Page 133 - JSOM Winter 2018

An Ongoing Series

What the SOF Community Needs to Know
About Dietary Supplements

Patricia A. Deuster, PhD, MPH

ABSTRACT
Dietary supplement (DS) use by military members and Special readiness. Importantly, a variety of DS products are readily
Operations Forces (SOF), in particular, is high. The “sports available in retail stores on military bases (e.g., Exchanges,
nutrition” market is expected to be one of the fastest growing GNC, 5-Star) and, if not sold on bases, are certainly avail-
segments because a “performance edge” is certainly desirable able over the Internet and niche stores near military bases. It
within the military. DS products are readily available in retail is not surprising SOF Operators and enablers might turn to
stores on military bases, over the Internet, and in niche stores DSs, given their requirement to perform highly specialized
near military bases. Thus, use of some DSs raises a number of and dangerous tasks under extreme environmental conditions
unique concerns, particularly considering the potential for in- (e.g., hot, cold temperatures, high altitude, depth). However,
teractions among combinations of DS ingredients and concur- interactions between combinations of DS ingredients and any
rent medications taken under military operational conditions. concurrent medications taken under military operational con-
5
All those who work with SOF should have a basic understand- ditions are unknown. Thus, use of some DSs raises a number
ing of the DS world. This article briefly reviews selected DS of unique concerns. All those who work with SOF and their en-
regulations, identifies concerns and risks related to various DS ablers need to have a basic understanding of the DS world. This
products, and describes the purpose, functions, and resources article briefly reviews selected DS regulations, identifies con-
of Operation Supplement Safety. Examples of regulatory con- cerns and risks related to various DSs, and describes the pur-
cerns, adverse events, red flags, and tools are provided to help pose, functions, and resources of Operation Supplement Safety
SOF communities sustain their health and performance. (OPSS). Examples of regulatory concerns, adverse events, red
flags, and tools are described to help SOF communities sustain
Keywords: adulteration; human performance; new dietary their health and performance.
ingredient; regulations; tainted products; supplements
Regulations

Introduction Dietary supplements are regulated by the Dietary Supplement
Health and Education Act (DSHEA) of 1994, which laid out the
Dietary supplements (DSs) are a billion dollar industry. In major framework for DSs and defined them as those products
2000 or so, the DS market was valued at approximately $12 (except tobacco) containing one or more of the following di-
billion, whereas in 2016, it was valued at $132.8 billion, with etary ingredients: vitamins, minerals, herbs or other botanicals,
1
the expectation or forecast of reaching $220.3 billion in 2022. amino acids, and other substances (e.g., enzymes, organ tissues,
2
Although no data are available, to my knowledge, regarding glandulars, and metabolites). Dietary supplements are intended
9
how much money the industry derives from military members, for ingestion and to supplement the diet by increasing the total
it is reasonable to expect a large share. Why? Because DS use dietary intake of that ingredient, and were placed in a special
9
by military members and Special Operations Forces (SOF) category under the general umbrella of “foods,” not drugs. As
3–6
is high. The sports nutrition market is expected to be one of such, they are exempt from US Food and Drug Administration
7,8
the fastest growing segments because a “performance edge” is (FDA) drug approval standards. Moreover, the FDA does not
certainly desirable within the military. evaluate the safety, efficacy, or quality of DS ingredients or
products. Thus, DHSEA permits products to be marketed with
Although, in fact, SOF Operators may augment their diets with limited content labeling, no documented health benefits, and
DSs (e.g., protein powders and beverages, omega 3, vitamin little or no safety data. This regulation may have been suitable
D), some products can potentially cause harm and compromise in 1994 when only about 4,000 DSs were available, but not in
Correspondence to Patricia A. Deuster, PhD, MPH, Consortium for Health and Military Performance; Department of Defense Center of Ex-
cellence Department of Military and Emergency Medicine Uniformed Services University, 4301 Jones Bridge Rd, Bethesda, MD; or patricia
.deuster@usuhs.edu
Dr Deuster is a professor and director of the Consortium for Health and Military Performance: A Defense Center of Excellence, Department of
Military and Emergency Medicine, Uniformed Services University, Bethesda, MD.

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