Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children

The assessment of stress level, anxiety, depressive symptoms, and defense mechanisms among Polish and English medical students

INTRODUCTION

Medical education is proven to be associated with a high degree of psychological stress. Different coping strategies used by students have been investigated on their efficacy. So far, studies on medical students have been limited to a single population.

AIM OF THE STUDY

Our study aimed to identify differences in the prevalence of depressive symptoms, anxiety, stress levels, and defense mechanisms among two groups of medical students, the Polish and English-speaking divisions.

MATERIALS AND METHODS

The study included two groups of first-year medical students, the Polish and English-speaking divisions, comprising 305 participants (n = 204 Polish, n = 101 English, men = 127, women = 176). It was divided into two periods: the students received author questionnaires during an exam-free academic period and then completed the same questionnaires during an exam session. The survey contained questions pertaining to demographics and studying habits among participants and included the Defense Style Questionnaire and Depression Anxiety Stress Scales. Data were analyzed using STATISTICA version 12.0, and p ≤ 0.05 was considered significant.

RESULTS

Polish medical students presented with significantly increased overall stress levels (p = 0.007858) and depressive symptoms (p = 0.030420) compared to the English division students. Polish students also presented with more symptoms of stress, depression, and anxiety during the exam period compared to the exam-free period (p = 0.000625), which did not apply to the English-speaking students. The English division students reached higher scores in the mature defense mechanisms section than the Polish students (p = 0.000001). The use of mature defense mechanisms correlated negatively with the intensity of stress, anxiety, and depressive symptoms in both groups, while immature defense mechanisms promoted higher values of those variables (p = 0.000001).

CONCLUSIONS

Our study showed significant and multidirectional differences between medical students of the Polish and English divisions attending the same university. Such results could suggest that strategies aimed at reducing depressive symptoms among medical students ought to be adapted towards the needs of a specific population.

Prevalence and correlates of depressive symptoms in secondary school children in Dhaka city, Bangladesh

Objectives: Depression is a leading contributor to the global burden of disease, and often starts at a young age. Depression in young people can increase the risk of unhealthy lifestyle behaviour and can lead to substantial disability, social problems, poor health, and suicide. Other research has examined depressive symptoms among adult populations in Bangladesh, but little is known about other age groups. The aim of this study was to assess the prevalence and socio-demographic correlates of depressive symptoms among secondary school children of Dhaka city, Bangladesh.Design: A self-completed questionnaire was administered to 898 students from eight secondary schools of Dhaka, the capital City of Bangladesh. Of the respondents, 755 (372 males, 383 females; average age 14.26 years; SD 1.15) completed the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). A score of 10 or more was used to indicate depressive symptoms. Parents completed a separate questionnaire to provide individual and household/family-level data. Generalized Estimating Equations (GEE) was used to assess sociodemographic and lifestyle factors associated with adolescent depressive symptoms.Results: Among the responding adolescents, 25% reported depressive symptoms with prevalence more common among females than males (30% vs. 19%). Factors significantly associated with symptoms of depression included being female, aged 15-16 years, self-perception of non-normal weight, feeling unsafe at school, sleep disturbance, low life satisfaction, high intake of sugary drinks, and regularly skipping breakfast.Conclusion: Depressive symptoms are prevalent among secondary school children in urban Bangladesh. Interventions for adolescents with depressive symptoms could focus on lifestyle practices such as weight management, personal safety, sleep hygiene and healthy eating.

High Carbonated Soft Drink Intake is Associated with Health Risk Behavior and Poor Mental Health among School-Going Adolescents in Six Southeast Asian Countries

Carbonated soft drink (CSD) intake has been associated with various risk behaviors in adolescents in high-income countries, but there is lack of evidence of this association in cross-nationally representative samples of school adolescents in low- and middle-income countries. This study aimed to assess the association between CSD intake, health risk behavior, and poor mental health behavior among school-going adolescents in six Southeast Asian countries. Cross-sectional national "Global School-Based Student Health Survey (GSHS)" data from 36173 school-going adolescents from Bangladesh, Indonesia, Laos, Philippines, Thailand, and Timor-Leste were analyzed. Results indicate that across all six Southeast Asian countries, in the past 30 days 23.9% of study participants had consumed no CSD, 38.8% had consumed CSD <once/day, 19.9% once a day and 17.5% ≥ two times/day. In the final adjusted logistic regression model CSD intake was associated with increased odds of having been attacked, having sustained an injury, being in a physical fight, being bullied, school truancy, tobacco use, alcohol use, and lifetime drunkenness. In addition, the consumption of CSD ≥two times/day was associated with increased odds of ever used cannabis and ever used amphetamine. Higher intake of CSD was positively associated with a history of loneliness, anxiety, suicide ideation, suicide planning, and suicide attempts. CSD intake in low- and middle-income countries is associated with several health risk behaviors and poor mental health that are similar to those observed in high-income countries.

Effect of caffeine ingestion on free-throw performance in college basketball players

Background

It is currently unclear whether pre-exercise caffeine ingestion can improve free-throw shooting performance, a vital skill in basketball. The purpose of this study was to investigate the effects of caffeine on free-throw shooting performance in college-aged basketball players.

Methods

Twelve males (23.1 ± 1.9 years; 180.1 ± 8.8 cm; 77.1 ± 12.4 kg) and six females (22.0 ± 1.3 years; 169.4 ± 8.9 cm; 67.0 ± 11.1 kg) who competed at the college level ingested 6 mg per kg of body mass of (a) caffeine or (b) maltodextrin (placebo) on two separate occasions in a random order. After 60 min, they performed five sets of a match-simulated basketball protocol comprising six sideline-to-sideline sprints on a standard basketball court followed by two free-throws after each set. The number of successful shots was counted. Heart rate and rating of perceived exertion (RPE) after each sprint set were also recorded.

Results

Caffeine ingestion did not improve overall free-throw success (caffeine = 6.1 ± 1.7 vs. placebo = 5.5 ± 2.0; p = 0.34) compared with placebo across all five sets. There was no change in shooting accuracy across sprint sets in either trial despite significant increases in both heart rate and RPE. Caffeine increased heart rate (p = 0.02) but had no effect on RPE (p = 0.57) across five sets compared with placebo.

Conclusions

Ingestion of 6 mg of caffeine per kg of body mass did not improve basketball free-throw performance. Free-throw performance did not deteriorate with increasing number of sprint sets.

Association of frequent intake of fast foods, energy drinks, or convenience food with atopic dermatitis in adolescents

PURPOSE

Specific food consumption, besides food allergy, may aggravate atopic dermatitis (AD). However, previous reports on the association between AD and food intake in adolescents are scarce. The aim of this study was to determine the relationship between AD and specific food consumption frequency in adolescents.

METHODS

A cross-sectional analysis using data from the Korea Youth Risk Behavior Web-based Survey 2017 was performed. The frequency of food consumption in the recent-diagnosed AD group (AD diagnosed within 12 months) compared to those in the previous-diagnosed AD (AD diagnosed more than 12 months ago) or control group were investigated.

RESULTS

A total of 53,373 participants were eligible for this study. The weighted prevalence of the recent-diagnosed AD and the previous-diagnosed AD was 7.39% and 18.00%, respectively. When compared with subjects with the previous-diagnosed AD, those with the recent-diagnosed AD were significantly more likely to frequently consume fast foods (odds ratio OR 1.405; 95% CI 1.150-1.717), energy drinks (OR 1.457; 95% CI 1.175-1.807), or convenience food (OR 1.304; 95% CI 1.138-1.495). Patients of the recent-diagnosed AD were significantly more likely to frequently consume fast foods (OR 1.374; 95% CI 1.155-1.634) than the control group. The differences in the frequency of specific food consumption among groups were more pronounced in high school students than in middle school students.

CONCLUSIONS

Frequent intake of fast foods, energy drinks, and convenience food was related to the recent-diagnosed AD in adolescents. Prospective cohort and interventional studies are needed to identify causal relationships.

Caffeine consumption during development alters spine density and recovery from repetitive mild traumatic brain injury in young adult rats

Caffeine is the most commonly used psychostimulant throughout the world, with its consumption being especially prevalent among adolescents and young adults, as over 75% of this group consumes caffeine daily. Similarly, the adolescent and young adult age group exhibit the highest incidence of traumatic brain injury (TBI). Given that both caffeine consumption and mild TBI (mTBI) are more prevalent among the late adolescent/young adult age group and that changes in dendritic spine morphology during this developmental period are poorly understood, this study sought to examine the effects of caffeine consumption during late adolescence/early adulthood on recovery from repetitive mTBI (RmTBI). The study specifically focused on changes to neuronal dendritic morphology as synaptic changes likely underlie long-term behavioral outcomes. The results demonstrate that during young adulthood caffeine consumption differentially affects the RmTBI outcomes of males and females, where the effects of caffeine and RmTBI were often additive in males while being equally detrimental, but rarely additive, in females. In general, caffeine and RmTBI induced the greatest impairments in males on cognitive and motor tasks whereas in females the most significant detriments were on pain-related tasks. Both caffeine and RmTBI increased spine density in the Cg3 (medial prefrontal cortex [mPFC]), AID (orbitofrontal cortex [OFC]), and nucleus accumbens (NAc), which is proposed to reflect an impairment in the normal pruning processes. Overall, despite caffeine's neuroprotective abilities among other age groups, this study offers concerning results regarding the detrimental effects of caffeine and RmTBI, in isolation, and especially in combination, in this susceptible population.

Caffeine and Clinical Outcomes in Premature Neonates

Caffeine is the most widely used drug by both adults and children worldwide due to its ability to promote alertness and elevate moods. It is effective in the management of apnea of prematurity in premature infants. Caffeine for apnea of prematurity reduces the incidence of bronchopulmonary dysplasia in very-low-birth-weight infants and improves survival without neurodevelopmental disability at 18-21 months. Follow-up studies of the infants in the Caffeine for Apnea of Prematurity trial highlight the long-term safety of caffeine in these infants, especially relating to motor, behavioral, and intelligence skills. However, in animal models, exposure to caffeine during pregnancy and lactation adversely affects neuronal development and adult behavior of their offspring. Prenatal caffeine predisposes to intrauterine growth restriction and small growth for gestational age at birth. However, in-utero exposure to caffeine is also associated with excess growth, obesity, and cardio-metabolic changes in children. Caffeine therapy is a significant advance in newborn care, conferring immediate benefits in preterm neonates. Studies should help define the appropriate therapeutic window for caffeine treatment along with with the mechanisms relating to its beneficial effects on the brain and the lung. The long-term consequences of caffeine in adults born preterm are being studied and may depend on the ability of caffeine to modulate both the expression and the maturation of adenosine receptors in infants treated with caffeine.

Integrative Approaches to Stress, Anxiety, and Resilience

Anxiety is one of the most common psychiatric conditions affecting adolescents and youth in the United States, with over 30% of adolescents having an anxiety disorder of any type. The conventional approach to anxiety management can include medications that in some patient populations can increase the risk of suicidality. Untreated anxiety and sequela of anxiety can have a significant impact on the life of a child and can impact them into adulthood. Integrative treatments in the setting of anxiety and stress management can be used along with conventional approaches to evoke the relaxation response. Integrative approaches can also teach children and youth tools that may serve to help them learn to better manage the symptoms of anxiety and build resilience throughout their lifetime. [Pediatr Ann. 2019;48(6):e226-e230.].

Cola Beverages: Clinical Uses versus Adverse Effects

Methods:

In this systematic review we tried to explore these new uses for practitioners and also reemphasize on the most evidence-based complications of cola consumption like bone loss and metabolic and cardiovascular adverse effects in cases of misuse and overuse from both clinical and nutritional points of view via searching the PubMed database.

Results:

We chose 145 journal articles from the most relevant ones plus 30 extra references and categorized their topics in two classes of medical uses and adverse effects.

Conclusion:

It could be stated that cola beverages have demonstrated interesting uses and benefits in medicine but their use should be regulated as strict as possible.

Do sleeping habits mediate the association between time spent on digital devices and school problems in adolescence?

Background

This study examined the associations of Internet and computer screen time with school difficulties and the role of sleep quality and soft and energy drinks consumption.

Methods

We used data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents (aged 11.0-15.9 years, N = 7595, 48.1% boys). We examined the inter-relations between time spent with on digital devices (time spent playing digital games or Internet use), sleeping quality (sleeping shortage, sleeping difficulties), soft/energy drinks consumption and school problems (low academic achievement, disliking school, being pressured by schoolwork and truancy), using structural equation modeling.

Results

Results showed that the more time adolescents spent on digital devices during leisure time, the more school problems they had. This association was mediated by a higher consumption of soft or energy drinks and a lower quality of sleeping. The direct effect of time spent on digital devices on school problems and its indirect effect via sleeping quality were relatively small (-0.26 and -0.30, respectively, standardized solution), compared with the indirect effect of time spent on digital devices via soft/energy drinks consumption as well as sleeping quality (0.65, standardized solution).

Conclusions

Time spent on digital devices is associated with school problems, with sleeping and soft/energy drinks consumption playing a substantial role in this association.

The extent, nature, and nutritional quality of foods advertised to children in Lebanon: the first study to use the WHO nutrient profile model for the Eastern Mediterranean Region

Objective

Exposure to food marketing may influence children’s food preferences and consumption patterns and may increase the risk of childhood obesity. The WHO Office for the Eastern Mediterranean Region (EMR) has recently released a regional nutrient profile model (WHO EMR) for the purpose of regulating the marketing of food and beverages to children. This study aimed at 1) analyzing the frequency and types of food and drink advertisements during children’s viewing time in Lebanon; 2) examining the nutritional content of the advertised food products in reference to the nutrient thresholds specified by the WHO EMR model; and 3) assessing the proportion of food advertisements that included health messages.

Design

This study consisted of a cross-sectional content analysis of food advertisements on local TV channels, during children’s viewing time.

Setting

Three local Lebanese channels with the highest viewership among 4- to 14-year-olds were selected. Recorded broadcasts (September 2016 through January 2017) were analyzed between 3 pm and 10 pm on weekdays and between 8 am and 10 pm on weekend days.

Results

Approximately 31% of advertisements were for foods or drinks. The proportion of food advertisements was the highest during children’s programs (43%) compared to general viewing (32%) and parental guidance (29%) programs. Approximately 8 out of 10 food advertisements were for products that did not meet the standards of the WHO EMR model. Of concern was the heavy advertisement of alcoholic beverages during programs for general audiences. The majority of the advertisements that comprised a health claim were for foods that did not meet the WHO EMR’s nutritional standards (79%).

Conclusions

The findings of this study, which is the first to utilize the new WHO EMR profile model, should be viewed as a foundation for the development of food marketing policies aimed at reducing children’s exposure to TV food advertisements in Lebanon, a country that harbors a high burden of childhood obesity.

Review: Trends, Safety, and Recommendations for Caffeine Use in Children and Adolescents

OBJECTIVE

Caffeine use is common in children and adolescents, but the recommendations for safe consumption are based on decades-old data collected exclusively in adults. Increased availability of caffeine-containing products and a concerted marketing effort aimed at children and adolescents, has increased interest in understanding the physiological, behavioral, and psychological effects of caffeine within this population. This manuscript provides a review of the literature concerning trends and safety of ingested caffeine in children and adolescents.

METHOD

A search of the National Library of Medicine database was conducted using the terms caffeine, children, adolescents, and safety, in addition to tailored searches on specific topics using combinations of search terms such as energy drinks, cardiovascular, mood, cognitive, mental health, sleep, and regulations.

RESULTS

The majority of the literature reviewed here suggests that typical, moderate caffeine consumption in children and adolescents is relatively safe, but that higher doses of caffeine consumption (>400 mg) can cause physiological, psychological, and behavioral harm, in particular in subgroups of children, such as those with psychiatric or cardiac conditions. More attention is being paid to the potential adverse effects of both acute and chronic caffeine use, and additional regulations surrounding the sale and marketing of highly caffeinated beverages are now being considered.

CONCLUSION

More research is needed to fill in gaps in our knowledge, including understanding the relationship between caffeine use and initiation of other substances, such as cigarettes, alcohol, or marijuana, identifying individuals at risk for caffeine toxicity, and developing harm-reduction strategies.

Inverse association between caffeine intake and depressive symptoms in US adults: data from National Health and Nutrition Examination Survey (NHANES) 2005-2006

The objective of this study was to examine the association between caffeine consumption and depressive symptoms. We used data from the 2005-06 National Health and Nutritional Examination Surveys (NHANES). A total of 4737 individuals aged ≥ 18 years who answered the caffeine intake and PHQ-9 questionnaires were selected for this study. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9) with total scores between 0 and 27. Those with PHQ-9 total scores ≥ 10 were considered as having clinically relevant depression. To investigate the association of caffeine intake and PHQ-9 scores, a multiple logistic regression was used in different models. The overall weighted prevalence of depression was 5.5% (4.3% in men and 6.6% in women). After controlling for potential confounders (age, sex, family PIR, education, marital status, disease history, sleep disorders, thyroid problems, physical activity, social support, smoking, total energy, and cholesterol, retinol, vitamin A, beta-carotene, beta-criptoxanthin, vitamin B1, iron, and phosphorus levels), a significant nonlinear inverse association between caffeine consumption and PHQ-9 scores was observed. In conclusion, caffeine's psychostimulant properties appear to protect against depressive symptoms; however, additional prospective studies are required to ascertain whether or not caffeine consumption can lead to a decrease in depressive symptoms.

Green Tea, Coffee, and Caffeine Consumption Are Inversely Associated with Self-Report Lifetime Depression in the Korean Population

This study investigated the associations of green tea, coffee, and caffeine consumption with self-report lifetime depression in the Korean population using data from the Korean National Health and Nutrition Examination Survey. In total, 9576 participants (3852 men and 5724 women) aged 19 years or older were selected for the present study. Green tea, coffee, and caffeine consumption levels were assessed with a validated food frequency questionnaire. Multivariate logistic regression analysis was used to determine the odds ratios (OR) and 95% confidence intervals (CIs) for depression according to green tea, coffee, and caffeine consumption. Frequent green tea consumers (≥3 cups/week) had 21% lower prevalence of depression (OR = 0.79, 95% CI = 0.63–0.99, p for trend = 0.0101) than green tea non-consumers after adjustment for potential confounders. Likewise, frequent coffee drinkers (≥2 cups/day) had 32% lower prevalence of depression (OR = 0.68, 95% CI = 0.55–0.85, p for trend = 0.0026) than coffee non-drinkers after adjustment for potential confounders. Also, participants in the highest quartile of caffeine consumption had 24% lower prevalence of depression than those in the lowest quartile (OR = 0.76, 95% CI = 0.62–0.92, p for trend = 0.0032). Frequent consumption of green tea, coffee, or caffeine was associated with a reduced prevalence of self-report lifetime depression in Korean adults. A prospective study and randomized clinical trials should be conducted to confirm the inverse relationships of green tea and coffee consumption with risk of depression.

Energy drinks, caffeine, junk food, breakfast, depression and academic attainment of secondary school students

BACKGROUND

Energy drinks are widely consumed, and concerns have been raised about possible negative outcomes.

AIMS

The aim of the present research was to examine associations between consumption of energy drinks, caffeine and junk food, and academic attainment in a sample of UK secondary school students.

METHODS

A total of 3071 students agreed to participate in the study; 2677 completed the survey on one occasion (52.4% female, 47.6% male; approximately 20% of the sample from each school year) and 1660 (49.6% female, 50.4% male) completed the survey a second time, approximately six months later. The academic attainment measure was based on Key Stage 3 and Key Stage 4 grades for Maths and English.

RESULTS

In the cross-sectional analyses, logistic regressions showed that consumption of energy drinks was associated with a greater likelihood of being in the low academic achievement group. This was not found for other sources of caffeine. The effect of energy drinks was still significant when demographic, academic and health/lifestyle variables were covaried. However, inclusion of an unhealthy diet variable (junk food) removed the significant effect of energy drinks. Similar observations were made in the longitudinal study, with the poorer attainment of those who consumed energy drinks reflecting breakfast omission and depression.

DISCUSSION

The present findings indicate that consumption of energy drinks is associated with an increased likelihood of poor academic attainment that reflects energy drink consumption being part of an unhealthy diet or being associated with skipping breakfast rather than a more specific effect, such as being a source of caffeine. Although the current study extends previous research by utilising a longitudinal design, intervention studies are now required to better answer questions relating to causality and direction of effect.

At-a-glance - Perceptions of caffeinated drinks among youth and young adults in Canada

The current study assessed youth and young adults' perceptions and attitudes toward caffeine and energy drinks (EDs). An online survey was conducted with 2036 panelists aged 12-24, about caffeine and ED knowledge, caffeine perceptions, and perceptions of ED safety. Few respondents (2.1%) could state Health Canada's recommended limit for caffeine intake, although most participants (64.9%) correctly stated the maximum number of EDs that should be consumed per day. When shown four beverages, only 17.5% correctly identified the beverage with the most caffeine. Overall, young people generally have low levels of knowledge about caffeine amounts and intake from caffeinated beverages.

Energy drink consumption among New Zealand adolescents: Associations with mental health, health risk behaviours and body size

AIM

With the increase in popularity of energy drinks come multiple concerns about the associated health indicators of young people. The current study aims to describe the frequency of consumption of energy drinks in a nationally representative sample of adolescents and to explore the relationship between energy drink consumption and health risk behaviours, body size and mental health.

METHODS

Data were collected as part of Youth'12, a nationally representative survey of high school students in New Zealand (2012). In total, 8500 students answered a comprehensive questionnaire about their health and well-being, including multiple measures of mental well-being, and were weighed and measured for height.

RESULTS

More than one-third (35%) of young people consumed energy drinks in the past week, and 12% consumed energy drinks four or more times in the past week. Energy drink consumption was significantly associated with greater depressive symptoms, greater emotional difficulties and lower general subjective well-being. Frequent energy drink consumption was also associated with binge drinking, smoking, engagement in unsafe sex, violent behaviours, risky motor vehicle use and disordered eating behaviours. There was no association between consumption of energy drinks and student body size.

CONCLUSIONS

Consumption of energy drinks is associated with a range of health risk behaviours for young people. Strategies to limit consumption of energy drinks by young people are warranted.

The negative impact of sugar-sweetened beverages on children's health: an update of the literature

While sugar sweetened beverage (SSB) consumption has declined in the last 15 years, consumption of SSBs is still high among children and adolescents. This research synthesis updates a prior review on this topic and examines the evidence regarding the various health impacts of SSBs on children's health (overweight/obesity, insulin resistance, dental caries, and caffeine-related effects). We searched PubMed, CAB Abstracts and PAIS International to identify cross-sectional, longitudinal and intervention studies examining the health impacts of SSBs in children published after January 1, 2007. We also searched reference lists of relevant articles. Overall, most studies found consistent evidence for the negative impact of SSBs on children's health, with the strongest support for overweight/obesity risk and dental caries, and emerging evidence for insulin resistance and caffeine-related effects. The majority of evidence was cross-sectional highlighting the need for more longitudinal and intervention studies to address this research question. There is substantial evidence that SSBs increase the risk of overweight/obesity and dental caries and developing evidence for the negative impact of SSBs on insulin resistance and caffeine-related effects. The vast majority of literature supports the idea that a reduction in SSB consumption would improve children's health.

Association between Caffeine Consumption and Depression in NHANES 2009-2010

BACKGROUND AND PURPOSE

Caffeine is ubiquitous in foods, supplements, and medications and has been hypothesized to be associated with several health-related outcomes, including mental health disorders such as anxiety. We explored a possible relationship between caffeine consumption and depression using data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

Data from 1,342 adult NHANES participants were included. Statistical software for complex survey sample designs was used to perform two multivariable logistic regressions with a binary indicator of depression as the dependent variable: one using dietary caffeine consumption and one using the caffeine metabolite AAMU as the independent variable. Both analyses were adjusted for gender, race/ethnicity, smoking status, and use of anti-depressants.

RESULTS

We observed a descriptive, albeit non-significant (p = 0.12), pattern of increasing odds of depression with increasing levels of the AAMU caffeine metabolite.

CONCLUSION

Our finding of a possible association between caffeine metabolite level and depression is compelling because it is independent of self-reported caffeine consumption. Prospective studies are warranted to further explore the temporal relationship.

Tea, cocoa, coffee, and affective disorders: vicious or virtuous cycle?

BACKGROUND

The prevalence of psychiatric disorders is increasing worldwide, which underscores the importance of increasing research in this field, in terms of better detection, prevention based on improvement of lifestyle and diet, and effectiveness of treatment. Increasing evidence suggest that diet and exercise can affect proper neuronal development and physiology and protect the brain from neurological illnesses or injuries. Of note, cocoa, tea, and coffee are being actively investigated because they are rich in (poly)phenolic compounds that can modulate mental health, namely brain plasticity, behavior, mood, depression, and cognition.

METHODS

We here systematically review human studies conducted on tea, cocoa, and coffee as related to affective disorders such as depression and anxiety. We carried out a systematic literature search in April 2016, using MEDLINE, on data from the last 10 years. After screening 955 articles, we selected 17 articles that met the criteria of being human studies and that used whole foods or their components.

RESULTS

The results of our systematic review indicate that consumption of tea, cocoa, or coffee might have protective effects against depression.

CONCLUSIONS

Even though this is encouraging, it should be underscored that the near totality of the current evidence comes from observational studies. Ad-hoc human trials and mechanistic, basic science studies are needed before we can provide sound advice to the public.

Dietary behaviour, psychological well-being and mental distress among adolescents in Korea

BACKGROUND

Dietary intake is important for physical and mental health. The aim of this investigation was to assess associations between dietary behaviours and psychological well-being and distress among school-going adolescents in Korea.

METHODS

In a cross-sectional nationally representative survey, 65,212 students (Mean age = 15.1 years, SE = 0.02 and 52.2% male and 47.8% female) responded to a questionnaire that included measures of dietary behaviour, psychological well-being and mental distress.

RESULTS

In logistic regression analyses, adjusted for age, sex, socioeconomic status, school level, school types, Body Mass Index, physical activity, and substance use, positive dietary behaviours (regular breakfast, fruit, vegetable, and milk consumption) were positively and unhealthy dietary behaviours (intake of caffeine, soft drinks, sweet drinks and fast food consumption) were negatively associated with self-reported health, happiness and sleep satisfaction. Positive dietary behaviours (regular breakfast, fruit, vegetable, and milk consumption) were negatively associated with perceived stress and depression symptoms. Unhealthy dietary behaviours (consumption of fast food, caffeine, sweetened drinks and soft drinks) were associated with perceived stress and depression symptoms.

CONCLUSIONS

The study found strong cross-sectional evidence that healthy dietary behaviours were associated with lower mental distress and higher psychological well-being. It remains unclear, if a healthier dietary behaviour is the cause or the sequela of a more positive well-being.

Development of a Rapid Method for the Determination of Caffeine in Coffee Grains by GC-FID-A Fully Validated Approach

A simple method for the determination of caffeine in coffee grains by GC-FID (Gas Chromatography-Flame Ionisation Detector) is presented in the current work. The method was fully validated according to ISO (International Organization for Standardization) 17025 requirements and European Commission regulations. The accuracy, as provided by recovery experiments, was higher than 93%, and the precision, as provided by the (%) relative standard deviation under reproducibility conditions, was lower than 5%. A vast number of independent parameters that lead in the increase of uncertainty of methods were investigated. The analysis was performed without use of an internal standard, which was proven to be reliable according to several validation methods. The method was applied in real samples, and possible health claims were investigated.

The Safety of Ingested Caffeine: A Comprehensive Review

Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.

Systems Pharmacology-based strategy to screen new adjuvant for hepatitis B vaccine from Traditional Chinese Medicine Ophiocordyceps sinensis

Adjuvants are common component for many vaccines but there are still few licensed for human use due to low efficiency or side effects. The present work adopted Systems Pharmacology analysis as a new strategy to screen adjuvants from traditional Chinese medicine. Ophiocordyceps sinensis has been used for many years in China and other Asian countries with many biological properties, but the pharmacological mechanism has not been fully elucidated. First in this study, 190 putative targets for 17 active compounds in Ophiocordyceps sinensis were retrieved and a systems pharmacology-based approach was applied to provide new insights into the pharmacological actions of the drug. Pathway enrichment analysis found that the targets participated in several immunological processes. Based on this, we selected cordycepin as a target compound to serve as an adjuvant of the hepatitis B vaccine because the existing vaccine often fails to induce an effective immune response in many subjects. Animal and cellular experiments finally validated that the new vaccine simultaneously improves the humoral and cellular immunity of BALB/c mice without side effects. All this results demonstrate that cordycepin could work as adjuvant to hepatitis b vaccine and systems-pharmacology analysis could be used as a new method to select adjuvants.

Caffeine Consumption and General Health in Secondary School Children: A Cross-sectional and Longitudinal Analysis

Although caffeine is sometimes associated with beneficial effects in adults, the substance may be dangerous if intake is too high. This concern is particularly relevant in regards to children and adolescents, as consumption of energy drinks may be particularly high in such populations. For this reason, the current study examined data from the Cornish Academies Project to determine whether caffeine intake in secondary school children was related to responses to a single-item measure of general health. Two cross-sections of data were available: questionnaires were completed by 2030 at baseline, by 2307 at 6-month follow-up, and by 1660 at both time-points. Relationships were, therefore, explored both cross-sectionally and longitudinally. High caffeine consumption (i.e., 1000 mg/week) was associated with low general health in both cross-sections of data, and analyses of individual caffeine sources suggested that the effects related specifically to cola and energy drinks. However, after controlling for additional aspects of diet, demography, and lifestyle, total weekly intake only remained significantly associated with general health at the latter time-point. Further to this, null findings from cross-lag and change-score analyses suggest that caffeine and general health were unlikely to be causally linked in this sample. However, due to methodological limitations, such as the two cross-sections of data being collected only 6 months apart, it is suggested that further longitudinal and intervention studies are required in order for firm conclusions to be drawn.

Aged mice receiving caffeine since adulthood show distinct patterns of anxiety-related behavior

Caffeine is the psychostimulant most consumed worldwide. Anxiogenic effects of caffeine have been described in adult animals with controversial findings about its anxiogenic potential. Besides, the effects of caffeine on anxiety with aging are still poorly known. In this study, adult mice (6months old) started to receive caffeine (0.3 and 1.0mg/mL, drinking water) during 12-14months only in the light cycle and at weekdays. The open field (OF) and elevated plus maze (EPM) testing were used to determine the effects of caffeine on anxiety-related behavior in adult and aged mice (18-20months old). Because aging alters synaptic proteins, we also evaluated SNAP-25 (as a nerve terminals marker), GFAP (as an astrocyte marker) and adenosine A₁ and A_2A receptors levels in the cortex. According to the OF analysis, caffeine did not change both hypolocomotion and anxiety with aging. However, aged mice showed less anxiety behavior in the EPM, but after receiving caffeine (0.3mg/mL) during adulthood they were anxious as adult mice. While SNAP-25 and adenosine A_2A receptors increased with aging, both GFAP and adenosine A₁ receptors were not affected. Caffeine at moderate dose prevented the age-related increase of the SNAP-25, with no effect on adenosine A_2A receptors. The absence of effect for the highest dose suggests that tolerance to caffeine may have developed over time. Aged mice showed high responsiveness to the OF, being difficult to achieve any effect of caffeine. On the other hand this substance sustained the adult anxious behavior over time in a less stressful paradigm, and this effect was coincident with changes in the SNAP-25, suggesting the involvement of this synaptic protein in the ability of caffeine to preserve changes related to emotionality with aging.

Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes

BACKGROUND

Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs).

METHODS

The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools.

RESULTS

EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1-3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover.

CONCLUSIONS

EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour.

A Review of Energy Drinks and Mental Health, with a Focus on Stress, Anxiety, and Depression

Background: Concerns have been expressed regarding the potential for caffeinated energy drinks to negatively affect mental health, and particularly so in young consumers at whom they are often targeted. The products are frequently marketed with declarations of increasing mental and physical energy, providing a short-term boost to mood and performance. Although a certain amount of evidence has accumulated to substantiate some of these claims, the chronic effects of energy drinks on mental health also need to be addressed.

Methods: To review the relevant literature, PubMed and PsycINFO were searched for all peer-reviewed articles published in English that addressed associations between energy drink use and mental health outcomes. Case reports were also considered, though empirical studies investigating acute mood effects were excluded as a review of such articles had recently been published. Fifty-six articles were retrieved: 20 of these (along with eight more identified through other means) were included in the current review, and, because the majority addressed aspects of stress, anxiety, and depression, particular focus was placed on these outcomes.

Results: Though a number of null findings (and one negative relationship) were observed, the majority of studies examined reported positive associations between energy drink consumption and symptoms of mental health problems.

Conclusions: Though the findings imply that energy drink use may increase the risk of undesirable mental health outcomes, the majority of research examined utilized cross-sectional designs. In most cases, it was therefore not possible to determine causation or direction of effect. For this reason, longitudinal and intervention studies are required to increase our understanding of the nature of the relationships observed.

Breakfast and Energy Drink Consumption in Secondary School Children: Breakfast Omission, in Isolation or in Combination with Frequent Energy Drink Use, is Associated with Stress, Anxiety, and Depression Cross-Sectionally, but not at 6-Month Follow-Up

A considerable amount of research suggests that breakfast omission and the frequent use of caffeinated energy drinks may be associated with undesirable effects, and particularly so in children and adolescents. The current paper presents cross-sectional and longitudinal data from the Cornish Academies Project to investigate the effects of consuming energy drinks and missing breakfast on stress, anxiety, and depression in a cohort of secondary school children from the South West of England. Questionnaires were administered at two time-points (spaced 6 months apart) to collect information relating to diet and lifestyle over the previous 6 months. Demographic and school data were acquired through the School Information Management System, and single-item measures of stress, anxiety, and depression were administered at the second time-point only. Associations between breakfast and energy drink consumption and stress, anxiety, and depression were investigated, and a multivariate approach was taken so that additional variance from diet, demography, and lifestyle could be controlled for statistically. Cross-sectional analyses showed that breakfast omission was consistently associated with negative outcomes, and that this was largely observed for both those who frequently consumed energy drinks and those who did not. However, cross-lag analyses showed that neither breakfast omission or energy drink consumption, alone or in combination, was predictive of stress, anxiety, or depression at 6-month follow-up. This suggests that associations between breakfast and mental health may be bi-directional rather than breakfast being the causal factor.