The report, issued this month, was prepared by the Institute of Medicine (IOM) at the request of the US Department of Defense, the Samueli Institute, the National Institutes of Health, and the Food and Drug Administration.
The examination was initiated due to concerns that the current lack of guidance could compromise the health and performance of military personnel, who have specific nutritional needs and who face special conditions such as extreme heat or cold or risks such as injury or bleeding.
The IOM committee that prepared the report made three major proposals to manage the safe use of supplements by this population group: A system to monitor use; a framework to determine the level of concern for supplements in a military context; and a system to report adverse events.
Supplement usage
IOM reports that over two-thirds of the military (69 percent) are using supplements, which is statistically similar to usage by the general population (73 percent).
However, military personnel are more likely to be using multivitamins only, it said. This highlights opportunities to increase usage of single supplements, minerals, and other supplements, whose benefits may be advantageous to a military lifestyle.
"The main driver of overall military supplement usage is older age, but the relationship is relatively weak. High usage of sports nutrition and muscle-building
supplements by the youngest age group may be diluting the strength of the relationship," wrote the report.
"Opportunities, therefore, exist among the younger age groups to increase supplement usage beyond sports and bodybuilding nutrition."
Monitoring usage
IOM suggested that the current quantity and quality of data collected on supplement use by the military needs to increase.
Additional surveys should be conducted that would include questions related to both adverse events and beneficial outcomes, as well as the use of specific supplements that may be of concern, said the committee.
These data could then be used as a signal to apply the framework recommended by the group that would determine the level of concern about particular supplements.
Supplements of concern
"Determining the effects of dietary supplements on military personnel is important, particularly because of the extent to which their vulnerabilities and needs can differ from the general population," writes the report.
"The committee recommends that the military initiate reviews on those dietary supplements that raise an initial concern."
The severity of adverse events and the prevalence of use would be the two major criteria by which to begin a review.
However, IOM identified three challenges in applying a framework to determine the level of concern: Insufficient data on safety; dietary supplements that contain multiple ingredients; and the potential presence of contaminants.
Adverse event surveillance
"Even minor detriments to health, which may cause only minimal discomfort to a civilian, such as mild dehydration, might compromise a service member's performance and the success of the military operation under certain circumstances," said the committee.
It therefore highlighted the importance of a system to report, analyze, and identify concerns associated with the use of dietary supplements within the military, suggesting that the current reporting system for medicines be extended to include supplements.
The system would then serve as a signal to initiate the review of a supplement, or to restrict use.
The surveillance system would need to include: An adverse events reporting system; a forum to exchange data on supplements; and an increase in the reporting of adverse events.
"Until such a system or approach is in place, our service members will continue to make decisions about their own health without knowing the risks and benefi ts associated with supplements under military contexts, potentially compromising their performance and the resulting success of military operations," concluded the report.
For the full report, click here .
