Supplements are in the process of gaining an unlikely ally in the war on health and well-being: the U.S. military.
Military members are perceived more positively than any other profession, and two-thirds of soliders are at least “somewhat confident” that a dietary supplement they have taken worked as advertised, according to data and insights presented at the Council for Responsible Nutrition’s annual conference in Dana Point, Calif., Nov. 5.
“The dietary supplements industry is at an inflection point. Health trends are in favor of more research and application of these products,” said Wayne Jonas, M.D., president and CEO of the Samueli Institute, which conducts research for the Pentagon.
Jonas said members of the military use supplements at a higher rate than the civilian population, with multivitamins being the top supplement used.
Energy drinks are consumed by 25 percent of women and 45 percent of men. Almost three-quarters of women take supplements, mostly for weight management. Herbal supplements are used by only about 5-8 percent, but ginseng is used by 14 percent, according to one Army study. Other studies among different service divisions show sports drinks are consumed by between 19 and 79 percent, protein by between 12 and 47 percent, creatine by between 14 and 20 percent.
Among Marines in Afghanistan, eight out of ten service members use multiple supplements, with nine out of ten using stimulants. Almost half of those serving in Afghanistan had pain, and 15 percent are taking opiods to manage pain.
“You go to sleep with Ambien and wake up with caffeine. This is the routine for the average service member deployed,” said Jonas. “Caffeine is ubiquitous and is served up in all situations.”
Jonas said that, unlike the National Institutes of Health (NIH), which focuses on efficacy, the military is more interested in “effectiveness,” which he characterized as whether a supplement “works in a real-life setting compared to something else. There’s a huge opportunity to conduct research in a military setting to push these areas.”
An example illustrating the difference between efficacy and effectiveness is ear acupuncture for pain. Jonas said the NIH would be interested in looking for the biological mechanism in the brain and studying the placebo effect. “The military didn’t care about it. They said, ‘Could you train medics in the battlefield?’ They wanted a pragmatic study – not that they didn’t care about placebo and mechanism of action, but they’re more interested in real life.”
7 areas of focus
The military has seven areas they are actively investigating, areas ripe for supplement solutions. These are:
- Reduce chronic pain.
- Optimize performance – especially in elite forces but also in general because 40 percent of applicants are automatically rejected in recruitment centers because of obesity.
- Sleep support. This is one of the top priorities of the Army Surgeon General.
- Reduce reliance on pharmaceutical drugs, because of both side effects and cost.
- Improve mental health.
- Mitigate Post-Traumatic Stress Disorder (PTSD) and traumatic brain injury (TBI) – the signature health issues over the last 10 years.
- Optimize cognitive function.
Action picking up on the brain front
Improving cognitive function as well as treating injuries in the brain remain areas of keep focus for the military, said Jonas.
“We are increasingly developing war techniques that are less about physical and more on cognitive,” he said. “Currently, there are embedded microphones and automatic communications, and visual-enhancement devices. Integrating and managing information is a challenge for anybody but especially when you’re out in the field. The point is, if there are areas in the dietary supplements industry that can address these areas, there is a lot of interest in the military.”
A number of studies are currently under way to investigate just that.
One, called the OO3 study, is investigating the use of omega-3 fatty acids on depression and suicide. “In the U.S., there are low levels of omega-3s in general. But a blood survey done in the military show the average service member had the lowest of the low in terms of the omega-3 to omega-6 ratio,” noted Jonas.
In a recent issue of Military Medicine, a study titled, “Nutritional Armor: Omega-3 for the Warfighter” documented studies showing omega-3 deficiency could adversely affect health in areas such as cardiovascular disease, metabolic syndrome, depression, increased suicidal risk, surgical recovery, immune function, wound healing, and proper inflammatory response.
The SuperChicken OO3 study looked at integrating omega-3s into chicken and meat and then test the fatigue and physical fitness of 72 soldiers in a 10-week double-blind study. The most salient study detail is that “it tastes good except in bacon,” said Jonas. While performance results may not have measured up, the military nonetheless discovered that integrating omega-3s into commonly consumed foods could be one method of delivering the goods to have a major effect on conditions such as depression, suicide and heart disease.
“In World War II the recruits were thin and hungry, so the military started feeding them,” said Jonas. “That led directly to the school lunch program.”
The Metabolically Optimized Brain Study is a two-year study, currently underway, to use supplements for brain function. A steering committee has been established, which is in the process of determining the best ingredients to use in a study examining effects on cognitive function.
The military is different from other government agencies such as the NIH and FDA, said Jonas. “The military is a leader, and is fine with implementing its own regulations,” he said. “Sometimes the military will act to regulate even when the FDA does not, as with DMAA, and other times will act to recommend even when the FDA will not, as with omega-3s.”
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