Energy Drinks

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.

Chronic Pancreatitis Pain Associated With Energy Drink Consumption: A Case Report

Chronic pancreatitis is commonly associated with heavy alcohol use and cigarette smoking, though many cases of chronic pancreatitis are idiopathic. Energy drink consumption has been on the rise over the last decade, with an adverse health risk profile including gastrointestinal symptoms such as dyspepsia, reflux, and gastritis. There have been several case reports linking energy drink consumption to presentations of acute pancreatitis in adult patients. To our knowledge, the association between energy drinks and episodes of chronic pancreatitis flares has not been well studied. This article explores a case of chronic pancreatitis pain related to excessive energy drink consumption in an adult male patient. This study aims to shed light on energy drinks as a potential etiology of chronic pancreatitis flares, and emphasizes the importance of counseling patients on the potential risks of excessive energy drink consumption.

Energy drinks, substance use, and posttraumatic stress symptoms among Palestinian athletes: the mediating role of perceived self-efficacy and resilience

The current study aimed to test the association between energy drinks, substance use, and posttraumatic stress symptoms, and the mediating role of perceived self-efficacy and resilience among Palestinian athletes. The sample of our study consisted of 480 Palestinian athletes: 160 women and 320 men, all were selected from five Palestinian universities located in the West Bank of Palestine. The findings of our study revealed that energy drinks positively correlated with substance abuse, and posttraumatic stress symptoms. In addition, a negative association was found between perceived self-efficacy, substance use, and posttraumatic stress symptoms. Moreover, a negative association was found between resilience, substance use, and posttraumatic stress symptoms. Results of Structural equation modeling (SEM) revealed that resilience and perceived self-efficacy mediated the association between energy drinks, substance use and posttraumatic stress symptoms. Our findings underline the importance of enhancing resilience and perceived self-efficacy among athletes to prevent initial substance use/misuse, as several traits found in resilient athletes such as high self-esteem, empathy, help-seeking, and self-awareness are important in deterring athletes from engaging in harmful substances like tobacco, marijuana, and alcohol.

Effects of energy drinks on myogenic differentiation of murine C2C12 myoblasts

Energy drinks, often advertised as dietary supplements that enhance physical and mental performance, have gained increasing popularity among adolescents and athletes. Several studies on individual ingredients such as caffeine or taurine have reported either adverse or favorable influences on myogenic differentiation, a key process in muscle regeneration to repair microtears after an intense workout session. However, the impact of different energy drinks with various formulas on muscle differentiation has never been reported. This study aims to examine the in vitro effects of various energy drink brands on myogenic differentiation. Murine C2C12 myoblast cells were induced to differentiate into myotubes in the presence of one of eight energy drinks at varying dilutions. A dose-dependent inhibition of myotube formation was observed for all energy drinks, supported by reduced percentage of MHC-positive nuclei and fusion index. Moreover, expression of myogenic regulatory factor MyoG and differentiation marker MCK were also decreased. Furthermore, given the variation in formulas of different energy drinks, there were remarkable differences in the differentiation and fusion of myotubes between energy drinks. This is the first study to investigate the impact of various energy drinks on myogenic differentiation and our results suggest an inhibitory effect of energy drinks in muscle regeneration.

Soft Drink Intake in Europe—A Review of Data from Nationally Representative Food Consumption Surveys

Public health interest in reducing the intake of sugar-sweetened soft drinks has resulted in various guidelines and initiatives related to their consumption, together with an increase in availability and sales of low and no-sugars versions. The aim of this review was to gain insight regarding individual-level amounts and types of soft drinks consumed across the lifecycle as reported in nationally representative surveys in Europe. The review highlighted significant gaps and challenges regarding the availability of recent country-specific soft drink consumption data including heterogeneity in categorisations used in reporting soft drinks. Nonetheless, crude estimates of mean intake (across countries) indicated that total soft drinks and soft drinks with sugars was highest in adolescents and lowest in infants/toddlers and older adults. For infants/toddlers, crude mean intakes of soft drinks with reduced/no sugars were higher than soft drinks with sugars. The review also found that consumption of total soft drinks is decreasing with a shift to consumption of soft drinks with reduced/no sugars in replacement of sugars-containing soft drinks. This review provides valuable insight into what data are currently available on soft drink consumption in Europe with heterogeneity in categorisations, terminology, and definitions of soft drinks observed.

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 drinks, depression, insomnia and stress among Palestinians: The mediating role of cigarettes smoking, electronic cigarettes and waterpipe

We investigated the association between energy drinks, depression, insomnia and stress among Palestinians and whether cigarette smoking, electronic cigarettes, and waterpipe mediate the association between these variables. Our study sample consisted of 506 Palestinian adults: 120 men and 386 women recruited from online advertisements, e-mail campaigns and social media. Findings showed a positive correlation between energy drinks, depression, insomnia, and stress. While a positive correlation was found between energy drinks, cigarette smoking, electronic smoking and waterpipe. Results of path analysis showed that energy drinks, cigarette smoking, electronic smoking and waterpipe mediated the correlation between energy drinks, insomnia, depression and stress. Thus, there is an urgent need to increase community awareness regarding the adverse effects of excessive energy drink consumption among Palestinians. Accordingly, training programs, workshops, and open days targeting Palestinians to improve awareness of the adverse effects of energy drinks on physical and mental health are crucial to reducing Palestinians' extensive use of energy drinks.

Non-Cardiac Conditions that Mimic Cardiac Symptoms in Athletes

When considering the variety of complaints an athlete can present with, chest pain is arguably the most concerning given the potential for catastrophic outcomes. Luckily, these do not comprise the majority of cases, and indeed, are quite rare. The bulk of presentations of athletes with chest pain are due to musculoskeletal, gastrointestinal, and pulmonary causes. Each and every healthcare provider who works closely with athletes must have a thorough understanding of contributing conditions that present as chest pain. Here, we explore some of the more prevalent causes of non-cardiac chest pain, classic presentations, and management considerations.

Habits of Energy Drink Consumption among Teens in Slovenia - Focus Group Findings

Introduction

Teachers in Slovenia have been noticing the increased consumption of energy drinks among pupils. Therefore, the purpose of this study was to investigate habits that contribute to the frequency of energy drink consumption.

Method

36 teens participated in the study: elementary school pupils (6th and 8th grades), general upper secondary school pupils, and secondary technical school pupils (1st and 3rd year). In the course of the study 6 group interviews were held to help investigate young people’s habits and their reasons for energy drink purchase and consumption. Moreover, we investigated the influence of age on the consumption and knowledge about energy drink ingredients, as well as their influence on the body.

Results

Interview analysis showed that energy drink consumers are predominantly secondary school pupils. Their choice most frequently depends on the price, their taste, or the brand. What influences elementary school pupils’ purchasing decisions are price, packaging, and advertisements, while secondary school pupils choose their drinks according to the lack of energy and how tired they feel. The predominant factors preventing energy drink consumption are health problems among family members and friends. Secondary school pupils know more about energy drink ingredients than elementary school pupils.

Conclusion

On the basis of these findings, we will design a survey questionnaire for Slovenian teenagers and teachers, didactic material, and suggestions for improving educational programmes.

Interaction of Energy Drinks with Prescription Medication and Drugs of Abuse

In recent years, the consumption of energy drinks (EDs) has become increasingly popular, especially among adolescents. Caffeine, a psychostimulant, is the main compound of EDs which also contain other substances with pharmacological effects. This review aims to compile current evidence concerning the potential interactions between EDs, medicines, and drugs of abuse as they are frequently consumed in combination. The substances involved are mainly substrates, inductors or inhibitors of CYP1A2, psychostimulants, alcohol and other depressant drugs. Furthermore, intoxications reported with EDs and other substances have also been screened to describe acute toxicity. The results of our review show that the consumption of both EDs alone and in combination is not as safe as previously thought. Health professionals and consumers need to be aware of the potential interactions of these drinks as well as the absence of long-term safety data.

Knowledge and prevalence of energy drinks consumption in Shanghai, China: a cross-sectional survey of adolescents

Background

In recent years, energy drinks (EDs) have been widely used among young people around the world. The extensive use of EDs also affects the sleep and exercise of adolescents.

Aims

This study aimed to investigate the consumption of EDs, the knowledge, attitude towards EDs and associated factors of EDs consumption among adolescents in Shanghai, China.

Methods

A total of 4608 adolescents completed a self-administered questionnaire assessing EDs use history, knowledge and attitude towards EDs. Adolescent Self-rating Life Events Checklist (ASLEC) was used to assess their life events. All participants were divided into two groups based on whether they used them or not. t-test and χ² test were used to compare the differences between the two groups, and binary logistic regression analysis was used to investigate the related factors for EDs consumption.

Results

70.5% of the participants reported having ever used EDs. The main avenues to getting information on EDs were from advertisements. 67.56% of them believed that EDs had adverse effects on health. 22.09% of the participants and 31.55% of their parents took a negative attitude towards EDs. Compared with the non-consumption group, participants in the consumption group were likely to be male, with older age, identified EDs more correctly and did not believe EDs had adverse effects, with more positive attitude and higher ASLEC score. Logistic regression results showed that gender, age, attitude of parents and themselves, knowledge of EDs and ASLEC score significantly predicted EDs consumption.

Conclusion

EDs consumption was popular among adolescents in Shanghai, and the tailored intervention programmes need to be developed based on the characteristics of adolescents.

The Medicinal Chemistry of Caffeine

The purine alkaloid caffeine is the most widely consumed psychostimulant drug in the world and has multiple beneficial pharmacological activities, for example, in neurodegenerative diseases. However, despite being an extensively studied bioactive natural product, the mechanistic understanding of caffeine's pharmacological effects is incomplete. While several molecular targets of caffeine such as adenosine receptors and phosphodiesterases have been known for decades and inspired numerous medicinal chemistry programs, new protein interactions of the xanthine are continuously discovered providing potentially improved pharmacological understanding and a molecular basis for future medicinal chemistry. In this Perspective, we gather knowledge on the confirmed protein interactions, structure activity relationship, and chemical biology of caffeine on well-known and upcoming targets. The diversity of caffeine's molecular activities on receptors and enzymes, many of which are abundant in the CNS, indicates a complex interplay of several mechanisms contributing to neuroprotective effects and highlights new targets as attractive subjects for drug discovery.

Energy Drinks and Sports Performance, Cardiovascular Risk, and Genetic Associations; Future Prospects

The consumption of energy drinks (e.g., containing caffeine and taurine) has increased over the last decade among adolescents and athletes to enhance their cognitive level and improve intellectual and athletic performance. Numerous studies have shown that drinking moderate doses of such drinks produces beneficial effects, as they considerably boost the sporting performance of elite athletes in various sports, including both endurance and explosive events. However, apart from their ergogenic effects, the regular consumption of energy drinks also increases blood pressure and consequently incites problems such as hypertension, tachycardia, and nervousness, all of which can lead to cardiovascular disorders. A potential positive correlation between genetics and the moderate consumption of energy drinks and athletic performance has recently been reported; notwithstanding, a better understanding of the genetic variants involved in metabolism is a key area for future research to optimize the dose of energy drink consumed and obtain the maximal ergogenic effect in elite sports. The aim of this literature review, therefore, is to present the results of recent studies, classifying them according to the differences in the associations between energy drinks and: (i) Athletic performance; (ii) cardiovascular risk factors while practicing sports; and (iii) genetic associations and future prospects between the consumption of energy drinks and performance.

Energy Drink Effects on Hemodynamics and Endothelial Function in Young Adults

INTRODUCTION

Cardiovascular side effects associated with energy drink consumption may be related to effects on vascular endothelial function, heart rate, blood pressure, and electrocardiogram parameters. We sought to measure them following energy drink consumption.

METHODS

Forty-four healthy non-smoking young volunteer medical students, at an average age of 24.7 years (range 23-27 years, 34 males), with an average BMI of 23.4, received electrocardiograms and had their heart rates and blood pressures taken. Subjects then underwent baseline testing of endothelial function using the technique of endothelium-dependent flow-mediated dilatation (FMD) with high-resolution ultrasound. The subjects then drank an energy drink (24 oz Monster Energy Drink®). Hemodynamic measurements were repeated 15 and 90 min later. FMD and the electrocardiogram were repeated 90 min later. The FMD was calculated as the ratio of the post-cuff release and the baseline diameter.

RESULTS

Energy drink consumption resulted in a significantly attenuated peak FMD response (mean ± SD): baseline 5.1 ± 4.1% versus post-energy drink (2.8 ± 3.8%; p = 0.004). In addition, systolic and diastolic blood pressures and heart rate increased after 15 min. Diastolic blood pressure and heart rate remained increased 90 min following energy drink consumption. There were no significant changes in electrocardiogram parameters.

CONCLUSION

Energy drink consumption was associated with an acute significant impairment in endothelial function in young healthy adults as well as with significant hemodynamic changes. As energy drinks are becoming more popular, it is important to study their effects to better determine safe consumption patterns.

Padrões de consumo de bebidas energéticas e suplementos alimentares à base de cafeína por frequentadores de academias

Objetivo: Avaliar o nível de conhecimento, hábitos, e prevalência de consumo de energéticos e suplementos à base de cafeína por praticantes de exercícios físicos em academias. Métodos: Foi empregado um questionário autoaplicável de 27 perguntas no Google® Forms, divulgado em mídias sociais entre setembro e outubro de 2018. Resultados: Participaram 200 frequentadores de academias, 71% adultos jovens, 52% tendo mais de 2 anos de prática e frequência regular de 5 - 6 vezes por semana. A maioria da amostra era mulher (58,5%), praticante de musculação (61,6%) de MG (62,5%). O consumo sem orientação profissional foi de 81,6% nos energéticos e 53,9% para suplementos à base de cafeína. 73,3% dos consumidores de energéticos tinham objetivos relacionados com atividades sociais, preferindo a marca RedBul® (40,4%). Entre os consumidores de suplementos de cafeína houve preferência por termogênicos (32,7%) e cafeína pura (29,9%), com objetivo principal a melhora de performance (28,7%), apresentando respostas ergolíticas de taquicardia e palpitações como registrado nos energéticos. Não houve registro de efeitos adversos em 19,2% dos consumidores de cafeína e 40,8% de energéticos. As dosagens de consumo dos produtos estavam dentro da faixa de segurança (< 6 mg/kg). Conclusão: O consumo de ambos produtos foi feito sem orientação profissional, porém, com dosagens dentro da faixa de segurança. O consumo de bebidas energéticas esteve voltado para atividades sociais e melhora da performance esportiva. Foram registrados efeitos ergolíticos.

Mechanisms for the reduction of caffeine consumption: What, how and why

BACKGROUND

Anecdotal evidence suggests consumers of caffeine self-administer strategies to reduce consumption, but little is known of what these strategies are or how they are implemented. This study aimed to understand the lived experience of reducing caffeine consumption including specific techniques (what) and implementation strategies (how), harm and withdrawal symptoms (why).

METHODS

We developed a classification system through an inductive and deductive approach and applied it to a large dataset derived from online sources.

RESULTS

A total of 112 internet sources were identified, containing 2,682 different strategies. The classification system identified 22 categories of Behaviour Change Techniques (BCT): 10 categories were directly aligned with a BCT, one was split into two categories (substance and behavioural substitution), six represented a cluster of BCT's (e.g., withdrawal management and maintaining momentum) and four appeared to uniquely represent a consumer perspective (e.g., realisation of a problem). The most common techniques were substance substitution, seek knowledge and information, avoidance of caffeine and identify prompts for change. The most frequently perceived benefit was the stimulating effects of caffeine and a feeling of mental alertness. The most frequently cited harms were sleep problems including insomnia and concerns about dependence (or addiction) to caffeine. We found 16 categories of withdrawal symptoms. The most frequently endorsed symptom was headaches, followed by fatigue, exhaustion and low energy.

CONCLUSIONS

Consumers use a wide range of techniques when attempting to reduce caffeine consumption. Treatment approaches are focused on fading, but the current study found consumers most frequently focus on substance and behavioural substitution.

The acute effects of thermogenic fitness drink formulas containing 140 mg and 100 mg of caffeine on energy expenditure and fat metabolism at rest and during exercise

BACKGROUND

Thermogenic fitness drink formulas (TFD) have been shown to increase energy expenditure and markers of lipid metabolism. The purpose of the current study was to compare TFD formulas containing different caffeine concentrations versus a placebo drink on energy expenditure and lipid metabolism at rest and during exercise.

METHODS

Thirty-two recreationally active participants (22.9 ± 0.7 y, 167.1 ± 1.4 cm, 68.8 ± 2.0 kg, 24.0 ± 1.2% fat) who were regular caffeine consumers, participated in this randomized, double-blind, crossover design study. Participants reported to the laboratory on three occasions, each of which required consumption of either a TFD containing 140 mg or 100 mg of caffeine or a placebo. Baseline measurements of resting energy expenditure (REE) and resting fat oxidation (RFO) were assessed using indirect calorimetry as well as measurements of serum glycerol concentration. Measurements were repeated at 30, 60, 90 min post-ingestion. Following resting measures, participants completed a graded exercise test to determine maximal oxygen uptake (V̇O2max), maximal fat oxidation (MFO) and the exercise intensity that elicits MFO (Fatmax), and total energy expenditure (EE).

RESULTS

A significant interaction was shown for REE (p < 0.01) and RFO (p < 0.01). Area under the curve analysis showed an increased REE for the 140 mg compared to the 100 mg formula (p = 0.02) and placebo (p < 0.01) and an increased REE for the 100 mg formula compared to placebo (p = 0.02). RFO significantly decreased for caffeinated formulas at 30 min post ingestion compared to placebo and baseline (p < 0.01) and significantly increased for the 140 mg formula at 60 min post-ingestion (p = 0.03). A main effect was shown for serum glycerol concentrations over time (p < 0.01). No significant differences were shown for V̇O2max (p = 0.12), Fatmax (p = 0.22), and MFO (p = 0.05), and EE (p = 0.08) across drinks.

CONCLUSIONS

Our results suggest that TFD formulas containing 100 and 140 mg of caffeine are effective in increasing REE and that a 40 mg of caffeine difference between the tested formulas may impact REE and RFO in healthy individuals within 60 min of ingestion.

Cardiovascular and Autonomic Responses to Energy Drinks-Clinical Implications

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.

Anxiety-like behavior and whole-body cortisol responses to components of energy drinks in zebrafish (Danio rerio)

The current study investigated the independent and combined effects of caffeine and taurine on anxiety-like behavior and neuroendocrine responses in adult zebrafish (Danio rerio). Caffeine (1,3,7-trimethylpurine-2,6-dione), the world’s most commonly used psychoactive drug, acts as an adenosine receptor blocker and a mild central nervous system stimulant. However, excessive use of caffeine is associated with heightened anxiety levels. Taurine (2-aminoethanesulfonic acid), a semi-essential amino acid synthesized within the human brain, has been hypothesized to play a role in regulating anxiolytic behavior. Caffeine and taurine are two common additives in energy drinks and are often found in high concentrations in these beverages. However, few studies have investigated the interaction of these two chemicals with regards to anxiety measures. A suitable vertebrate to examine anxiety-like behavior and physiological stress responses is the zebrafish, which has shown promise due to substantial physiological and genetic homology with humans. Anxiety-like behavior in zebrafish can be determined by analyzing habituation to novelty when fish are placed into a novel tank and scototaxis (light avoidance) behavior in the light-dark test. Stress-related neuroendocrine responses can be measured in zebrafish by analyzing whole-body cortisol levels. The goal of this study was to determine if exposure to caffeine, taurine, or a combination of the two compounds altered anxiety-like behavior and whole-body cortisol levels in zebrafish relative to control. Zebrafish were individually exposed to either caffeine (100 mg/L), taurine (400 mg/L), or both for 15 min. Zebrafish in the control group were handled in the same manner but were only exposed to system tank water. After treatment, fish were transferred to the novel tank test or the light-dark test. Behavior was tracked for the first 6 min in the novel tank and 15 min in the light-tark test. Fifteen min after introduction to the behavioral task, fish were euthanized for the analysis of whole-body cortisol levels. The results demonstrate that caffeine treatment decreased the amount of exploration in the top of the novel tank and increased scototaxis behavior in the light-dark test, which supports the established anxiogenic effect of acute exposure to caffeine. Taurine alone did not alter basal levels of anxiety-like behavioral responses nor ameliorated the anxiogenic effects of caffeine on behavior when the two compounds were administered concurrently. None of the drug treatments altered basal levels of whole-body cortisol. The current results of this study suggest that, at least at this dose and time of exposure, taurine does not mitigate the anxiety-producing effects of caffeine when administered in combination, such as with energy drink consumption.

Impact of Energy Drinks on Health and Well-being

PURPOSE OF REVIEW

Energy drinks and energy shots are functional supplements with higher caffeine content marketed toward adolescents and young adults with the intention of boosting energy. Parallel to its rising popularity, there are safety concerns with the consumption of these beverages. Herein, we reviewed the impact these supplements produce on health and well-being.

RECENT FINDINGS

Most of the promoted benefits of the beverages can be attributed to caffeine. The physiologic effects, if any, of other ingredients such as vitamins and herbal extracts are unclear. The presence of a higher caffeine content as compared to soft drinks may predispose to caffeine intoxication in susceptible individuals. Also, the practice of co-ingestion of these beverages with alcohol is still prevalent and associated with serious consequences. Strict regulations (restriction of sales, clear warning labels, capping caffeine levels) and public education may help prevent the adverse outcomes from these beverages.

Acute Effects of an "Energy Drink" on Short-Term Maximal Performance, Reaction Times, Psychological and Physiological Parameters: Insights from a Randomized Double-Blind, Placebo-Controlled, Counterbalanced Crossover Trial

The current study examined the relationships between the effects of consuming a caffeine-containing “energy drink” upon (i) short-term maximal performance, (ii) reaction times, and (iii) psychological factors (i.e., mood state, ratings of perceived exertion (RPE), and affective load) and on physiological parameters (i.e., blood pressure and blood glucose). A randomized, double-blind, placebo-controlled, counterbalanced crossover design was implemented in this study. Nineteen male physical-education students (age: 21.2 ± 1.2 years; height: 1.76 ± 0.08 m; body-mass: 76.6 ± 12.6 kg) performed two test sessions: after drinking the “Red Bull’ beverage (RB) and after drinking a placebo (PL). One hour after ingestion of each drink, resting blood glucose and blood pressure were measured and the participants completed the Profile of Mood States questionnaire. Then, after a 5-min warm-up, simple visual reaction time and handgrip force were measured, and the 30-s Wingate test was performed. Immediately after these tests, the RPE, blood glucose, and blood pressure were measured, and the affective load was calculated. Differences between treatments were assessed using two-way repeated measures analyses of variance and paired t-tests, as appropriate. Relationships between the test variables were assessed using Bland–Altman correlations. Significant (i) improvements in peak and mean power output, handgrip force, pre- and post-exercise blood glucose, blood pressure, and vigor and (ii) reductions in reaction times, depression, confusion, fatigue, anger, anxiety, RPE, and affective load scores were observed after RB compared to PL. There were significant correlations of (i) physical performances and reaction times with (ii) RPE, affective load, and pre- and post-exercise blood glucose levels. Gains in peak and mean power were significantly correlated with reductions in fatigue, anxiety (peak power only), and anger (mean power only). The reduction of reaction times was significantly correlated with decreases in confusion and anger and with increases in vigor. Handgrip force and reaction times were significantly correlated with pre- and post-exercise blood pressures. We conclude that RB ingestion has a positive effect on physical performance and reaction times. This effect is related to ergogenic responses in both psychological (i.e., RPE, affective load, and mood state) and physiological (i.e., blood glucose and blood pressure) domains.

Caffeine in the Diet: Country-Level Consumption and Guidelines

Coffee, tea, caffeinated soda, and energy drinks are important sources of caffeine in the diet but each present with other unique nutritional properties. We review how our increased knowledge and concern with regard to caffeine in the diet and its impact on human health has been translated into food-based dietary guidelines (FBDG). Using the Food and Agriculture Organization list of 90 countries with FBDG as a starting point, we found reference to caffeine or caffeine-containing beverages (CCB) in 81 FBDG and CCB consumption data (volume sales) for 56 of these countries. Tea and soda are the leading CCB sold in African and Asian/Pacific countries while coffee and soda are preferred in Europe, North America, Latin America, and the Caribbean. Key themes observed across FBDG include (i) caffeine-intake upper limits to avoid risks, (ii) CCB as replacements for plain water, (iii) CCB as added-sugar sources, and (iv) health benefits of CCB consumption. In summary, FBDG provide an unfavorable view of CCB by noting their potential adverse/unknown effects on special populations and their high sugar content, as well as their diuretic, psycho-stimulating, and nutrient inhibitory properties. Few FBDG balanced these messages with recent data supporting potential benefits of specific beverage types.

A thematic content analysis of how marketers promote energy drinks on digital platforms to young Australians

OBJECTIVE

This study aimed to explore the nature and extent of, and level of user-engagement with, appealing strategies used by the food industry to promote energy drinks on digital platforms.

METHODS

Thematic content analysis was employed to code the textual and visual elements of the data that were extracted from the online media pages of nine energy drinks, including posts on Facebook, YouTube, Twitter, and content of websites and advergames.

RESULTS

Four main themes were derived from the 624 textual and visual elements of digital marketing content of energy drink brands, including online social connectivity, desired social identity, enhancement of performance and enhancement of mood.

CONCLUSIONS

Energy drinks were popular on digital platforms, as evidenced by the large volume of user-engagement (e.g. 'likes' and 'comments') especially on social networking sites. Energy drink brands appear to target young people, given that the marketing appeals are likely attuned with young people's desires or aspirations. Implications for public health: To counter the effects of digital marketing on young people's health, regulations are needed to safeguard adolescents and young adults, as well as younger children, and consideration should be given to including all forms of marketing communication platforms, including the internet.

Digital Promotion of Energy Drinks to Young Adults Is More Strongly Linked to Consumption Than Other Media

OBJECTIVE

To examine whether digital marketing strategies are more strongly associated with energy drink use than other marketing and whether Theory of Planned Behavior (TPB) constructs mediated the effects of digital marketing on energy drink use.

DESIGN

A cross-sectional online survey using the TPB was administered in 2016.

SETTING

Illawarra region of New South Wales, Australia.

PARTICIPANTS

A total of 359 young adults aged 18-24 years completed the survey. Participants were mainly students.

MAIN OUTCOME MEASURES

Relative impacts of digital and other marketing on energy drink use and the mediating effects of TPB constructs: attitudes, subjective norm, and perceived behavioral control.

ANALYSIS

Stepwise regression analysis was employed to compare the effects on energy drink use from digital and other marketing. Mediation analysis was used to examine the mediating effects of the TPB constructs.

RESULTS

Digital marketing was more strongly associated than other marketing with young adults' energy drink use. Attitudes, subjective norms, and perceived behavioral control mediated the effects of digital marketing on energy drink use.

CONCLUSIONS AND IMPLICATIONS

The marketing of unhealthy food and beverages such as energy drink products on the Internet requires greater scrutiny. Future interventions may focus on strategies to attenuate young adults' attitudes toward energy drinks, denormalize energy drink use, and strengthening self-efficacy to reject energy drinks among this age group.