title: A systematic review and meta-analysis on the prevalence of dietary supplement use by military personnel.
abstract: BACKGROUND
  Although a number of studies have been conducted on the prevalence of dietary supplement (DS) use in military personnel, these investigations have not been previously summarized. This article provides a systematic literature review of this topic.
  
  
  METHODS
  Literature databases, reference lists, and other sources were searched to find studies that quantitatively examined the prevalence of DS use in uniformed military groups. Prevalence data were summarized by gender and military service. Where there were at least two investigations, meta-analysis was performed using a random model and homogeneity of the prevalence values was assessed.
  
  
  RESULTS
  The prevalence of any DS use for Army, Navy, Air Force, and Marine Corps men was 55%, 60%, 60%, and 61%, respectively; for women corresponding values were 65%, 71%, 76%, and 71%, respectively. Prevalence of multivitamin and/or multimineral (MVM) use for Army, Navy, Air Force, and Marine Corps men was 32%, 46%, 47%, and 41%, respectively; for women corresponding values were 40%, 55%, 63%, and 53%, respectively. Use prevalence of any individual vitamin or mineral supplement for Army, Navy, Air Force, and Marine Corps men was 18%, 27%, 25%, and 24%, respectively; for women corresponding values were 29%, 36%, 40%, and 33%, respectively. Men in elite military groups (Navy Special Operations, Army Rangers, and Army Special Forces) had a use prevalence of 76% for any DS and 37% for MVM, although individual studies were not homogenous. Among Army men, Army women, and elite military men, use prevalence of Vitamin C was 15% for all three groups; for Vitamin E, use prevalence was 8%, 7%, and 9%, respectively; for sport drinks, use prevalence was 22%, 25% and 39%, respectively. Use prevalence of herbal supplements was generally low compared to vitamins, minerals, and sport drinks, ≤5% in most investigations.
  
  
  CONCLUSIONS
  Compared to men, military women had a higher use prevalence of any DS and MVM. Army men and women tended to use DSs and MVM less than other service members. Elite military men appeared to use DSs and sport drinks more than other service members.
authors.affiliation: US Army Research Institute of Environmental Medicine, Natick, MA, USA. joseph.j.knapik.ctr@mail.mil.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Knapik
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Steelman
authors.forename: Sally S
authors.initials: SS
authors.lastname: Hoedebecke
authors.forename: Emily K
authors.initials: EK
authors.lastname: Farina
authors.forename: Krista G
authors.initials: KG
authors.lastname: Austin
authors.forename: Harris R
authors.initials: HR
authors.lastname: Lieberman
mesh_terms: D019587:Dietary Supplements / Q000032:analysis / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data; D015995:Prevalence