Quality Improvement Project to Assess the Safety of Dietary Supplements Sold on Two United States Army Installations,...

Approximately 50% of the United States (U.S.) adult population uses at least one dietary supplement (DS). Higher DS use is reported among occupations with high physical fitness demands. As of 2021, roughly 75% of U.S. military service members (SMs) used at least one DS weekly. The primary objective of this quality improvement project was to characterize the DS environment on two U.S. military installations.

Fort Drum in the United States and Camp Buehring in Kuwait were surveyed from March to August 2024. A team of 12 health professionals (Registered Dietitian Nutritionists, Health Educators, and Certified Strength and Conditioning Specialists) analyzed 1,209 unique DS sold on Fort Drum and/or Camp Buehring. By analyzing the DS labels, our team assessed DS for dosage of vitamins and minerals, caffeine content, presence of stimulants and prohibited substances, as well as for the Operation Supplement Safety (OPSS)-vetted third-party certification organization seals.

Of the 1,209 unique DS examined, 250 (21%) contained a proprietary blend, matrix, or complex. Additionally, 461 (38%) had more than 200% of the established Daily Value for at least one vitamin or mineral, 63 (5%) contained more than 200 mg of caffeine per serving, and 87 (7%) were found to contain multiple stimulants. Only 120 (10%) of the DS were certified by an OPSS-vetted third-party certifying agency. No prohibited substances were identified on the labels of the evaluated DS.

Given the significant risk to medical readiness, it behooves the Department of Defense (DoD) to more closely monitor DS sold on installations. As the lead organization for supplement education and mandatory safety training, OPSS should play a central role in reassessing the vetting process of DS sold on military installations. Integrating OPSS into this process would help mitigate the risk of SMs inadvertently consuming prohibited substances.