Association Between Dietary Supplement Use and ICD-9-CM Code Classification in Active Duty US Navy and Marine Corps Service Members

Mil Med. 2019 Oct 1;184(9-10):e531-e537. doi: 10.1093/milmed/usz053.


Introduction: This study is the first to our knowledge to examine associations of survey-reported dietary supplement use with medical record diagnoses, rather than retrospective self-reported supplement use at the time of the medical encounter or case reports of adverse events. Dietary supplement (DS) use and adverse events associations in US Navy and Marine Corps personnel remains unknown. This study assessed associations of DS use in active duty (AD) personnel with ICD-9-CM diagnostic codes from outpatient medical encounters from the Military Health System Data Repository (MDR).

Materials and methods: This cross-sectional investigation used a one-time survey of DS use among AD conducted August through December 2014. Survey data were matched to MDR data accessed in September 2016, and associations between the survey responses and diagnoses were analyzed. Statistical significance was set at alpha level 0.005, and 99.5% confidence intervals (CIs) were calculated. MDR data were matched with survey results for 1,708 personnel. Multivariable logistic regression analyses examined whether use of specific classes of supplements was associated with disease.

Results: Results revealed significant associations between vitamin supplement use and ICD-9-CM-diagnosed diseases of the nervous system (odds ratio [OR]: 1.72, 99.5% CI: 1.11-2.68) and diseases of the musculoskeletal system and connective tissue (OR: 1.59, 99.5% CI: 1.17-2.17). Joint health supplement category use was associated with diseases of the musculoskeletal system and connective tissue (OR: 1.81, 99.5% CI: 1.12-2.94) and injury and poisoning (OR: 1.82, 99.5% CI: 1.10-3.04).

Conclusions: The percentages of service members with diseases in specific ICD-9-CM diagnostic categories were similar to those reported in other studies using military medical data. There is a greater prevalence of dietary supplement use by the service members who participated in this survey compared with the general population, with 73% of US Navy and Marine Corps personnel reporting use of dietary supplements one or more times per week compared to the estimated 50% of all Americans currently using some form of dietary supplement. The DoD ensures the optimal readiness, performance, and health of its military service members, thus future longitudinal evaluation of dietary supplement use by this population will test the preliminary findings of this study.

Keywords: ICD9; US Marine Corps; US Navy; active duty; adverse events; dietary supplements; military; supplements.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Dietary Supplements / statistics & numerical data*
  • Female
  • Humans
  • International Classification of Diseases / trends*
  • Male
  • Military Personnel / statistics & numerical data*
  • Retrospective Studies
  • Surveys and Questionnaires
  • United States