Longitudinal changes in adverse effects reporting in multiple dietary supplement classifications: The US military dietary supplement use study

Joseph J Knapik; Daniel W Trone; Ryan A Steelman; Harris R Lieberman

doi:10.1016/j.fct.2024.114635

Longitudinal changes in adverse effects reporting in multiple dietary supplement classifications: The US military dietary supplement use study

Food Chem Toxicol. 2024 Apr 4:188:114635. doi: 10.1016/j.fct.2024.114635. Online ahead of print.

Authors

Joseph J Knapik¹, Daniel W Trone², Ryan A Steelman³, Harris R Lieberman⁴

Affiliations

¹ Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA. Electronic address: joseph.j.knapik.vol@health.mil.
² Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA.
³ Defense Centers for Public Health-Aberdeen, 8300 Ricketts Point Rd, Building E-2850, Aberdeen Proving Ground, MD, 21010, USA.
⁴ Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.

PMID: 38582347
DOI: 10.1016/j.fct.2024.114635

Abstract

Over 70% of United States military service members (SMs) regularly use dietary supplements (DSs) and about 18% have reported adverse effects (AEs) associated with use. This investigation examined longitudinal changes in AEs reporting among DS users. On two separate occasions 1.3 ± 0.2 years apart (mean ± standard deviation), 5778 SMs completed identical questionnaires on DS use and associated AEs. Among SMs reporting DS use ≥1 time/week, ≥1 AE was reported by 19% and 15% in the baseline and follow-up phases, respectively. The risk of reporting DS use at follow-up was similar among those reporting and not reporting AEs at baseline for most DS categories including prohormones, proteins/amino acids, individual vitamins and minerals, multivitamin/multiminerals, herbals, fish oils, joint health products, and other DSs. An exception was combination products where those reporting AEs at baseline had an increased risk of use at follow-up (risk ratio = 1.13, 95% confidence interval = 1.06-1.09). Those reporting AEs at baseline and continuing DS use in the follow-up were more likely to report AEs at follow-up compared to those not reporting baseline AEs. In conclusion, AEs reported at baseline did not deter many participants from using DSs in the follow-up period, and many SMs reporting AEs at baseline continued reporting them at follow-up.

Keywords: Combination products; Herbals; Joint health products; Mineral; Multivitamin/multimineral; Prohormone; Vitamin.