Energy drinks: a new health hazard for adolescents

Food-Related Online Media (Mukbang and Cookbang) Exposure and Dietary Risk Behaviors in Korean Adolescents

BACKGROUND

Studies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use.

OBJECTIVES

This study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data.

METHODS

In this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, mean duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar-sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders.

RESULTS

Frequent mukbang/cookbang watching (≥5 times/wk compared with never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR: 1.20; 95% CI: 1.13, 1.28), frequent nighttime eating (OR: 1.43; 95% CI: 1.33, 1.54), and frequent intakes of fast foods (OR: 1.69; 95% CI: 1.58, 1.80), SSBs (OR: 1.47; 95% CI: 1.30, 1.66), and high-caffeine drinks (OR: 1.41; 95% CI: 1.33, 1.50), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had "no influence" on their dietary behavior, had higher prevalence of dietary risk behaviors than nonviewers (perceived "no influence" compared with nonviewers-OR: 1.18; 95% CI: 1.10, 1.26, breakfast skipping; OR: 1.15; 95% CI: 1.06, 1.24, nighttime eating; OR: 1.40; 95% CI: 1.30, 1.50, fast foods; OR: 1.22; 95% CI: 1.07, 1.38, SSBs; OR: 1.28; 95% CI: 1.20, 1.37, high-caffeine drinks).

CONCLUSIONS

Our findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

Case report on energy drink consumption among Health Sciences University students in Gauteng Province, South Africa

Background

There are claims that energy drink (ED) consumption can bring about an improvement in mental functioning in the form of increased alertness and enhanced mental and physical energy. These claims address the lifestyle of a student of sleep deprivation and academic pressure with ED consumption becoming a popular practice amongst students. The study’s objectives were to determine the prevalence, reasons for, and patterns of ED and alcohol mixed with ED (AmED) consumption amongst university students.

Case presentation

Registered students of the Health Sciences University, Gauteng Province, South Africa, formed the study population where this quantitative cross-sectional survey conveniently collected data by means of previous validated self-administered questionnaires from 490 students representing the diverse demographics of the university. Questions on the socio-demographic profile of the participants; pattern of alcohol use; reasons, pattern, and preferred types of EDs use; and the pattern, reason, and experience of AmED use during the past 12 months were asked. Frequency and percentages of distributions were determined, and the possible factors contributing to ED consumption were computed using the chi-square test. Results indicated that a total of 58% of students were consuming EDs mainly to stay awake (31%), to be more alert (14%), and to help with concentration (15%), 69% were consuming alcohol, and 16% were consuming AmEDs.

Conclusion

There is an urgent need for an appropriate public health prevention intervention so that ED consumers can make informed choices when indulging in these health behaviors before the seemingly harmless consumption of ED amongst students becomes a public health issue.

Energy drink consumption, psychological distress, and suicidality among middle and high school students

BACKGROUND

Previous research has found links between energy drink consumption and mental health outcomes in youth. However, little is known about the factors that could moderate these relationships. The present study examined the associations between energy drink consumption and psychological distress, suicidal thoughts, and suicide attempts among adolescents, and tested whether sex and school type (i.e. middle vs. high school) would moderate these associations.

METHODS

Data on students in grades 7 through 12 was obtained from the 2017 Ontario Student Drug Use and Health Survey (N  =  5,538). Multivariable Poisson regression analyses were used to examine associations between energy drink consumption and mental health outcomes. Analyses were weighted and adjusted for the complex survey design.

RESULTS

Energy drink consumption was associated with greater risk of moderate to serious (adjusted incidence rate ratio (IRR) 1.19, 95% confidence interval (CI) 1.03-1.37) and serious (IRR: 1.45, 95% CI: 1.13-1.86) levels of psychological distress, suicidal thoughts (IRR: 1.98, 95% CI: 1.62-2.42), and suicide attempts (IRR: 3.67, 95% CI: 2.26-5.95). The association between energy drink consumption and mental health outcomes was much stronger among boys and middle school students.

LIMITATIONS

The cross-sectional nature of the data precludes causal inferences and there is possibility of bias related to self-reports.

CONCLUSIONS

Energy drink consumption among adolescents is strongly and differentially associated with mental health problems among male and female middle and high school students. Future research is necessary to replicate and disentangle the observed differences in more detail to inform the development of tailored interventions.

Health Related Nutritional Knowledge and Dietary Behavior Regarding Caffeine Intake among High School Students in Yongin Region

Objectives

We aimed to examine health-related nutritional knowledge and dietary behavior related to caffeine intake among high school students (n = 310) in the Yongin region of Korea.

Methods

Data were collected using a face-to-face survey, and analyzed using chi-square test, t- test, and logistic regression analysis.

Results

The level of caffeine intake in respondents was divided into low (< 30 mg/d; n = 208) and high caffeine intake groups (> 30 mg/d; n = 102). Total nutritional knowledge related to bone disease was higher in the low intake group (score 2.75) than the high intake group (score 2.39; p < 0.05). The high intake group had lower scores for nutritional knowledge (score 0.70; p < 0.05) related to how caffeinated beverages affect sleep and for dietary behavior (score 3.25; p < 0.001), based on “I avoid caffeinated foods before sleep,” than the low intake group (nutritional knowledge score, 0.80; dietary behavior score, 3.76).

Conclusion

In the overall analysis, the low caffeine intake group had better nutritional knowledge related to bone and sleep health, and healthier dietary behavior related to sleep health compared with the high intake group.

Associations Between Korean Adolescents' Energy Drink Consumption and Suicidal Ideation and Attempts

PURPOSE

This study examined associations between caffeinated energy drink consumption patterns and (1) participant characteristics and health-risk behaviors and (2) suicidal ideation and attempts in Korean adolescents.

METHODS

Participants included 8961 adolescents who consumed the drinks more than once weekly. Data were analyzed via logistic regression.

RESULTS

Rates of suicidal ideation and attempts in participants who consumed the drinks more than once daily were higher relative to those for participants who consumed the drinks 3-6 and 1-2 times weekly.

CONCLUSIONS

Further research is required to establish causality in these relationships.

Behavioural correlates of energy drink consumption among adolescents: A review of the literature

Despite regulatory measures on the labelling of energy drinks (EDs), their consumption among adolescents continues to grow in popularity, but teachers increasingly report significant behavioural concerns among students who disclose habitual ED consumption. A review of papers published between January 2010 and October 2016 was undertaken to determine whether an association between adverse behaviour and consumption of ED exists. Findings indicate that ED consumption among adolescents is associated with alcohol and substance use, risky behaviours and psychological states including sensation seeking, depression and anxiety symptoms. ED consumption impacts negatively on executive functions and increases hyperactivity/inattention symptoms among adolescents. An inverse association between ED consumption and sleep duration exists. The findings highlight the need for greater awareness of the potential risk of ED consumption among adolescents.

Clinical Symptoms and Adverse Effects Associated With Energy Drink Consumption in Adolescents

OBJECTIVE

The aims of the study were to determine the prevalence of energy drink consumption by adolescents, to identify associated clinical symptoms and adverse effects, and to gain an understanding to the motivation behind its consumption.

METHODS

A prospective, questionnaire-based study was conducted at 2 emergency departments from June 2011 to June 2013. The questionnaire was distributed to a convenience sample of adolescents aged 12 to 18 years. Stratification was performed on the basis of frequency of consumption: frequent consumption (at least once a month) and infrequent consumption (less frequent than once a month).

RESULTS

Data analysis was performed on 612 completed questionnaires. Two hundred two responders (33%) were considered frequent energy drink consumers. Frequent consumers were more likely to be involved in high-risk behaviors and more likely to consume other caffeinated drinks. In the previous 6 months, frequent energy drink consumers were more likely to report headache (76%), anger (47%), and increased urination (24%) and were more likely to require medical evaluation for headache (41%) and difficulty breathing (22%). Frequent energy drink consumers were more likely to believe that energy drinks "help me do better in school" (12%), "help me do better in sports" (35%), "are just for fun" (46%), "help me stay up at night" (67%), and "make me concentrate/focus better" (34%).

CONCLUSIONS

Clarifying common misconceptions associated with energy drink consumption, especially in high-risk adolescents and frequent energy drink consumers, may decrease the frequency of symptoms experienced by adolescents, such as headache and difficulty breathing, requiring medical evaluation.

Caffeine consumption patterns and determinants among adolescents in Serbia

BACKGROUND

The number of adolescents who use caffeine is constantly increasing. As juvenile age is vulnerable, it is reasonable to expect that they will differently perceive reason and react to caffeine use than adults, and be more prone to unwanted physiological and psychological consequences of its consumption.

AIM

Analysis of the scope and pattern of caffeine consumption among adolescents in Serbia.

STUDY DESIGN

The cross-sectional survey was implemented in the study population of 191 Serbian adolescents during 2010.

RESULTS

The median daily intake of caffeine was 95.6 mg. The major source of caffeine was brewed coffee, and the most common reasons for caffeine intake were leisure, peer influence, or habit. Only 57.6% of the subjects were aware that caffeine is present in consumed beverages. Sex affected the pattern, but not the overall level, of caffeine consumption. No association between caffeine consumption and smoking status, frequency of caffeine use in the family, or negative personal experience with caffeine effects was observed.

CONCLUSION

Our investigation provides first and rather detailed insight into caffeine-containing beverage consumption scope and pattern among Serbian adolescents. For accurate estimation and analysis of caffeine intake in this population, randomized studies with prospective longitudinal design, caffeine content measurement, and more subjects involved are warranted.

Energy drink use is associated with alcohol and substance use in eighth, tenth, and twelfth graders

The increasing prevalence of energy drink (ED) use and its link with negative behaviors and adverse health outcomes has garnered much attention. Use of EDs combined with alcohol among college students has been of particular interest. It is unclear if these relationships develop in the context of college, or if similar associations exist in younger individuals. The present study examined associations between ED consumption patterns and other substance use in an adolescent, school-based sample. Participants were N = 3743 students attending 8th, 10th or 12th grade in a suburban central Virginia public school system who completed a prevention needs assessment survey in 2012. Chi-square analyses and logistic regressions were used to compare rates of alcohol, tobacco and other drug use across three ED use groups: moderate/heavy (12.6%), light (30.5%), and non-users (57%). Over 40% of the sample reported recent (past month) ED use, with males more likely to report moderate/heavy ED use than females (14.0% and 11.1%, respectively; p = 0.02). After adjusting for gender and grade, ED use group predicted lifetime alcohol, tobacco and other drug use (all p < 0.001). Moderate/heavy ED users were most likely and ED non-users were least likely to report using each of the 13 substances in the survey, with light ED users intermediate to the other two groups. Moderate/heavy ED users were consistently most likely to report licit and illicit substance use. Additional research is needed to better understand which adolescents are at greatest risk for adverse health behaviors associated with ED use.

Energy Drink and Coffee Consumption and Psychopathology Symptoms Among Early Adolescents: Cross-Sectional and Longitudinal Associations

Background: Little is known about possible links between energy drink use and psychopathology among youth. This study examined cross-sectional and longitudinal associations between energy drink consumption and psychopathology among early adolescents. In addition, associations between psychopathology and coffee consumption were examined to assess whether findings were specific to energy drinks or also applied to another commonly used caffeinated beverage. Methods: One hundred forty-four youth who participated in the Camden Youth Development Study (72 males; mean age 11.9 at wave 1; 65% Hispanic, 30% African American) were assessed using self-report measures of frequency of energy drink and coffee consumption and depression, anxiety, conduct disorder (CD) symptoms, and teacher reports of attention-deficit hyperactivity disorder (ADHD). Youth (92%) were reassessed 16 months later. Results: Concurrently, energy drink and coffee consumption were associated with similar psychopathology symptoms; when the other beverage was adjusted for, energy drinks remained associated with CD and coffee remained associated with panic anxiety. Initial energy drink consumption predicted increasing ADHD and CD over time, though the association with CD dropped to a trend level of significance when coffee was adjusted for. Initial levels of hyperactive ADHD predicted increasing coffee consumption over time; this association remained when energy drinks were controlled. Social anxiety was associated with less increase in energy drink consumption over time, controlling for coffee. Conclusion: Energy drink and coffee consumption among early adolescents are concurrently associated with similar psychopathology symptoms. Longitudinally, the associations between these beverages and psychopathology differ, indicating that these substances have differing implications for development over time.

Alcohol and energy drink use among adolescents seeking emergency department care

Emergency department (ED) visits due to energy drinks rose drastically from 2007 to 2011. Consuming alcohol mixed with energy drinks by young people is particularly concerning. Among youth (aged 14-20 years) in the ED reporting past-year alcohol use, we assessed frequency, reasons, and medical consequences of consuming alcohol and energy drinks in the same beverage or on the same occasion, and relationships with other risk behaviors. The sample included 439 youth (M(age)=18.6 years, SD=1.4; 41% male; 73% Caucasian): those who drank alcohol, but not energy drinks (Non-Users; 41%, n=178), those who drank alcohol and energy drinks on separate occasions (Separate; 23%, n=103), and those who combined alcohol and energy drinks in the same beverage or on the same occasion (Combined; 36%, n=158). Common reasons for combining energy drinks and alcohol were hiding the flavor of alcohol (39%) and liking the taste (36%). Common consequences were feeling jittery (71%) and trouble sleeping (46%). Combined users had the highest rates of risk behaviors (e.g., drug use, sexual risk behaviors, driving after drinking) and alcohol use severity. Multinomial logistic regression indicated that men, those who had sex after substance use, those who had used drugs, and those with higher alcohol severity were more likely to be Combined users than Non-Users. Those with higher alcohol severity were also more likely to be Combined users than Separate users. Combining energy drinks and alcohol is associated with higher rates of other risk behaviors among young drinkers. Future studies are needed to determine longitudinal relationships of energy drink use on substance use problem trajectories.

An emerging adolescent health risk: caffeinated energy drink consumption patterns among high school students

OBJECTIVE

To examine the prevalence, patterns, and correlates of energy drink use among adolescents, and determine whether more frequent use of energy drinks is associated with poorer health and behavioral outcomes.

METHODS

Data were from a 2012 cross-sectional survey of 8210 students in grades 7, 9, 10 and 12 attending public schools in Atlantic Canada. Multinomial logistic regression analysis was used to examine correlates of energy drink use patterns, including substance use, sensation seeking, risk of depression, and socioeconomic status.

RESULTS

Nearly two-thirds of survey respondents (62%) reported consuming energy drinks at least once in the previous year, with about 20% reporting use once or more per month. Sensation seeking, depression, and substance use were all higher among energy drink users relative to non-users, and in higher frequency users relative to lower frequency users.

CONCLUSIONS

The prevalence of energy drink consumption among high school students was high. The association of energy drinks with other potential negative health and behavioral outcomes suggests that use of these products may represent a marker for other activities that may negatively affect adolescent development, health and well-being.

Energy drinks, weight loss, and disordered eating behaviors

OBJECTIVE

The present study examined energy drink consumption and relations with weight loss attempts and behaviors, body image, and eating disorders.

PARTICIPANTS/METHODS

This is a secondary analysis using data from 856 undergraduate students who completed the American College Health Association-National College Health Assessment II confidentially online during February 2012.

RESULTS

This study revealed that the majority reported lifetime consumption of energy drinks (68.4%) and a substantial minority (30.2%) reported past-30-day consumption. Chi-square and t test results suggest that consumption is associated with concerns about personal appearance, weight loss attempts, and disordered eating behaviors (eg, vomiting). Hierarchical logistic regressions revealed that after controlling for demographics, the relations between energy drink consumption and the act of trying to lose weight, the use of diet pills, and the use of vomiting/laxatives remained significant.

CONCLUSIONS

The current findings suggest that energy drink consumption is associated with weight loss attempts, poor body image, and unhealthy weight loss behaviors. Future research should examine the prevalence of energy drink consumption for the purpose of weight loss.

Assessment of pattern for consumption and awareness regarding energy drinks among medical students

BACKGROUND

Energy drink is a type of beverage which contains stimulant drugs chiefly caffeine and marketed as mental and physical stimulator. Coffee, tea, soft drinks and other caffeinated beverages are not considered as energy drinks. Purpose of our study was to evaluate the awareness of medical students regarding energy drinks and their pattern and reason of energy drinks consumption.

METHODS

This was a cross sectional and observational study conducted during the period of January - December 2012 at four Medical Colleges (Dow Medical College, Sindh Medical College, Jinnah Medical College and Liaquat National Medical College) of Karachi, Pakistan. Over all 900 M.B.B.S students were invited to participate after taking written consent but viable questionnaire was submitted by 866 students, estimated response rate of 96%. All data was entered and analyzed through SPSS version 19.

RESULT

Out of 866 participants, majority were females 614 (70.9%) and only 252 (28.5%) were males, with a mean age of 21.43 ± 1.51 years. Energy drinks users were 350 (42.89%) and non users were 516 (59.58%). Only 102 (29.3%) users and 159 (30.7%) non users know the correct definition of Energy drinks. Regarding awareness, mostly user and non users thought that usage of energy drinks had been on rise due to its usefulness in reducing sleep hours [users193 (43.9%), nonusers 247 (56.1%) (p < 0.05)], for studying or completing major projects [users184 (45.0%), nonusers 225 (55.0%) (p < 0.05)] and for refreshment purposes [users179 (44.9%), nonusers 220 (55.1%) (p < 0.05)]. Two main reasons of not using energy drinks by non-users were "awareness from its side effects" 247 (47.8%) and "have no specific reason" 265 (51.3%). Most common side effects reported by users were fatigue 111 (31.7%) and weight gain 102 (29.4%).

CONCLUSION

In sum, the fact that despite serious side effects of weight gaining and fatigue, practice of consuming energy drinks is highly prevalent among medical students, particularly because they are ever ready to boost their energy level and reduce sleep hours due to stress of exams and projects. This warrants the creation of continued public health awareness about the appropriate use of caffeinated beverages, their potential benefits, side effects and correction of wrong perceptions.

Knowledge, attitudes and practices toward energy drinks among adolescents in Saudi Arabia

The objective of this study is to explore the knowledge, attitudes and intake of energy drinks among adolescents in Saudi Arabia. A multi-stage stratified sampling procedure was carried out to select 1061 school children aged 12-19 years, from Jeddah city, Saudi Arabia. A short self-reported questionnaire was administrated in order to collect the data. Of adolescents in the study, 45% drank energy drinks (71.3% males and 35.9% females; P<0.001). Advertisements were the main source of information on energy drinks (43%). The major reasons for consuming energy drinks were taste and flavour (58%), to 'try them' (51.9%) and 'to get energy' (43%), albeit with significant differences between genders (P<0.001). About half of the adolescents did not know the ingredients of these drinks, and 49% did not know that they contain caffeine (P-values <0.006 and <0.001 between genders, respectively). The greater majority (67%) considered energy drinks to be soft drinks. The study indicates the need for Saudi adolescents to be warned on the over-consumption of energy drinks. The study brings to attention the need for educational programmes related to increasing awareness in the community of the health effects related to high consumption of energy drinks.

What are the health implications associated with the consumption of energy drinks? A systematic review

There is increasing interest regarding the potential health effects of energy drink (ED) consumption. The aim of the present review was to investigate the existing evidence on health outcomes associated with ED consumption. Studies published between 1966 and February 2011 were retrieved and included if they met the following criteria: were randomized or pseudo randomized control trials; studied a human population; reported a health-related measure; and investigated a whole ED (as opposed to individual ingredients). Study quality was evaluated and data extracted using standardized tools. Fifteen studies were identified, the majority of which had less than 30 participants and included a short term of follow-up (range: 30 min-3 h). The following outcome measures were included: cardiorespiratory effects, physiological measures, pathological measures, and body composition. The mean dosage of ED was 390 mL (range: 250-750 mL). Commercial ED funding and/or study associations were identified in six studies. Studies investigating long-term consumption and follow-up were lacking. The findings from this review do not allow definitive dietary recommendations to be made regarding safe levels of ED consumption; caution should be exercised when consuming these drinks until further high-quality research is undertaken to substantiate findings.

Adolescent caffeine consumption and self-reported violence and conduct disorder

Caffeine is the most widely used psychoactive substance in the world and currently the only one legally available to children and adolescents. The sale and use of caffeinated beverages has increased markedly among adolescents during the last decade. However, research on caffeine use and behaviors among adolescents is scarce. We investigate the relationship between adolescent caffeine use and self-reported violent behaviors and conduct disorders in a population-based cross-sectional sample of 3,747 10th grade students (15-16 years of age, 50.2 % girls) who were enrolled in the Icelandic national education system during February 2012. Through a series of multiple regression models, while controlling for background factors, Attention Deficit Hyperactivity Disorder symptoms and current medication and peer delinquency, and including measures on substance use, our findings show robust additive explanatory power of caffeine for both violent behaviors and conduct disorders. In addition, the association of caffeine to the outcomes is significantly stronger for girls than boys for both violent behaviors and conduct disorders. Future studies are needed to examine to what extent, if at all, these relationships are causal. Indication of causal connections between caffeine consumption and negative outcomes such as those reported here would call into question the acceptability of current policies concerning the availability of caffeine to adolescents and the targeting of adolescence in the marketing of caffeine products.

International Society of Sports Nutrition position stand: energy drinks

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature on the safety and efficacy of the use of energy drinks (ED) or energy shots (ES). The ISSN has concluded the following. 1. Although ED and ES contain a number of nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES appear to be carbohydrate and/or caffeine. 2. The ergogenic value of caffeine on mental and physical performance has been well-established but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. 3. Consuming ED 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance. 4. Many ED and ES contain numerous ingredients; these products in particular merit further study to demonstrate their safety and potential effects on physical and mental performance. 5. There is some limited evidence that consumption of low-calorie ED during training and/or weight loss trials may provide ergogenic benefit and/or promote a small amount of additional fat loss. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. 6. Athletes should consider the impact of ingesting high glycemic load carbohydrates on metabolic health, blood glucose and insulin levels, as well as the effects of caffeine and other stimulants on motor skill performance. 7. Children and adolescents should only consider use of ED or ES with parental approval after consideration of the amount of carbohydrate, caffeine, and other nutrients contained in the ED or ES and a thorough understanding of the potential side effects. 8. Indiscriminant use of ED or ES, especially if more than one serving per day is consumed, may lead to adverse events and harmful side effects. 9. Diabetics and individuals with pre-existing cardiovascular, metabolic, hepatorenal, and neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should avoid use of ED and/or ES unless approved by their physician.

Health risks of energy drinks: what nurses and consumers need to know

Energy drinks have become very popular, yet they present health concerns and workplace safety issues related to mental and physical effects of the drinks, which are mainly related to the central nervous system and include heightened alertness, altered sleep patterns, arrhythmias and, rarely, seizures. In the workplace, any pharmacologic agent or substance, such as energy drinks, may present a risk to the delivery of health care, and the use energy drinks during pregnancy and lactation are a concern and patient education is warranted.

Influence of caffeine on the liking of novel-flavored soda in adolescents

BACKGROUND

Soda manufacturers claim that caffeine is added to soda as a flavor enhancer, but many researchers have speculated that caffeine is added to increase the hedonic and reinforcing properties of the soda. Studies in adults have demonstrated that caffeine can condition flavor preferences when added to novel-flavored beverages.

OBJECTIVES

The purpose of this study was to test the hypothesis that caffeine added to novel-flavored drinks would increase liking and preference in adolescents.

METHODS

Adolescents (n = 99) between the ages of 12 and 17 rated and ranked seven novel soda drinks. They were then randomly assigned to consume one of these beverages paired with either caffeine (1 or 2 mg/kg) or placebo over four consecutive days and rate liking. On the final visit, participants retasted the seven beverages and provided hedonic ratings and rankings.

RESULTS

Participants in the 2-mg/kg caffeine group increased the liking of the beverage over the exposure period after an initial decrease, but there was no change in liking for those in the placebo group or in the 1-mg/kg group. The increase in liking in the 2-mg/kg group was accompanied by a decrease in perceived bitterness, but no change in beverage ranking or consumption during the post-test.

CONCLUSIONS

Caffeine added to novel beverages results in a decrease in liking followed by an increase in liking with repeated exposures that may result from habituation to the bitterness of caffeine. Change in bitter perception may be the mechanism by which adolescents establish regular caffeine use.

Energy drinks mixed with alcohol: misconceptions, myths, and facts

Background

Whilst energy drinks improve performance and feelings of alertness, recent articles suggest that energy drink consumption combined with alcohol may reduce perception of alcohol intoxication, or lead to increased alcohol or drug use. This review discusses the available scientific evidence on the effects of mixing energy drinks with alcohol.

Methods

A literature search was performed using the keywords “energy drink and Red Bull^®” and consulting Medline/Pubmed, PsycINFO, and Embase.

Results

There is little evidence that energy drinks antagonize the behavioral effects of alcohol, and there is no consistent evidence that energy drinks alter the perceived level of intoxication of people who mix energy drinks with alcohol. No clinically relevant cardiovascular or other adverse effects have been reported for healthy subjects combining energy drinks with alcohol, although there are no long-term investigations currently available. Finally, whilst several surveys have shown associations, there is no direct evidence that coadministration of energy drinks increases alcohol consumption, or initiates drug and alcohol dependence or abuse.

Conclusion

Although some reports suggest that energy drinks lead to reduced awareness of intoxication and increased alcohol consumption, a review of the available literature shows that these views are not supported by direct or reliable scientific evidence. A personality with higher levels of risk-taking behavior may be the primary reason for increased alcohol and drug abuse per se. The coconsumption of energy drinks being one of the many expressions of that type of lifestyle and personality.