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Nutritional Supplements and Performance Enhancers, Your Health and Implications for PRP/SMOD/Flying Personnel

By Col. Marcel Dionne, 341st Medical Group deputy commander / Published February 11, 2010

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MALMSTROM AIR FORCE BASE, Mont. -- A regular exercise routine, a nutritionally balanced diet and a good rest/work/sleep cycle are key to a fit body and healthy mind. The nutritional balance portion of any plan is not real difficult for the average service member, but those who work long hours and have limited time for physical training may be tempted to try ill-advised short-cuts in achieving improved fitness.

Although some fad diets, diet pills and a last-minute overly aggressive exercise program may eek out a "pass" on your upcoming PT test, Airmen using these measures will usually not get any lasting health benefit and may actually do more physical harm than good to their bodies.

The supplements industry is essentially unregulated due to the 1994 Dietary Supplement Health and Education Act. Manufacturers of these products are not held to content, concentration or purity standards. Some of these products have clear benefits, while others have unproven benefits.

In fact, some performance enhancers have clearly dangerous side effects, especially if taken in combination with medications or in certain operational/occupational environments. Just because something is deemed natural or organic does not automatically make it good for you.

With the Air Force's recent emphasis on a fit force and twice yearly PT testing, some Airmen may be attracted to nutritional or performance-enhancing supplements to get that edge or maintain a high personal fitness level. So, what are some of the health concerns and operational implications of performance enhancers with respect to members' PRP, Space & Missile Operator Duties or flying status?

PRP, SMOD and flying personnel are required to report use of nutritional supplements to their medical provider. To facilitate disclosure, medical screening personnel will ask the questions, "Are you taking any medications, diet aids, nutritional supplements or vitamins/minerals?"

AFMAN 10-3902 and AFI 48-123 specify: 1) nutritional supplements may be used by PRP and SMOD personnel without CMA or flight surgeon approval, provided the product is used in accordance with US manufacturers' directions for its intended use; and 2) the use of herbal medications should be discussed with the CMA/flight surgeon prior to use to determine intended use or underlying condition.

Exceptions: PRP and SMOD personnel are required to consult the CMA whenever the member is within 12 hours of reporting to PRP duties and will be using the product for the first time, or the member has questions or experiences adverse reactions with the nutritional supplement.

The Official Air Force Approved Aircrew Medications list directs that flyers can only use dietary, herbal or nutritional supplements with the approval of a flight surgeon.

Products containing ephedra and its derivatives (Ma Huang, ephedrine), hemp extract, androstenedione and other anabolic steroids are banned by the Air Force. The use of these and other natural supplements have been implicated in potentially serious medical conditions such as hormonal imbalance, sexual dysfunction, sleep disturbances, aggressive or labile mood swings, dehydration, kidney or liver failure, cardiovascular problems and sudden death. Many of these supplements have medicinal properties that can and do interact negatively with prescribed or over-the-counter medications.

Airmen interested in improving their performance should make an appointment with their primary care manager and visit the Health and Wellness Center. The best way to be safe if using supplements is to consider the following guidelines:

· Do not start using a supplement until you have discussed your desire to use a supplement with your medical provider.
· Be sure to read product labels and closely follow directions for use. Research the product. Good places to start are:

www.fda.gov
http://dietary-supplements.info.nih.gov
http://health.nih.gov/topic/DietarySupplements

· Start with a single product, and take the lowest dose. Increase the dosage gradually to no more than the recommended amount.
· Hydration is key to avoiding damage to your kidneys, liver, and heart. If you feel worse after taking it or if you develop new symptoms, discontinue use.
· If you are hypertensive, pregnant/breastfeeding, taking prescription or over-the-counter medications, check with your health care provider first. Some supplements can interact negatively with certain drugs or foods.
· Purchase supplements from the most reliable producers. Established manufacturers and major companies are more likely to produce a quality product. Terms such as natural do not assure safety.
· Be wary of sensational claims. If it sounds too good to be true, it probably is!

Remember, there is no substitute for a healthy diet and proper exercise. This is the best way to stay healthy. If using supplements, be sure to comply with the PRP/SMOD/flying requirements and keep your healthcare provider in the loop.
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