Sleepy Teens and Energy Drink Use: Results From an Ethnically Diverse Sample of Youth

Energy drinks in Tamale: Understanding youth perceptions, consumption patterns, and related factors

Energy drinks (EDs) have become a popular choice for young people seeking physical and cognitive boosts, with ingredients such as caffeine, taurine, and B vitamins aimed at improving academic, athletic, and alertness levels. However, the popularity of these drinks is also driven by low prices, taste, brand loyalty, and gendered marketing, with boys being more likely to consume them. Despite the supposed benefits, EDs have been associated with high-risk behaviours, deaths, and adverse health effects, especially those related to cardiovascular risk. Meanwhile, in Ghana, the use of EDs is on the rise. Hence, this study aimed to examine the prevalence and consumption patterns, perceptions, and factors associated with ED consumption among the youth of the Tamale Metropolis. The study was cross-sectional, consisting of 541 participants. The group consisted of 340 males and 201 females, between the ages of 15 and 45. A questionnaire was utilized to obtain data on the respondents' consumption patterns and perceptions of EDs, as well as their socio-demographic characteristics. The results of the study indicated that a large percentage of the respondents, 98.7%, had consumed EDs before, while 78.7% currently consume them. Respondents believed that EDs provided additional energy (81.00%) and reduced stress (62.30%). However, they also perceived side effects such as insomnia (60.60%) and restlessness (51.40%). Also, the highest proportion of respondents (83.4%) had poor knowledge of EDs. They were unaware of the classification of EDs and their ingredients, side effects, and benefits. Age, marital status, level of education, work intensity, EDs served at gatherings, and knowledge of EDs was significantly associated with ED consumption (p < .05). Consumption was higher among those aged 26 to 35 years, singles, individuals with no formal education, and those with high work intensity. The high consumption was also associated with low knowledge levels. It is recommended that public health and nutrition professionals engage in further advocacy efforts to improve the youth's knowledge and perception of EDs in a positive manner. In addition, lawmakers should use legislation to influence consumption rates and safeguard the health of consumers.

Prevalence of energy drink consumption world-wide: A systematic review and meta-analysis

BACKGROUND AND AIMS

The increasing market for energy drinks (EDs) in recent years, as well as the health risks caused by their consumption, prompt calls to estimate the prevalence of ED use among different countries. This systematic review and meta-analysis aimed to synthesize the prevalence of ED use in different continents and age groups.

METHOD

We searched two databases (i.e. PubMed and PsycInfo) on 31 March 2023 to identify studies reporting the prevalence of ED use. A total of 192 studies (196 distinct samples; n = 1 120 613; 53.37% males) from the United States, Europe, Asia, Oceania and Africa were included in the analysis. A random-effects model was applied to estimate the overall pooled prevalence at several time-periods. Subgroup analyses were performed to provide prevalence based on continent and age group. The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal checklist. Measurements included prevalence of ED use (i.e. life-time, past 12 months, past 30 days, past 7 days and daily use), continent and age group (i.e. children, adolescents, young adults and adults).

RESULTS

The life-time ED use world-wide-pooled prevalence was estimated to be 54.7% [95% confidence interval (CI) = 48.8-60.6; I2  = 99.80], 43.4% (95% CI = 36.1-50.6; I2  = 99.92) in the past 12 months, 32.3% (95% CI = 28.8-35.8; I2  = 99.82) in the past 30 days, 21.6% (95% CI = 18.7-24.5; I2  = 99.95) in the past 7 days and 8.82% (95% CI = 6.3-11.4; I2  = 99.95) daily ED use. Subgroups analyses showed significant differences in ED life-time use within age groups (P = 0.002) and continents (P = 0.035).

CONCLUSIONS

The world-wide prevalence of energy drink use appears to be high, particularly among adolescents and young adults.

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.

Individual, Social, and Environmental Correlates of Energy Drink Use Among Adolescents

OBJECTIVE

To investigate the correlates of adolescent energy drink (ED) use using a socioecological approach to inform future interventions.

METHODS

In 2017-2018, 3,688 students attending 25 randomly selected Western Australian secondary schools completed a self-report survey. A backward stepwise logistic regression analysis was used to construct a model of the most significant individual (n = 12), social (n = 3), and environmental (n = 4) factors associated with being an ED user (ie, past month ED use).

RESULTS

Overall, 18% of participants were ED users. The factors significantly associated with being an ED user included being male (P < 0.001), having a higher disposable income (P < 0.001), perceiving EDs as good for health (P = 0.009), perceiving EDs as safe for someone their age to drink (P < 0.001), having a sensation-seeking personality (P = 0.011), having friends who drink EDs (P < 0.001), having parents who would give them an ED if asked (P < 0.001), and having EDs available at home (P < 0.001).

CONCLUSIONS AND IMPLICATIONS

Initiatives to reduce ED intake among adolescents need to be multifaceted, addressing individual, social, and environmental factors. It is also important that educational interventions target both parents and adolescents.

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

Energy drinks (EDs) are non-alcoholic beverages providing an extra boost in physical/cognitive performance and mood. Besides the physiological effects related to the high-caffeine content of EDs, long-term emotional, social, and behavioral effects have been recently receiving attention. However, a few systematic reviews have focused on the critical yet understudied periods of childhood and adolescence. We have undertaken a comprehensive systematic review of the evidence on any psychosocial correlates of ED consumption in 0-18-year-old subjects, as published up to April 1, 2021, in MEDLINE/PubMed, PsycINFO, and Cochrane Reviews and Central Register of Controlled Trials. Of the initial 789 records, 104 original articles were included in the systematic review. Seventy percent of them were published from 2016 onwards; among investigated topics, substance use ranked first, followed by psychological and socio-educational factors; the less investigated topic was risky behaviors. Taste and energy-seeking were the main drivers of consumption, which generally happened at home or during sport/recreational activities, without perception of health-related risks. Positive associations with ED consumption were found for sensation seeking, irritability/anger, and suicide ideation, plan, or attempts. Finally, participants with lower grades, a low parental monitoring, or bad influences from peers were more likely to consume EDs. Conclusion: With ~ 70% of papers published since the 2 comprehensive reviews on children/adolescents were carried out, an update of the literature with a broad focus is of great importance. Consumption of EDs by children/adolescents lies in the potential interplay between personality traits, school performance, and influences by family members and peers. What is Known: • Taste and energy-seeking are the main drivers of energy drink consumption, which mostly happened at home or in sport/recreational activities. What is New: • Perception of risks related to energy drinks is associated with a lower consumption, as based on cross-sectional studies. • As mostly based on cross-sectional studies: 1. energy drink consumption is related to sensation seeking, irritability/anger, and suicide ideation or attempts; 2. students with a lower school performance, low parental monitoring, or bad peer influence, are more likely to consume energy drinks.

Too Jittery to Sleep? Temporal Associations of Actigraphic Sleep and Caffeine in Adolescents

Caffeine consumption has been linked to poor sleep health in adolescents, but it is unknown whether poor sleep predicts caffeine consumption, and/or whether caffeine consumption predicts poor sleep, particularly when sleep is measured objectively. Data were collected from a micro-longitudinal sub-study of the age 15 wave of the Fragile Families and Child Wellbeing Study (n = 589). Adolescents wore an actigraphy device and completed daily surveys for ~1 week. Daily surveys assessed subjective sleep quality and caffeinated beverage consumption (0 = no caffeine, 1 = any caffeine). Separate mixed models assessed whether actigraphy-measured sleep duration, timing, maintenance efficiency, and subjective quality predicted next-day caffeinated beverage consumption within and between adolescents. Variability (standard deviation) of sleep duration and timing, sleep regularity index, and social jetlag were tested as additional between-person predictors. Lagged models tested whether daily caffeinated beverage consumption predicted sleep that night (n = 458). Adolescents with more variable sleep duration and midpoint had higher average odds of consuming caffeinated beverages compared to others. After adolescents consumed ≥1 caffeinated beverage, they had later sleep onset that night and wake time the next morning than usual versus when they did not consume caffeine. Curbing caffeinated beverage consumption may aid in the maintenance of regular sleep schedules and advance sleep timing in adolescents.

Energy Drinks Consumption Associated with Emotional and Behavioural Problems via Lack of Sleep and Skipped Breakfast among Adolescents

The aim of our study was to explore whether energy drink consumption is associated with both emotional and behavioural problems and whether this association might be mediated by amount of sleep and breakfast consumption among adolescents. The nationally representative Health Behaviour in School-aged Children (HBSC) study, realised in 2018 in Slovakia in schools, was used to acquire needed data, with the research sample of 8405 adolescents from 11 to 15 years old (mean age = 13.43; 50.9% boys) who completed the questionnaires on their own in a presence of researchers and research assistants. Emotional and behavioural problems were assessed by a Strengths and Difficulties Questionnaire, while energy drinks consumption, breakfast consumption and sleep duration was assessed by questions in line with the HBSC study protocol. Linear regression models assessed the associations between energy drinks consumption and emotional and behavioural problems. Mediation by sleep duration and breakfast consumption was assessed with parallel mediation models. Energy drink consumption was significantly associated with emotional (p < 0.001) and behavioural problems (p < 0.001), with higher consumption of energy drinks leading to more emotional and behavioural problems. Results from a parallel mediation analysis indicated that energy drink consumption is indirectly related to both emotional and behavioural problems through its relationship with the amount of sleep and breakfast consumption. Parents and professionals working with adolescents should be aware that unhealthy dietary habits and lack of sleep might be related to emotional and behavioural problems.

Energy drink intake is associated with insomnia and decreased daytime functioning in young adult females

OBJECTIVE

To investigate the association between energy drink (ED) use and sleep-related disturbances in a population-based sample of young adults from the Raine Study.

DESIGN

Analysis of cross-sectional data obtained from self-administered questionnaires to assess ED use and sleep disturbance (Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire (FOSQ-10) and the Pittsburgh Sleep Symptoms Questionnaire-Insomnia (PSSQ-I)). Regression modelling was used to estimate the effect of ED use on sleep disturbances. All models adjusted for various potential confounders.

SETTING

Western Australia.

PARTICIPANTS

Males and females, aged 22 years, from Raine Study Gen2-22 year follow-up.

RESULTS

Of the 1115 participants, 66 % were never/rare users (i.e. <once/month) of ED, 17·0 % were occasional users (i.e. >once/month to <once/week) and 17 % were frequent users (≥once/week). Compared with females, a greater proportion of males used ED occasionally (19 % v. 15 %) or frequently (24 % v. 11 %). Among females, frequent ED users experienced significantly higher symptoms of daytime sleepiness (FOSQ-10: β = 0·93, 95 % CI 0·32, 1·54, P = 0·003) and were five times more likely to experience insomnia (PSSQ-I: OR = 5·10, 95 % CI 1·81, 14·35, P = 0·002) compared with never/rare users. No significant associations were observed in males for any sleep outcomes.

CONCLUSIONS

We found a positive association between ED use and sleep disturbances in young adult females. Given the importance of sleep for overall health, and ever-increasing ED use, intervention strategies are needed to curb ED use in young adults, particularly females. Further research is needed to determine causation and elucidate reasons for gender-specific findings.

Consumption of energy drinks among adolescents in Norway: a cross-sectional study

Background

Energy drink (ED) consumption is increasing all over the world. We sought to describe the consumption of EDs among adolescents in Norway, and to explore the determinants of daily and high consumption.

Methods

Population-based cross-sectional data were collected from a sample of 31,091 secondary school students in grade 8–13 aged 12–19 years. School grade, residency, socioeconomic status (SES), physical activity and leisure screen time were included in multiple regression analyses, in order to investigate their associations with daily and high (≥four times weekly) ED consumption.

Results

52.3% of the respondents were ED consumers and 3.5% were high consumers. Boys consumed twice as much ED as girls (boys: 36.3 ml/day, girls: 18.5 ml/day, geometric means), and the proportion of male high consumers was 3.7-times higher than that of females. The adjusted odd ratio (OR) of upper secondary school (grades 11–13, ages 15–19) students being high ED consumers were higher than for lower secondary school (grades 8–10, ages 12–15) students (OR 1.1(confidence interval (CI):1.0–1.3)), as well as higher for rural than urban residents (OR 1.3 (CI: 1.1–1.5)). Gradients for the increased ORs of being a high ED consumer were found for decreased SES, decreased frequency of physical activity and increased daily leisure screen time.

Conclusions

More than half of the respondents reported that they were ED consumers. Daily and high consumption were independently associated with male gender, physical inactivity, high leisure screen time, low socioeconomic status and rural residency.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6236-5) contains supplementary material, which is available to authorized users.

Knowledge and Behavior of Saudi College Athletes toward Energy and Sports Drinks with an Emphasis on Microbial Quality and Safety

The aim of this study was to assess the knowledge and behavior of university athletes in Saudi Arabia regarding energy drinks (EDs) and sports drinks (SDs). In addition, the microbiological quality of available local drinks was also assessed. The presence of total bacterial coliform count, Escherichia coli, Salmonella, and Staphylococcus aureus on these drinks was also determined. Of the 120 university athletes surveyed, 69 were currently using SDs, and 51 were using EDs. The study consisted of a 10-question survey assessing the athletes’ sociodemographic characteristics, personal habits, and SD- and ED-related knowledge and habits. With regard to the question about the primary reason for using EDs, n = 26 respondents (50.98%) reported that providing energy (speed, strength, and power) was the main reason for consuming these beverages. Conversely, n = 25 respondents (36.23%) believed that recovery from injury or illnesses was the main reason for the consumption of SDs. A majority of university athletes (n = 43, 62.32%) who used SDs believed that SDs were safe to use, while n = 22 respondents (43.14%) were unaware of any adverse health effects associated with the consumption of EDs. Of the total of 26 SDs and EDs tested, microbial contamination was present in only two products. Microbial levels and the total bacterial count for most of the samples were very low (<1 log CFU/mL). However, some drinks had a slightly higher microbial level, which could be harmful or cause spoilage with improper storage. Thus, our findings suggest that improvements in microbial quality are needed for these beverages.

Eveningness and Later Sleep Timing Are Associated with Greater Risk for Alcohol and Marijuana Use in Adolescence: Initial Findings from the National Consortium on Alcohol and Neurodevelopment in Adolescence Study

BACKGROUND

Abundant cross-sectional evidence links eveningness (a preference for later sleep-wake timing) and increased alcohol and drug use among adolescents and young adults. However, longitudinal studies are needed to examine whether eveningness is a risk factor for subsequent alcohol and drug use, particularly during adolescence, which is marked by parallel peaks in eveningness and risk for the onset of alcohol use disorders. This study examined whether eveningness and other sleep characteristics were associated with concurrent or subsequent substance involvement in a longitudinal study of adolescents.

METHODS

Participants were 729 adolescents (368 females; age 12 to 21 years) in the National Consortium on Alcohol and Neurodevelopment in Adolescence study. Associations between the sleep variables (circadian preference, sleep quality, daytime sleepiness, sleep timing, and sleep duration) and 3 categorical substance variables (at-risk alcohol use, alcohol bingeing, and past-year marijuana use [y/n]) were examined using ordinal and logistic regression with baseline age, sex, race, ethnicity, socioeconomic status, and psychiatric problems as covariates.

RESULTS

At baseline, greater eveningness was associated with greater at-risk alcohol use, greater bingeing, and past-year use of marijuana. Later weekday and weekend bedtimes, but not weekday or weekend sleep duration, showed similar associations across the 3 substance outcomes at baseline. Greater baseline eveningness was also prospectively associated with greater bingeing and past-year use of marijuana at the 1-year follow-up, after covarying for baseline bingeing and marijuana use. Later baseline weekday and weekend bedtimes, and shorter baseline weekday sleep duration, were similarly associated with greater bingeing and past-year use of marijuana at the 1-year follow-up after covarying for baseline values.

CONCLUSIONS

Findings suggest that eveningness and sleep timing may be under recognized risk factors and future areas of intervention for adolescent involvement in alcohol and marijuana that should be considered along with other previously identified sleep factors such as insomnia and insufficient sleep.