Dietary Supplements in Aircrew

"Ok, I got this nailed- Vitamin M, dip, coffee, Jack & Coke. That's what makes a fighter pilot" ~ Anonymous Fighter Pilot

Although this may be the typical formula that fighter pilots from decades past relied on for optimal performance, the modern combat aviator tends to take a much more sophisticated cocktail of performance enhancing supplements. According to a 2013 article in Forbes Magazine, VMS (Vitamins, Minerals and Supplements) reported revenue of $32 billion from supplements alone in 2012.

Since manufacturers have lobbied for their products to be considered food (supplements to one's diet) by the FDA, they are free from the strict regulatory oversight required for medications.

Any person choosing to put these products into their bodies should ask three main questions regarding each substance:

1. What are the benefits?
2. What are the risks?
3. Are the potential benefits worth the risk?

Dietary Supplements Classification System – Risks and Benefits

The Dietary Supplements Classification Table was developed to assist military personnel in making informed decisions about supplements. Benefit was ranked on a scale of low, moderate, or high potential benefit. Safety concern was similarly ranked on a scale of minimal, low, moderate, or high concern.

Supplements by Zone

Scores of 1-3 are in the "green zone," 4-8 in the "yellow zone," and 9-12 in the "red zone."

DIETARY SUPPLEMENT USE IN AIRCREW

Any of the medications found in the 'Red Zone' above should definitely be avoided. Substances that should be absolutely avoided by aircrew include:

• Ephedra
• Bitter Orange (Synephrine)
• Testosterone Precursors or Anabolic Compounds
• Melatonin

The U.S. Navy also categorizes Energy Drinks/Shots, Ginkgo Biloba, Echinacea, and Ginseng as Category C (prohibited in aircrew and requiring at minimum 24 hours removal from flying duties).

GENERAL GUIDANCE ON SUPPLEMENT USE

• Dietary Supplements are regulated like food by the FDA. They can be marketed and sold with limited or no research on effectiveness.
• Dietary supplement ingredients are poorly regulated and labels may or may not represent actual substances or amounts of each substance.
• Dietary supplements may have adverse effects, trigger allergic reactions, or interact with medications or other supplements.
• If using an approved supplement, ensure it has the United States Pharmacopeia (USP) Verified Dietary Supplement Ingredient Mark, Consumer Lab (CL) seal of approval, or comes from a reputable manufacturer.
• DO NOT PURCHASE SUPPLEMENTS FROM EXCLUSIVELY INTERNET COMPANIES!
• In the Department of Defense; flyers, special operational personnel, and those members on the Personnel Reliability Program (PRP) program are required to report use of nutritional supplements to their flight surgeon or medical provider.

COMMONLY USED DIETARY SUPPLEMENTS

Essential Multivitamins & Minerals

These substances and other essential nutrients are required for metabolic processes, but cannot be synthesized by the body and therefore are derived exclusively from one's diet. It is important to note that some vitamins (K,A,D, & E) can actually result in dangerous overdose.

Aeromedical Recommendation: Probably no appreciable benefit for a large majority of aircrew, unless specifically recommended by flight surgeon or AME. Though, very low risk unless taken in large amounts.

Sports Drinks (not 'Energy' Drinks)

Effective for rehydration and replenishing electrolytes for training or sports that exceed one hour. Shoot for drinks containing 4-8% carbs (14-19 grams/8 oz serving).

Aeromedical Recommendation: Useful for aircrew who double as endurance athletes. No harm for in-flight use and may provide quick and easy source of energy.

Sports Gels

Sports gels are used to deliver substantial energy resources in a small, easily carried packet for endurance athletes. These products are usually high in carbohydrates (typically 20-30 grams per serving).

Aeromedical Recommendation: Small risk for gastrointestinal upset if used in-flight. Recommend ground-testing prior to in-flight use.

Protein & Individual Amino Acid Supplements

An additional 10-15 grams of protein per day is all that is needed to gain a pound of muscle mass. Too much protein will unnecessarily stress the kidneys and liver. For recreational athletes, calculate your desired protein intake using 0.5 grams per pound of body weight daily. For athletes trying to maximize muscle mass, ingest no more than 0.9 grams per pound daily.

Aeromedical Recommendation: Protein is a form of nutrition, needed for energy and metabolic processes. Getting your nutrition from natural food sources rather than a plastic container from GNC is preferable.