Psychological and socio-educational correlates of energy drink consumption in children and adolescents: a systematic review

Physiological Impacts of Energy Drink Consumption: A Clinical Analysis in Adolescents

Energy drink (ED) consumption among Israeli-Arab adolescents is widespread. This study aimed to investigate the acute glycemic and insulin effects of EDs in healthy adolescents. Seventy-one Israeli-Arab adolescents (56% girls, average age 16.04 ± 1.03 years) participated in a non-randomized, case-controlled, open-label study. Participants consumed ED (n = 36) or a volume- and carbohydrate-matched non-caffeinated soft drink (SD, n = 35), followed by a 2 h glucose tolerance test. Blood glucose was measured at baseline and 15, 30, 60, and 120 min post-consumption (T0, T15, T30, T60 and T120, respectively). Serum insulin concentration and caffeine relative intensity were determined 45 min post-consumption (T45). Blood glucose levels peaked significantly at T15 and remained significantly higher at T30 in the ED group compared to the SD group (p = 0.005, p = 0.017, respectively). Insulin concentrations were substantially higher at T45 in the ED group (t [64] = 2.794, p = 0.001). This pattern was especially prominent in heavy ED consumers. A positive correlation emerged between the amount of caffeine consumed (mg/kg), blood glucose levels at T15 and T30, and insulin concentration at T45. This study is the first to demonstrate the glycemic and insulin responses to ED consumption in adolescents, suggesting that regulatory measures limiting ED sales to adolescents could improve their health.

Consumption of energy drinks by children and young people: a systematic review examining evidence of physical effects and consumer attitudes

OBJECTIVE

To update an earlier review, published in 2016, on the health and other outcomes associated with children and young people's consumption of energy drinks (EDs).

STUDY DESIGN

Review article.

SYSTEMATIC REVIEW

Systematic searches of nine databases (ASSIA, CINAHL, Cochrane Library, DARE, Embase, ERIC, MEDLINE, PsycINFO and Web of Science) retrieved original articles reporting the effects of EDs experienced by children and young people up to the age of 21 years. Searches were restricted by publication dates (January 2016 to July 2022) and language (English). Studies assessed as being weak were excluded from the review. Included studies underwent narrative synthesis.

RESULTS

A total of 57 studies were included. Boys consumed EDs more than girls. Many studies reported a strong positive association between ED consumption and smoking, alcohol use, binge drinking, other substance use and the intentions to initiate these behaviours. Sensation-seeking and delinquent behaviours were positively associated with ED consumption, as were short sleep duration, poor sleep quality and low academic performance. Additional health effects noted in the updated review included increased risk of suicide, psychological distress, attention-deficit hyperactivity disorder symptoms, depressive and panic behaviours, allergic diseases, insulin resistance, dental caries and erosive tooth wear.

CONCLUSIONS

This review adds to the growing evidence that ED consumption by children and young people is associated with numerous adverse physical and mental health outcomes. Where feasible and ethical, additional longitudinal studies are required to ascertain causality. The precautionary principle should be considered in regulatory policy and restriction of ED sales to this population.

PROSPERO REGISTRATION

CRD42021255484.

Novel Energy Drink Improves Cognitive Function and Mood, without Influencing Myocardial Oxygen Demand or Ventricular Repolarization in Adult Gamers: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial

OBJECTIVES

To examine the efficacy of acute consumption of a novel energy drink (C4S) versus placebo for improving cognitive and gaming performance and mood. Secondarily, we examined the cardiovascular safety profile of acute C4S consumption.

METHODS

Forty-five healthy, young adult video gamers completed two experimental visits in randomized order where they consumed either C4S or a placebo and then completed a validated battery of neurocognitive tests, played five video games, and completed a mood state survey. Blood pressure (BP), heart rate (HR), oxygen saturation, and electrocardiogram measurements were taken at baseline and repeated throughout each visit.

RESULTS

Acute consumption of C4S improved cognitive flexibility (absolute mean or median difference [95% CI] = +4.3 [2.2-6.4]; p < 0.001; d = 0.63), executive function (+4.3 [2.3-6.3]; p < 0.001; d = 0.63), sustained attention (+2.1 [0.6-3.6]; p = 0.01; d = 0.44), motor speed (+2.9 [0.8-4.9]; p < 0.001; d = 0.44), psychomotor speed (+3.9 [0.1-7.7]; p = 0.04; d = 0.32) working memory (+1.0 [0.1-1.9]; p = 0.02; d = 0.35), and performance in the two-dimensional visuospatial game Tetris (+463 [-419-2,065] pts; p = 0.049; d = 0.30) compared to placebo. C4S also improved Fatigue-Inertia (-1 [-3-0]; p = 0.004; d = 0.45), Vigor-Activity (+2.4 [1.3-3.6]; p < 0.001; d = 0.64), Friendliness (+0 [0-1]; p = 0.04; d = 0.32), and Total Mood Disturbance (-3 [-6-0]; p = 0.002; d = 0.44). BP increased slightly in C4S versus placebo, while HR decreased from baseline to post-drink in the C4S condition. Rate-pressure-product was higher in C4S versus placebo independent of time but did not increase from baseline. There was no effect on corrected QT interval.

CONCLUSION

Acute consumption of C4S was efficacious for cognitive performance, visuospatial gaming performance, and mood enhancement, and had no effect on myocardial oxygen demand or ventricular repolarization, despite being associated with increases in BP.

Caffeinated energy drink consumption among Emirati adolescents is associated with a cluster of poor physical and mental health, and unhealthy dietary and lifestyle behaviors: a cross-sectional study

Background

Consumption of caffeinated energy drinks (CED) has escalated during the last few years, especially among schoolchildren, with evident adverse health sequelae in this critical age group.

Objective

This study examined the prevalence of CED consumption and its associations with sleep, physical and mental health, and dietary and lifestyle habits among schoolchildren in the United Arab Emirates (UAE).

Method

A structured self-administered online questionnaire was developed and disseminated among schoolchildren aged 14-18 years, selected from schools of the seven emirates of the UAE.

Results

More than 4,500 (N= 4,648) responses received. A relatively low prevalence of CED consumption (20%) was found among schoolchildren in the UAE. However, those who reported CED consumption were more likely to report unhealthy dietary (skipping breakfast, frequent snacking, and eating fast foods, low fruit, and vegetable intake) and lifestyle behaviors (long screen time, poor sleep health), in addition to poor self-reported mental and physical health than non-users. CED consumption was significantly and variably associated with multiple sociodemographic factors such as students' nationality, parental companionship, sex, school type, education level (children's and parents'), daily allowance, academic performance, screen time, sleep quality parameters, self-reported physical and mental health, and parents' employment. Sources of knowledge about CED were social media (55%), friends/schoolmates (52%), and family members (52%). Students believed that CED constitute sugar (87%), caffeine (69%), artificial flavors (67%) sweeteners (54%), and stimulating components (43%). The majority (70%) of students reported that CED consumption increases the risks for heart disease, diabetes, high blood sugar (65%), addiction (64%), high blood pressure (59%), and obesity (57%).

Conclusion

These results offer important insights for health professionals, child health specialists, policymakers, and parents in the UAE regarding adolescents' attitudes, knowledge and behaviors toward CED consumption.

Determinants of pupils' energy drink consumption - Findings from a Hungarian primary school

Consumption of energy drinks is harmful in childhood and adolescence, and its increasing popularity makes it a public health threat in this age group. Our study aimed to assess energy drink (ED) consumption and identify the context and determinants of its consumption at a Hungarian primary school. A mixed-method approach was used for the research, including a survey filled in by 157 10-15-year-old pupils and World Café workshops (WCWs) involving pupils, home-room teachers, and Parental Council representatives (N = 39). The Jamovi 2.2.5. The software was used to perform descriptive statistics and logistic regression, and a causal loop diagram was created based on the results of the WCWs. The survey results revealed that almost one-third of the pupils consumed EDs regularly, and most daily consumers drank high amounts (500ml). Most students considered ED consumption unhealthy, yet every fifth drank them. Buying breakfast on the way to school increased the odds of ED consumption almost threefold. According to the WCWs' findings, the determinants of ED consumption were embedded in two critical contextual sets; one was the need for energy and concentration boost and the Perception of high social acceptance of ED consumption. Our results suggest that interventions to reduce students' ED consumption need to include increased parents' involvement in controlling their children's screen time and encouraging them to provide breakfast at home for their children. There is also an urgent need to restrict the marketing of EDs and strictly regulate access to EDs for under-18s.

Energy drinks and alcohol use among adolescents: A longitudinal study

BACKGROUND

Alcohol use is a leading cause of reduced health among young people. Consumption of energy drinks might be a risk factor for alcohol use. The aim of this study was to examine if more frequent consumption of energy drinks in early adolescence was associated with higher concurrent alcohol consumption, and with stronger increase in alcohol use throughout adolescence.

METHODS

The data came from MyLife, a longitudinal study where Norwegian adolescents completed e-questionnaires in the autumn of 2017, 2018, 2019, 2020, and 2021. The participants were a nationwide sample of 2916 adolescents (mean age: 14.25 [SD = 0.85], 56% girls). At baseline, adolescents self-reported how often they had consumed energy drinks over the past month, a range of family factors, individual characteristics, and substance use. Self-reports of alcohol use (frequency, usual quantity, and frequency of consuming five or more units) were collected at all five assessments and combined into continuous variables.

RESULTS

The results of fully adjusted growth curve models indicate that more frequent consumption of energy drinks at baseline was associated with greater concurrent alcohol use (p < .001), and greater increase in alcohol use over time (p < .05). The effect of energy drinks on concurrent alcohol use was stronger for girls, but the effect on increase over time was stronger for boys.

CONCLUSION

Consumption of energy drinks in early adolescence is associated with more alcohol use throughout adolescence, but the effect size was rather modest in this sample of Norwegian adolescents.