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7 Research Needs
Pages 368-376

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From page 368...
... . In agreement with the committee's recommendation that both risks and benefits be considered in management decisions about dietary supplements, studies that focus on answering questions about potential safety concerns and putative benefits may need to be prioritized separately according to the 368
From page 369...
... The military has unusual access to its members' medical records, and its population is in better general health and includes fewer individuals at risk for certain diseases and drug interactions, all of which should facilitate the identification of potential concerns and possible benefits associated with the use of dietary supplements by service members. KEY CONSIDERATIONS FOR CONDUCTING MILITARY NUTRITION RESEARCH Study Designs In conducting research of interest to the military, it is critical that the efficacy and safety of dietary supplements be tested with representative subjects engaged in training that is similar to combat and in specific military
From page 370...
... Research populations should represent the current targeted population participating in garrison training, serving in combat, or both. Animal Models Although the military can conduct studies of the effects of dietary supplements on subjects undergoing the physical stresses of training or conditions simulating combat, using human models for the simulation of severe mental and emotional stress presents practical and ethical limitations.
From page 371...
... For example, better understanding of the molecular and genetic regulatory bases of physiological responses to extreme environments will permit more credible qualitative and quantitative comparisons of animal and human outcomes, and hence more precise predictions of adverse effects in humans. Methods to Quantify Stress There are many stressors experienced by deployed service members and the corresponding stress responses can be perceived in the short or long term.
From page 372...
... The committee recommends that the military narrow its research questions to those traditional botanicals that are believed to affect physical and mental functions; one approach to focus their searches might be consultation with expert ethnobotanists and pharmacognocists. In addition, the military should consider conducting research to develop a framework approach to determine the efficacy of dietary supplements.
From page 373...
... As with benefits, for all areas of research described, it is necessary to determine the dosage and duration of use of the dietary supplement leading to adverse effects and to consider the impact of unique military environments on these effects. Frequency and Severity of Adverse Events Before prioritizing research on adverse effects or taking management action, it is important to determine the frequency and severity of adverse events of interest to the military; one way to acquire this information is the use of well-designed surveys (Chapter 2)
From page 374...
... of use indicated by the surveillance system, adverse event reports suggesting a potential for concern, or a known hazardous component in a multi-ingredient dietary supplement constitute signals calling for review and possibly management action. If literature reviews fail to reveal any safety data, then the military should consider conducting safety evaluation studies of the product or significant ingredients and potential effects of ingredient interactions (see above)
From page 375...
... Briefly, the committee recommends continuing the collection of usage data by expanding the Department of Defense Health Related Behaviors Survey; it also recommends that more comprehensive surveys be conducted at select military sites where service members are likely to face higher risks due to the intensity of their training or exposure to extreme environments. As described in Chapter 5, adequate surveillance systems will help alert the military to potential concerns.
From page 376...
... The designated oversight committee should decide on a timeline and specific criteria to validate this approach as well as to review the results. Research on Education Methods Research should be conducted to identify the effectiveness of various methods of communication and outreach to educate service members, commanders, health care personnel, and physical training and fitness centers staff on the use of dietary supplements.


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