Analysis of the Consumption of Caffeinated Energy Drinks among Polish Adolescents

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.

Caffeine Consumption in Polish Adults: Development and Validation of a Polish Questionnaire for Assessing Caffeine Intake

Objective: Caffeine is one of the oldest natural substances consumed by people. Its consumption in Poland has not been well described. The aim of this study was to design and validate an online food frequency questionnaire (FFQ) on caffeine intake and to use it to estimate caffeine consumption in Polish adults.Method: The FFQ was prepared and validated in a pilot study. The intake assessment was conducted in 2019-2020 on 372 respondents, aged 18 to 60 years. The FFQ included products such as coffee, tea, energy drinks, and carbonated drinks, as well as supplements and chocolate.Results: We showed good repeatability of the FFQ and it was considered a valid tool. The mean total caffeine intake among all participants was 426.7 mg ± 283.4 mg/day of all sources; in women, it was 446.4 mg ± 306.2 mg/day, while in men, it was 394.1 ± 236.4 mg/day. Forty-three percent of the respondents consumed more than 400 mg of caffeine/day. Coffee was the main source of caffeine and contributed to 65% of total caffeine consumption. Women consumed 90% more green tea than men (p < 0.01). Overweight and obese people have 20% greater total caffeine intake (p = 0.01) and consumed 20% more coffee (p = 0.02) and 30% more black tea (p = 0.01) than people of normal weight.Conclusions: Average caffeine consumption among Polish adults slightly exceeds the safe consumption dose established by the European Food Safety Authority. Body weight status can differentiate caffeine intake.

The Influence of Beverages on Resin Composites: An In Vitro Study

Dental composites, through their structural diversity, represent the biomaterials frequently used in dental reconstructive therapy. The aim of our study was to observe the influence of different beverage environment conditions on seven types of obturation dental materials with different compositions. Our research focused on the surface modification analysis of the materials after the immersion in the different beverages; in this regard, we used the EDAX technique correlated with the energy-dispersive X-ray fluorescence (XRF). The pH of the drinks and that of the simulated saliva solution were determined by the titrimetric method, a sodium hydroxide solution 0.1 mol/dm3 was prepared and used for the titration. An amount of 5 mL of each analyzed solution was added to 15 mL of distilled water to obtain a dilution, to which 3 drops of phenolphthalein (as a color indicator-Phenolphthalein, 3,3-Bis(4-hydroxyphenyl)-1(3H)-isobenzofuranone, C20H14O4 Mw: 318.32, purchased from Merck) were added for each analysis. For each solution, the experiment was repeated three times in order to obtain accurate results. The results of our study materialized into a real plea for modifying the patients' behavior in terms of diet and preferences for acidic drinks, so that their quality-of-life valence can be improved by keeping the composite materials in a long-term unalterable state on the one hand; on the other hand, systemic damage can be prevented as well.

Effect of various factors on energy drinks consumption, and their connection with alcohol consumption

Energy drinks (EDs) have become widely popular among adolescents and young adults. Excessive consumption of EDs can lead to ED abuse and alcohol abuse. Therefore, this study has aimed to analyse the consumption of EDs in a group of patients suffering from alcohol dependence and among young adults, considering such issues as the amounts consumed, underlying reasons and threats arising from excessive consumption of ED and their mixing with alcohol (AmED). The study included 201 men (101 patients treated due to alcohol dependence and 100 young adults/students). Each research participant responded to questions in a survey designed by the researchers (socio-demographic data, clinical data, including consumption of ED, AmED and alcohol), the MAST and SADD. The participants also had their arterial blood pressure measured. EDs were consumed by 92% of the patients and 52% of young adults. A statistically significant dependence was confirmed between consumption of ED and tobacco smoking (p < 0.001), as well as the place of residence (p = 0.044). For 22% of the patients, ED consumption had an effect on alcohol consumption, where 7% admitted to feeling an increased urge to drink alcohol, and 15% said ED consumption decreased it. A statistically significant relationship (p < 0.001) was also shown between ED consumption and the consumption of EDs mixed with alcohol (AmED). This study may implicate that widespread consumption of EDs predisposes to the consumption of alcohol mixed with ED or separate.

Secondary School Students and Caffeine: Consumption Habits, Motivations, and Experiences

Adolescents may be particularly vulnerable to the effects of caffeine due to a lack of tolerance, their small size, changing brain physiology, and increasing independence. Concerns about adolescent caffeine consumption relate to potentially serious physiological and psychological effects following consumption. Motivations driving caffeine intake are not well understood among adolescents but are important to understand to reduce harmful behavioural patterns. This study explored caffeine consumption habits (sources, amount, frequency) of New Zealand adolescents; and factors motivating caffeine consumption and avoidance. The previously validated caffeine consumption habits questionnaire (CaffCo) was completed by 216 participants (15-18 years), with most (94.9%) consuming at least one caffeinated product daily. Chocolate, coffee, tea, and kola drinks were the most consumed sources. The median caffeine intake was 68 mg·day^-1. Gender (boy) and being employed influenced the source, but not the quantity of caffeine consumed. One-fifth (21.2%) of adolescents consumed more than the recommended European Food Safety Authority (EFSA) safe level (3 mg·kg^-1·day^-1). Taste, energy, and temperature were the main motivators for consumption, and increased energy, excitement, restlessness, and sleep disturbances were reported effects following caffeine consumption. This study provides information on caffeinated product consumption among New Zealand adolescents, some of whom consumed caffeine above the EFSA safe level. Public health initiatives directed at adolescents may be important to reduce potential caffeine-related harm.

Caffeine, D-glucuronolactone and Taurine Content in Energy Drinks: Exposure and Risk Assessment

The consumption of energy drinks (EDs) is increasing globally while the evidence and concern about the potential health risks are also growing. Caffeine (generally 32 mg/100 mL) together with a wide variety of other active components such as taurine (usually 4000 mg/L) and D-glucuronolactone (generally 2400 mg/L) are the main ingredients of EDs. This study aims to assess the exposures to caffeine, taurine and D-glucuronolactone from EDs in various consumption scenarios and consumer profiles and to characterize the risks by evaluating caffeine and taurine intakes with their reference values and by calculating the margin of safety (MOS) for D-glucuronolactone. While the exposure assessment results showed that caffeine intakes from EDs ranged from 80 to 160 mg (1.14-4 mg/kg b.w.) for the considered scenarios, the risk characterization estimated some risks that could be managed with consumption recommendations such as limiting EDs in 40, 60 and 80 kg b.w. consumers to 175, 262.5 and 350 mL, respectively, to prevent sleep disturbances and to 375, 562.5 and 750 mL to prevent general caffeine adverse health risks, respectively. Dietary exposure to D-glucuronolactone from EDs ranged from 600 to 1200 mg (7.5-30 mg/kg b.w.). As D-glucuronolactone MOS ≥ 100 is only observed when EDs consumption is limited to 250 mL, for individuals weighing above 60 kg, some risks were observed in some of the studied scenarios. A taurine exposure from EDs varied from 1000 to 2000 mg (12.5-50 mg/kg b.w.) and consumptions over 500 mL were estimated to generate intakes above the reference value. In conclusion, the management of these risks requires a European legal framework for EDs with maximum limits for the active components, volume size limitations and labeling improvements along with the development of education and awareness programs and risk communication actions in collaboration with the industry and society.

Risky behaviors, substance use, and other lifestyle correlates of energy drink consumption in children and adolescents: a systematic review

Increasing concerns have been raised on the health-related risks connected with energy drink (ED) consumption in children and adolescents, with high acute or chronic consumers exceeding 10% in either age group in Europe in 2011. Preliminary evidence has suggested a common pattern of ED and substance use, especially alcohol. Additional evidence has been accumulating very fast; in addition, other lifestyle and risky behaviors may contribute to shed light on the complex interplay of factors involved in ED consumption. We have undertaken a comprehensive systematic review of the evidence on psychosocial correlates of ED consumption in 0-18 years subjects, as published up to April 1, 2021, in MEDLINE/PubMed, PsycINFO, and Cochrane Reviews and Central Register of Controlled Trials, which allowed to select 104 original articles. Only ~ 10% of the papers provided results based on longitudinal analyses. A common pattern of ED consumption and polysubstance use, including alcohol, tobacco, and soft and hard drugs, was still confirmed in adolescents; violent and risky behaviors were also related to a higher ED consumption. In addition, frequent ED consumers are more likely to have bad dietary habits, including consumption of sugar-sweetened beverages and junk foods. A generally inconclusive evidence was found for sport/physical activities, although sedentary behaviors were generally related to ED consumption.

CONCLUSIONS

Frequent ED consumption might be a screening indicator to identify students at risk of substance use or other risky/problem behaviors; enquiring about an adolescent's recent ED consumption could create opportunities for early intervention/prevention by informed pediatricians.

WHAT IS KNOWN

• Substances, especially alcohol, are associated with energy drinks in most cross-sectional studies.

WHAT IS NEW

• Violent behaviors are associated with energy drink consumption, in the absence of longitudinal studies; problematic use of internet/videogames deserves further investigation; unhealthy dietary patterns are related to energy drinks; evidence on physical activity is inconclusive, but sedentary behaviors are related to energy drinks.

Sleep and energy drink consumption among Norwegian adolescents - a cross-sectional study

Background

Adolescents are recommended to get 8–10 h of sleep at night, yet more than 80% fail to obtain this goal. Energy drink (ED) consumption has been linked to later bedtime in adolescents. Therefore, we aimed to investigate the potential association between ED consumption and sleep duration, and shuteye latency among adolescents in Norway.

Methods

This study was based on data from 15- to 16-year-old adolescents living in Oppland County in 2017. In total, 1353 adolescents were included in the analysis. Multiple regression models were used to estimate the associations between the frequency of ED consumption with sleep duration, shuteye latency, and getting 8 h of sleep.

Results

Forty-six point five percent of the adolescents reported sleeping more than 8 h at night. Those who reported ED consumption at any frequency had significantly shorter sleep duration than those who did not. On average, high consumers of ED (consuming ED ≥ 4 times a week) had 0.95 (95% CI: 0.61, 1.28) hours (i.e., 57 min) less sleep than those who never consumed ED. In addition, high consumers had more than 25 min (95% CI: 13.95, 36.92) longer shuteye period than those who never consumed ED.

Conclusion

Most ED consumers fail to obtain the recommended 8 h of sleep at night, which could be a consequence of shorter sleep duration and longer shuteye latency. We found a dose-response relationship between frequency of ED consumption and reduced sleep. Yet, the potential long-term effects of both ED consumption and insufficient sleep among adolescents remain unclear.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12972-w.

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.

Consumption and effects of caffeinated energy drinks in young people: an overview of systematic reviews and secondary analysis of UK data to inform policy

BACKGROUND

This overview and analysis of UK datasets was commissioned by the UK government to address concerns about children's consumption of caffeinated energy drinks and their effects on health and behaviour.

METHODS

We searched nine databases for systematic reviews, published between 2013 and July 2021, in English, assessing caffeinated energy drink consumption by people under 18 years old (children). Two reviewers rated or checked risk of bias using AMSTAR2, and extracted and synthesised findings. We searched the UK Data Service for country-representative datasets, reporting children's energy-drink consumption, and conducted bivariate or latent class analyses.

RESULTS

For the overview, we included 15 systematic reviews; six reported drinking prevalence and 14 reported associations between drinking and health or behaviour. AMSTAR2 ratings were low or critically low. Worldwide, across reviews, from 13% to 67% of children had consumed energy drinks in the past year. Only two of the 74 studies in the reviews were UK-based. For the dataset analysis, we identified and included five UK cross-sectional datasets, and found that 3% to 32% of children, across UK countries, consumed energy drinks weekly, with no difference by ethnicity. Frequent drinking (5 or more days per week) was associated with low psychological, physical, educational and overall well-being. Evidence from reviews and datasets suggested that boys drank more than girls, and drinking was associated with more headaches, sleep problems, alcohol use, smoking, irritability, and school exclusion. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) assessment suggests that the evidence is weak.

CONCLUSIONS

Weak evidence suggests that up to a third of children in the UK consume caffeinated energy drinks weekly; and drinking 5 or more days per week is associated with some health and behaviour problems. Most of the evidence is from surveys, making it impossible to distinguish cause from effect. Randomised controlled trials are unlikely to be ethical; longitudinal studies could provide stronger evidence.

PROSPERO REGISTRATIONS

CRD42018096292 - no deviations. CRD42018110498 - one deviation - a latent class analysis was conducted.

Dietary Habits, Diet Quality, Nutrition Knowledge, and Associations with Physical Activity in Polish Prisoners: A Pilot Study

Physical activity and healthy diets are determinants of the health of convicts who are deprived of freedom. However, little research has focused on these two aspects concurrently. The aim of this study is to analyze the relationships between the level of prisoners’ physical activity and their dietary habits, diet quality, and nutritional knowledge. The cross-sectional study was conducted with 226 prisoners. The inclusion criteria included male sex, age 18–65 years, and consent for the research. We excluded the subjects who met any of the following conditions: female sex, unwillingness to participate, and dangerous prisoner status. The KomPAN questionnaire was used to assess the prisoners’ eating habits, diet quality, and level of nutrition knowledge. The “Last 7d” short form of the International Physical Activity Questionnaire (IPAQ) was used to assess the prisoners’ level of physical activity. A significant correlation between the prisoners’ age and their levels of physical activity was found (p = 0.008). Prisoners who were aged 18–29 and over 40 declared a low level of physical activity, whereas those aged 30–40 reported a high or medium level. The level of physical activity of the surveyed prisoners was not significantly correlated with their dietary habits, the quality of their diet, or their nutrition knowledge.

Relationships between Body Composition Parameters and Phase Angle as Related to Lifestyle among Young People

The aim of the study was to indicate which body composition parameters and which lifestyle components affect the phase angle (PA) value in young adults. Two-hundred-and-eighty-one students at Wroclaw Medical University participated in the study. A survey on respondent lifestyles was followed by anthropometric measurements, body composition analysis, and basal metabolic rate (BMR) calculation. The differences in the body composition of men and women corresponded to their sexual anatomy and physiology. Sex-dependent differences in lifestyle were also reported. The study revealed a relationship between PA and height, weight, BMR, BMI (body mass index), FFM (fat-free body mass), bone mass, water mass, muscle mass (r~0.4–0.7), ECW/ICW (extracellular water/intracellular water) and fat mass (r~−(0.4–0.6)) for the entire studied group. The relationship between PA values and lifestyle components concerned consumption of energy drinks, cola, alcohol, water, vegetables and fruits, meat, and also intervals between meals, time for physical exercises, and screen time (r~±0.2). The research shows that the PA value increases with an increase in positive body composition parameters. Following the principles of proper nutrition and physical activity increases PA values in most cases.

Trends in energy drink and combined alcohol and energy drinks consumption among Italian high school students, 2008-2019

BACKGROUND

Energy Drinks (ED) are caffeinated beverages marketed as attention and endurance enhancers. The main purpose of this study is to provide national estimates of the prevalence of alcohol mixed with energy drink (AmED) and ED use among school-aged adolescents. A secondary objective is to examine the differences in the prevalence of AmED and ED consumption by gender.

METHODS

For this study, we used data from twelve consecutive years, from ESPAD-Italia®2008 to ESPAD-Italia®2019.

RESULTS

From 2008-2019, the prevalence of lifetime consumption of energy drinks increased significantly for male (64.5-75.7%, p < 0.001) and female (46.8-61.8%, p < 0.001). We also observed an increase in both genders for last year prevalence (male: 51.6-63.4%, p < 0.001; female: 32.5-38.3%, p < 0.001), instead prevalence in last month showed an increase only in males (males: 37.5-45.4%, p = <0.001; females: 19.9-20.3%, p = 0.426). Finally, frequent use showed a fluctuating trend, particularly in females (males: 3.2-4.3%, p = 0.422; females: 0.8-0.8%, p = 0.643). From 2013-2019, the prevalence of AmED consumption did not show relevant changes among adolescents. A clear gender gap is evident for both ED and AmED usage prevalence, in all the years considered for lifetime, last year, last month and frequent use.

CONCLUSIONS

The findings suggest that the prevalence of ED consumption among Italian high school students is very high and has grown substantially over the past 12 years. Differently the prevalence of AmED use, although widespread, did not increase overall since 2013.

Social determinants and changes in energy drink consumption among adolescents in Norway, 2017-2019: a cross-sectional study

OBJECTIVES

To describe the social determinants and development in energy drink consumption among Norwegian adolescents in 2017, 2018 and 2019.

DESIGN

Cross-sectional, online, annual, nationwide surveys (Ungdata).

SETTING

Responses collected online from January 2017 to December 2019.

PARTICIPANTS

Lower and upper secondary school students (n=297 102) aged 12-19 years who responded in 2017, 2018 and 2019.

MAIN OUTCOME MEASURES

Frequency of energy drink consumption.

RESULTS

Over the 3-year period, 66.4% of the men and 41.8% of the women had consumed energy drink once a week or more. The proportion of female high consumers (consuming energy drink more than four times a week) increased from 3.3% to 4.9% between 2017 and 2019; for male, the increase was from 9.8% to 11.5%. In females, the proportion of high consumers increased with 24% (relative risk; CI) (1.24; 1.09 to 1.41) from 2017 to 2018 and 46% (1.46; 1.31 to 1.62) from 2017 to 2019. The corresponding increases in males were 10% (1.10; 1.01 to 1.20) from 2017 to 2018 and 12% (1.12; 1.05 to 1.19) from 2017 to 2019. Any energy drink consumption as well as high energy drink consumption were independently associated with school level, less central residency, low socioeconomic status, physical inactivity and high leisure screen time.

CONCLUSION

We found an increase in high consumers among both boys and girls between 2017 and 2019. The observed increase in energy drink consumption among adolescents can explain some of the increased sales of energy drink in Norway.

Effects of Energy Drink Consumption on Physical Performance and Potential Danger of Inordinate Usage

The rise in energy drink (ED) intake in the general population and athletes has been achieved with smart and effective marketing strategies. There is a robust base of evidence showing that adolescents are the main consumers of EDs. The prevalence of ED usage in this group ranges from 52% to 68%, whilst in adults is estimated at 32%. The compositions of EDs vary widely. Caffeine content can range from 75 to 240 mg, whereas the average taurine quantity is 342.28 mg/100 mL. Unfortunately, exact amounts of the other ED elements are often not disclosed by manufacturers. Caffeine and taurine in doses 3–6 mg/kg and 1–6 g, respectively, appear to be the main ergogenic elements. However, additive or synergic properties between them seem to be implausible. Because of non-unified protocol design, presented studies show inconsistency between ED ingestion and improved physical performance. Potential side effects caused by abusive consumption or missed contraindications are the aspects that are the most often overlooked by consumers and not fully elucidated by ED producers. In this review, the authors aimed to present the latest scientific information on ED components and their possible impact on improving physical performance as well as to bring emphasis to the danger of inordinate consumption.

Energy Drink Consumption among Adolescents Attending Schools in Lubumbashi, Democratic Republic of Congo

BACKGROUND

The consumption of energy drinks (EDs) is increasing in the general population, but little is known about the consumption of EDs among pupils in Africa. This study was designed to assess the consumption of EDs among pupils between 10 and 17 years of age and to assess average caffeine concentrations contained in EDs sold in Lubumbashi.

METHODS

We conducted a cross-sectional survey in five schools using a standardised questionnaire taken face-to-face. Samples of locally purchased EDs were analysed by High Performance Liquid Chromatography with Ultra-Violet spectrometry (HPLC-UV).

RESULTS

Of 338 pupils (54% girls), 63% reported having consumed at least one ED in the last week and 34% drank at least one ED a day. The cheapest ED was the most widely consumed. Among pupils having consumed at least one ED in the last week, 79% reported consuming it for refreshment and 15% to get energy. For those who reported not consuming EDs, 40% reported that their parents or teachers forbade them to drink EDs. Some (14%) teenagers, mainly boys, mixed ED with alcohol. The concentrations of caffeine measured in twelve brands of EDs ranged from 7.6 to 29.4 mg/100 mL (median 23.3), giving caffeine contents of 37.5 to 160 mg (median 90 mg) per can or bottle. The estimated daily intake of caffeine through EDs was between 51.3 mg and 441.3 mg among those consuming EDs regularly.

CONCLUSION

Our study convincingly demonstrates that caffeine-containing EDs are not only consumed by youngsters living in affluent societies. We documented widespread regular consumption of EDs among (pre-)adolescent schoolchildren living in Lubumbashi, a large city of the Democratic Republic of Congo (DRC). In view of the global market expansion of caffeinated EDs, it is reasonable to suspect that similar surveys in other urban areas of sub-Saharan Africa would yield similar findings. Pricing and advertising regulations and education on EDs are necessary to limit the regular consumption of EDs among adolescents.

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.

The Influence of Popular Beverages on Mechanical Properties of Composite Resins

Currently, composite resins are used in many restorative procedures. Previous studies showed that drinking beverages may affect the mechanical properties such as microhardness or flexural strength of dental composite resins. The aim of the present study was to investigate the influence of common beverages on the mechanical properties of composite resins. Samples of the materials were prepared according to the ISO 4049:2010 standard and producer’s recommendations. The samples were next conditioned in tested fluids: distilled water, sparkling water, Coca-Cola, Red Bull and orange juice for 7 days. Vickers microhardness and flexural strength testing was performed after 7 days. Performed statistic tests confirmed the significance of microhardness changes of the tested materials in terms of both different conditioning of the samples and different composite materials. The mean flexural strength of composites was highest in distilled water and it was reduced after one week in different beverages. We conclude that all tested beverages influenced on Vickers microhardness of tested composite resins. Flexural strength only in one material was statistically significantly influenced by tested beverages. The results of this study should be taken into consideration by a dentist preparing recommendations for the patients after dental treatment with usage of composite material or after cementing composite based fixed dentures.

Protective effect of caffeine and/or taurine on the 6-hydroxydopamine-induced rat model of Parkinson's disease: Behavioral and neurochemical evidence

BACKGROUND

Caffeine and taurine, which possess neuro-modulatory activity happen to be consumed together as part of the constituents of energy drinks, could have beneficial effects and prevent neuronal deterioration in Parkinson's disease (PD).

OBJECTIVE

This study aimed to investigate behavioral and neurochemical effects of these two agents in an animal model of PD at two time points to evaluate possible neuro-protective or neuro-modulatory effects.

METHODS

Stereotaxic injection of 6-hydroxydopamine (6-OHDA) in rat striatum was used to model PD-like behavior in animals. Motor behavior was assessed by a characteristic rotation behavior response to the apomorphine challenge and dopamine levels in the striatum were quantified using HPLC-ED.

RESULTS

A reduction in apomorphine induced rotations following administration of caffeine and/or taurine as compared to the untreated lesioned group (controls) was shown. Significant decreases in dopamine levels were also seen in the ipsilateral side of 6-OHDA group, this effect was not significantly reversed in caffeine and taurine treated groups. Treatments partially restored the content of DA levels in the lesioned striatum.

CONCLUSIONS

Current results demonstrated beneficial effects for the combination of caffeine and taurine in PD animal model, suggesting that consumption of both agents could be a new added therapeutic target for Parkinson's disease prevention and treatment.

Association between energy drink consumption and substance use in adolescence: A systematic review of prospective cohort studies

BACKGROUND

It is unclear whether energy drink (ED) consumption is associated with substance use (SU) in adolescence. The purpose of this study is to clarify the association.

METHODS

A systematic review was conducted using a wide range of electronic bibliographic databases to search for published prospective cohort studies on the topic from inception to 14th August 2019. The risk of bias was addressed by using the Risk Of Bias In Non-randomised Studies - of Interventions; ROBINS-I. Studies targeting adolescents were collected. Additionally, we collected studies that examined an association between the extent of energy drink consumption as exposure variables and any substance use as outcome variables.

RESULTS

Five studies met the eligibility criteria. ED consumption was associated with adolescent use of alcohol, tobacco, cannabis, prescription stimulants, and analgesics. However, the overall risk of bias in the included studies was severe.

CONCLUSION

ED consumption may be associated with SU in adolescence, particularly alcohol use. The results, however, were still inconclusive due to the relatively low methodological quality in the included studies. Evidence from more well-designed trials is needed in future research.

Epistaxis and Its Associated Factors Among Precollege Students in Southern Ethiopia

Background

Epistaxis is one of the most common otorhinolaryngological emergencies affecting the majority of the population in their lifetime, with some of them requiring serious medical attention. This study aimed to assess the prevalence and associated factors of epistaxis among pre-college students in Wolaita Sodo, Ethiopia.

Methods

An institution-based cross-sectional study was conducted. Data were collected using a pre-tested interviewer administered questionnaire. The study participants were selected by systematic random sampling technique. A logistic regression analysis was employed to assess the presence and strength of association factors with epistaxis. An adjusted odds ratio with 95% confidence interval was used to determine the presence and strength of the association at 0.05 level of significance.

Results

Of 387 participants, 57.1% of them were male, and the mean age of all participant was 18.05±1.401 SD years. The overall epistaxis prevalence was 108 (27.9%). Blood group O, which accounted for about 43.4% was more prevalent. Blood group O (AOR=3.96, 95% CI=1.5-10.4), participants who drink coffee daily (AOR=2.75, 95% CI=1.0-7.4), and participants who took a bath frequently with both hot and cold-water (AOR=4.55, 95% CI=1.1-18.6) were significantly associated with epistaxis.

Conclusion

The type of blood group, interval of coffee drinking, and type of bathing were significantly associated with epistaxis. Working on the identified associated factor and increased awareness about epistaxis for the students with effective first aid training is mandatory.

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.

Consumption of acidic drinks, knowledge and concern about dental erosive wear in Norwegian high school students

OBJECTIVES

The objectives of the present study were to assess the consumption of acidic beverages, knowledge and concern about preventing dental erosive wear, and to examine potential associations between these variables, in a sample of high school students.

MATERIALS AND METHODS

A survey measuring acidic beverage consumption, knowledge and concern about erosive tooth wear was conducted at 13 high schools in Rogaland county, Norway.

RESULTS

Of the 850 students who completed the questionnaire, 26% reported that they drink acidic beverages every day. There were significant gender differences for the consumption of acidic drinks. The survey also demonstrated that a high proportion of students lacks basic knowledge of what erosive tooth wear is, and that this lack of knowledge is associated with a more frequent intake of acidic beverages. However, students who responded that they are concerned about preventing dental erosive wear reported that they drink soft drinks and energy drinks less frequently than students who are not concerned about this.

CONCLUSIONS

Results from this study support assumptions about a lack of knowledge about dental erosive wear in youth, and that this lack of knowledge is associated with a more frequent intake of acidic drinks.

Energy drink: the consumption prevalence, and awareness of its potential health implications among commercial drivers in the Ho municipality of Ghana

Background

Consumption of energy drinks has become an escalating global public health problem. The work schedule and irregular sleeping habits of commercial bus drivers make them highly susceptible to getting fatigued, hence most of them consume energy drinks as a fatigue management strategy. However, consumption of energy drinks produces numerous psychomotor side effects that if consumed among drivers puts the traveling public in danger of road accidents. This study sought to assess the prevalence of energy drink consumption and awareness of associated potential health problems among commercial long-distance bus drivers operating from the Ho municipality.

Methods

The study population comprised about 266 commercial bus drivers. This was a cross-sectional study involving 132 participants who completed a structured questionnaire on the participants’ socio-demographic characteristics, frequency of consumption and reasons for consumption. It also included questions to assess the knowledge of the ingredients and side effects of energy drinks. Respondents were selected using a convenience sampling technique. Descriptive analysis and Chi-square test of association were used to analyse the data.

Results

A majority (62.1%) of the drivers had more than 10 years of commercial driving experience. A 75% energy drink consumption prevalence was recorded with driving performance enhancement (78.8%) as the predominant reason for consumption. 7–10 bottles per week were consumed by most (32.2%) of the drivers. Also, 72.0% had poor knowledge of the side effects linked with energy drink consumption as well as the ingredients for preparation.

Conclusion

Energy drinks were consumed by the majority of the drivers at the Ho main bus terminal of which most of the drivers had poor knowledge of the potential health problems linked with the consumption of these drinks. The consumption of energy drinks was observed to be higher among the drivers with lower education levels, higher monthly income and those who worked long hours in a day. The Ghana National Road Safety Commission (GNRC) in collaboration with other private road transport unions in Ghana should organize regular seminars for commercial bus drivers on the potential dangers and effects associated with energy drink consumption.

Energy drinks

Purpose

This research aimed to study patterns of energy drinks (ED) consumption among university students and to identify the determinants for their preferences.

Design/methodology/approach

This cross-sectional study was conducted among 400 students from various departments of Jashore University of Science and Technology, Bangladesh, by convenience sampling. A self-administered, structured questionnaire was used to collect data.

Findings

About 52.3 per cent of the students were between 21 and 23 years of age, and half of them were male. More than half (53 per cent) of the students had consumed ED at least once in their lifetime. Only 22.1 per cent of these consumers had any knowledge of the ingredients in ED, and 4.3 per cent did not know the possible negative impacts. Bivariate analysis was performed to identify the variables significantly associated with ED consumption among students. The risks of ED consumption were found to be: male gender (Odds Ratio (OR) = 4.04; 95 per cent Confidence Interval (CI) = 2.36–6.92), father educated up to SSC (OR = 18.47; 95 per cent CI = 2.30–148.90) or college and above (OR = 17.01; 95 per cent CI = 2.31–135.60), smoker (OR = 3.87; 95 per cent CI = 1.61–9.35) and doing irregular physical activity (OR = 2.43; 95 per cent CI = 1.23–4.78).

Originality/value

ED consumption among university students is high, but their perception regarding the ingredients and potential health hazards is opaque. Therefore, it is imperative that at both community and individual levels, interventions should focus on educating and empowering individuals to make firm and positive decisions concerning their dietary habits and health.

[Prevalence and associated factors to energy drinks consumption among teenagers in the province of Barcelona (Spain)]

OBJECTIVE

To analyse the prevalence of energy drinks consumption among 4th year high school students in the province of Barcelona (Spain), and its association to sociodemographic characteristics and health related habits.

METHOD

Cross-sectional study including 8078 students from randomly selected high schools in 41 municipalities. Sociodemographic and health characteristics were collected from the Questionnaire on health related habits. Studied variables: energy drinks consumption, sociodemographic characteristics, health related habits and risk behaviours. Descriptive and bivariate analyses were performed. To analyse the factors associated with energy drinks consumption, logistic regression models were used, adjusting by sex and age and considering significance at p-value <0.05.

RESULTS

30.9% of the sample consumed energy drinks during the last week. According to the model, consumption was higher among men (odds ratio [OR]: 3.29; 95% confidence interval [95%CI]: 2.82-3.83), first generation migrants (OR: 2.46; 95%CI: 2.01-3.03), and children of parents without studies (OR: 3.15; 95%CI: 2.08-4.77). Not having breakfast (OR: 1.53; 95%CI: 1.17-2.00), practising sport (OR: 1.40; 95%CI: 1.11-1.75), regular alcohol (OR: 1.51; 95%CI: 1.19-1.91) and tobacco (OR: 1.79; 95%CI: 1.33-2.41) consumption, and a worse school performance (OR: 2.21; 95%CI: 1.47-3.32), were also risk factors for energy drinks use.

CONCLUSIONS

Energy drinks consumption is a prevalent habit among adolescents. Its pattern varies depending on sociodemographic characteristics, with gender playing a relevant role. Health related habits and risk behaviours have been associated too to energy drinks use. Further evidence regarding consumption and its risk factors will allow the development of effective preventive strategies.

Food Products That May Cause an Increase in Blood Pressure

PURPOSE OF REVIEW

To review latest reports of the food products which might increase blood pressure and therefore might participate in the pathogenesis of hypertension.

RECENT FINDINGS

Results of clinical study suggest that consumption of high-sodium food leads to transient increase in plasma sodium concentration. This is accompanied by blood pressure increase. Results of both clinical and experimental studies suggest direct vasculotoxic effects of sodium. Increased plasma sodium concentration could mediate its effects on blood pressure by changes in endothelial cell stiffness and glycocalyx integrity. Energy drinks are non-alcoholic beverages with increasing popularity. Clinical, interventional, randomized, placebo controlled, and cross-sectional studies showed that energy drinks may increase arterial blood pressure. Blood pressure increase after exposure for the energy drinks is mainly related to the caffeine content in these drinks. Many case reports were published concerning the clinically significant increase in blood pressure caused by the consumption of liquorice root or food products containing liquorice, such as candies, tea, Pontefract cookies, and chewing gum. Liquorice contains a precursor of glycyrrhetic acid. Glycyrrhetic acid reduces the activity of the 11β-hydroxysteroid dehydrogenase type 2 (11ß-HSD2) isoenzyme, which leads to activation of the mineralocorticoid receptor by cortisol in the distal convoluted tubule resulting in hypertension, hypokalemia, and metabolic alkalosis. The relationship between chronic alcohol intake and blood pressure is well established on the basis of a diverse body of evidence including animal experiments, epidemiological studies, mendelian randomization studies, and interventional studies. Results of recent studies suggested that binge drinking (i.e., episodic consumption of a very high amount of alcohol beverages) has pronounced hypertensinogenic effects. Recently, it was documented that also low doses of alcohol may increase the risk of cardiovascular complications. Therefore, the amount of alcohol consumption that is safe is zero. High-salt food products, energy drinks, food products containing liquorice, and alcoholic beverages have hypertensinogenic properties. Patients with hypertension and other cardiovascular diseases should avoid even accidental consumption of these food products.

Assessment of Antioxidant Properties of Classic Energy Drinks in Comparison with Fruit Energy Drinks

Energy drinks (EDs) contain sugar, caffeine, and other bioactive compounds. Recently, new types of EDs, enriched with fruit juices, natural pigments, and plant extracts, have been launched in the market. The objective of this study was to investigate the composition and antioxidant properties of the most popular classic and fruit EDs. The study was carried out including 24 of the most popular energy drinks (classic and fruit EDs). The composition of EDs, especially caffeine and sugar, and antioxidant properties (antioxidant capacity, total polyphenols, total anthocyanins, vitamin C) were analyzed. Energy drinks with added fruit juice or natural pigments had a significantly higher (p ≤ 0.05) antioxidant capacity compared to classic energy drinks. Fruit EDs had a higher concentration of polyphenols and vitamin C. In some fruit EDs, slight amounts of anthocyanins were found. Generally, EDs are not a rich source of polyphenols and are not distinguished by high antioxidant capacity. However, fruit energy drinks and/or ones with added natural pigments have much better antioxidant properties than classic EDs. Both classic and fruit EDs contain a large amount of caffeine and sugar, therefore, it would be advisable not to drink large amounts of EDs for possible related health issues.

An experimental study on perceptions of energy drink ads among youth and young adults in Canada

Current regulations in Canada prohibit the marketing of caffeinated energy drinks (CEDs) for use during sports, with alcohol, and by children. The study examined perceptions of CED ads in association with sports and alcohol use, as well as target age groups. An online survey was conducted in 2015 with youth and young adults aged 12-24 years (n = 2010). Participants completed three experiments in which they were randomized to view CED advertisements: 1) sports/party-themed ads, 2) sports-themed ad, and 3) party-themed ad, vs. control 'product information' ads. For each ad, participants were asked about perceived target age group, and if the ad promoted using CEDs during sports and with alcohol. Logistic regression models were fitted to test differences in outcomes between conditions. The majority of respondents reported that the ads, across all themes, targeted people their age. In experiment 1, both sports/party-themed ads were more likely to be perceived as promoting use of CEDs during sports (AOR = 13.32; 95% CI 9.90, 17.91, and AOR = 9.73; 95% CI 7.38, 12.81, respectively), and with alcohol (AOR = 8.55; 95% CI 6.37, 11.48, and AOR = 2.81; 95% CI 2.08, 3.78, respectively), compared to the control ad. In experiment 2, the sports-themed ad was more likely to be perceived as promoting use of CEDs during sports (AOR = 15.02; 95% CI 11.83, 19.08), but not with alcohol, compared to the control ad. In experiment 3, the party-themed ad was more likely to be perceived as promoting use of CEDs with alcohol (AOR = 13.79; 95% CI 10.69, 17.78), but not during sports, compared to the control ad. Ads from leading energy drink brands are perceived as targeting young people and encouraging energy drink use during sports and with alcohol, despite Canadian regulations prohibiting these marketing practices.

Caffeinated energy drink consumption and predictors of use among secondary school students over time in the COMPASS cohort study

Consumption of caffeinated energy drinks (CED) by youth is a public health priority, given the lack of regulation and evidence for both short and long-term health effects of CED use. Considering the potential risks associated with excessive caffeine consumption, this paper examined CED consumption and predictors of CED use over time in a large sample of Canadian secondary school students participating in the COMPASS study.

Using linked longitudinal data (n = 4949) from the first three years of the COMPASS study (2012/13 to 2014/15), three logistic Generalized Estimated Equation models were performed to examine predictors of weekday CED use, weekend CED use, and weekly CED use.

The prevalence of weekly CED use remained fairly consistent across the three years of follow-up; 12.5% in year-1, 11.3% in year-2, and 11.4% in year-3. Smokers and marijuana users at follow-up were all at greater odds of weekday or weekly CED use, regardless of baseline use. Binge drinkers at baseline were at greater odds for weekday or weekly CED use, but not if they started binge drinking after their baseline year. Marijuana users at follow-up were all at greater odds of weekend CED use, regardless of baseline marijuana use.

>1 in 10 youth reported consuming CEDs one or more times per week, where specific subpopulations of youth, such as marijuana users, appear to be more frequent CED users. Although CED use remained relatively constant over the three-year period examined, prevalence of CED use remains problematic among secondary school students.

Risk assessment of energy drinks with focus on cardiovascular parameters and energy drink consumption in Europe

To assess the possible cardiovascular risks associated with energy drink (ED) consumption in Europe, a comprehensive literature research was performed in regard to (i) possible ED-induced dose-dependent cardiovascular outcomes, (ii) ED consumption patterns in Europe and (iii) the risks of EDs in combination with alcohol. The identified intervention studies primarily investigated acute ED effects in young healthy adults. Moderate consumption of EDs corresponding to an acute caffeine intake of up to 200 mg did not result in clinically relevant cardiovascular changes in young healthy adults. However, high intake of EDs (about 1 L) was associated with moderate to severe adverse effects in some participants (i.a. prolonged QTc interval, palpitations). Studies have indicated that on some occasions, a substantial proportion of ED consuming children and adolescents (12% in 16 EU Member States) drink EDs in high quantities (≥1 L). This could pose a possible health risk to this group since adverse effects by such high ED consumption have been observed already in young healthy adults. Among further measures that might be considered to minimize this identified risk, policy makers could develop information and educational programs with the aim of raising public awareness.

A Retrospective Study on the Epidemiological and Clinical Features of Emergency Patients with Large or Massive Consumption of Caffeinated Supplements or Energy Drinks in Japan

Objective We conducted a retrospective study on the epidemiological and clinical features of patients with acute caffeine poisoning in Japan. Methods Letters requesting participation were sent to 264 emergency departments of hospitals, and questionnaires were mailed to those that agreed to participate. Patients Participants were patients transported to emergency departments of hospitals between April 2011 and March 2016 after consuming large or massive amounts of caffeinated supplements and/or energy drinks (caffeine dose ≥1.0 g). Results We surveyed 101 patients from 38 emergency departments. Since April 2013, the number of patients has markedly increased. Of these young patients (median age, 25 years), 53 were men, and 97 had consumed caffeine in tablet form. Estimated caffeine doses (n=93) ranged from 1.2 to 82.6 g (median, 7.2 g). Serum caffeine levels on admission (n=17) ranged from 2.0 to 530.0 μg/mL (median level, 106.0 μg/mL). Common abnormal vital signs and laboratory data on admission included tachypnea, tachycardia, depressed consciousness, hypercreatinekinasemia, hyperglycemia, hypokalemia, hypophosphatemia, and hyperlactatemia. Common signs and symptoms in the clinical course included nausea, vomiting, excitement/agitation, and sinus tachycardia. Seven patients (6.9%) who had consumed ≥6.0 g of caffeine, or whose serum caffeine levels on admission were ≥200 μg/mL, developed cardiac arrest. Ninety-seven patients (96.0%) recovered completely, but 3 patients (3.0%) died. Conclusion The present analysis of data from more than 100 emergency patients revealed clinical features of moderate to fatal caffeine poisoning. We recommend highlighting the toxicity risks associated with ingesting highly caffeinated tablets.

Consumption and correlates of sweet foods, carbonated beverages, and energy drinks among primary school children in Saudi Arabia

Objectives:

To assess the consumption of sweets, carbonated beverages, and energy drinks along with their correlates among primary school children.

Methods:

A total of 725 children (7-12 years old) were randomly recruited from 10 elementary schools from Al-Baha city, Saudi Arabia in 2013, using a multi-stage stratified sampling technique and pre-tested validated questionnaire.

Results:

Approximately 26.1% of children reported consuming sweets on daily basis, and 63.4% consumed sweets occasionally during the week. Approximately 56.3% children were reportedly drinking carbonated beverages weekly and 17.1% in daily basis. Weekly consumption of energy drinks was reported in 21.9% and daily consumption in 4.3% of the children. Daily sweets consumption was positively associated with children age (odds ratio [OR]=1.5, 95% confidence interval [CI]: 4.5-9.5, p=0.035), consuming carbonated beverages (OR=3.4, 95% CI: 2.2-5.2, p<0.001), energy drinks (OR=2.5, 95% CI: 1.1-5.4, p=0.029), eating high fat food (OR= 1.6, 95% CI: 1.1 - 2.4, p=0.023), and inversely with children body mass index (BMI) (OR=0.9, 95% CI: 0.8-0.9, p<0.001). Consuming carbonated beverages on regular basis was positively associated with consuming energy drinks (OR=9.0, 95% CI: 4.0-21.0, p<0.001).

Conclusion:

Unhealthy dietary choices were found to be prevalent at early age. Comprehensive intervention programs should be established to prevent unhealthy dietary choices and promote healthier dietary behaviors. Qualitative studies are needed for better understanding of children’s dietary behaviors.

The Effect of Acute Consumption of Energy Drinks on Blood Pressure, Heart Rate and Blood Glucose in the Group of Young Adults

Background: Energy drinks (EDs) are very popular among young people, who consume them for various reasons. A standard ED typically contains 80 mg of caffeine, as well as glucose, taurine, vitamins and other ingredients. Excessive consumption of EDs and accumulation of the above ingredients, as well as their mutual interactions, can be hazardous to the health of young adults. The purpose of this study was to assess the effect of acute consumption of energy drinks on blood pressure, heart rate and blood glucose. Methods: The study involved 68 volunteers, healthy young adults (mean age 25 years), who were divided into two groups: the first consumed three EDs at one-hour intervals, and the second drank the same amount of water. All participants had their blood pressure (BP)—systolic and diastolic (SBP and DBP)—as well as heart rate (HR) and blood glucose (BG) measured. In addition, participants could report any health problems before and after consuming each portion of ED. Results: In the above experiment, having consumed three portions of ED (240 mg of caffeine), the participants presented a significant increase in DBP (p = 0.003), by over 8%, which coincided with a lack of any significant impact on SBP (p = 0.809). No significant changes were noted in HR (p = 0.750). Consumption of EDs caused a significant increase (p < 0.001) in BG, by ca. 21%, on average. Some participants reported various discomforts, which escalated after 2 and 3 EDs. Conclusions: Acute consumption of EDs contributed to increased diastolic blood pressure, blood glucose and level of discomfort in healthy young people. Our results reinforce the need for further studies on a larger population to provide sufficient evidence.

Energy drink and ginseng consumption by Italian university students: a cross-sectional study

INTRODUCTION

The consumption of energy drinks (ED) and ginseng by young people to enhance their mental and physical performance has become widespread. Reported side-effects of ED have raised doubts regarding their safety. This cross-sectional study investigates the phenomenon.

METHODS

An anonymous questionnaire was administered to a representative sample of Verona university students. The resulting data were analyzed with Excel 2013, STATA 13 software.

RESULTS

ED and ginseng consumption was reported by 38.6% and 37.4% of the students, respectively. More than 70% of ED and ginseng users were 18 to 22 years old. Excluding non-responders, ED consumers were mostly males (51.8% vs 33.0%), contrary to ginseng consumers (females 40.4% vs 30.9%). Being a working student was significantly positively associated both to EDs (OR 1.5) and ginseng use (OR 1.4). The most frequently reported academic and other reasons for ED use were: "to study longer" (47.5%), and "to socialize" (29.1%). The most often used combinations were ED containing alcohol (65.6%) and ginseng-coffee beverages (71.8%).

CONCLUSIONS

The diffusion of ED and ginseng consumption warrants prevention and monitoring measures, and deserves further analysis.

In vitro effect of energy drinks on human enamel surface

Abstract Introduction Energy drinks (ED) possess low pH and citric acid in their composition, making them potentially erosive beverages that can contribute to the high dental erosion rates found currently in the general population and also in young people. Objective To evaluate the mean pH and titratable acidity of commercial ED and the influence of a brand of ED on the superficial microhardness of human enamel. Material and method Ten commercial ED were selected and the pH of two lots of each ED with and without gas was obtained. Acid titration was conducted with the addition of NaOH aliquots until the pH 7 was reached. Eighteen human enamel specimens were allocated in three groups (N=6), Red Bull (RB), Red Bull Light (RBL) and distilled water (C), submitted to an acid challenge with the ED, six consecutive times, with 12 hours intervals, during three days. Knoop microhardness was measured before and after the acid challenge. Result All ED brands tested presented low pH levels ranging from 2.1 to 3.2. Regarding titratable acidity, it was found that the amount of base required promoting the neutralization of the solutions ranged from 1200μL to 3750μL. Samples of human enamel in the RB and RBL groups submitted to the acid challenge presented significantly decreased Knoop microhardness when compared with the group C. Conclusion All ED examined have potential to promote mineral loss due to the low pH and high titratable acidity. The ED analyzed promoted significant mineral losses on the dental enamel surface.

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.

Use pattern and predictors of use of highly caffeinated energy drinks among South Korean adolescents: a study using the Health Belief Model

OBJECTIVES

Concerns about the use of highly caffeinated energy drinks among Korean adolescents remains. We compared adolescents' perceptions regarding the use of drinks to their behaviours and factors.

DESIGN

A structured questionnaire based on the Health Belief Model was administered to 850 freshmen and sophomores at three high schools in Bucheon, South Korea. Benefits were defined as beneficial effects from the use of highly caffeinated energy drinks (eg, awakening from sleepiness) and harms as adverse effects of the drinks (eg, cardiac palpitation). Likelihood of action represents the likelihood of taking actions that are perceived to be more beneficial after comparison of the benefits and harms of caffeine use. Descriptive analysis was used to quantify the relationship between their beliefs about highly caffeinated energy drinks and their use. We conducted hierarchical logistic regression to compute ORs and 95% CIs for: (1) demographic factors, (2) health threat, (3) likelihood of action and (4) cues to act.

RESULTS

Altogether, 833 students responded to the questionnaire (effective response rate=98.0%). About 63.0% reported use of highly caffeinated energy drinks and 35.2% had used them as needed and habitually. The more susceptible the respondents perceived themselves to be to the risk of using these drinks, the less likely they were to use them (OR: 0.73, 95% CI 0.50 to 1.06). The more severe the perception of a health threat, the less that perception was associated with use (OR: 0.44, 95% CI 0.29 to 0.67). Likelihood of action was the strongest predictor of use, explaining 12.5% in use. Benefits and harms (OR: 4.43, 95% CI 2.77 to 7.09; OR: 1.86, 95% CI 1.16 to 2.99) also were significant predictors.

CONCLUSIONS

Enhancing adolescents' perceptions of benefits and harms regarding using highly caffeinated energy drinks could be an effective way to influence the use of these drinks.

The evaluation of adolescent chest pain: a screening ECG or PSC-17?

PURPOSE OF REVIEW

The present review offers an update on entities presenting as chest pain in the adolescent population. It discusses recently proposed tools and shared mental models used in primary and urgent care settings to evaluate chest pain, and their focus on identifying life-threatening processes. We consider whether the current practice may be improved by accounting for the increasingly recognized non-life-threatening causes of adolescent chest pain.

RECENT FINDINGS

The present experiences and behaviors of adolescents have added new causes of chest pain to the work-up of this disquieting chief complaint. The initial approach to adolescent chest pain has classically focused on ruling out life-threatening entities, and current diagnostic algorithms offer systematic approaches with similar emphases. A growing body of literature on the nonlife-threatening causes of adolescent chest pain, often categorized as idiopathic, suggests a need to reevaluate our practice.

SUMMARY

Adolescent chest pain is most often noncardiac and non-life threatening in nature, yet current diagnostic algorithms and evaluations emphasize identifying the exceptional case of cardiac chest pain. Familiarizing ourselves with the more common causes of chest pain and with our present approach to the evaluation of this particular chief complaint, may help us to better counsel our patients and avoid unnecessary use of valuable resources.

Energy drinks – consumption and awareness among students of Medical University of Lublin

Energy drinks (ED), containing caffeine, taurine and another substances, are one of the more frequently used legal stimulants. Still, because these can endanger consumers’ health, it is thought that their marketing should be legally controlled.

In our study, we analyzed the frequency of energy drink consumption, as well as the knowledge held about these drinks among medicine and dentistry students of the Medical University of Lublin. In the study, 131 students participated, and the study was done in the form of a survey. The results of this indicate that 81 students (61.83%) declared a daily consumption, and most respondents (78.48%) stated at least a one time consumption of 250 to 749 ml of energy drink. What is more, 26.25% of respondents combined ED with other substances, most frequently with coffee and alcohol. Regarding knowledge of ED effects, contents and side effects, more males than females actively sought and held this information. Furthermore, more than half of all respondents believed that the availability of EDs in Poland should be limited.

Our study showed that the awareness of the effects and mechanisms of action of EDs, among the questioned students is relatively high. Nevertheless, they frequently consume EDs and combine these with other stimulants.

Consumption of energy drinks by children and young people: a rapid review examining evidence of physical effects and consumer attitudes

OBJECTIVE

To examine patterns of energy drink consumption by children and young people, attitudes towards these drinks, and any associations with health or other outcomes.

DESIGN

Rapid evidence assessment and narrative synthesis.

DATA SOURCES

9 electronic bibliographic databases, reference lists of relevant studies and searches of the internet.

RESULTS

A total of 410 studies were located, with 46 meeting the inclusion criteria. The majority employed a cross-sectional design, involved participants aged 11-18 years, and were conducted in North America or Europe. Consumption of energy drinks by children and young people was found to be patterned by gender, with boys consuming more than girls, and also by activity levels, with the highest consumption observed in the most and least sedentary individuals. Several studies identified a strong, positive association between the use of energy drinks and higher odds of health-damaging behaviours, as well as physical health symptoms such as headaches, stomach aches, hyperactivity and insomnia. There was some evidence of a dose-response effect. 2 experimental studies involving small numbers of junior athletes demonstrated a positive impact on limited aspects of sports performance. 3 themes emerged from the qualitative studies: reasons for use; influences on use; and perceived efficacy and impact. Taste and energy-seeking were identified as key drivers, and branding and marketing were highlighted as major influences on young people's consumption choices. Awareness of possible negative effects was low.

CONCLUSIONS

There is growing evidence that consumption of energy drinks is associated with a range of adverse outcomes and risk behaviours in terms of children's health and well-being. However, taste, brand loyalty and perceived positive effects combine to ensure their popularity with young consumers. More research is needed to explore the short-term and long-term impacts in all spheres, including health, behaviour and education.

TRIAL REGISTRATION NUMBER

CRD42014010192.

Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes

BACKGROUND

Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs).

METHODS

The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools.

RESULTS

EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1-3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover.

CONCLUSIONS

EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour.