Awareness of energy drink intake guidelines and associated consumption practices: a cross-sectional study

The Era of Energy Drinks: Consumption Pattern, Awareness, Perception, and Their Adverse Impact on Adolescent Health in Egypt

BACKGROUND

Despite the risks associated with energy drinks (EDs), the consumption of EDs remains high, especially among adolescents, so the study aimed to assess the consumption pattern, awareness, perception of EDs, and their adverse impact on adolescent health.

METHODS

A cross-sectional design was used. The study setting is Damanhur City, Beheira governorate, Egypt, with a sample size of 350 participants. A structured interview questionnaire was used to collect the data and consisted of five parts: socio-demographic data, pattern of use, negative adverse effects of EDs, knowledge, and perception.

RESULTS

The data reveal that 38.5% of the studied sample consumed EDs, and 14.2% of them consumed more than one time per day. The main reason for consumption was feeling fatigue among 46.4%, followed by 28.7% to increase concentration. Only 36% had satisfactory awareness, and 45.7% perceived that excessive consumption has dangerous effects. Age, educational stage, gender, awareness, and perception are significant influencers on the consumption of EDs. The reported adverse impacts were polyuria among 51.4%, followed by tachycardia (40.0%) and insomnia (35%).

CONCLUSION

About one-third of studied adolescents consume EDs regularly and reported several adverse health effects, such as polyuria and tachycardia. The main reason for consumption was feeling fatigued among about half of the studied adolescents. Low awareness levels and negative perceptions were significantly associated with consumption.

RECOMMENDATION

Implement educational programs about EDs and their possible risks to improve the awareness level among adolescents. Further studies should be carried out across different countries.

A randomised experimental study comparing perceptions of two energy drink health warning labels

ISSUE ADDRESSED

Consumption of energy drinks is a public health concern, particularly in adolescents and young adults. This study explored energy drink consumers' reactions to an energy drink-specific warning label (risk of cardiac effects) and a more general sugary drink warning label (risk of obesity).

METHODS

An online experimental study randomly allocated Australian energy drink consumers aged 18-39 years (N = 435) to view one of two label conditions (cardiac effects or obesity). Participants were assessed on: intention to reduce energy drink consumption, perceived health threat, perceived label effectiveness and policy support for energy drink warning labels.

RESULTS

Mean intentions to reduce consumption scores were similar across the two label conditions (Mobesity  = 2.5, Mcardiac  = 2.6) overall; and were higher for the cardiac label (compared to obesity label) for some subgroups: females (Mobesity  = 2.3, Mcardiac  = 2.8; p = .037), older (25-39 years; Mobesity  = 2.4, Mcardiac  = 2.8; p = .016); and higher education level (Mobesity  = 1.9, Mcardiac  = 2.7; p = .004). While perceived health threat measures were higher for obesity than cardiac effects, perceived label effectiveness measures of 'believable' and 'relevant to me' were higher for the cardiac label than the obesity label (believable: 71.0% vs 56.1%; relevant: 42.5% vs 29.4%). Participants who viewed the cardiac label were more likely to support policy than those shown the obesity label (OR = 1.6, 95%CI [1.1, 2.3], p = .02).

CONCLUSIONS

Health effect warnings labels were perceived by energy drink consumers to be impactful and are supported. Labels with energy drink-specific health effects may offer additional benefit. SO WHAT?: Policy makers can feel confident that warning labels on energy drinks will confer public health benefit.

Energy drink consumption among Australian adolescents associated with a cluster of unhealthy dietary behaviours and short sleep duration

BACKGROUND

Non-alcoholic energy drinks ('energy drinks') are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption.

METHODS

Participants were 8942 students in Years 8 to 11 (aged 12 to 17 years) who participated in the 2018 National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. A multistage stratified random sampling procedure was used. Within the school setting, students self-completed an online questionnaire assessing their dietary, physical activity and sedentary behaviours. A multilevel logistic regression model was used to examine associations between energy drink consumption and sociodemographic and behavioural factors.

RESULTS

Overall, 8% of students reported consuming energy drinks on a weekly basis ('regular consumers'). A further 16% indicated they consume less than one cup per week of these types of drinks, while around three-quarters (76%) reported they do not consume energy drinks. Regular consumption of energy drinks was independently associated with being male, having greater weekly spending money, high intakes of snack foods, fast food, other sugar-sweetened beverages and fruit juice, as well as short sleep duration. There was no independent association with other sociodemographic characteristics (i.e., year level, level of disadvantage, geographic location), consumption of vegetables and fruit, physical activity level, or sedentary recreational screen time.

CONCLUSIONS

While most Australian adolescents do not consume energy drinks, regular consumption is more prevalent among males, and consumption appears to cluster with other unhealthy dietary behaviours and short sleep duration. Findings support the need for policies that will reach identified at-risk groups (e.g., increased regulation of the marketing and sale of energy drinks), as well as suggest opportunities for interventions targeting energy drink consumption alongside other unhealthy dietary behaviours.

Country and Gender Differences in the Color Association with Energy Drinks: A Survey in Taiwanese and Japanese Students

This study investigated differences in the color association with energy drinks between two populations in different cultures, i.e., Taiwanese and Japanese. An anonymous, self-administered paper questionnaire was administered to first- and second-year students at National Taiwan Normal University (Taiwan) and Naragakuen University (Japan). In our inter-country, gender-stratified comparison, the color selected most often in response to the question, “What color comes to your mind for energy drink label?” was red for the Taiwanese and blue for the Japanese. The color associations with energy drinks selected by 20% or more participants in at least one population and showing statistical difference were extracted as noticeable difference. The present study demonstrates that the color and energy drink functions are closely associated. Specifically, yellow and nourishment, black and stimulant, yellow and vitamin supplement, green and dietary fiber supplement, and red and iron supplement are tightly associated regardless of the country. The strong tie between cosmetic and white is specific to the Taiwanese consumers. This suggests that careful color selection based on consumers’ environmental and cultural backgrounds is important in communicating information regarding energy drink functions. It would be worth for energy drink manufacturers to consider those associations in designing labels for products.

Factors Influencing Energy Drink Consumption in Participants and Viewers of Extreme Sports

Objective

To quantify energy drink consumption and influences affecting consumption in those who participate in or watch extreme sports.

Methods

An online survey, informed by focus groups, was administered via Quadrics®. Advertisement was via social media, emailing extreme sport clubs, flyers at extreme sport locations, and word of mouth. Participation was limited to those >18 y who watched and/or participated in extreme sports. The study was conducted in New Zealand, with international online availability. Variables measured comprised age, sex, energy drink consumption, reasons for their use, extreme sport viewing, advertising, and sponsorship. Logistic regression models were utilised.

Results

Amongst participants who completed the questionnaire (n = 247), the mean (SD) age was 26.2 (8.2) y, 40.5% were female, 57.9% consumed energy drinks, and 25.5% consumed >one per week. For every year older, odds of consuming energy drinks were 3.1% lower (p=0.04). A 31% increase in energy drink consumption for every single increase of viewing extreme sport per week was observed (p=0.009); however, reported viewing of advertising was not associated with increased consumption.

Conclusions

A large proportion of extreme sport enthusiasts regularly consume energy drinks, especially younger adults. Extreme sport viewing, where energy drink sponsorship is common, appears to increase their consumption, even if not considered advertising by the viewers themselves.

Influence of Psychosocial Factors on Energy Drink Consumption in Korean Nursing Students: Never-consumers versus Ever-consumers

Purpose

This study aimed to investigate the status of caffeine-containing energy drink consumption among Korean nursing students and to identify associated psychological factors.

Methods

In total, 187 Korean nursing students participated in this cross-sectional study. A self-administered questionnaire was used to identify participants' general characteristics and psychosocial factors (self-esteem, academic stress, depression, and college adjustment) associated with energy drink consumption. Data were analyzed with SPSS using descriptive statistics, the x² test, the t-test, and logistic regression.

Results

More than two-thirds (73.3%) of the participants had consumed energy drinks. Among the investigated psychological factors, depression appeared to most strongly influence energy drink consumption behaviors in this population.

Conclusion

The consumption of caffeine-containing energy drinks was found to be common among nursing students preparing to become health care professionals; depressed nursing students were more likely to have consumed energy drinks than non-depressed students. Nursing educators should emphasize the early detection of unhealthy beverage consumption habits and provide appropriate education to enhance healthy behaviors in future health care professionals.

Informing Intervention Strategies to Reduce Energy Drink Consumption in Young People: Findings From Qualitative Research

OBJECTIVE

To determine young people's knowledge of energy drinks (EDs), factors influencing ED consumption, and intervention strategies to decrease ED consumption in young people.

DESIGN

Eight group interviews with young people (aged 12-25 years).

SETTING

Community groups and secondary schools in Perth, Western Australia.

PARTICIPANTS

Forty-one young people, 41% of whom were male and 73% of whom consumed EDs.

PHENOMENON OF INTEREST

Factors influencing ED consumption and intervention strategies informed by young people to reduce ED consumption.

ANALYSIS

Two researchers conducted a qualitative content analysis on the data using NVivo software.

RESULTS

Facilitators of ED consumption included enhanced energy, pleasant taste, low cost, peer pressure, easy availability, and ED promotions. Barriers included negative health effects, unpleasant taste, high cost, and parents' disapproval. Strategies to reduce ED consumption included ED restrictions, changing ED packaging, increasing ED prices, reducing visibility in retail outlets, and research and education.

CONCLUSION AND IMPLICATIONS

Because many countries allow the sale of EDs to people aged <18 years, identifying ways to minimize potential harm from EDs is critical. This study provided unique insights into intervention strategies suggested by young people to reduce ED consumption. In addition to more research and education, these strategies included policy changes targeting ED sales, packaging, price, and visibility. Future research might examine the feasibility of implementing such interventions.

A review of caffeine use as a risk or protective factor for women's health and pregnancy

PURPOSE OF REVIEW

To provide a narrative synthesis of recently published studies on caffeine use as a risk or protective factor for health outcomes, with a focus on women's health and pregnancy.

RECENT FINDINGS

Based on predominantly observational studies, moderate caffeine intake has been shown to be a protective factor for liver cancer, certain bowel conditions, colorectal cancer, skin cancer, and regular menstrual cycle function. However, heavy consumption is a risk factor for osteoporosis, urinary incontinence, and poorer birth and child developmental outcomes. Residual confounding and issues surrounding retrospective self-reported intake are cited as key limitations in the majority of these studies. Moderate caffeine intake has been associated with lower risk of cardiovascular disease and metabolic syndrome; however, recent genetic epidemiology studies provide no evidence for a causal relationship.

SUMMARY

Greater inclusion of female participants in studies, and analysis of sex differences in the relationship between caffeine intake and certain health conditions, is necessary. The current literature suggests caffeine's role as a risk or protective factor differs across health conditions. Often, there are plausible biological mechanisms for this relationship. However, a continued precautionary stance is recommended until direct causal pathways are established. Review of recently published studies does not suggest that current intake guidelines for adults and for pregnant woman need to be modified.