Supplements-make informed choices Published April 7, 2009 By Staff Sgt. Mike Andriacco 380th Air Expeditionary Wing Public Affairs SOUTHWEST ASIA -- At different bases throughout the Air Force, Airmen are turning to dietary supplements in an effort to maintain a fit force and high personal fitness levels, while causing possible risk to their health. This can particularly pose a problem in deployed environments when Airmen usually make an extra effort to reach fitness goals without the distractions commonly associated with home station where, maintaining a home, family, school and a social life can limit their activity levels. "Dietary supplements are not regulated by the Food and Drug Administration," said Maj. (Dr.) Stephen Titus, the 380th Expeditionary Medical Group's chief of the medical staff. "This places the responsibility to understand the ingredients' side effects on the shoulders of the consumer. Without oversight of the FDA, there is no third party to drive manufacturers to ensure that their product is both safe and efficacious." The Dietary Supplement Health and Education Act of 1994 exempts supplements from regulation as long as they don't claim to cure or prevent any disease. Manufacturers may state that ingredients "may" or "have been shown in studies" to promote a particular health benefit but there is no requirement for the studies cited to be current or reproducible. A statement of benefits may also be made if accompanied by the disclaimer: "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease." The manufacturer can also maintain substantiated proof that their product is documented to treat a nutritional deficiency, but it is up to the customer to request the proof of the claim and any supporting information. The company is not required to disclose it. Because the companies are not required to ensure the safety or consistency of the product they sell, it is entirely up to the Airman to know what they are putting into their bodies and how that can impact their mission performance. This includes reading the ingredients list and researching potential results. "There can be a number of side effects related to the consumption of supplements," said Major Titus. "We have seen cardiovascular and gastrointestinal problems, dehydration, and sports related injuries. Hydration is the key to supplement safety. Most supplements are processed in the kidneys or liver, and can cause damage to both if the user does not increase their water consumption while taking them." Here are some common ingredients in supplements and what is known about them: - Kola Nut - This is an herbal source of caffeine. There is no known therapeutic dose of caffeine. Single doses of 500mg can produce toxicity. - Yerba Mate - Contains the stimulants caffeine, theophylline and theobromine. There is no known therapeutic dose. Long-term use may increase the risk of some cancers. - Cassia Mimosoides Extract - Thought to be a lipase inhibitor. Some studies in rats have shown fat loss, not demonstrated in humans. The therapeutic dose is not known. - White Willow Bark - Willow has salicin, which is a chemical precursor to aspirin. The general therapeutic range (for pain) is 60 to 120 mg. Sometimes up to 150 mg. - Taurine - Synthesized in the body and found in most energy drinks, is an organic acid related to bile found in the lower intestine. It has not been proven to have any endurance or energy benefits and while produced synthetically now, is still sometimes derived from cow urine. - Protein - The most widely used nutritional supplement for muscle growth, protein does have studies showing it can help increase muscle volume when used in conjunction with weight training. However, users should be aware that it can put a strain on their kidneys. - Creatine - Also looked at in organized studies, has shown no benefit in endurance exercises, but has shown an increase in weight lifting abilities. Creatine may affect fluid balance, leading to dehydration, thus placing the user at risk. If an Airman uses it, they should hydrate frequently. "If an Airman is on any type of medication, prescription or over-the-counter, we encourage them to see a physician prior to starting a supplement regimen," said Major Titus. "There may be an interaction between the supplement and medication that the Airman is unaware of." Airman should be aware that using dietary supplements can lead to physical injuries that can inhibit or slow the member's ability to train physically. It is important to always follow the label's instructions and to avoid mixing supplements. Some supplement ingredients can interfere with each other and cause an adverse reaction. Everyone needs to be aware of what they are putting into their body. More information can be found at the Food and Drug Administration's website http://www.fda.gov in the nutrition and supplement sections.