for more support (e.g., family strife, children acting out, job instability for non-service members, family role conflict, non-supportive relationships outside the family, and/or domestic violence). With MFFM, families have individual, family, and community resources for additional support. The aim of the model is to foster a multi-level approach that strengthens family resilience and, as a result, Warfighter resilience.

Individual approaches to addressing stress include breathing exercises, yoga, mindfulness exercises, and cognitive restructuring. Family strategies include developing and maintaining strong communication skills, shared family routines, and the building of support networks. The bottom line of the MFFM is that at any point along the model, individuals, families, and communities can strengthen resilience resources to promote total family resilience and fitness.

Members of the MFFM team presented the Military Family Fitness Model at the USDA/DoD Family Resilience conference at the end of April. We encourage you to get more information on the conference presentation, read the abstract, and see the PowerPoint slides presented.

DCoE's (Defense Centers of Excellence) report [PDF] on the Family Conference can be read here.

New Army resilience training program targets NCOs and spouses

HPRC Fitness Arena:
The two-week Soldier 360° resilience training program for Warfighters and their spouses is being implemented by the Army with a focus on NCOs.

Soldier 360° is a resilience program being implemented by the Army for Warfighters who have combat experience and their families. In fact, Warfighters take the second half of the two-week class with their spouses, while childcare is provided for those who need it. It’s aimed at non-commissioned officers who are nominated by their commanders. The course provides Warfighters with information and strategies on stress management, anger management, relaxation, health, communication, conflict resolution, nutrition, sleep, combat stress, and management of non-optimal behaviors. It also teaches physical fitness, yoga, meditation, conditioning, injury prevention, and pain management. The program combines financial counseling with Military and Family Life Consultant Program counselors, acupuncturists, physicians, and a myriad of others. Read another article from Army.mil for more information.

Comprehensive Soldier Fitness adds to the roster of total force fitness programs

HPRC Fitness Arena:
The Army’s CSF program—now adapted for the Air Force, Navy, Marines, DoD civilians, and families—provides another avenue to total force fitness.

True total force fitness and overall well-being are crucial to Warfighter readiness and success, and awareness of this is now spreading like wildfire. Admiral Mullen’s Total Force Fitness Initiatives center on the importance of mind, body, family, and environment for overall Warfighter resilience.

There are numerous programs within the military designed to support and enhance Warfighter resilience – some unit specific and some branch or joint-service specific. The HPRC is in the process of gathering information on these myriad programs and highlighting those that are clearly evidence-based, that highlight the importance of mind-body integration, and that teach Warfighter-relevant skills and strategies for performance optimization.

Last week we added a section in our Total Force Fitness domain on the Comprehensive Soldier Fitness (CSF) program. We describe the program, give step-by-step information about  its components, and highlight where to go for more information and program participation.

To give you a brief overview, CSF is an integrated Total Force Fitness (TFF) resilience-building program developed by the Army in collaboration with researchers in positive psychology and resilience building. CSF is designed to give Warfighters, their families, and their communities the knowledge, skills, and behaviors to “thrive in their lives” and successfully adapt to life’s challenges. Consistent with some of the components of Total Force Fitness identified by the DoD, CSF has five basic sectors: physical, social, emotional, spiritual, and family.

CSF was initially developed for the Army community, but it has now been adapted for use by the Air Force, Navy, and Marines. In addition, CSF provides training tools specifically designed for family members. Most of the training materials require AKO/DKO access, but the main exception is the family member materials, which are available for immediate download (with registration).

We hope that this new area of our website will be useful, help foster resilience in all, and provide a one-stop shop for previewing some resilience programs ongoing within the military.

Tainted dietary supplements: How do you know?

Dietary supplements do not require approval by the FDA, so how can you know if the supplement you are considering is tainted? Read on for warning signs and new actions by the FDA that can help.

Tainted dietary supplements most often occur among products typically marketed for weight loss, sexual enhancement, and bodybuilding. They can have deceptive labeling as well as undeclared, harmful ingredients. The question is: How can consumers protect themselves from these products?

The Food and Drug Administration (FDA) has recently taken some steps to help consumers look out for potentially harmful dietary supplement products.  Consumers and healthcare professionals can receive notifications from the FDA by subscribing to the RSS feed. The Commissioner of Food and Drugs also sent a letter to the dietary supplement industry reminding them of their responsibility to prevent the sale of tainted products in the United States. The FDA has also made it easier to report to the FDA about tainted products.

Some of these tainted dietary supplement products contain active ingredients of FDA-approved drugs or other compounds that are not classified as dietary ingredients. These products can have serious side effects, including death. The FDA has identified roughly 300 tainted products that are not legal dietary supplements and are warning consumers about the serious side effects of these products. Consumers should be cautious of:

  • Product ads that claim to “melt your fat away,” or claim that “diet and exercise [are] not required,” or products that use the words “guaranteed,” “scientific breakthrough,” or “totally safe.”
  • Products that use numerous testimonials about “results seen” from using the product.
  • Any product that is labeled or marketed in a foreign language. Consumers should not buy or consume these products.
  • Products that are marketed as herbal alternatives to FDA-approved drugs.
  • Products marketed and sold on the Internet.

    There have been some recent voluntary recalls due to FDA investigations of dietary supplement products. Some of these have included weight-loss products that contained the prescription drug ingredient sibutramine. Sexual enhancement products have also been recalled for containing the undeclared drug ingredients sulfosildenafil and tadalafil. Other products marketed as supplements have been identified as containing various prescription drug ingredients.

    It is important that consumers be aware that, under the Dietary Supplement Health and Education Act of 1994, companies do not need FDA approval prior to marketing such products. Thus, generally speaking, the FDA does not approve dietary supplements.

    Consumers need to be savvy when they make product purchases, and when in doubt, check with a healthcare professional or registered dietitian to determine if you need a dietary supplement product and to help determine what could be a tainted product. If it looks too good to be true, chances are it is.  For more information, read the “FDA’s Beware of Fraudulent ‘Dietary Supplements’.”

    Did you get enough sleep?

    If you needed an alarm clock to wake up this morning, you probably didn't get enough sleep. You know you have had enough sleep when you are able to wake up naturally, feeling refreshed.

    The amount of the time spent sleeping is decreasing: the average amount of sleep reported for middle-aged people in the late 1050s—around eight to nine hours—has decreased in recent times to about seven or eight hours. And the number of individuals who sleep less than six hours each night has significantly increased. These changes in sleep patterns may be indicative of sleep deprivation in society at large. This is not surprising, as the modern society seems to offer twice as much work (on the job, at home, etc.) and half as much time to complete it. Consequently, we are awake for extended periods of time, thus reducing the amount of time we spend sleeping.

    However, we all know that sleep is essential! Sleep is vital to restore and renew many body systems; and sleep deprivation may result in poor performance, increased sleepiness, reduced alertness, delayed response time, difficulty maintaining attention, decreased positive mood, and increased long-term health risks. Some research studies have even shown that sleep deprivation is associated with increased risk of death.

    So adequate sleep is vital for everyone to optimally perform the activities of daily living. But you may wonder, “How can I determine how much sleep I need to function at my best?” Dr. Michael Bonnet, director of the Sleep Laboratory at the Dayton. Ohio, Department of Veterans Affairs Medical Center provides a very simple but practical test you can use to determine how much sleep you need. According to him, if you need an alarm clock to wake up, try going to bed a little earlier the following night (e.g., 15 minutes earlier). If you still need an alarm clock to wake up the next morning, push your bedtime a little earlier again (i.e., another 15 minutes). Continue doing this until you no longer need an alarm to wake up.

    I actually tried this test and found out I was not the “night owl” I thought I was. It looks like I function at my best if I retire for the night a couple of hours earlier than I used to. Sleep is important! It significantly affects your performance, health, and quality of life. And it is especially important to Warfighters, who can rarely get enough when deployed. So in addition to a healthy diet and regular exercise, try to get enough sleep each night whenever your situation makes it possible.

    Source: National Sleep Foundation

    No weights, no gym… No problem.


    Have you ever been tempted to try the exercise equipment advertised on late-night infomercials—the products that promise to enhance various body parts or provide a great workout for a low, low price? Most of it isn’t necessary to get into the shape you want. Some of the most effective workouts can be done at home­­—with only your own body weight. It’s not that equipment is bad—correct use of weights and some machines can be very effective—but it isn’t necessary, nor is it an excuse to prevent you from getting in a good workout when equipment isn’t available.

    There are some clear benefits to exercising at home without the use of equipment, including saving time and money that you would spend at a gym. Most importantly, exercising by using your body weight provides you with the ability to exercise anytime and anywhere—you aren’t restricted only to the times when you have access to the piece of equipment or device. Also, there are a variety of ways to go about a home-based program, ranging from workouts on DVD to a workout you create for yourself. Those already familiar with online workouts may know that YouTube has been afire with videos of extraordinarily fit people demonstrating their workouts done with minimal equipment in their homes, backyards, or local parks. Always proceed with caution—these videos are impressive and can be useful, but realize that they come with a risk of serious injury. Before you begin any home workout, consult your physician and/or an exercise professional to determine what is safe, and best for you.

    We list some examples below of fitness moves that can be performed at home without equipment. These moves should be performed properly and at the right intensity level for them to be effective and safe. The American Council on Exercise (ACE) provides an Exercise Library that displays the proper form for many exercises.

    Core

    Crunches (Supine Reverse, Supine Bicycle)

    Plank (Front, Side)

    Glute Activation Lunges

    Bridge

    Vertical Toe Touches

    Upper Body

    Inchworms

    Push Ups (Standard, Single Leg Raise)

    Downward-Facing Dog

    Superman

    Bird-Dog

    Lower-Body Strength

    Lunges (Forward, Side,

    Bridge (Standard, Single Leg)

    Squats (Single Leg)

    Wall Sits

    Inverted Flyers

    Full Body

    Spider Walks

    Sprinter Pulls

    Mountain Climbers

    Squat Jumps (Cycled Split)

    Jump and Reach

    For a complete workout, visit ACE’s At Home (Without Equipment) Workout.

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    Treadmills vs. elliptical machines – which is better?

    HPRC Fitness Arena:
    A look at two gym favorites.

    Treadmill Elliptical Machines

    Reuters.com has an article that examines the advantages and disadvantages of treadmills versus elliptical exercise machines.

    Read the full article here.

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    Follow-up article questions the validity of military's blood test screening for concussions/TBI

    HPRC Fitness Arena:
    Wired Magazine questions the Army's research on concussions and traumatic brain injuries.

    Doctor Analyzing X-Ray

    In the 10/18 In the Crosshairs, we linked to a story on  from CNN.com that reported on military medical researchers that have developed a blood test that can detect if someone has suffered a concussion or a mild traumatic brain injury.

    In response, Wired.com has an article in their  Danger Room section that calls into question the research that has been done by the Army.

    Read the full article here.