Nutritional Armor: Dietary Supplements in the Military
The special issue, entitled Nutritional Armor: Omega-3 for the Warfighter, reports findings from an expert panel convened by Samueli Institute and the National Institutes of Health (NIH) to assess the optimal level of fatty acids in a typical military diet.
Historically, policies and guidelines for the use of supplements by service members focused almost exclusively on product quality and safety while warning against unproven health claims. Adverse effects from supplement use in the military have gotten widespread publicity and sometimes resulted in banning of a supplement or ingredient.
The publication of the special issue of Military Medicine indicates a shift from mostly reactive to a more proactive interest in the use of dietary supplements for the benefit of service members. Military leaders are now beginning to look at if and how supplements might be recommended for protecting warfighters from injury, accelerating their recovery and enhancing their performance.
The special issue of Military Medicine seeks to identify how the proper balance of fatty acids can improve health, performance, brain function and response to injury. As an unconventional workplace, with special demands and risks, the military has a unique opportunity to affect the dietary intake for its employees and help guide dietary decisions that can result in a healthier, more productive workforce. Active duty soldiers are often captive diners eating at facilities on base both at home and in a deployed environment. Finding the right nutritional balance is particularly important for this group, whose dining choices are made by a combination of procurement staff, defense logistics personnel and health education professionals, long before that soldier steps into the food line or opens an MRE in the field.
As reported in the special issue, the expert panel convened by Samueli Institute and NIH unanimously agreed that a military Daily Recommended Intake for omega-3 fatty acids should be established while also working to lower current intakes of omega-6s. In addition, general health, performance, depression and suicide prevention, post-traumatic stress and traumatic brain injury were areas of interest to the panel. As adverse side effects were deemed small to negligible, they determined:
- Sufficient evidence exists to support increasing omega-3 intake for:
- Cardiovascular, immunological, and surgical benefits
- Depressive symptom reduction and possibly suicide prevention
- Preloading with omega-3 fatty acids before combat exposure may be beneficial
- Promising evidence exists for enhanced recovery from traumatic brain injury
- Insufficient data were available to evaluate post-traumatic stress disorder and impulsive aggression
For optimal health, results from well-conducted food, diet and supplement studies might be better interpreted when considering the dietary ratio or balance of omega-3 and omega-6. Nutrition scientists are examining the literature for evidence that omega-3 supplements cannot overcome the risks associated with diets with excessive omega-6. Based on studies analyzing omega-3 and omega-6 fatty acid balance, the panel concluded that there should be a concerted attempt to elevate the omega-3 status among U.S. military personnel.
However, the science is incomplete. Questions still remain about the optimal omega-6/omega-3 balance for each condition, how to best ingest these nutrients and exactly how the body reacts to them. But current and ongoing research is helping to build an evidence base and refine our understanding.
Where to Go from Here
While I am pleased that Samueli Institute and NIH were able to provide some guidance to the military as they look to improve the lives of service members, I am more intrigued by the possibility of a military leadership keen to explore the positive potential of diet, nutrition and the use of dietary supplements. The strain of more than a decade of active warfare, with its accompanying stresses of multiple deployments, extended separation from family, and frequent challenges in re-integration upon return in the form of post-traumatic stress, has left the military in need of new approaches to these challenges. This includes examining the evidence base for the use of dietary supplements to fill these gaps.
Specifically, the military has needs in the following areas:
- Reduce chronic pain
- Optimize performance
- Support sleep quality and quantity
- Reduce reliance on prescription drugs
- Improve mental health
- Mitigate post-traumatic stress
- Optimize cognitive function
- Buffer the effects of extreme environments
In 2013, the U.S. Army Surgeon General, LTG Patricia Horoho, launched a new initiative to shift the Army Medical Command from a health care system to a system of health. The project, named the Performance Trial, rests on a framework of three keys to build and sustain health: activity, nutrition and sleep. Like the shift indicated by the examination of potential benefits of fatty acids in the diet of service members, General Horoho’s change in approach to health and wellbeing indicates a military that is seeking proactive opportunities to support the health of service members at home and abroad.
Currently Samueli Institute is engaged in several research programs with the military focused on dietary supplements and nutrition—including a Congressionally-mandated, two-year project to examine dietary supplement use and optimal brain and cognitive function in the military. But there is considerably greater opportunity available to support this important population and related population groups of first responders.
An evidence-based approach to health and performance enhancement with food, diet and supplements is ripe for a new look. Samueli Institute has been providing the tools for moving food and supplements into that vision. Using our trusted relationships with the military and our research tools such as SEaRCH™ we seek to work with those in the food and supplement domains to advance our understanding of these areas for the benefit of or service members, their families and out country. For more information see: www.samueliinstitute.org or contact Keri Marshall.