Role of nutritional supplements in military personnel: a review article

Document Type : Review article


1 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

2 Department of Clinical Immunology, University Hospital Lozenetz, Bulgaria


Introduction:Military personnel need to use nutritional supplements to increase physical and mental efficiency and protect against occupational injuries. However, Information is limited about the effectiveness and efficiency of nutritional supplements related to military personnel needs. The aim of this study is to review the studies in the field of nutritional supplements required for the military personnel. 
Methods: In this review study, articles related to nutritional supplements needed to protect against intense noise, improve trauma and enhance physical and mental function in military personnel were reviewed. The articles were extracted from the databases of PubMed, Scopus, Web of Sciences and Persian databases as the SID and Magiran between 1993 and 2018.
Results:The results of the review showed that supplementation of magnesium and vitamin B12 to protect against abnormal sounds, supplementation of glutamine and omega-3 in trauma, supplementation of beta-alanine in physical activity and caffeine in mental function can be beneficial.
Conclusion: Nutritional supplements can be useful for military personnel from different aspects. However, the supplements discussed in this article only cover a small part of the supplements required by the military. In addition, although evidence suggests the potential benefits of nutritional supplements to military personnel, but this subject is still controversial and requires further studies. 


1. Rezaee M, Mojtahed M, Ghasemi M, Saedi B. Assessment of Impulse Noise Level and Acoustic Trauma in Military Personnel. Trauma Mon. 2012; 16(4): 182–187. doi:10.5812/kowsar.22517464.2674
2.Ashtary-Larky D, Lamuchi-Deli N, Milajerdi A, Bakhtiar Salehi M, Alipour M, Kooti W, et al. Inflammatory and Biochemical Biomarkers in Response to High Intensity Resistance Training in Trained and Untrained Men. Asian J Sports Med. 2017; 8(2):e13739 doi:10.5812/asjsm.13739.
3. Barboza SD, Joseph C, Nauta J, Van Mechelen W, Verhagen E. Injuries in Field Hockey Players: A Systematic Review. Sports Med. 2018; 48(4):849-66.
4. Gleeson M, Nieman DC, Pedersen BK. Exercise, nutrition and immune function. J Sports Sci. 2004; 22(1):115-25.
5. Lieberman HR, Stavinoha TB, McGraw SM, White A, Hadden LS, Marriott BP. Use of dietary supplements among active-duty US Army soldiers. Am J Clin Nutr. 2010; 92:985–95. doi:10.3945/ajcn.2010.29274
6. Rhodes K, Braakhuis A. Performance and Side Effects of Supplementation with N-Acetylcysteine: A Systematic Review and Meta-Analysis. Sports Med. 2017; 47(8):1619-36.
7.  Holube I, von Gablenz P, Schüssler F, Jacob R. Hearing test results of 18- to 20-year old men preceding military conscription from 2008-2010. Laryngorhinootologie. 2018; 97(3):189-198. doi:10.1055/s-0043-115732
8.  Armed Forces Health Surveillance Center Noise-induced hearing injuries, active component, US Armed Forces, 2007-2010. MSMR. 2011; 18(6):7–10 PMID:21793620
9.  Attias J, Sapir S, Bresloff I, Reshef-Haran I, Ising H. Reduction in noise-induced temporary threshold shift in humans following oral magnesium intake. Clin Otolaryngol Allied Sci. 2004; 29 (6):635–41. doi:10.1111/j.1365-2273.2004.00866.x
10. Attias J, Weisz G, Almog S, Shahar A, Wiener M, Joachims Z, et al. Oral magnesium intake reduces permanent hearing loss induced by noise exposure. Am J Otolaryngol. 1994; 15(1):26-32. doi:10.1016/0196-0709(94)90036-1
11.  Abaamrane L, Raffin F, Gal M, Avan P, Sendowski I. Long-term administration of magnesium after acoustic trauma caused by gunshot noise in guinea pigs. Hear Res. 2009; 247(2):137–145.  doi:10.1016/j.heares.2008.11.005
12. Cevette MJ, Vormann J, Franz K. Magnesium and hearing. J Am Acad Audiol. 2003; 14 (4): 202–212.
13. Shemesh Z, Attias J, Ornan M, Shapira N, Shahar A. Vitamin B12 deficiency in patients with chronic-tinnitus and noise- induced hearing loss. Am J Otolaryngol. 1993; 14(2):94–99.  doi:10.1016/0196-0709(93)90046-A
14. Quaranta A, Scaringi A, Bartoli R, Margarito MA, Quaranta N. The effects of 'supra-physiological' vitamin B12 administration on temporary threshold shift. Int J Audiol. 2004; 43:162–165.
15.  Rahmani R, Mousavi Tabar SY, Karamali M. Epidemiology of trauma in new soldiers during a military training period in one Sepaah training camp, 2012. J Nurse Phys War.2012;19(1):5-8.
16. Calder PC, Deckelbaum RJ. Intravenous fish oil in hospitalized adult patients: reviewing the reviews. Curr Opin Clin Nutr Metab Care 2013; 16(2): 119–23. doi:10.1097/MCO.0b013e32835dbde9
17. Calder PC. Lipids for intravenous nutrition in hospitalised adult patients: a multiple choice of options. Proc Nutr Soc 2013; 72(3): 263–76.    doi:10.1017/S0029665113001250
18. Norouzi Javidan A, Sabour H, Latifi S, Abrishamkar M, Soltani Z, Shidfar F, et al. Does consumption of polyunsaturated fatty acids influence on neurorehabilitation in traumatic spinal cord-injured individuals? A double-blinded clinical trial. Spinal Cord. 2014; 52(5):378-82.
19. Matsuoka Y, Nishi D, Yonemoto N, Hamazaki K, Matsumura K, Noguchi H, et al. Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid (TPOP): study protocol for a randomized controlled trial. BMC Psychiatr. 2013;13(1):8. doi:10.1186/1471-244X-13-8
20. Weimann A, Bastian L, Bischoff WE, Grotz M, Hansel M, Lotz J, et al. Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma. Nutr J. 1998; 14(2):165-72.
21. Chuntrasakul C, Siltham S, Sarasombath S, Sittapairochana C, Leowattana W, Chockvivatanavanit S, et al. Comparison of a immunonutrition formula enriched arginine, glutamine and omega-3 fatty acid, with a currently high-enriched enteral nutrition for trauma patients. J Med Assoc Thai. 2003; 86(6):552-61.
22. Lekmanov AU, Erpuleva UV, Zolkina IV, Rossaus PA. Study of glutamine solution use efficiency in pediatric patients with heavy thermic burns and concomitant injuries in the intensive care unit.  Anesteziol Reanimatol. 2013(1): 49-51.  PMID:23808255
23. Kibor DK, Nyaim OE, Wanjeri K. Effects of enteral glutamine supplementation on reduction of infection in adult patients with severe burns. East Afr Med J. 2014 Jan; 91(1):33-6.
24.  Lorenz KJ, Schallert R, Daniel V. Immunonutrition - the influence of early postoperative glutamine supplementation in enteral/parenteral nutrition on immune response, wound healing and length of hospital stay in multiple trauma patients and patients after extensive surgery. GMS Interdiscip Plast Reconstr Surg DGPW. 2015 Dec 15;4. doi:10.3205/iprs000074
25. Goswami S, Kandhare A, Zanwar AA, Hegde MV, Bodhankar SL, Shinde S, et al.  Oral L-glutamine administration attenuated cutaneous wound healing in Wistar rats. Int Wound J. 2016; 13(1):116-24.
26. Blass SC, Goost H, Tolba RH, Stoffel-Wagner B, Kabir K, Burger C, et al. Time to wound closure in trauma patients with disorders in wound healing is shortened by supplements containing antioxidant micronutrients and glutamine: a PRCT. Clin Nutr. 2012; 31(4):469-75.
27.  Wong A, Chew A, Wang CM, Ong L, Zhang SH, Young S. The use of a specialised amino acid mixture for pressure ulcers: a placebo-controlled trial.  J Wound Care. 2014; 23(5):259-69. doi:10.12968/jowc.2014.23.5.259
28. Fulgoni VL. Current protein intake in America: analysis of the National Health and Nutrition Examination Survey, 2003–2004. Am J Clin Nutr. 2008; 87 Suppl:1554S–7S. doi:10.1093/ajcn/87.5.1554S
29. Knapik JJ, Trone DW, Austin KG, Steelman RA, Farina EK, Lieberman HR. Prevalence, Adverse Events, and Factors Associated with Dietary Supplement and Nutritional Supplement Use by US Navy and Marine Corps Personnel. J Acad Nutr Diet. 2016; 116(9):1423-42. doi:10.1016/j.jand.2016.02.015
30. de Andrade Kratz C, de Salles Painelli V, de Andrade Nemezio KM, da Silva RP, Franchini E, Zagatto AM, et al. Beta-alanine supplementation enhances judo-related performance in highly-trained athletes. J Sci Med Sport. 2017; 20(4):403-08. doi:10.1016/j.jsams.2016.08.014
31. Hoffman JR, Landau G, Stout JR, Hoffman MW, Shavit N, Rosen P, et al. β-Alanine ingestion increases muscle carnosine content and combat specific performance in soldiers. Amino Acids. 2015; 47(3):627-36.
32. Hoffman JR, Landau G, Stout JR, Dabora M, Moran DS, Sharvit N, et al. β-alanine supplementation improves tactical performance but not cognitive function in elite special operation soldiers. J Int Soc Sports Nutr. 2014; 11(1):15. doi:10.1186/1550-2783-11-15
33. Van der Pols JC, Kanesarajah J, Bell A, Lui CW. Current dietary supplement use of Australian military veterans of Middle East operations. Public Health Nutr. 2017; 20(17): 3156-65.  doi:10.1017/S1368980017001975
34.  Knapik JJ, Austin KG, McGraw SM, Leahy GD, Lieberman HR. Caffeine consumption among active duty United States Air Force personnel. Food Chem Toxicol. 2017;105:377-86.  doi:10.1016/j.fct.2017.04.050
35. Tharion WJ, Shukitt-Hale B, Lieberman HR. Caffeine effects on marksmanship during high-stress military training with 72-hour sleep deprivation. Aviat Space Environ Med. 2003; 74(4):309-14.
36. Lieberman HR, Tharion WJ, Shukitt-Hale B, Speckman KL, Tulley R. Effects of caffeine, sleep loss, and stress on cognitive performance and mood during U.S. Navy SEAL training. Psychopharmacol. 2002; 164(3):250-61.
37. Kamimori GH, McLellan TM, Tate CM, Voss DM, Niro P, Lieberman HR. Caffeine improves reaction time, vigilance and logical reasoning during extended periods with restricted opportunities for sleep. Psychopharmacol. 2015; 232(12):2031-42.
38. Shahmohammadi HA, Hosseini SA, Hajiani E, Malehi AS, Alipour M.  Effects of Green Coffee Bean Extract Supplementation on Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial. Hepat Mon. 2017; 17(4):e45609. doi:10.5812/hepatmon.45609
39. Salicio VM, Fett CA, Salicio MA, Brandão CF, Stoppiglia LF, Fett WC, Botelho C. The effect of caffeine supplementation on trained individuals subjected to maximal treadmill test. Afr J Tradit Complemen Alternat Med. 2017; 14(1):16-23.
40. Singh C, Kawatra R, Gupta J, Awasthi V, Dungana H. Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study. Noise Health. 2016; 18(81):93-7.  doi:10.4103/1463-1741.178485
41. Oliver JM, Jones MT, Kirk KM, Gable DA, Repshas JT, Johnson TA, et al. Effect of Docosahexaenoic Acid on a Biomarker of Head Trauma in American Football. Med Sci Sport Exerc. 2016; 48(6):974-82.  doi:10.1249/MSS.0000000000000875
42. Matsumura K, Noguchi H, Nishi D, Hamazaki K, Hamazaki T, Matsuoka YJ. Effects of omega-3 polyunsaturated fatty acids on psychophysiological symptoms of post-traumatic stress disorder in accident survivors: A randomized, double-blind, placebo-controlled trial.  J Affect Disord. 2017; 224:27-31. doi:10.1016/j.jad.2016.05.054
43. Sun Y, Wang LX, Zhou YF, Sun SG, Mao XF, Deng XD, et al. Effects of glutamine combined with ulinastatin on inflammatory response of patients with severe burn injury. Zhonghua Shao Shang Za Zhi. 2013; 29(4):349-54. PMID:24351534
44. Guo GH, Deng ZY, Wang YX, Xing JJ, Peng Y, Li GH. Effects of glutamine enriched enteral feeding on immunoregulation in burn patients. Zhonghua Shao Shang Za Zhi. 2007; 23(6):406-8.
45. Peng X, Yan H, You Z, Wang P, Wang S. Glutamine granule-supplemented enteral nutrition maintains immunological function in severely burned patients. Burns. 2006; 32(5):589-93. doi:10.1016/j.burns.2005.11.020
46. Batéjat D, Coste O, Van Beers P, Lagarde D, Piérard C, Beaumont M. Prior sleep with zolpidem enhances the effect of caffeine or modafinil during 18 hours continuous work. Aviat Space Environ Med. 2006; 77(5):515-25