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Zhang Y, Gui Z, Jiang N, Pu X, Liu M, Pu Y, Huang S, Huang S, Chen Y. Association between Hyperactivity and SSB Consumption in Schoolchildren: A Cross-Sectional Study in China. Nutrients 2023; 15:nu15041034. [PMID: 36839392 PMCID: PMC9965227 DOI: 10.3390/nu15041034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Sugar-sweetened beverages (SSBs) consumption has risen significantly, which may lead to various health problems. Studies about the association between SSBs and attention-deficit/hyperactivity disorder (ADHD) in children are rare and inconsistent. We have used the two-stage cluster sampling method to select 6541 students aged 6-12. We further investigated their basic information and SSB intake. Teachers' questionnaires and parents' questionnaires were used to evaluating the hyperactive behaviors in children. We examined the associations between SSB consumption and hyperactivity index (HI) by adopting the censored least absolute deviation (CLAD) estimator. Then, we further evaluated the impacts of sex and age on the association between SSB intake and hyperactivity. Children who weekly drank SSB two or more times were associated with 0.05 (0.04, 0.07) and 0.04 (0.02, 0.06) higher scores of ln (HI+1) reported by teachers and parents, respectively, compared to non-consumers children (p for trend < 0.05). A stronger association between SSB intake and hyperactivity occurred in girls and old children. (p for interaction < 0.05). SSB intake has a positive correlation with the risk of hyperactivity in children, and the frequency of SSB consumption and hyperactivity have a dose-response relationship.
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Abbasalizad Farhangi M, Mohammadi Tofigh A, Jahangiri L, Nikniaz Z, Nikniaz L. Sugar-sweetened beverages intake and the risk of obesity in children: An updated systematic review and dose-response meta-analysis. Pediatr Obes 2022; 17:e12914. [PMID: 35466543 DOI: 10.1111/ijpo.12914] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/29/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The prevalence of childhood obesity has increased worldwide and has reached alarming proportions. Contradictive results from studies and reviews have fuelled an endless debate on the role of SSBs in the development of childhood obesity. OBJECTIVE This study aimed to assess the impact of sugar-sweetened beverages (SSBs) intake on body mass index (BMI), body fat percentage (BFP), and waist circumference (WC) among children. METHODS Databases including PubMed/MEDLINE, Scopus, Cochrane Library, EMBASE, and Web of Science were searched up to August 2021. Observational studies reporting the relation between SSBs intake and BMI, BFP, and WC were included. STATA version 15 was used to analyse the data. RESULTS In this meta-analysis, 33 studies with 121 282 subjects were included. Excessive SSBs intake was associated with 0.75 kg/m2 increase in BMI in children and adolescents (WMD: 0.75; CI 0.35-1.15; p < 0.001). In addition, high SSBs intake was significantly associated with higher WC (WMD: 2.35 cm; 95% CI, 1.34, 3.37; p = 0.016) and BFP (WMD: 2.81; CI 2.21-3.41; p < 0.001). No departure from linearity was detected in dose-response meta-analysis between SSBs consumption and changes in BMI, WC, and BFP. CONCLUSION High SSBs consumption was associated with increased BMI, WC, and BFP among children and adolescents. Further large prospective long-term interventions are recommended to confirm the observed relationships.
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Affiliation(s)
- Mahdieh Abbasalizad Farhangi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Mohammadi Tofigh
- Department of general surgery, school of medicine, Shahid Beheshti University of medical sciences, Tehran, Iran
| | - Leila Jahangiri
- Department of Health Promotion and Education, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Associations between free sugar intake and markers of health in the UK population: an analysis of the National Diet and Nutrition Survey rolling programme. Br J Nutr 2022; 128:225-236. [PMID: 34369329 DOI: 10.1017/s0007114521002981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Recommendations for free sugar intake in the UK should be no more than 5 % of total energy due to increased health risks associated with overconsumption. It was therefore of interest to examine free sugar intakes and associations with health parameters in the UK population. The UK National Diet and Nutrition Survey rolling programme (2008-2017) was used for this study. Dietary intake, anthropometrical measurements and clinical biomarker data collated from 5121 adult respondents aged 19-64 years were statistically analysed. Compared with the average total carbohydrate intake (48 % of energy), free sugars comprised 12·5 %, with sucrose 9 % and fructose 3·5 %. Intakes of these sugars, apart from fructose, were significantly different over collection year (P < 0·001) and significantly higher in males (P < 0·001). Comparing those consuming above or below the UK recommendations for free sugars (5 % energy), significant differences were found for BMI (P < 0·001), TAG (P < 0·001), HDL (P = 0·006) and homocysteine concentrations (P = 0·028), and significant sex differences were observed (e.g. lower blood pressure in females). Regression analysis demonstrated that free sugar intake could predict plasma TAG, HDL and homocysteine concentrations (P < 0·0001), consistent with the link between these parameters and CVD. We also found selected unhealthy food choices (using the UK Eatwell Guide) to be significantly higher in those that consumed above the recommendations (P < 0·0001) and were predictors of free sugar intakes (P < 0·0001). We have shown that adult free sugar intakes in the UK population are associated with certain negative health parameters that support the necessary reduction in free sugar intakes for the UK population.
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Giussani M, Lieti G, Orlando A, Parati G, Genovesi S. Fructose Intake, Hypertension and Cardiometabolic Risk Factors in Children and Adolescents: From Pathophysiology to Clinical Aspects. A Narrative Review. Front Med (Lausanne) 2022; 9:792949. [PMID: 35492316 PMCID: PMC9039289 DOI: 10.3389/fmed.2022.792949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/21/2022] [Indexed: 01/09/2023] Open
Abstract
Arterial hypertension, dyslipidemia, alterations in glucose metabolism and fatty liver, either alone or in association, are frequently observed in obese children and may seriously jeopardize their health. For obesity to develop, an excessive intake of energy-bearing macronutrients is required; however, ample evidence suggests that fructose may promote the development of obesity and/or metabolic alterations, independently of its energy intake. Fructose consumption is particularly high among children, because they do not have the perception, and more importantly, neither do their parents, that high fructose intake is potentially dangerous. In fact, while this sugar is erroneously viewed favorably as a natural nutrient, its excessive intake can actually cause adverse cardio-metabolic alterations. Fructose induces the release of pro-inflammatory cytokines, and reduces the production of anti-atherosclerotic cytokines, such as adiponectin. Furthermore, by interacting with hunger and satiety control systems, particularly by inducing leptin resistance, it leads to increased caloric intake. Fructose, directly or through its metabolites, promotes the development of obesity, arterial hypertension, dyslipidemia, glucose intolerance and fatty liver. This review aims to highlight the mechanisms by which the early and excessive consumption of fructose may contribute to the development of a variety of cardiometabolic risk factors in children, thus representing a potential danger to their health. It will also describe the main clinical trials performed in children and adolescents that have evaluated the clinical effects of excessive intake of fructose-containing drinks and food, with particular attention to the effects on blood pressure. Finally, we will discuss the effectiveness of measures that can be taken to reduce the intake of this sugar.
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Affiliation(s)
- Marco Giussani
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy
| | - Giulia Lieti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Antonina Orlando
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy
| | - Gianfranco Parati
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Simonetta Genovesi
- Cardiologic Unit, Istituto Auxologico Italiano, Istituto Ricovero Cura Carattere Scientifico (IRCCS), Milan, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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A pilot feasibility study investigating the impact of increasing sucrose intakes on body composition and blood pressure. J Nutr Sci 2021; 10:e60. [PMID: 34422262 PMCID: PMC8358843 DOI: 10.1017/jns.2021.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 01/19/2023] Open
Abstract
Epidemiological and intervention studies have reported negative health effects of sucrose intake, but many of these studies were not representative of typical dietary habits. In this pilot study, we aimed to test the effect of increasing sucrose intakes for 1 week on body composition and blood pressure and explore the feasibility of consuming high intakes of sucrose in addition to a habitual diet. In a randomised crossover design study, twelve healthy participants (50 % female, age 28⋅4 ± 10 years, BMI 25 ± 3 kg/m2), consumed either 40, 80 or 120 g sucrose in 500 ml water in addition to their habitual diet every day for 1 week, with a 1-week washout between treatment periods. Body composition (assessed using bioelectrical impedance) and blood pressure measurements were taken before and after each intervention phase. All participants reported no issues with consuming the sucrose dose for the intervention period. There was a significant increase in systolic blood pressure following 120 g sucrose intake (P = 0⋅006), however there was no significant changes to blood pressure, body weight, BMI, percentage protein, fat or water (P > 0⋅05) when comparing change from baseline values. There was also no effect of sucrose intakes on energy or macronutrient intakes during the intervention (P > 0⋅05). We show here that varying doses of sucrose over a 1-week period have no effect on body composition or blood pressure. The amounts of sucrose used were an acceptable addition to the habitual diet and demonstrate the feasibility of larger-scale studies of chronic sucrose supplementation.
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Oliveira T, Ribeiro I, Jurema-Santos G, Nobre I, Santos R, Rodrigues C, Oliveira K, Henrique R, Ferreira-e-Silva W, Araújo A. Can the Consumption of Ultra-Processed Food Be Associated with Anthropometric Indicators of Obesity and Blood Pressure in Children 7 to 10 Years Old? Foods 2020; 9:E1567. [PMID: 33126771 PMCID: PMC7692221 DOI: 10.3390/foods9111567] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 12/14/2022] Open
Abstract
The consumption of ultra-processed foods plays an important role in the development of obesity and hypertension. The present study investigated the association between consumption of food according to the degree of processing and anthropometric indicators of obesity and blood pressure in children. This is a cross-sectional study with 164 children aged 7-10 years. The body mass index (BMI) for age, waist circumference (WC), and waist-to-height ratio (WHtR) was evaluated. Food consumption was analyzed by three 24-h dietary recalls, and classified as: G1-unprocessed or minimally processed; G2-culinary ingredients and processed food; and G3-ultra-processed food. Linear regression analyses were used to investigate the associations among variables. The average energy consumption was 1762.76 kcal/day, split into 45.42%, 10.88%, and 43.70%, provided by G1, G2, and G3, respectively. Adjusted linear regression analyses identified that the caloric contribution of G1 was inversely associated with DBP, showing that for each 10% increase in the energy intake of minimally processed foods, there was a reduction of 0.96 mmHg in the DBP (β:-0.10; 95% CI:-0.19 to -0.01; r2 = 0.20). There was no association between the caloric contribution of food groups and BMI, WC, WHtR, and SBP. Increasing consumption of G1 could be a strategy for the prevention and treatment of hypertension in schoolchildren.
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Affiliation(s)
- Tafnes Oliveira
- Department of Nutrition, Universidade Federal de Pernambuco (UFPE), Recife-PE 50670-901, Brazil; (T.O.); (I.R.); (G.J.-S.); (I.N.); (R.S.)
| | - Isabella Ribeiro
- Department of Nutrition, Universidade Federal de Pernambuco (UFPE), Recife-PE 50670-901, Brazil; (T.O.); (I.R.); (G.J.-S.); (I.N.); (R.S.)
| | - Gabriela Jurema-Santos
- Department of Nutrition, Universidade Federal de Pernambuco (UFPE), Recife-PE 50670-901, Brazil; (T.O.); (I.R.); (G.J.-S.); (I.N.); (R.S.)
| | - Isabele Nobre
- Department of Nutrition, Universidade Federal de Pernambuco (UFPE), Recife-PE 50670-901, Brazil; (T.O.); (I.R.); (G.J.-S.); (I.N.); (R.S.)
| | - Ravi Santos
- Department of Nutrition, Universidade Federal de Pernambuco (UFPE), Recife-PE 50670-901, Brazil; (T.O.); (I.R.); (G.J.-S.); (I.N.); (R.S.)
| | - Camilla Rodrigues
- Department of Nutrition, Centro Acadêmico de Vitória (CAV)-Universidade Federal de Pernambuco (UFPE), Vitória de Santo Antão-PE 55608-680, Brazil; (C.R.); (K.O.); (W.F.S.)
| | - Kevin Oliveira
- Department of Nutrition, Centro Acadêmico de Vitória (CAV)-Universidade Federal de Pernambuco (UFPE), Vitória de Santo Antão-PE 55608-680, Brazil; (C.R.); (K.O.); (W.F.S.)
| | - Rafael Henrique
- Department of Physical Education, Universidade Federal de Pernambuco (UFPE), Recife-PE 50670-901, Brazil;
| | - Wylla Ferreira-e-Silva
- Department of Nutrition, Centro Acadêmico de Vitória (CAV)-Universidade Federal de Pernambuco (UFPE), Vitória de Santo Antão-PE 55608-680, Brazil; (C.R.); (K.O.); (W.F.S.)
| | - Alice Araújo
- Department of Public Health, Centro Acadêmico de Vitória (CAV)-Universidade Federal de Pernambuco (UFPE), Vitória de Santo Antão-PE 55608-680, Brazil
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Farhangi MA, Nikniaz L, Khodarahmi M. Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: a systematic review and dose-response meta-analysis. J Transl Med 2020; 18:344. [PMID: 32891165 PMCID: PMC7487688 DOI: 10.1186/s12967-020-02511-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the current systematic review and meta-analysis, we summarized the studies that evaluated the effects of sugar-sweetened beverages (SSBs) intake on blood pressure among children and adolescents. METHODS In a systematic search from PubMed, Scopus, Embase and Cochrane electronic databases up to 20 April 2020, the observational studies that evaluated the association between sugar-sweetened beverages intake and hypertension, systolic or diastolic blood pressure (SBP, DBP) were retrieved. RESULTS A total of 14 studies with 93873 participants were included in the current meta-analysis. High SSB consumption was associated with 1.67 mmHg increase in SBP in children and adolescents (WMD: 1.67; CI 1.021-2.321; P < 0.001). The difference in DBP was not significant (WMD: 0.313; CI -0.131- 0.757; P = 0.108). High SSB consumers were 1.36 times more likely to develop hypertension compared with low SSB consumers (OR: 1.365; CI 1.145-1.626; P = 0.001). In dose-response meta-analysis, no departure from linearity was observed between SSB intake and change in SBP (P-nonlinearity = 0.707) or DBP (P-nonlinearity = 0.180). CONCLUSIONS According to our finding, high SSB consumption increases SBP and hypertension in children and adolescents.
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Affiliation(s)
| | - Leila Nikniaz
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdieh Khodarahmi
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
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Pérez-Gimeno G, Rupérez AI, Vázquez-Cobela R, Herráiz-Gastesi G, Gil-Campos M, Aguilera CM, Moreno LA, Leis Trabazo MR, Bueno-Lozano G. Energy Dense Salty Food Consumption Frequency Is Associated with Diastolic Hypertension in Spanish Children. Nutrients 2020; 12:nu12041027. [PMID: 32283662 PMCID: PMC7230361 DOI: 10.3390/nu12041027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 01/09/2023] Open
Abstract
High blood pressure (BP) is a risk factor for cardiovascular disease and sodium consumption is related to high BP. Moreover, sugar-sweetened beverages (SSB) and the Dietary Approach to Stop Hypertension (DASH) influence BP. For this reason, we investigated whether: 1) children with risk of elevated BP had a higher consumption frequency (CF) of energy-dense salty foods (EDSF), high-sugary foods (HSF) and SSB or a low DASH score; and 2) children with a higher CF of EDSF showed a worse anthropometric and metabolic profile. Anthropometry, BP and general biochemical parameters were measured in 687 Spanish children (5-16 years) with normal or excess weight. A food frequency questionnaire was used to calculate EDSF, HSF and SSB consumption, and modified DASH score. Results showed that sex and pubertal stage influenced modified DASH score. Diastolic hypertension was associated to higher CF of EDSF in the whole sample and to higher CF of SSB in pubertal children, both independently of nutritional status. In addition, CF of EDSF was positively associated with CF of HSF and SSB and inversely associated with modified DASH score. Targeted policies and intervention programs, specific for different age ranges, should be established that aim to reduce salt consumption from snacks and processed foods, which could reduce HSF and SSB consumption as well.
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Affiliation(s)
- Gloria Pérez-Gimeno
- GENUD Research group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50009 Zaragoza, Spain; (G.P.-G.); (A.I.R.)
| | - Azahara I. Rupérez
- GENUD Research group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50009 Zaragoza, Spain; (G.P.-G.); (A.I.R.)
| | - Rocío Vázquez-Cobela
- Investigation Unit in Nutrition, Growth and Human Development of Galicia GI Pediatric Nutrition-Santiago Health Research Institute (IDIS), Pediatrics Department, Universitary Clinical Hospital of Santiago, Santiago de Compostela University, 15706 Santiago de Compostela, Spain
| | - Gonzalo Herráiz-Gastesi
- Unidad de Endocrinología Pediátrica, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Mercedes Gil-Campos
- Metabolic Pediatric and Investigation Unit, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Concepción M. Aguilera
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Bioquímica y Biología Molecular II, Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada, 18071 Granada, Spain
| | - Luis A. Moreno
- GENUD Research group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50009 Zaragoza, Spain; (G.P.-G.); (A.I.R.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Rosaura Leis Trabazo
- Investigation Unit in Nutrition, Growth and Human Development of Galicia GI Pediatric Nutrition-Santiago Health Research Institute (IDIS), Pediatrics Department, Universitary Clinical Hospital of Santiago, Santiago de Compostela University, 15706 Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-619-019-196
| | - Gloria Bueno-Lozano
- GENUD Research group, Universidad de Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria (IIS) Aragón, 50009 Zaragoza, Spain; (G.P.-G.); (A.I.R.)
- Investigation Unit in Nutrition, Growth and Human Development of Galicia GI Pediatric Nutrition-Santiago Health Research Institute (IDIS), Pediatrics Department, Universitary Clinical Hospital of Santiago, Santiago de Compostela University, 15706 Santiago de Compostela, Spain
- Unidad de Endocrinología Pediátrica, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, 50009 Zaragoza, Spain
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Cardiovascular and Autonomic Responses to Energy Drinks-Clinical Implications. J Clin Med 2020; 9:jcm9020431. [PMID: 32033367 PMCID: PMC7073550 DOI: 10.3390/jcm9020431] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/22/2020] [Accepted: 02/03/2020] [Indexed: 12/14/2022] Open
Abstract
There is an increasing consumption of energy drinks both in the United States and worldwide. The components of these beverages are sometimes unclear but commonly include caffeine, sugars, taurine, and B-vitamins. Young people, particularly those engaged in sports, studying, and in the military are especially likely to be consumers of energy drinks. While limited data are available regarding their autonomic and hemodynamic effects, current literature suggests that energy drink consumption is accompanied by increases in blood pressure, sympathetic drive, and also in QT prolongation. There are no systematic long term studies identifying consequences of frequent energy drink consumption. However, multiple anecdotal reports implicate energy drinks in adverse cardiovascular events including atrial fibrillation, ventricular arrhythmia, myocardial infarction, and sudden death. Events such as atrial fibrillation may even occur in otherwise healthy subjects with structurally normal hearts. It is likely that these cardiovascular outcomes are triggered by the hemodynamic, autonomic, and electrocardiographic responses to energy drink consumption. What remains unclear is how concomitant use of other stimulants such as amphetamines and nicotine may interact to potentiate neural and circulatory responses and cardiovascular consequences when combined with energy drinks.
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