Abstract
Background
Objective
Design and participants
Results
Conclusions
Keywords
US Department of Health and Human Services. Strengthening knowledge and understanding of dietary supplements. https://ods.od.nih.gov/About/dshea_Wording.aspx. Accessed December 2, 2015.
US Department of Health and Human Services. Strengthening knowledge and understanding of dietary supplements. https://ods.od.nih.gov/About/dshea_Wording.aspx. Accessed December 2, 2015.
Methods
Barlas FM, Higgins WB, Pflieger JC, et al. 2011 Health related behaviors survey of active duty military personnel. https://www.documentcloud.org/documents/694942-2011-final-department-of-defense-survey-of.html. Accessed March 5, 2018.
Sampling and Recruitment

Survey Questions
Data Analysis
SAS. The SURVEYREG Procedure, Taylor Series Linearization. https://support.sas.com/documentation/cdl/en/statug/63962/HTML/default/viewer.htm#statug_surveyreg_a0000000274.htm. Accessed December 27, 2017.
Results
Service | Work setting | Pay grade (rank) | Sex | Sample (n) | Eligible sample (n) | Usable respondents (n) | Usable responses (%) |
---|---|---|---|---|---|---|---|
Army | NA | E1-E4 | Male | 19,833 | 19,317 | 997 | 5.0 |
E5-E6 | Male | 5,977 | 5,822 | 1,141 | 19.6 | ||
E7-E9 | Male | 2,129 | 2,074 | 709 | 34.2 | ||
WO1-WO5 | Male | 2,111 | 2,056 | 531 | 25.8 | ||
O1-O3 | Male | 2,109 | 2,054 | 404 | 19.7 | ||
O4 and above | Male | 1,447 | 1,409 | 752 | 53.4 | ||
E1-E4 | Female | 8,009 | 7,801 | 882 | 11.3 | ||
E5-E6 | Female | 2,429 | 2,366 | 551 | 23.3 | ||
E7-E9 | Female | 857 | 835 | 278 | 33.3 | ||
WO1-WO5 | Female | 513 | 500 | 167 | 33.4 | ||
O1-O3 | Female | 814 | 793 | 256 | 32.3 | ||
O4 and above | Female | 622 | 606 | 264 | 43.6 | ||
Total | 46,850 | 45,632 | 6,932 | 15.2 | |||
Navy | NA | E1-E4 | Male | 11,972 | 11,912 | 852 | 7.2 |
E5-E6 | Male | 6,085 | 6,055 | 1,477 | 24.4 | ||
E7-E9 | Male | 2,141 | 2,130 | 996 | 46.8 | ||
WO1-WO5 | Male | 586 | 583 | 293 | 50.3 | ||
O1-O3 | Male | 2,783 | 2,769 | 637 | 23.0 | ||
O4 and above | Male | 1,033 | 1,028 | 486 | 47.3 | ||
E1-E4 | Female | 4,794 | 4,770 | 761 | 16.0 | ||
E5-E6 | Female | 2,346 | 2,334 | 872 | 37.4 | ||
E7-E9 | Female | 820 | 816 | 504 | 61.8 | ||
WO1-WO5 | Female | 27 | 27 | 22 | 81.5 | ||
O1-O3 | Female | 1,121 | 1,115 | 418 | 37.5 | ||
O4 and above | Female | 442 | 440 | 253 | 57.5 | ||
Total | 34,150 | 33,979 | 7,571 | 22.3 | |||
Marine Corps | NA | E1-E4 | Male | 20,003 | 19,855 | 1,742 | 8.8 |
E5-E6 | Male | 5,932 | 5,888 | 1,622 | 27.5 | ||
E7-E9 | Male | 2,096 | 2,080 | 1,047 | 50.3 | ||
WO1-WO5 | Male | 775 | 769 | 401 | 52.1 | ||
O1-O3 | Male | 2,061 | 2,046 | 584 | 28.5 | ||
O4 and above | Male | 1,398 | 1,388 | 567 | 40.9 | ||
E1-E4 | Female | 4,731 | 4,696 | 1,317 | 28.0 | ||
E5-E6 | Female | 1,732 | 1,719 | 687 | 40.0 | ||
E7-E9 | Female | 305 | 303 | 164 | 54.1 | ||
WO1-WO5 | Female | 35 | 35 | 14 | 40.0 | ||
O1-O3 | Female | 354 | 351 | 138 | 39.3 | ||
O4 and above | Female | 78 | 77 | 56 | 72.7 | ||
Total | 39,500 | 39,208 | 8,339 | 21.3 | |||
Air Force | NA | E1-E4 | Male | 12,026 | 12,000 | 2,680 | 22.3 |
E5-E6 | Male | 5,973 | 5,960 | 2,226 | 37.3 | ||
E7-E9 | Male | 2,540 | 2,534 | 1,263 | 49.8 | ||
O1-O3 | Male | 3,395 | 3,388 | 879 | 25.9 | ||
O4 and above | Male | 1,326 | 1,323 | 530 | 40.1 | ||
E1-E4 | Female | 4,778 | 4,767 | 1,643 | 34.5 | ||
E5-E6 | Female | 2,339 | 2,334 | 1,017 | 43.6 | ||
E7-E9 | Female | 1,025 | 1,023 | 552 | 54.0 | ||
O1-O3 | Female | 1,332 | 1,329 | 499 | 37.5 | ||
O4 and above | Female | 534 | 533 | 285 | 53.5 | ||
Total | 35,268 | 35,190 | 11,574 | 32.9 | |||
Coast Guard | Ashore | E1-E4 | Male | 2,341 | 2,322 | 779 | 33.5 |
E5-E6 | Male | 2,449 | 2,429 | 1,146 | 47.2 | ||
E7-E9 | Male | 705 | 699 | 462 | 66.1 | ||
WO1-WO5 | Male | 304 | 302 | 194 | 64.2 | ||
O1-O3 | Male | 556 | 552 | 273 | 49.5 | ||
O4 and above | Male | 642 | 637 | 348 | 54.6 | ||
E1-E4 | Female | 505 | 501 | 217 | 43.3 | ||
E5-E6 | Female | 323 | 320 | 217 | 67.8 | ||
E7-E9 | Female | 75 | 74 | 51 | 68.9 | ||
WO1-WO5 | Female | 29 | 29 | 21 | 72.4 | ||
O1-O3 | Female | 163 | 162 | 82 | 50.6 | ||
O4 and above | Female | 104 | 103 | 63 | 61.2 | ||
Afloat | E1-E4 | Male | 2,830 | 2,807 | 365 | 13.0 | |
E5-E6 | Male | 1,038 | 1,030 | 365 | 35.5 | ||
E7-E9 | Male | 198 | 196 | 113 | 57.5 | ||
WO1-WO5 | Male | 43 | 43 | 28 | 65.6 | ||
O1-O3 | Male | 187 | 186 | 72 | 38.8 | ||
O4 and above | Male | 64 | 63 | 23 | 36.2 | ||
E1-E4 | Female | 270 | 268 | 64 | 23.9 | ||
E5-E9 | Female | 143 | 142 | 50 | 35.3 | ||
Officers | Female | 68 | 67 | 25 | 37.1 | ||
Air | E1-E4 | Male | 634 | 629 | 133 | 21.1 | |
E5-E6 | Male | 546 | 542 | 176 | 32.5 | ||
E7-E9 | Male | 103 | 102 | 43 | 42.2 | ||
WO1-WO5 | Male | 16 | 16 | 6 | 37.5 | ||
O1-O3 | Male | 193 | 191 | 70 | 36.6 | ||
O4 and above | Male | 45 | 45 | 34 | 75.6 | ||
E1-E4 | Female | 103 | 102 | 21 | 20.6 | ||
E5-E9 | Female | 82 | 81 | 14 | 17.3 | ||
Officers | Female | 12 | 12 | 6 | 50.0 | ||
Total | 14,771 | 14,653 | 5,461 | 37.3 |
DS Use Prevalence and Univariate Analysis of Characteristics Associated with Use
Frequency of use | Multivitamins or multiminerals | Individual vitamins or minerals | Antioxidants | Bodybuilding | Herbals | Weight loss | Fish oil |
---|---|---|---|---|---|---|---|
←% (n)→ | |||||||
Two or more per day | 3.2 (1,269) | 3.2 (1,267) | 2.7 (1,077) | 3.7 (1,467) | 1.5 (593) | 3.6 (1,427) | 3.6 (1,424) |
Once a day | 33.4 (13,250) | 19.5 (7,720) | 18.2 (7,258) | 12.3 (4,878) | 7.3 (2,888) | 6.8 (2,694) | 14.4 (5,697) |
Every other day | 6.8 (2,698) | 5.0 (1,979) | 5.7 (2,273) | 7.1 (2,816) | 2.6 (1,029) | 2.5 (991) | 3.5 (1,385) |
Once a week | 5.8 (2,301) | 5.1 (2,020) | 7.0 (2,791) | 4.1 (1,626) | 4.7 (1,859) | 3.1 (1.229) | 4.3 (1,701) |
Once a month | 7.2 (2,856) | 8.6 (3,405) | 8.0 (3,190) | 5.3 (2,102) | 6.9 (2,730) | 4.5 (1,783) | 5.8 (2,295) |
Never in past year | 42.9 (17,019) | 57.6 (22,803) | 57.3 (22,850) | 66.6 (26,412) | 75.7 (29,948) | 78.5 (31,110) | 67.2 (26,585) |
Missing | 0.9 (357) | 1.1 (435) | 1.1 (439) | 0.9 (357) | 1.2 (475) | 0.9 (357) | 1.2 (475) |
Characteristic | No. of DS Categories Reported ≥1 Time/wk | DS Categories Reported ≥1 Time/wk | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Any DS | 1-2 | 3-4 | 5 or more | Multivitamin or multimineral | Individual vitamins or minerals | Antioxidants | Bodybuilding | Herbal | Weight loss | Fish oils | |
←%±SE→ | |||||||||||
Total (N=39,877) | 69.1±0.34 | 48.3±0.43 | 31.1±0.40 | 20.7±0.36 | 49.5±0.36 | 33.1±0.34 | 33.9±0.34 | 27.2±0.33 | 16.3±0.27 | 16.2±0.27 | 26.0±0.32 |
Sex | |||||||||||
Male (n=27,446) | 67.9±0.39 | 47.5±0.50 | 30.6±0.47 | 21.8±0.42 | 48.0±0.42 | 31.1±0.39 | 33.8±0.39 | 29.9±0.38 | 16.6±0.31 | 15.8±0.31 | 26.6±0.36 |
Female (n=12,431) | 75.4±0.46 | 51.9±0.62 | 33.3±0.58 | 14.8±0.44 | 58.2±0.53 | 43.8±0.53 | 33.8±1.51 | 12.0±0.35 | 14.8±0.39 | 19.0±0.43 | 22.4±0.44 |
Age (y) | |||||||||||
<18 (n=4,256) | 70.2±1.03 | 44.0±1.31 | 32.1±1.25 | 23.9±1.15 | 50.8±1.12 | 35.9±1.07 | 38.0±1.08 | 29.6±1.04 | 19.2±0.90 | 18.0±0.89 | 27.0±0.99 |
18-24 (n=8,605) | 67.6±0.73 | 45.7±0.93 | 30.3±0.86 | 24.0±0.81 | 45.4±0.77 | 34.2±0.73 | 34.1±0.73 | 34.8±0.75 | 17.9±0.59 | 18.2±0.60 | 23.1±0.65 |
25-29 (n=8,003) | 69.9±0.75 | 48.6±0.95 | 29.6±0.87 | 21.7±0.80 | 49.5±0.80 | 32.1±0.74 | 33.0±0.76 | 30.4±0.75 | 17.0±0.61 | 18.1±0.64 | 24.8±0.69 |
30-39 (n=11,987) | 69.2±0.61 | 50.2±0.78 | 31.5±0.73 | 18.3±0.61 | 51.3±0.66 | 31.2±0.61 | 32.9±0.61 | 23.4±0.56 | 14.6±0.47 | 15.5±0.47 | 26.1±0.57 |
≥40 (n=7026) | 69.3±0.79 | 51.5±0.99 | 33.2±0.92 | 15.3±0.76 | 52.5±0.84 | 34.1±0.78 | 32.7±0.78 | 14.1±0.62 | 13.7±0.59 | 9.8±0.49 | 32.2±0.79 |
Education | |||||||||||
Some HS or HS graduate (n=20,046) | 64.3±0.76 | 46.5±0.99 | 29.1±0.92 | 24.4±0.86 | 42.2±0.79 | 32.2±0.74 | 32.9±0.75 | 30.7±0.74 | 17.4±0.60 | 18.6±0.63 | 22.4±11.6 |
Some Cllg or Cllg degree (n=12,368) | 70.3±0.43 | 47.8±0.54 | 31.4±0.51 | 20.9±0.45 | 50.9±0.46 | 33.6±0.43 | 34.5±0.44 | 27.9±0.42 | 16.8±0.35 | 17.1±0.35 | 26.2±0.66 |
Graduate degree (n=7,426) | 72.1±0.71 | 53.0±0.94 | 32.9±0.88 | 14.0±0.71 | 56.7±0.79 | 32.4±0.74 | 31.9±0.75 | 17.8±0.66 | 12.4±0.53 | 18.3±0.45 | 31.3±0.75 |
Marital status | |||||||||||
Married (n=25,508) | 68.9±0.42 | 45.8±0.72 | 31.6±0.50 | 18.8±0.43 | 50.1±0.45 | 31.9±0.42 | 32.7±0.42 | 24.3±0.40 | 15.1±0.33 | 15.2±0.33 | 26.0±0.39 |
Not married (n=14,369) | 69.4±0.57 | 49.7±0.54 | 30.3±0.66 | 23.9±0.63 | 47.5±0.60 | 35.1±0.58 | 35.5±0.58 | 32.2±0.58 | 18.4±0.49 | 18.0±0.47 | 25.9±0.53 |
Service branch | |||||||||||
Army (n=6,932) | 68.0±0.73 | 49.0±0.92 | 31.5±0.86 | 19.5±0.75 | 48.3±0.77 | 32.7±0.72 | 32.1±0.72 | 24.5±0.69 | 15.5±0.58 | 16.8±0.58 | 25.2±0.66 |
Navy (n=7,571) | 70.0±0.68 | 46.5±0.88 | 32.0±0.82 | 21.5±0.77 | 51.3±0.74 | 35.0±0.71 | 36.4±0.71 | 26.2±0.69 | 17.7±0.56 | 16.1±0.55 | 27.4±0.66 |
Marine Corps (n=8,339) | 70.3±0.67 | 43.8±0.86 | 28.9±0.79 | 27.4±0.80 | 47.2±0.73 | 34.9±0.70 | 36.5±0.70 | 37.2±0.72 | 19.8±0.60 | 22.3±0.61 | 27.3±0.65 |
Air Force (n=11,574) | 69.2±0.46 | 51.3±0.60 | 30.8±0.55 | 17.9±0.47 | 50.8±0.50 | 30.9±0.46 | 32.0±0.47 | 26.7±0.45 | 14.8±0.36 | 12.9±0.33 | 24.9±0.43 |
Coast Guard (n=5461) | 68.0±0.69 | 49.4±0.90 | 31.8±0.83 | 18.9±0.71 | 51.6±0.74 | 32.1±0.69 | 35.4±0.71 | 24.5±0.64 | 14.0±0.51 | 10.3±0.44 | 27.2±0.65 |
Rank | |||||||||||
Junior enlisted (E1-E4) (n=12,462) | 67.2±0.63 | 45.4±0.79 | 30.6±0.74 | 24.0±0.68 | 45.5±0.66 | 34.2±0.62 | 34.3±0.62 | 31.8±0.61 | 18.3±0.50 | 18.4±0.51 | 24.1±0.56 |
Senior enlisted (E5-E9) (n=17,733) | 69.9±0.45 | 48.6±0.58 | 31.1±0.54 | 20.3±0.48 | 51.2±0.49 | 32.9±0.46 | 34.3±0.46 | 24.9±0.43 | 16.1±0.36 | 17.5±0.37 | 26.7±0.43 |
Warrant officer (n=1,678) | 69.5±1.41 | 46.4±1.84 | 36.1±1.77 | 17.5±1.43 | 54.8±1.53 | 32.5±1.44 | 34.4±1.46 | 19.0±1.22 | 15.4±1.13 | 11.3±0.96 | 32.1±1.44 |
Officer (n=8,004) | 72.1±0.61 | 54.9±0.81 | 31.9±0.75 | 13.2±0.57 | 56.0±0.68 | 30.2±0.62 | 30.9±0.64 | 20.8±0.58 | 11.6±0.45 | 7.6±0.37 | 28.8±0.63 |
Occupational category | |||||||||||
Combat (n=9,025) | 71.1±0.71 | 45.9±0.91 | 31.3±0.85 | 22.9±0.77 | 50.2±0.78 | 34.2±0.73 | 36.0±0.74 | 32.2±0.74 | 17.5±0.59 | 18.1±0.61 | 26.9±0.68 |
Combat service (n=10,921) | 67.4±0.68 | 50.9±0.84 | 30.4±0.76 | 18.7±0.69 | 47.8±0.70 | 31.9±0.66 | 31.7±0.61 | 23.1±0.61 | 14.4±0.51 | 14.6±0.51 | 25.4±0.60 |
Combat service support (n=19,930) | 68.8±0.47 | 48.3±0.59 | 31.3±0.55 | 20.3±0.49 | 50.0±0.50 | 33.0±0.46 | 33.5±0.45 | 26.4±0.45 | 16.7±0.38 | 16.0±0.37 | 25.7±0.43 |
Body mass index (kg/m2) | |||||||||||
≤24.9 (n=11,750) | 66.4±0.66 | 51.3±0.83 | 31.2±0.77 | 17.5±0.66 | 47.5±0.68 | 32.2±0.63 | 32.6±0.65 | 25.8±0.62 | 15.3±0.51 | 8.0±0.36 | 21.6±0.56 |
25.0-29.9 (n=20,905) | 69.6±0.46 | 47.7±0.59 | 31.1±0.55 | 21.3±0.49 | 50.5±0.50 | 33.0±0.46 | 33.7±0.47 | 28.3±0.46 | 16.4±0.37 | 16.7±0.38 | 27.1±0.44 |
≥30 (n=6,363) | 71.1±0.80 | 45.8±1.03 | 31.0±0.95 | 23.2±0.89 | 49.8±0.88 | 34.0±0.83 | 35.3±0.84 | 26.1±0.78 | 17.4±0.66 | 26.3±0.79 | 28.8±0.79 |
Vigorous physical activity (min/wk) | |||||||||||
<75 (n=18,969) | 64.6±0.51 | 52.4±0.65 | 31.1±0.60 | 16.6±0.51 | 46.5±0.53 | 29.7±0.48 | 29.5±0.48 | 19.3±0.44 | 13.9±0.38 | 13.9±0.37 | 22.8±0.44 |
75-150 (n=4,215) | 69.6±1.01 | 50.4±1.28 | 31.0±1.21 | 18.6±0.97 | 49.0±1.08 | 30.8±0.98 | 32.4±1.00 | 29.1±0.99 | 15.1±0.77 | 14.7±0.76 | 25.0±0.92 |
>150 (n=15,430) | 73.4±0.52 | 43.9±0.66 | 31.2±0.62 | 24.9±0.59 | 53.1±0.58 | 37.1±0.56 | 38.5±0.56 | 35.3±0.56 | 19.3±0.46 | 19.1±0.46 | 29.6±0.52 |
Moderate physical activity (min/wk) | |||||||||||
< 150 (n=15,129) | 64.4±0.57 | 54.3±0.72 | 30.1±0.66 | 15.6±0.53 | 45.6±0.58 | 28.3±0.52 | 28.5±0.52 | 20.5±0.48 | 13.5±0.40 | 13.8±0.42 | 22.1±0.48 |
150-300 (n=14,610) | 69.4±0.56 | 47.7±0.70 | 31.6±0.65 | 20.6±0.59 | 49.9±0.59 | 33.7±0.56 | 34.3±0.56 | 26.2±0.53 | 16.2±0.45 | 16.7±0.45 | 26.7±0.53 |
>300 (n=8,499) | 74.2±0.71 | 42.1±0.90 | 31.6±0.84 | 26.3±0.80 | 56.3±0.79 | 38.4±0.76 | 39.7±0.77 | 36.6±0.77 | 20.1±0.63 | 18.5±0.61 | 29.5±0.71 |
Strength training (day/wk) | |||||||||||
<1 (n=11,327) | 57.7±0.68 | 58.9±0.88 | 29.2±0.81 | 11.9±0.61 | 40.6±0.67 | 25.0±0.58 | 24.3±0.59 | 10.2±0.44 | 10.6±0.43 | 11.3±0.44 | 18.5±0.53 |
1-2 (n=10,877) | 66.7±0.67 | 53.2±0.84 | 31.3±0.78 | 15.60.63 | 48.3±0.69 | 30.3±0.63 | 31.2±0.64 | 18.7±0.57 | 14.1±0.49 | 14.4±0.50 | 22.3±0.57 |
≥3 (n=16,149) | 77.7±0.48 | 40.7±0.62 | 32.0±0.59 | 27.3±0.57 | 56.3±0.56 | 39.7±0.55 | 41.2±0.55 | 43.2±0.56 | 21.3±0.46 | 20.3±0.46 | 32.9±0.52 |
Sleep (h/day) | |||||||||||
≤4 (n=979) | 69.7±2.17 | 49.5±2.72 | 28.1±2.40 | 27.4±2.16 | 48.1±2.30 | 32.6±2.08 | 33.5±2.12 | 27.0±2.06 | 17.8±1.69 | 23.3±1.88 | 23.8±1.87 |
5-6 (n=4,435) | 68.1±1.03 | 49.6±1.30 | 30.9±1.20 | 19.5±1.04 | 48.3±1.08 | 30.7±1.00 | 32.5±1.00 | 25.2±0.95 | 16.4±0.81 | 16.0±0.81 | 26.0±0.94 |
7-8 (n=4,552) | 69.0±1.00 | 50.4±1.28 | 31.3±1.20 | 18.2±1.03 | 51.0±1.06 | 30.6±0.99 | 31.7±0.99 | 26.6±0.98 | 12.8±0.69 | 12.6±0.74 | 28.4±0.99 |
≥9 (n=456) | 62.6±3.32 | 52.8±4.24 | 24.3±3.33 | 22.9±3.93 | 43.3±3.36 | 29.4±3.08 | 28.9±3.05 | 24.7±3.05 | 15.3±2.51 | 18.6±2.82 | 22.5±2.77 |
Alcoholic beverages | |||||||||||
Never (4,231) | 70.8±1.45 | 47.1±1.78 | 28.3±1.59 | 24.5±1.59 | 52.4±1.54 | 36.6±1.45 | 34.1±1.43 | 29.6±1.46 | 19.1±1.21 | 19.9±1.29 | 28.9±1.40 |
<1 time/mo (n=6,903) | 67.7±0.80 | 49.1±1.00 | 31.7±0.93 | 19.2±0.79 | 49.4±0.84 | 32.2±0.77 | 32.9±0.78 | 23.6±0.73 | 15.6±0.62 | 16.3±0.64 | 25.1±0.71 |
1 time/mo (n=892) | 70.1±0.63 | 48.3±0.80 | 30.8±0.73 | 21.0±0.67 | 51.2±0.68 | 33.2±0.63 | 34.6±0.64 | 27.3±0.61 | 16.3±0.51 | 16.1±0.50 | 26.1±0.59 |
1-3 times/wk (n=18,491) | 71.7±0.65 | 47.5±0.85 | 31.9±0.80 | 20.6±0.70 | 50.6±0.72 | 33.0±0.68 | 34.8±0.69 | 31.0±0.68 | 16.6±0.54 | 17.6±0.57 | 26.7±0.63 |
≥4 times/wk (n=9,360) | 68.0±1.51 | 48.5±1.88 | 32.0±1.76 | 19.4±1.61 | 47.0±1.57 | 29.3±1.44 | 31.6±1.46 | 27.6±1.46 | 17.0±1.24 | 14.5±1.18 | 26.7±1.40 |
Cigarette smoking | |||||||||||
Not at all (n=21,975) | 72.1±0.83 | 47.6±1.03 | 31.6±0.95 | 20.9±0.88 | 54.0±0.90 | 33.4±0.84 | 35.8±0.85 | 27.9±0.82 | 16.4±0.67 | 15.3±0.65 | 28.9±0.81 |
Some days (n=2,431) | 71.6±1.35 | 44.6±1.71 | 32.0±1.60 | 23.4±1.48 | 48.7±1.47 | 35.5±1.41 | 37.0±1.42 | 30.8±1.37 | 20.0±1.21 | 21.3±1.23 | 28.1±1.33 |
Every day (n=4,511) | 61.3±1.04 | 49.6±1.34 | 30.7±1.25 | 19.7±1.07 | 41.1±1.04 | 27.7±0.94 | 28.5±0.93 | 24.1±0.92 | 16.3±0.78 | 17.8±0.82 | 18.5±0.82 |
Participation in a weight control program | |||||||||||
No (n=38,686) | 68.8±0.35 | 48.4±0.44 | 31.1±0.41 | 20.5±0.36 | 49.5±0.37 | 32.9±0.34 | 33.7±0.34 | 27.3±0.34 | 16.3±0.28 | 15.5±0.27 | 25.9±0.32 |
Yes (n=1,111) | 76.2±1.91 | 45.0±2.65 | 30.4±2.37 | 24.6±2.30 | 50.9±2.28 | 37.8±2.19 | 37.2±2.21 | 22.9±1.93 | 18.4±1.72 | 37.1±2.22 | 28.4±2.06 |
Peer group deterrence of substance use | |||||||||||
No (n=23,225) | 70.2±0.69 | 44.2±0.89 | 31.1±0.84 | 24.7±0.78 | 50.9±0.75 | 36.8±0.73 | 36.9±0.73 | 30.0±0.71 | 19.4±0.61 | 18.4±0.59 | 28.2±0.68 |
Yes (n=10,563) | 68.7±0.39 | 49.6±0.49 | 31.1±0.45 | 19.3±0.40 | 49.1±0.41 | 31.9±0.38 | 32.7±0.39 | 26.3±0.37 | 15.4±0.30 | 15.5±0.31 | 25.3±0.36 |
Leadership deterrence of substance use | |||||||||||
No (n=30,245) | 71.4±0.71 | 43.0±0.93 | 31.0±0.88 | 26.1±0.84 | 51.4±0.79 | 38.1±0.78 | 38.1±0.77 | 32.2±0.75 | 20.3±0.65 | 19.8±0.65 | 29.1±0.72 |
Yes (n=2,963) | 68.4±0.39 | 49.8±0.49 | 31.1±0.45 | 19.0±0.39 | 49.0±0.41 | 31.6±0.38 | 31.6±0.38 | 25.7±0.37 | 15.2±0.30 | 15.2±0.30 | 25.1±0.35 |
Characteristics Independently Associated with DS Use
Characteristic | DS Categories Reported ≥1 Time/wk | |||||||
---|---|---|---|---|---|---|---|---|
Any DS | Multivitamin or multimineral | Individual vitamins or minerals | Antioxidants | Bodybuilding | Herbal | Weight loss | Fish oils | |
←OR (95 CI)→ | ||||||||
Sex | ||||||||
Male | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Female | 1.44 (1.36, 1.53) | 1.53 (1.45, 1.61) | 1.74 (1.64, 1.83) | 1.02 (0.96, 1.08) | 0.30 (0.28, 0.32) | 0.87 (0.82, 1.02) | 1.25 (1.17, 1.35) | 0.81 (0.76, 0.86) |
Age (y) | ||||||||
<18 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
18-24 | 0.94 (0.83, 1.07) | 0.87 (0.78, 0.98) | 0.89 (0.79, 1.00) | 0.84 (0.75, 0.95) | 1.29 (1.14, 1.47) | 0.87 (0.75, 1.01) | 0.98 (0.84, 1.14) | 0.83 (0.73, 0.95) |
25-29 | 0.97 (0.86, 1.09) | 0.94 (0.84, 1.04) | 0.84 (0.75, 0.95) | 0.81 (0.72, 0.90) | 1.06 (0.94, 1.20) | 0.88 (0.76, 1.01) | 1.02 (0.89, 1.19) | 0.89 (0.79, 1.01) |
30-39 | 0.90 (0.81, 1.02) | 0.95 (0.86, 1.06) | 0.84 (0.75, 0.94) | 0.81 (0.72, 0.90) | 0.73 (0.64, 0.82) | 0.76 (0.66, 0.87) | 0.89 (0.77, 1.02) | 0.93 (0.83, 1.05) |
≥40 | 0.88 (0.78, 1.00) | 0.95 (0.84, 1.06) | 1.00 (0.89, 1.13) | 0.83 (0.74, 0.93) | 0.39 (0.34, 0.46) | 0.75 (0.64, 0.88) | 0.60 (0.51, 0.70) | 1.22 (1.08, 1.39) |
Education | ||||||||
Some HS or HS graduate | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Some college or college degree | 1.28 (1.18, 1.39) | 1.31 (1.22, 1.42) | 1.07 (0.99, 1.17) | 1.11 (1.02, 1.20) | 1.13 (1.04, 1.24) | 1.06 (0.96, 1.18) | 0.97 (0.87, 1.07) | 1.21 (1.10, 1.32) |
Graduate degree | 1.38 (1.20, 1.58) | 1.52 (1.34, 1.73) | 1.16 (1.01, 1.34) | 1.13 (0.98, 1.29) | 0.89 (0.75, 1.05) | 1.01 (0.84, 1.20) | 0.75 (0.62, 0.90) | 1.53 (1.32, 1.77) |
Marital status | ||||||||
Not married | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Married | 0.97 (0.90, 1.04) | 1.06 (0.99, 1.13) | 0.92 (0.86, 0.98) | 0.88 (0.82, 0.94) | 0.76 (0.70, 0.82) | 0.83 (0.76, 0.91) | 0.92 (0.84, 1.00) | 0.89 (0.82, 0.96) |
Service branch | ||||||||
Army | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Navy | 1.08 (0.98, 1.18) | 1.12 (1.03, 1.22) | 1.11 (1.02, 1.22) | 1.22 (1.12, 1.33) | 1.05 (0.95, 1.17) | 1.18 (1.05, 1.33) | 0.91 (0.81, 1.02) | 1.16 (1.05, 1.27) |
Marine Corps | 1.17 (1.06, 1.28) | 1.05 (0.96, 1.15) | 1.16 (1.05, 1.27) | 1.22 (1.11, 1.33) | 1.40 (1.27, 1.55) | 1.27 (1.13, 1.43) | 1.31 (1.17, 1.47) | 1.20 (1.09, 1.33) |
Air Force | 1.02 (0.94, 1.10) | 1.07 (0.99, 1.15) | 0.91 (0.84, 0.98) | 1.00 (0.93, 1.08) | 1.09 (1.00, 1.20) | 0.96 (0.87, 1.07) | 0.70 (0.63, 0.78) | 1.02 (0.94, 1.11) |
Coast Guard | 0.98 (0.90, 1.07) | 1.12 (1.03, 1.21) | 0.99 (0.91, 1.08) | 1.16 (1.06, 1.26) | 0.96 (0.87, 1.06) | 0.89 (0.80, 1.01) | 0.54 (0.48, 0.62) | 1.12 (1.02, 1.23) |
Rank | ||||||||
Junior enlisted (E1-E4) | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Senior enlisted (E5-E9) | 1.17 (1.07, 1.28) | 1.22 (1.12, 1.33) | 0.95 (0.87, 1.04) | 1.01 (0.92, 1.10) | 0.98 (0.89, 1.08) | 0.91 (0.82, 1.02) | 1.05 (0.94, 1.17) | 1.04 (0.95, 1.15) |
Warrant officer | 1.20 (1.02, 1.41) | 1.43 (1.23, 1.66) | 0.92 (0.79, 1.08) | 1.03 (0.88, 1.21) | 0.88 (0.73, 1.06) | 0.90 (0.73, 1.10) | 0.75 (0.60, 0.93) | 1.21 (1.03, 1.42) |
Officer | 1.30 (1.18, 1.44) | 1.46 (1.33, 1.61) | 0.81 (0.73, 0.89) | 0.87 (0.79, 0.96) | 0.87 (0.78, 0.97) | 0.64 (0.56, 0.73) | 0.42 (0.37, 0.48) | 1.13 (1.01, 1.26) |
Occupational category | ||||||||
Combat service support | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Combat service | 1.14 (1.05, 1.24) | 1.04 (0.97, 1.12) | 1.09 (1.01, 1.18) | 1.12 (1.04, 1.21) | 1.24 (1.14, 1.34) | 1.04 (0.95, 1.15) | 1.16 (1.06, 1.28) | 1.06 (0.98, 1.16) |
Combat | 0.91 (0.85, 0.99) | 0.87 (0.81, 0.93) | 0.96 (0.89, 1.03) | 0.94 (0.87, 1.01) | 0.91 (0.84, 0.99) | 0.89 (0.81, 0.98) | 1.02 (0.92, 1.12) | 0.94 (0.87, 1.02) |
Body mass index (calculated as kg/m2) | ||||||||
≤24.9 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
25.0-29.9 | 1.23 (1.14, 1.33) | 1.16 (1.09, 1.25) | 1.15 (1.07, 1.24) | 1.07 (0.99, 1.15) | 1.15 (1.06, 1.26) | 1.12 (1.02, 1.24) | 2.81 (2.51, 3.15) | 1.27 (1.17, 1.38) |
≥30 | 1.36 (1.22, 1.50) | 1.13 (1.03, 1.24) | 1.23 (1.11, 1.36) | 1.15 (1.04, 1.26) | 1.10 (0.98, 1.23) | 1.22 (1.07, 1.38) | 5.44 (4.75, 6.23) | 1.35 (1.21, 1.50) |
Vigorous physical activity (min/wk) | ||||||||
<75 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
75-150 | 1.27 (1.14, 1.41) | 1.13 (1.02, 1.24) | 1.09 (0.99, 1.21) | 1.15 (1.04, 1.28) | 1.62 (1.45, 1.82) | 1.10 (0.96, 1.25) | 1.09 (0.95, 1.24) | 1.14 (1.02, 1.27) |
>150 | 1.58 (1.48, 1.69) | 1.35 (1.27, 1.44) | 1.45 (1.35, 1.54) | 1.50 (1.41, 1.60) | 2.16 (2.01, 2.33) | 1.46 (1.34, 1.59) | 1.48 (1.36, 1.62) | 1.44 (1.34, 1.54) |
Moderate physical activity (min/wk) | ||||||||
<150 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
150-300 | 1.26 (1.18, 1.36) | 1.20 (1.13, 1.28) | 1.29 (1.20, 1.38) | 1.31 (1.22, 1.40) | 1.39 (1.28, 1.51) | 1.23 (1.12, 1.35) | 1.24 (1.13, 1.37) | 1.29 (1.19, 1.39) |
>300 | 1.66 (1.52, 1.81) | 1.48 (1.37, 1.60) | 1.61 (1.49, 1.75) | 1.65 (1.52, 1.79) | 2.11 (1.92, 2.30) | 1.56 (1.40, 1.72) | 1.37 (1.23, 1.52) | 1.52 (1.39, 1.65) |
Strength training (d/wk) | ||||||||
<1 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
1-2 | 1.49 (1.37, 1.61) | 1.39 (1.29, 1.51) | 1.33 (1.22, 1.45) | 1.42 (1.30, 1.55) | 2.00 (1.77, 2.26) | 1.37 (1.22, 1.55) | 1.34 (1.19, 1.50) | 1.27 (1.15, 1.39) |
≥3 | 2.71 (2.50, 2.93) | 2.04 (1.90, 2.19) | 2.10 (1.94, 2.27) | 2.19 (2.03, 2.37) | 6.27 (5.60, 7.00) | 2.21 (1.99, 2.45) | 1.97 (1.77, 2.18) | 2.23 (2.05, 2.42) |
Sleep (h/day) | ||||||||
≤4 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
5-6 | 0.90 (0.72, 1.13) | 0.97 (0.79, 1.18) | 0.95 (0.77, 1.18) | 0.97 (0.79, 1.20) | 0.96 (0.76, 1.22) | 0.94 (0.73, 1.22) | 0.69 (0.55, 0.59) | 1.09 (0.87, 1.37) |
7-8 | 0.93 (0.75, 1.17) | 1.07 (0.87, 1.31) | 0.95 (0.77, 1.18) | 0.95 (0.77, 1.18) | 1.05 (0.83, 1.34) | 0.72 (0.55, 0.94) | 0.55 (0.43, 0.71) | 1.25 (0.99, 1.57) |
≥9 | 0.71 (0.50, 1.00) | 0.81 (0.58, 1.12) | 0.79 (0.56, 1.12) | 0.81 (0.57, 1.15) | 0.94 (0.64, 1.40) | 0.86 (0.55, 1.35) | 0.74 (0.48, 1.13) | 1.00 (0.69, 1.46) |
Alcoholic beverages | ||||||||
Never | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
<1 time/mo | 0.87 (0.74, 1.02) | 0.88 (0.76, 1.01) | 0.85 (0.74, 1.04) | 0.95 (0.83, 1.10) | 0.74 (0.63, 0.88) | 0.80 (0.67, 0.99) | 0.82 (0.68, 0.98) | 0.80 (0.69, 0.94) |
1 time/mo | 0.99 (0.85, 1.15) | 0.96 (0.84, 1.10) | 0.91 (0.80, 1.05) | 1.04 (0.90, 1.19) | 0.85 (0.73, 0.99) | 0.85 (0.71, 1.01) | 0.83 (0.69, 0.99) | 0.85 (0.73, 0.98) |
1-3 times/wk | 1.07 (0.92, 1.25) | 0.94 (0.82, 1.07) | 0.95 (0.82, 1.09) | 1.06 (0.92, 1.22) | 1.00 (0.85, 1.16) | 0.89 (0.75, 1.06) | 1.00 (0.83, 1.20) | 0.85 (0.73, 0.99) |
≥4 times/wk | 0.91 (0.75, 1.10) | 0.82 (0.68, 0.97) | 0.81 (0.67, 0.98) | 0.92 (0.77, 1.11) | 0.86 (0.70, 1.06) | 0.93 (0.74, 1.18) | 0.83 (0.65, 1.07) | 0.83 (0.68, 1.01) |
Cigarette smoking | ||||||||
Not at all | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Some days | 0.64 (0.57, 0.72) | 0.64 (0.57, 0.72) | 0.74 (0.66, 0.84) | 0.70 (0.62, 0.79) | 0.69 (0.60, 0.79) | 0.90 (0.78, 1.05) | 1.06 (0.91, 1.24) | 0.59 (0.52, 0.68) |
Every day | 1.01 (0.86, 1.18) | 0.87 (0.76, 1.00) | 1.07 (0.92, 1.24) | 1.01 (0.88, 1.17) | 0.90 (0.77, 1.06) | 1.12 (0.94, 1.35) | 1.30 (1.08, 1.55) | 1.01 (0.87, 1.18) |
Participation in a weight control program | ||||||||
No | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Yes | 1.46 (1.19, 1.81) | 1.08 (0.90, 1.30) | 1.18 (0.98, 1.42) | 1.15 (0.95, 1.39) | 0.78 (0.62, 0.98) | 1.10 (0.88, 1.39) | 2.94 (2.42, 3.57) | 1.18 (0.97, 1.45) |
Peer group deterrence of substance use | ||||||||
No | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Yes | 0.91 (0.85, 0.98) | 0.91 (0.85, 0.97) | 0.81 (0.75, 0.87) | 0.84 (0.78, 0.90) | 0.86 (0.79, 0.93) | 0.77 (0.71, 0.85) | 0.85 (0.77, 0.93) | 0.85 (0.79, 0.92) |
Leadership deterrence of substance use | ||||||||
No | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
Yes | 0.85 (0.78, 0.91) | 0.87 (0.81, 0.94) | 0.75 (0.70, 0.81) | 0.79 (0.73, 0.85) | 0.77 (0.71, 0.84) | 0.73 (0.66, 0.80) | 0.76 (0.69, 0.83) | 0.80 (0.74, 0.86) |
Discussion
Prevalence
US Food and Drug Administration. FDA acts to remove Ephedra-containing dietary supplements from market. ScienceDaily. November 25, 2004. www.sciencedaily.com/releases/2004/11/041124160436.htm. Accessed May 22, 2018.
Young S. Stop using Hydroxycut products, FDA says. http://www.cnn.com/2009/HEALTH/05/01/hydroxycut.fda.recall/index.html. May 1, 2009. Accessed May 23, 2018.
US Food and Drug Administration. Public notification: OxyELITE Pro Super Thermogenic contains hidden drug ingredient. http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm436017.htm. Accessed December 2, 2015.
Military Service | Any DS | Multivitamin or Multiminerals | Individual Vitamins or Minerals | Bodybuilding Supplements | Weight-Loss Supplements | |||||
---|---|---|---|---|---|---|---|---|---|---|
Present study (2011 DoD Survey) | Past studies | Present study (2011 DoD Survey) | Past studies | Present study (2011 DoD Survey) | Past studies | Present study (2011 DoD Survey) | Past study (2005 DoD Survey) | Present study (2011 DoD Survey) | Past study (2005 DoD Survey) | |
Army | 68.0±0.7 | 63.9±1.7 | 48.3±0.8 | 39.2±1.7 | 32.7±0.7 | 20.4±1.4 | 24.5±0.7 | 20.9±1.5 | 16.8±0.6 | 18.0±0.8 |
Navy | 70.0±0.7 | 70.7±1.7 | 51.3±0.7 | 48.6±1.9 | 35.0±0.7 | 29.6±1.7 | 26.2±0.7 | 19.1±1.5 | 16.1±0.6 | 18.8±1.0 |
Marine Corps | 70.3±0.7 | 74.2±1.4 | 47.2±0.7 | 47.6±1.6 | 34.9±0.7 | 28.6±1.4 | 37.2±0.7 | 28.4±1.3 | 22.3±0.6 | 21.1±1.1 |
Air Force | 69.2±0.5 | 68.0±1.1 | 50.8±0.5 | 45.4±1.2 | 30.9±0.5 | 23.5±1.0 | 26.7±0.5 | 17.8±1.1 | 12.9±0.3 | 15.9±1.0 |
Coast Guard | 68.0±0.7 | 69.9±1.5 | 51.6±0.7 | 47.7±1.7 | 32.1±0.7 | 22.3±1.4 | 24.5±0.6 | ND | 10.3±0.4 | ND |
DoD surveys (all services) | 69.1±0.3 | ND | 49.5±0.4 | ND | 33.9±0.3 | ND | 27.2±0.3 | 21.5±0.8 | 16.2±0.3 | 17.4±0.7 |
Characteristics Associated with DS Use
Conclusions
Acknowledgements
Author Contributions
References
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STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by Department of Defense Center Alliance for Nutrition and Dietary Supplements Research of the Defense Medical Research and Development Program, the US Army Medical Research and Materiel Command and by appointments to the Knowledge Preservation Program at the US Army Research Institute of Environmental Medicine (USARIEM) administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the USARIEM.
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