Page 97 - JSOM Winter 2018

FIGURE 1 Individual response in average response time to reactive whereas three of five participants (60%) in the PL group cor-
agility assessment. rectly identified their targets.
Thick dotted line represents average of each group. P, placebo; Post,
after; Pre, before; PSE (SERA in figure), proprietary spearmint extract The motivation to examine the PSE supplement was based on
with rosmarinic acid.
previous evidence that ingestion of these herbal ingredients
may enhance cognitive function 4,6,7,17,18 and reduce oxidative
stress and inflammation. 5,19-21 It was thought that the combi-
nation of these herbal ingredients could potentially offset the
negative sequelae associated with sleep restriction and/or sleep
deprivation. Though none of the outcomes in any of the phys-
ical performance measures was statistically significant, the ef-
fects of PSE supplementation on subjective feelings of energy,
focus, and alertness do provide support for the suggested ben-
efits of this supplement during sleep deprivation. In addition,
although the change in reactive agility between groups was
unclear, the 74% faster response time in the PSE group does
stimulate interest in additional investigation with a larger par-
ticipant population.
To the best of our knowledge, no previous investigations have
examined the efficacy of this herbal combination as an ergo-
Analysis of executive function revealed that during PRE test- genic aid. This herbal combination, using a similar dosing pro-
ing, all five participants in the PL group engaged the cor- tocol on tolerability and safety, has been examined by Lasrado
rect target, whereas four of five subjects of PSE engaged the et al., who reported no significant alterations in gastrointes-
22
correct target. After supplementation, on POST testing, all tinal tolerability, endocrine profile, and whole-blood hematol-
five participants in the PSE group engaged the correct tar- ogy after 90 days of supplementation. In addition, a 900mg
get, whereas only three of five participants in the PL group dose of PSE has been shown to provide more than a 100-fold
engaged the correct target. Fisher exact test results revealed safety margin when using the no observed adverse effect level
no significant differences (p = .64). The mean time (± stan- during a 90-day safety study. Our results were consistent
23
dard deviation) from puzzle construction to the completion with these studies in that only one participant reported gastro-
of target engagement was 249.4 ± 89.8 seconds and 196.4 ± intestinal discomfort and he was part of the PL group.
48.3 seconds for the PL and PSE groups, respectively, at PRE.
After the high-risk arrest and 24-hour sleep deprivation, the The small sample size per group was a definite limitation of
total time from puzzle construction to completion of target this study. However, investigating an elite team of counterter-
engagement was 211.0 ± 101.3 seconds and 184.2 ± 29.6 ror operators limits the ability to recruit a large group, because
seconds for the PL and PSE groups, respectively, at POST. as the subject pool is quite small. However, the opportunity to
The PRE and POST differences between the groups were un- examine this elite group with outstanding skill levels provided
clear (Table 1). a unique opportunity to explore the potential effects of a nu-
trient intervention in participants with a highly mastered skill
during periods of fatigue. In addition, measuring inflammatory
Discussion
and oxidative stress markers would provide potential support
The results of this study indicate that 17 days of a PSE can for PSE as an antioxidant. However, considering that POST
likely improve subjective feelings of energy, focus, and alert- testing occurred during an actual mission, collecting blood
ness after a tactical operation that occurred during a 24-hour samples was not an option. However, future studies should
period of sleep deprivation. The ability of the supplement to recruit a larger sample of participants and consider examin-
provide benefit on the physical performance measures was ing the effect of this supplement intervention on the inflam-
interpreted as unclear. Similarly, no statistical difference was matory response to stress and fatigue. In summary, although
observed between the PL and PSE groups in target identifica- the results of this study do not provide conclusive evidence on
tion. However, it was interesting to note that all participants in the efficacy of spearmint extract containing rosmarinic acid, it
the PSE group correctly identified their targets after the high- does suggest that additional research is warranted in a larger
risk operation accompanied by 24 hours of sleep deprivation, sample of participants.

TABLE 2 Magnitude-Based Inferences on Change Scores in Serial Subtraction and Subjective Measures of Energy, Focus, Fatigue, and
Alertness After Supplementation
PSE Trivial PL
Variable Mean Difference a % Chance Greater Interpretation
Serial subtraction 0.8 ± 4.2 38.0 45.2 16.8 Unclear
VAS: energy 5.1 ± 4.1 95.8 2.7 1.5 Very likely PSE
VAS: focus 1 ± 0.67 53.4 46.6 0.0 Possibly PSE
VAS: fatigue −1 ± 3.2 20.1 19.2 60.7 Unclear
VAS: alertness 3 ± 3.8 83.5 11.7 4.9 Likely PSE
PL, placebo; PSE, proprietary spearmint extract containing rosmarinic acid; VAS, Visual Analog Scale.
a Mean differences are reported as mean ± standard deviation.

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