Usefulness of a Risk Assessment Tool to Risk Stratify Dietary Supplements

The use of dietary supplements (DSs) is widespread in the military. Service members use DS for any number of reasons, to include supporting general health, increasing energy levels, enhancing performance, and promoting gains in strength. However, some readily available DS products are potentially unsafe. Therefore, the purpose of this study is to assess the ability of military medical students to use the Operation Supplement Safety DS risk assessment tool. The Operation Supplement Safety risk assessment tool was developed to assist Service members in making decisions about safe DS use.

Fourth-year medical students used an online assessment tool to risk stratify and evaluate the safety of 12 predesignated DS. The assessment tool consists of seven polar questions (yes/no), with an answer of "yes" given a score of 1 and an answer of "no" given a score of 0. Students recorded responses to each of the seven questions for each of the 12 DSs. The tool then generated a total score for each DS, which was compared to the previously identified correct total score. Students' scores for each individual yes/no question and final conclusion about DS safety were also assessed.

Forty responses for the 12 DSs were examined. Five supplements were expected to receive a score of ≥4, suggesting they were likely safe. The average scores (± standard deviation [SD]) for each DS vs. the correct safety score were fish oil (5.9 ± 1.4 vs. 7.0), iron (4.2 ± 1.4 vs. 4.0), melatonin (4.9 ± 0.8 vs. 5.0), multivitamin/mineral (3.8 ± 1.1 vs. 4.0), multivitamin/mineral for men (4.0 ± 1.0 vs. 5.0), performance-enhancing supplement A (1.5 ± 1.1 vs. 2.0), performance-enhancing supplement B (2.0 ± 1.0 vs. 3.0), performance-enhancing supplement C (0.6 ± 0.5 vs. 1.0), performance-enhancing supplement D (1.8 ± 1.0 vs. 3.0), performance-enhancing supplement E (1.5 ± 1.3 vs. 1.0), sexual enhancement supplement (1.3 ± 0.7 vs. 1.0), and weight loss supplement (1.1 ± 1.1 vs. 1.0).

The DS risk assessment tool provides consumers a quick way to screen DS for safety and can help consumers make more informed decisions when purchasing DS. Scores had minimal intersubject variability and were comparable to expected risk stratification. Our results suggest the assessment tool may be appropriate for medical students to use when investigating the safety of DS. We recommend additional research to verify whether the findings from this study would be similar for other potential users, as well as assess other psychometric properties.