The US military and dietary supplements: The opportunities and challenges

US Military personnel, particularly those on active duty, are under intense physical and psychological strain, often under difficult conditions, so it should come as no surprise that military ‘operators’ look to products like dietary supplements for support.

Survey data shows that usage is significantly higher than the general population, and increases even more when the soldiers move from the garrison to deployment.[1]​

They consume a lot of body building and weight loss products to help with performance and to ensure they meet fitness targets, and this has raised legitimate concerns: A 2016 paper in Drug Testing & Analysis​ reported that an estimated 10% of military personnel use “risky’ supplements.[​2]​

And military personnel are mostly buying their supplements online, despite there being GNCs close to or on base, and these choices are often being made based on recommendations from their mates.

The military has taken an active stance in trying to better educate and inform its personnel with initiatives like Operation Supplement Safety​, an online resource that lists, among other things, the Department of Defense’s prohibited dietary supplement "ingredients".

Education and recovery​

There is clearly demand for safe and efficacious dietary supplement products, but there are reports that brand loyalty is low, and turnover is high.

San Diego-based Krista Austin, owner of Performance & Nutrition Coaching, presented during our Sports Nutrition Summit​ in January about her experiences of working as a research fellow for military research institutes, where she focused on dietary supplement use in the military population.

Austin told us​ that the biggest challenge for the dietary supplements industry is around educating the warfighters:“They’re looking online, and they say, ‘what do I buy next?’ Often, the turnover of the actual supplements they’re using is really high because they don’t know if they’re working for them, so the more you can educate them and show them what does really work and give them evidence, then I think the better.”​

She also said that the biggest opportunity is around recovery, “because their recovery is different”.​

“When they deploy, they’re going to undergo possible energy deprivation, they may not have access to protein sources that are clean, so they’re always going to be looking for supplements that will enhance that recovery, let them maintain their muscle mass – or at least the capacity of the muscle function – and so that’s where I think the opportunities are: To provide them with a safe and efficacious supplement for doing so,” ​she said.  ​

HMB​

There are some studies that have been done on this in active military populations, with two around HMB (beta-hydroxy-beta-methylbutyrate), a metabolite of the amino acid leucine. The ingredient has been studied for its effects on bolstering muscle synthesis and preventing muscle fiber breakdown.

A 2016 paper published by scientists from the University of Central Florida, Ben-Gurion University of the Negev Beer-Sheva, and the Israel Defense Forces, indicated that HMB supplements at a dose of 3 grams per day for 23 days were associated with significantly lower levels of inflammatory markers.[​3]​

This was followed by another study from the same researchers which combined HMB with a probiotic (Bacillus coagulans​ GBI-30, 6086: GanedenBC30). This study, which included 26 soldiers, found that the combination may be more beneficial than HMB alone in maintaining muscle integrity during intense military training.[​4]​

Probiotics​

While we’re talking about probiotics, there’s already data in the literature suggesting how pre- and probiotics may help: Data published in 2017 by Natick scientists showed that the stressors experienced during military training may impact the composition of the gut microbiota and metabolic activity, and increase intestinal permeability by a whopping 62%. [​5]​

Whether prebiotics and/or probiotics can help remains to be seen, but we’ll have a presentation by Dr Ida Gisela Pantoja-Feliciano, research biologist, US Army Natick Soldier, Research, Development and Engineering Center (NSRDEC), at the IPA World Congress + Probiota Americas​​ in Vancouver this summer that discusses this issue in Warfighters.

Omega-3s​

And another ingredient category that’s attracted a lot of attention over the years among the Military is omega-3s. The November 2014 edition of Military Medicine​ focused on the fatty acids as “nutritional armor”, for example, with much interest in the role of omega-3s around lowering the severity of symptoms of post-traumatic stress disorder (PTSD),[​6]​  improving mood and reducing suicide rates among serving and ex-military personnel, speeding recovery from traumatic brain injury, and improving reaction times of fighter pilots.

We’re eagerly awaiting the results of the Ranger Resilience and Improved Performance on phospholipid bound Omega-3s (RRIPP-3) study​, which is exploring if omega-3 supplementation (Aker Biomarine’s krill oil) can improve cognitive processes in high-performing warfighters. The study ended last summer, so the scientists are now in the data analysis phase and we’ll hopefully see some publications this year.

Take home​

What’s clear to me is that there are concerns and challenges around dietary supplement use among the US Military, but also big opportunities.

In order for our troops to function at their highest levels, they need access to highest quality supplements, and for that, Uncle Sam needs the best of the best!

References​​
1. Austin et al., Applied Physiology, Nutrition, and Metabolism​​, 2016, Vol. 41, Number 1, Pages 88–95
2. Deuster et al., Drug Testing & Analysis​​, 2016, Volume 8, Issues 3–4, Pages 431–433
3. Hoffman et al., Nutrition Research​​, 2016, Volume 36, Issue 6, Pages 553–563
4. Gepner et al., Journal of Applied Physiology​​, Volume 123, Issue 1, Pages 11-18
5. Karl et al. American Journal of Physiology - Gastrointestinal and Liver Physiology​​, Volume 312, Issue 6, Pages G559-G571
6. Matsuoka et al., Journal of Affective Disorders​​, 2016, Volume 205, Pages 289-291