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FIGURE 2 Selection of well-vetted third-party certification logos. also hosts the “DoD Prohibited Dietary Supplement Ingre-
dient List,” part of an Ingredient Database (OPSSID) being
developed. This database is continually updated to contain
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all ingredients found in supplements (including prescription
and unapproved drugs and substances on the Controlled Sub-
stance Act list), with multiple possible synonyms, safety sheets,
FDA, or other federal announcements. OPSS.org also hosts a
section on Performance-Enhancing Substances to educate and
inform potential stakeholders and providers. 76

In 2025, OPSS will launch an app (called OPSSupp). With this
certification for Servicemembers and athletes and is strongly tool, Servicemembers can determine the presence of prohibited
recommended for Special Operators. The fourth (USP) does ingredients and screen the supplement for safety using several
not test for substances banned in sport; however, USP verifies search mechanisms. As such, this app will help Servicemem-
the supplement facts panel claims, claims outside the front la- bers make a purchase decision that mitigates risk.
bel on a product (Principal Display Panel) if appropriate, and
ensures no contaminants (toxic elements, pathogenic micro- Summary
organisms, non-pathogenic microorganism load) are present.
As noted above, the global DS market is a billion-dollar enter-
Importantly, DS products sold through Amazon must now be prise projected to grow at a compound annual rate of 9.0%
1
verified through a third-party Testing, Inspection, and Certifi- from 2023 to 2030. The DS industry is here to stay. Many DS
cation (TIC) organization (new policy effective 2 April 2024). companies are selling products that have been third-party cer-
This policy applies specifically to DS products marketed for tified and will enhance health and well-being. Unfortunately,
sports nutrition, bodybuilding, weight management, and sexual some unprincipled businesses envision huge profits from those
enhancement. These DS categories must now meet GMP stan- serving our county. These companies may put DS products on
dards and content claims and undergo screens for contaminants the market that are adulterated and contain prescription or
and active pharmaceutical compounds banned in sports. Note unapproved drugs. Healthcare professionals must be aware of
that DS products purchased from the Amazon website may not DS products and the challenges some present to maintain our
bear one of the seals with green checks listed in Figure 2. Servicemembers’ performance, safety, and welfare. The DoD
has answered the call to respond to the “dark side” of the in-
If a product does not have one of the seals shown in Figure dustry and the need to educate Servicemembers on the safe use
2, a Servicemember must complete multiple steps. First, they of DSs through the DoD-mandated program, Operation Sup-
must check the DS label to ensure that it does not contain any plement Safety, provided by CHAMP. However, there is a need
prohibited ingredients. If none are found, then the scoring sys- to work together across the professional and federal landscape
tem on the Operation Supplement Safety website should/can to promote testing of DSs for efficacy and safety before they
be used to check their DS. 73 are sold as DSs on the market.

Finding third-party certified DS products can be challenging Author Contributions
but is strongly encouraged. Certified products for omega-3 PAD, JRL, DPH, and ATL wrote the manuscript.
fatty acids, vitamin D, and others are readily available. How-
ever, we could only find one certified product containing nic- Disclaimer
otinamide riboside and no product including N-acetylcysteine The opinions and assertions expressed herein are those of the
(NAC) as an ingredient. Because so many DSs are not third- authors and do not reflect the official policy or position of the
party certified/verified, education is the primary solution. Uniformed Services University or the Department of Defense.
The contents of this publication are the sole responsibility of
DoD-Mandated Education the author(s) and do not necessarily reflect the views, opinions,
Navigating DSs can be difficult, given all the products cur- or policies of The Henry M. Jackson Foundation for the Ad-
rently on the market (and more on the way). Operation Sup- vancement of Military Medicine, Inc. Mention of trade names,
plement Safety (OPSS) team at the Consortium for Health and commercial products, or organizations does not imply en-
Military Performance (CHAMP) has developed resources to dorsement by the U.S. Government. This work was prepared
help Servicemembers who want to use DSs choose wisely. De- by military and civilian employees of the U.S. Government
partment of Defense Instruction (DoDI) 6130.06: Use of Di- as part of the individual’s official duties and, therefore, is in
etary Supplements in the DoD mandates OPSS as the program the public domain and does not possess copyright protection
of record which provides education and educational resources (public domain information may be freely distributed and cop-
necessary for Servicemembers, their families, leaders, health- ied; however, as a courtesy it is requested that the Uniformed
care providers, and allied health professionals. Services University and the author be given an appropriate
acknowledgment).
OPSS.org has a wide array of information and tools to help
individuals make informed decisions about DS use. There Disclosures
is an “Ask the Expert” portal, wherein anyone can receive The authors have no financial relationships or conflicts to
74
evidence-based answers within 8-10 business days. There disclose.
is also an interactive “OPSS Scorecard” described above on
the website called “Check Your Supplement”; it is very useful Funding
for determining quality and risk-stratifying products. OPSS No funding was received for this work.
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Dietary Supplements in the Military | 117