JMIR Publications

ABSTRACT

Background:

Dietary supplement use is prevalent among military personnel in the United States with over 60% reporting current use. Two subtypes of dietary supplements, weight loss and sport performance (WLSP) supplements, are commonly used by military personnel, who must comply with rigorous training schedules and weight restrictions for service and may misperceive these products as safe and effective adjuncts to their training regimens. WLSP supplements are associated with serious negative effects such as dehydration, stroke, and death. The U.S. Department of Defense (DoD) maintains a list of prohibited supplements for military personnel and has created the Operation Supplement Safety (OPSS) program and website (www.opss.org) to help educate military personnel. There is currently no routine, systematic surveillance of WLSP supplement use by military personnel. As such, data on peer-to-peer communication among military personnel on social media may offer insights into this group’s supplement use and attendant perceptions and norms.

Objective:

To better understand peer-to-peer communication about WLSP supplements among military personnel, we conducted a pilot study utilizing the social media website Reddit.

Methods:

A total of 64 relevant posts and 243 comments in response to the posts from 2009-2019 were collected from six military personnel affinity groups on Reddit, referred to as “subreddits.” The posts were coded by two independent reviewers using an inductive coding protocol to abstract year of posting (2009-2019), subreddit, and content consistent with the following themes: resources about supplement safety and regulation, discernability of supplement use through drug testing, harmful side effects, brand names or identifiers, and reasons for supplement use.

Results:

Analyses were conducted to determine the interrater reliability (kappa coefficients) of the coding of the collected posts and frequencies of keywords abstracted from the collected posts. Using qualitative analysis software, six themes for the collected posts and comments were identified. The results suggest that Reddit users in military subreddits engage in peer-to-peer communication about WLSP supplements through asking for advice. Sixty (93.8%) of the 64 posts were posting questions to the subreddit, while 4 (6.2%) posts included general information. A primary concern posted by users relates to which supplements military personnel can use without leading to a positive drug test. Reddit users routinely shared misinformation about the safety and legality of these supplements, Supplements to improve workout performance (pre-workout) were the most frequently mentioned reason for using WLSP supplements. The OPSS website was mentioned as a resource in 23 separate comments (9.5% of all comments).

Conclusions:

Our pilot study suggests that Reddit is a social media forum where military personnel seek out peer-to-peer advice about WLSP supplements and share misinformation about the safety and effectiveness of these products on physical performance, weight loss, and muscle building. Future directions for monitoring WLSP supplement use in military personnel are discussed.