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.

Caffeinated Drinks and Physical Performance in Sport: A Systematic Review

Caffeine (1,3,7-trimethylxanthine) is one of the most common substances used by athletes to enhance their performance during competition. Evidence suggests that the performance-enhancing properties of caffeine can be obtained by employing several forms of administration, namely, capsules/tablets, caffeinated drinks (energy drinks and sports drinks), beverages (coffee), and chewing gum. However, caffeinated drinks have become the main form of caffeine administration in sport due to the wide presence of these products in the market. The objective of this systematic review is to evaluate the different effects of caffeinated drinks on physical performance in various sports categories such as endurance, power-based sports, team sports, and skill-based sports. A systematic review of published studies was performed on scientific databases for studies published from 2000 to 2020. All studies included had blinded and cross-over experimental designs, in which the ingestion of a caffeinated drink was compared to a placebo/control trial. The total number of studies included in this review was 37. The analysis of the included studies revealed that both sports drinks with caffeine and energy drinks were effective in increasing several aspects of sports performance when the amount of drink provides at least 3 mg of caffeine per kg of body mass. Due to their composition, caffeinated sports drinks seem to be more beneficial to consume during long-duration exercise, when the drinks are used for both rehydration and caffeine supplementation. Energy drinks may be more appropriate for providing caffeine before exercise. Lastly, the magnitude of the ergogenic benefits obtained with caffeinated drinks seems similar in women and men athletes. Overall, the current systematic review provides evidence of the efficacy of caffeinated drinks as a valid form for caffeine supplementation in sport.

Energy Drink Consumption Among Finnish Adolescents: Prevalence, Associated Background Factors, Individual Resources, and Family Factors

Objectives: Energy drink consumption among adolescents has become a notable global phenomenon, and has been associated with numerous negative health outcomes. In order to understand the popularity of energy drinks among adolescents, and to target interventions, it is important to identify the determinants underpinning consumption. Methods: The nationally representative data (cross-sectional) were drawn from the Health Behaviour in School-aged Children (HBSC) surveys, conducted in 2014 and 2018, each comprising 13- and 15-year-old Finnish adolescents (n = 7405). Results: Weekly energy drink consumption increased among Finnish adolescents between 2014 (18.2%) and 2018 (24.4%), especially among girls. In 2018, boys typically consumed more than girls, and 15-year-olds more than 13-year-olds. Moreover, in 2018, weekly energy drink consumption was more prevalent among 15-year-old adolescents with a non-academic educational aspiration (46.0%) than among adolescents with an academic aspiration (18.3%). Gender (boys more than girls), older age (only in 2018), less parental monitoring, lower school achievement, and a lower level of health literacy explained around 28% of the variance in weekly energy drink consumption in both years. Conclusion: According to the findings, interventions to decrease the energy drink consumption, should be targeted at all adolescents, but especially at those with fewer individual resources. The interventions should also pay attention to family-level factors.

Sugar-sweetened beverage consumption from 1998-2017: Findings from the health behaviour in school-aged children/school health research network in Wales

To date no study has examined time trends in adolescent consumption of sugar-sweetened beverages and energy drinks, or modelled change in inequalities over time. The present study aimed to fill this gap by identifying historical trends among secondary school students in Wales, United Kingdom. The present study includes 11–16 year olds who completed the Health Behaviour in School-aged Children (HBSC) survey and the Welsh School Health Research Network (SHRN) survey between 1998 to 2017. Multinomial regression models were employed alongside tests for interaction effects. A total of 176,094 student responses were assessed. From 1998 to 2017, the prevalence of daily sugar-sweetened beverage consumption decreased (57% to 18%) while weekly consumption has remained constant since 2006 (49% to 52%). From 2013 to 2017, daily consumption of energy drinks remained stable (6%) while weekly consumption reports steadily decreased (23% to 15%). Boys, older children and those from a low socioeconomic group reported higher consumption rates of sugar-sweetened beverages and energy drinks. Consumption according to socioeconomic group was the only characteristic to show a statistically significant change over time, revealing a widening disparity between sugar-sweetened beverage consumption rates of those from low and high socioeconomic groups. Findings indicate a positive shift in overall consumption rates of both sugar-sweetened beverages and energy drinks. Adolescents from a low socioeconomic group however were consistently shown to report unfavourable sugar-sweetened beverages consumption when compared to peers from high socioeconomic group. Given the established longer term impacts of sugar-sweetened beverage and energy drink consumption on adolescent health outcomes, urgent policy action is required to reduce overall consumption rates, with close attention to equity of impact throughout policy design and evaluation plans.

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.

Use of Sports Supplements in Competitive Handball Players: Sex and Competitive Level Differences

Sports supplements are commonly used by elite athletes with the main goal of enhancing sport performance. Supplements use might be substantially different depending on the sport discipline, sex, and competitive level. To date, data about prevalence and the most-commonly used supplements in handball are scarce. Thus, the aim of this investigation was to determine the patterns of supplements use by handball players of both sexes and with different competitive levels: One hundred and eighty-seven handball players (112 men and 75 women) of different competitive levels (106 professional and 81 amateur) completed a validated self-administered questionnaire about supplements use. Supplements were classified according to the categorization of the Australian Institute of Sport (AIS). Overall, 59.9% of the handball players (n = 112) declared the use of at least one supplement and there were no significant differences between men and women (58.9% vs. 61.3%, p = 0.762) nor between professional vs. amateur handball players (67.1% vs. 53.8%, p = 0.074). The most prevalent supplements were sports drinks (42.2%), followed by energy bars (35.3%) and caffeine-containing products (31.6%). However, a greater consumption of group A supplements (those with strong scientific evidence; p = 0.029) and group B supplements (those with emerging scientific support, p = 0.012) was observed in male compared to female handball players. Supplements categorized as medical supplements were more commonly consumed in professional vs. amateur players (0.48 ± 0.80 vs. 0.21 ± 0.44, supplements p < 0.006). Additionally, a higher consumption of group B supplements was observed in professional compared to amateur players (0.58 ± 0.88 vs. 0.33 ± 0.72 supplements, p = 0.015). Handball players revealed a moderate use of supplements while sex and competitive level slighted changed the pattern of supplements use. A high portion of handball players use supplements as fuel during exercise and reported the use of caffeine-containing supplements to enhance performance.

Are students at Krakow universities turning to energy-boosting dietary supplements?

INTRODUCTION

Recent studies have revealed an increase in the consumption of dietary supplements including frequency of use of caffeine, which is addictive and potentially harmful in higher doses. Energy drinks include high doses of caffeine and are particularly targeted at young people.

OBJECTIVE

The aim of the study was to investigate the frequency of use of caffeine-containing energy products, associated factors and understanding the associated side- effects in university students.

MATERIAL AND METHODS

A cross-sectional questionnaire-based survey was conducted among students of the 5 largest Universities in Krakow. Statistical significance was set at the 0.05 level.

RESULTS

Around 35% of respondents reported the use of different supplements including high doses of caffeine. Frequency of caffeine-containing products consumption was significantly higher in female students compering to males. Also, those respondents who originated from big cities were more likely to use caffeine-containing products. The study revealed that these substances were also more popular among those participants who study economics. Most students use these substances in order to reduce feeling tired and the duration of sleep, others mainly to increase concentration prior to examinations. Almost one fourth of the group who used these substances admitted to having experienced some sideeffects in the past. They suffered mainly from insomnia, but also from excessive stimulation and muscle trembling. Almost half of the substances users did not know of any potential side-effects.

CONCLUSIONS

Attempts should be made to increase public awareness of the side-effects of these substances, particularly among the student population. These campaigns should be targeted especially at female students who come from bigger cities. This study is a step towards drawing attention to this issue.

Energy drinks consumption and perceptions among University Students in Beirut, Lebanon: A mixed methods approach

Background

Energy drinks (ED) are caffeine- and sugar-rich beverages with other ingredients that are marketed for their energy-boosting and performance-enhancing effects. The consumption of these drinks, with and without alcohol, is dramatically increasing worldwide, despite the reported side effects and potential harms to consumers. Few studies, to date, have explored the perceptions and experiences of young adults towards these beverages.

Objective

The present study aimed to explore the consumption patterns and correlates of ED consumption, as well as the perceptions and experiences of university students in Lebanon towards these beverages.

Methods

A sequential explanatory mixed-methods approach was adopted. Data collection was conducted in two private universities in Beirut, Lebanon. A self-administered 36-item quantitative survey was first used to explore the prevalence and correlates of ED consumption among a convenience sample of university students (n = 226). The survey included questions related to socio-demographic characteristics, anthropometric measurements, and other lifestyle behaviors, including physical activity of university students. The subsequent qualitative phase consisted of focus group discussions (FGD) conducted to further examine the perceptions and experiences of university students towards ED. Descriptive statistics and logistic regression analyses were conducted using survey data, whereas the transcribed FGD were analyzed thematically.

Results

A total of 226 university students completed the survey. Results showed that 45% of survey respondents consumed ED at least once in their life (ever consumers), among which 30% reported consumption of ED mixed with alcohol (AmED). Adjusting for socio-demographic and anthropometric characteristics, coffee and sports drinks consumption were significantly associated with ED (OR = 2.45, 95% CI = 1.20, 5.00, and OR = 4.88, 95%CI = 2.41, 9.88, respectively). In addition, physically active participants were 1.89 times (95%CI = 1.01, 3.51) more likely to consume ED compared to their inactive counterparts. During the qualitative phase, a total of six FGD were conducted with 29 university students, who reported consuming ED at least once per month. Three main themes were derived reflecting individual-, interpersonal/social- and environmental-level factors affecting ED consumption among university students. These themes were further supported by eight subthemes, including: perceived benefits of ED, experienced side effects, misinformation about content of ED, peer pressure and social image, as well as affordability and accessibility of ED.

Conclusion

Findings highlight the need for public health policies and programs to curb the growing public health phenomenon of ED consumption amongst university students. Such programs should consider the multi-level factors affecting ED consumption at the individual, interpersonal/social, and environmental levels, including educational campaigns on ED potential harms, regulating ED content and labeling, as well as restricting sales and marketing of these beverages, especially among young consumers.

Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015

Various diets and food components have been implicated as one of the environmental factors associated with inflammatory bowel disease (IBD). Patients are often recommended nutritional guidelines to manage disease symptoms. However, the current food consumption pattern of US adults with IBD that are nationally representative is unclear. A secondary analysis of National Health Interview Survey 2015 was performed to characterize the estimated US adults with IBD and their food intake and consumption frequency using bivariate and multivariate logistic regression. Fries were consumed by a greater number of people with IBD. IBD population drank less 100% fruit juice and ate more cheese and cookies than non-IBD population. Intake of fries (OR 1.60, 95% CI 1.14-2.25) and sports and energy drinks (OR 1.46, 95% CI 1.07-1.97) and more frequent drinking of regular soda were significantly associated with the likelihood of having been told one have IBD, while popcorn (OR 0.73, 95% CI 0.548-0.971) and milk (OR 0.70, 95% CI 0.497-0.998) were associated with smaller odds, adjusting for covariates. Foods typically labeled as junk food were positively associated with IBD. Nonetheless, of the assessed 26 foods, we found eating patterns between IBD and non-IBD population to be mostly analogous. It is unclear whether the results reflect potential change in food intake in IBD population long before the survey interview. Understanding the role of food intake in IBD risk/prevalence would benefit from identifying other environmental factors (i.e. food desert), food processing (i.e. frying), and potential bioactive food components that can induce intestinal inflammation that can increase the individual's susceptibility to IBD.

Energy drinks and population health: consumption pattern and adverse effects among Saudi population

BACKGROUND

Caffeine containing energy drinks (EDs) are heavily consumed, particularly among young adults. The number of reports of caffeine intoxication from caffeinated EDs and problems related to caffeine dependence and withdrawal is increasing. The objective was to assess the knowledge and perceived beneficial effects of EDs consumers, to assess consumption patterns and determine the adverse effects experienced by different EDs consumer groups residing in Saudi Arabia.

METHODS

An observational cross-sectional study with data from a randomly selected Saudi population was conducted during the period of January 15th, 2015, to April 15th, 2015, using a pre-tested 43-item questionnaire. The data were obtained and collected using interview questionnaires. Sociodemographic characteristics and data on EDs consumption patterns, the level of awareness among study subjects, and the purported benefits and reported adverse effects of EDs were collected. Frequency, percentage, and arithmetic means were calculated using Chi-square and ANOVA tests, and data with p < 0.05 were considered significant.

RESULTS

Of the 816 individuals invited to participate in the study, 783 participants responded and completed interviews, response rate was 96%. Consumers attributed the popularity of EDs to massive advertising media (46.7%) and their stimulating and invigorating effects (37.5%). EDs are consumed by subjects for their effects on fatigue reduction (64.6%), increased alertness and focus (75.8%), and assistance during long driving trips (75.7%). Study subjects reported suffering from adverse effects, including mainly diuresis (53.7%), palpitations (50.7%), insomnia (50.7%). Importantly, an inverse association was identified between knowledge of EDs and consumption rate, and a proportional association was identified between experienced adverse effects and consumption frequency. Lower knowledge scores were identified in daily consumers than in 1-3 times monthly consumers; higher adverse events were experienced by daily consumers than by 1-3 times monthly consumers. The majority of consumers (84.6%) recommended that authorities should regulate EDs consumption.

CONCLUSIONS

Excessive EDs consumption is associated with an increased risk of experiencing several adverse events, which is commensurate with published studies. Increasing knowledge about EDs and their possible risks could decrease their consumption by the general public.

Why are caffeinated alcoholic beverages especially risky?

PURPOSE

Evidence suggests that people drink more alcohol and experience more adverse alcohol-related consequences (ARCs) on occasions when they also consume caffeine. The current study examined whether this increase in risk is a result of caffeine attenuating the subjective effects of alcohol intoxication (i.e., the masking hypothesis).

METHODS

Undergraduate students (n = 148) reported their drinking patterns using a modified Timeline Followback approach. For each recalled drinking occasion, alcohol consumption, caffeine consumption, perceived blood alcohol concentration, and ARCs were assessed. Generalized linear mixed models were used to examine the influence that alcohol and caffeine consumption had on perceived intoxication and the experience of ARCs.

RESULTS

At the occasion level, greater caffeine consumption was associated with increased consumption of alcohol and increased ARCs. There was also a significant curvilinear relationship between the amount of alcohol consumed and perceived intoxication, such that the more alcohol was consumed on each occasion the less each additional drink increased perceived intoxication. Increased caffeine consumption weakened the association between alcohol consumption and perceived intoxication and it also weakened the association between alcohol consumption and ARCs. Specifically, the weakest relationship between ARCs and alcohol consumption existed at the highest level of caffeine consumption (240+ mg). Caffeine increased subjective intoxication.

CONCLUSIONS

These findings do not support the masking hypothesis. Caffeine was strongly associated with ARCs when consumed at high doses and this effect does not appear to be the result of drinking more alcohol or underestimating one's blood alcohol content. Efforts to reduce caffeinated alcohol beverage use are greatly needed.

Electronic device use and beverage related sugar and caffeine intake in US adolescents

Background

Despite recent declines in consumption of sugary beverages, energy drinks (ED) and sodas continue to contribute a substantial amount of sugar and caffeine to the diet of youth. Consumption of these beverages has been linked with electronic device use, however in-depth associations between sugar and caffeine intake from energy drinks and sodas with various electronic devices are not clear.

Objective

Describe the relationship of soda and energy drink consumption and associated added sugar and caffeine intake with electronic device use among adolescents.

Methods

Secondary data from the 2013–2016 cycles of Monitoring the Future Survey, a national, repeated, cross-sectional study, were analyzed. Information on energy drink and soda consumption by students in grades 8 and 10 (n = 32,418) from 252–263 schools randomly sampled from all US states was used.

Results

Soda and energy drink consumption decreased each year from 2013–2016 while daily use of electronic devices remained stable. An additional hour/day of TV was linked to a 6.92g (6.31,7.48; p<0.001) increase in sugar intake and a 32% (OR = 1.32; 1.29,1.35; p < .001) higher risk of exceeding World Health Organization (WHO) recommended sugar intakes. Further, each hour/day of TV was linked to a 28% increased risk of exceeding caffeine recommendations (OR = 1.25–1.31; p<0.001). Each hour per day talking on a cellphone was associated with an increased risk of exceeding WHO sugar and caffeine intakes by 14% (OR = 1.11–1.16; p<0.001) and 18% (OR = 1.15–1.21; p<0.001) respectively. Video game use was only weakly linked to caffeine intake. Computer use for school was associated with lower likelihood of exceeding sugar intake cut-offs.

Conclusion

While a trend towards reduced energy drink and soda intake from 2013–2016 was evident, greater electronic device use, especially TV time, was linked to higher intake of beverage-derived added sugar and caffeine amongst adolescents. Addressing these behaviours through counselling or health promotion could potentially help to reduce excess sugar and caffeine intake from sodas and energy drinks among this population.

Relationships between use of dietary supplements, caffeine and sensation seeking among college students

Objective: Caffeine and dietary supplement (DS) use by college students is not well-documented. Given reported associations between energy drink consumption and sensation seeking, we used the Sensation Seeking Scale Form V (SSS-V) to assess relationships between sensation-seeking, caffeine, and DS use. Participants: Data from 1,248 college students from five US institutions were collected from 2009 to 2011. Methods: Linear regression was used to examine relationships between scores on the SSS-V and caffeine and DS use, demographic, and lifestyle characteristics. Results: Male sex, nonHispanic race-ethnicity, higher family income, tobacco use, consuming caffeinated beverages, more than 400 mg caffeine per day, and energy drinks with alcohol at least 50% of the time, were significantly associated with higher total SSS-V scores (P < 0.001). Those using protein DSs had higher total, disinhibition, and boredom susceptibility SSS-V scores (Ps < 0.001). Conclusions: Results demonstrate a positive correlation between sensation-seeking attitudes and habitual caffeine, energy drink, and DS consumption.

Energy drink consumption in a pluri-ethnic population of adolescents in the Pacific

OBJECTIVE

Energy drinks are very popular among teenagers but may cause health problems. Energy drink consumption is partly associated with energy drink perception, but little is known about this in the Pacific Island Countries and Territories. The aim of this cross-sectional study was to identify the relationships between energy drink consumption, energy drink perception, weight status and sociodemographic characteristics in a school-going sample of Pacific adolescents.

DESIGN

A cross-sectional study carried out in the schools during school hours between July 2015 and April 2016.

SETTING

Sociodemographic characteristics, weight status, energy drink perception, and quantity of energy drinks consumed were obtained. Chi-square tests of independence, independent t tests, multivariate logistic regressions and multiple linear regressions were used.

SUBJECTS

A representative sample of 678 New Caledonian adolescents (11-16 years).

RESULTS

We found that one third of New Caledonian adolescents consume energy drinks. Boys are more likely to drink them than girls and Polynesians drink significantly more than European and Melanesian adolescents. Higher energy drink consumption in the New Caledonian adolescents is associated with good or neutral perceptions of the energy drink impact on health. Moreover, sex (being male) significantly influences the total energy drink consumption per week. Energy drink consumers have a tendency toward better perceptions of energy drinks than non-consumers.

CONCLUSIONS

Nutritional education targeting energy drink consumers should take these results into account by providing (community-based) educational programs, especially for adolescents from low socioeconomic backgrounds, boys, or those living in rural areas.

Do sleeping habits mediate the association between time spent on digital devices and school problems in adolescence?

Background

This study examined the associations of Internet and computer screen time with school difficulties and the role of sleep quality and soft and energy drinks consumption.

Methods

We used data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents (aged 11.0-15.9 years, N = 7595, 48.1% boys). We examined the inter-relations between time spent with on digital devices (time spent playing digital games or Internet use), sleeping quality (sleeping shortage, sleeping difficulties), soft/energy drinks consumption and school problems (low academic achievement, disliking school, being pressured by schoolwork and truancy), using structural equation modeling.

Results

Results showed that the more time adolescents spent on digital devices during leisure time, the more school problems they had. This association was mediated by a higher consumption of soft or energy drinks and a lower quality of sleeping. The direct effect of time spent on digital devices on school problems and its indirect effect via sleeping quality were relatively small (-0.26 and -0.30, respectively, standardized solution), compared with the indirect effect of time spent on digital devices via soft/energy drinks consumption as well as sleeping quality (0.65, standardized solution).

Conclusions

Time spent on digital devices is associated with school problems, with sleeping and soft/energy drinks consumption playing a substantial role in this association.

Investigating associations between caffeinated beverage consumption and later alcohol consumption among early adolescents

Previous research has demonstrated that caffeinated beverage consumption predicts alcohol consumption among early adolescents. This study aimed to investigate this association in two ways: (1) by examining if this association remained significant once other established risk factors for alcohol were adjusted for statistically; and (2) by considering three possible moderators of this association: gender, sensation-seeking, and parental monitoring. Data from the Camden Youth Development Study, a longitudinal, community-based study of middle-school students, were used. Youth were initially assessed in 6th and 7th grade and followed-up 16 months later. Self-reports of frequency of energy drink, coffee, and alcohol consumption, as well as sensation-seeking, perceived peer and best friend alcohol use, alcohol expectancies, and parental monitoring, were used. Results indicated that both energy drink and coffee consumption predicted later alcohol consumption, even after adjusting for other risk factors for alcohol consumption. Parental monitoring was a significant moderator of this link, such that youth who consumed energy drinks and reported low parental monitoring were particularly at risk for later alcohol consumption. These findings indicate that the link between earlier caffeine consumption and later alcohol consumption is not simply due to the co-occurrence of caffeine consumption with other risk factors for alcohol use. In addition, risk associated with early energy drink consumption appears to be particularly pronounced for youth in families characterized by low parental monitoring.

School Food Environment, Food Consumption, and Indicators of Adiposity Among Students 7-14 Years in Bogotá, Colombia

BACKGROUND

In Colombia, the prevalence of overweight/obesity in children has increased by 26% in the past 5 years. School food environment may be an important contributor and offers opportunities for effective intervention.

METHODS

We conducted a cross-sectional study among 7- to 14-year-old schoolchildren from 10 schools in Bogotá, Colombia. We examined the school food environment and the relationship of individual-level consumption, and physical activity with overweight/obesity, measured by body mass index and percentage body fat.

RESULTS

Schools with a restaurant/store were characterized as having excessive unhealthy foods. In the sample of 714 schoolchildren, 17.5% were overweight and 10.5% were obese. In multivariate models, boys had significantly increased odds of being overweight/obese (odds ratio [OR]: 1.53; p = .01) as compared to girls. Schoolchildren who consumed a greater number of energy drinks (OR = 1.82; p = .04), and those who spent more than 3 hours per schoolday watching TV (OR = 1.53; p < .01) had increased odds of being overweight/obese.

CONCLUSIONS

Approximately 1 in 4 schoolchildren were overweight/obese, with boys, energy drink consumers, and those with low physical activity having increased risk. School-based interventions focused on improving food options and providing health behavior education may be effective to reduce overweight among children in Bogotá and similar settings.

Exposure to Caffeinated Energy Drink Marketing and Educational Messages among Youth and Young Adults in Canada

The objective of the current study was to evaluate young Canadians’ exposure to caffeinated energy drink marketing and educational messages that warn about the potential health risks of energy drinks. An online survey was conducted in 2015 with youth and young adults aged 12–24 years recruited from a national online panel (n = 2023). Respondents were asked about their exposure to energy drink marketing and educational messages that warn about the potential health risks of energy drinks. Regression models were fitted to examine correlates of exposure to marketing and to educational messages. Over 80% of respondents reported ever seeing energy drink marketing through at least one channel, most commonly television (58.8%), posters or signs in a convenience or grocery store (48.5%), and online ads (45.7%). The mean number of marketing channels selected was 3.4 (SD = 2.9) out of ten. Respondents aged 18–19 (vs. 12–14 and 15–17) and 20–24 (vs. 12–14 and 15–17) reported significantly more channels of exposure to marketing. Overall, 32% of respondents reporting ever seeing an educational message about energy drinks. The most frequently reported sources of exposure were at school (16.2%), online (15.0%), and on television (12.6%). Respondents aged 18–19 (vs. 12–14, 15–17 and 20–24) and 20–24 (vs. 15–17) were significantly more likely to report having seen an educational message. Exposure to energy drink marketing was common among youth and young adults and was significantly more prevalent than exposure to educational messages that warn about the potential health risks of energy drinks. A comprehensive policy approach, including enforcing responsible marketing and increasing education surrounding the risks of consuming energy drinks, may be an effective approach in promoting lower-risk consumption of CEDs.

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.

Total Sugar-Sweetened Beverage Intake Among US Adults Was Lower When Measured Using a 1-Question Versus 4-Question Screener

PURPOSE

To compare the performance of a 1-question survey screener measuring total sugar-sweetened beverage (SSB) intake to a screener measuring SSB types separately using 4 questions.

DESIGN

Cross-sectional.

SETTING

Web-based 2014 SummerStyles survey.

PARTICIPANTS

A total of 4167 US adults (≥18 years).

MEASURES

Frequency of SSB intake measured using a 1-question screener was compared to frequency using a 4-question screener (regular soda, fruit drinks, sports/energy drinks, sweetened coffee/tea). SSB intake (number of time/day) was categorized as 0, >0 to <1, and ≥1 time/day; difference in mean intake was calculated between 4 questions versus 1.

ANALYSIS

Paired t tests were used, and agreement was evaluated using weighted κ and Lin's concordance correlation coefficient (CCC).

RESULTS

Mean SSB intake was 1.7 (95% confidence interval [CI]: 1.65-1.79) times/day using 4 questions and 0.6 (95% CI: 0.56-0.62) times/day using 1 question ( P < .001). Intake frequency based on 4 questions versus 1 was 16.0% versus 38.5% for 0 time/day, 15.6% versus 42.5% for >0 to <1 time/day, and 68.4% versus 18.9% for ≥1 time/day. There was fair agreement for the 3 SSB intake categories (κ: .27) and poor absolute agreement between the 2 continuous measures (Lin's CCC: 0.31).

CONCLUSION

Daily SSB intake was significantly lower using a 1-question screener versus a 4-question screener. Researchers should assess SSB types separately or consider that daily SSB intake is likely underestimated with 1 question.

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

This study examines the association between use of energy drinks or products (EP), EP expectancies, and the association between EP use and sleep in a racially and ethnically diverse sample (N = 2,485) of adolescents. Prevalence of EP use was approximately 18%, with no statistically significant racial or ethnic differences in prevalence. There were significant racial and ethnic differences in EP expectancies; Hispanic and Multiracial or Other groups endorsed less positive expectancies than Whites and Asians. EP use was significantly associated with later weekend bedtimes, shorter weekend total sleep time (TST), a smaller weekend-weekday difference in TST, and more trouble sleeping, even after adjusting for covariates. There were no significant race or ethnicity interactions between EP use and sleep. EP use is an independent correlate of sleep problems in adolescents across racial or ethnic groups.

Consumption Patterns of Energy Drinks in Portuguese Adolescents from A City in Northern Portugal

INTRODUCTION

Energy drinks are youth-targeted beverages that contain high amounts of caffeine and other stimulants. A number of deleterious health effects associated with consumption of these drinks have already been reported. Despite the health concerns, energy drinks research has been sparse, especially at younger ages. The main purpose of this study was to determine the prevalence of energy drinks consumption and patterns of use among adolescents.

MATERIALS AND METHODS

Cross-sectional study of students aged between 11 - 17 years-old attending four public schools in Braga, cluster sampled. A self-administrated questionnaire was used to access sociodemographic data, self-reported academic performance as well as energy drinks consumption patterns, attitudes, awareness and associated symptoms.

RESULTS

In a total of 1414 adolescents studied (mean age 15.1 ± 1.5 years; 53.9% were females), 56.7% reported to have used energy drinks at least once (62.5% in males; 52.1% in females). Of those, 34% described a regular consumption (at least once a month) and 14.1% a weekly consumption. The most common reasons for energy drinks consumption were the pleasant taste (49%), desire to increase global energy (35%) or sports performance (33%). On average, energy drinks users were older compared with non-users. Energy drinks consumption was associated with male gender and with self-reported worse academic performance. Approximately onethird experienced at least one symptom after consumption. In addition, 39.9% of energy drinks consumers reported mixing those with alcohol.

DISCUSSION

Consumption of energy drinks has been increasing. The prevalence found for its consumption in this study is similar to that reported in the literature. Knowledge about motivation, general awareness of the risks or other variables related to consumption of these drinks might allow a better characterization of this behavior.

CONCLUSION

This study showed a high prevalence of energy drinks consumption among adolescents from a city in Northern Portugal, with self-reported symptoms after consumption and common concomitant use of alcohol.

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.

Use and Perceptions of Caffeinated Energy Drinks and Energy Shots in Canada

INTRODUCTION

In Canada, energy drinks and energy shots are currently classified and regulated differently (food and drugs versus natural health products, respectively), on the assumption that they are used and perceived differently. The current study examined potential differences in use and perceptions of energy drinks and shots.

METHODS

An online survey was conducted in 2015 using a national commercial online panel of youth and young adults aged 12-24 years (n=2,040 retained for analysis in 2016). Participants were randomized to view an image of an energy shot or drink, and were asked about 14 potential reasons for using the product. Past consumption of each product was also assessed. Chi-square and t-tests were conducted to examine differences in use and perceptions between products.

RESULTS

Overall, 15.6% of respondents reported using both energy shots and drinks. Of all respondents, <1% had tried only energy shots, whereas 58.0% had tried only energy drinks. For each product, the most commonly reported reasons for use were "to stay awake" and "to increase concentration or alertness." Out of 14 potential reasons for use, respondents were significantly more likely to endorse seven of the reasons for energy drinks rather than shots; however, the magnitude of these differences was modest and the ordering of the reasons for use of each product was comparable.

CONCLUSIONS

Despite differences in prevalence of ever-use of energy shots and drinks, consumption patterns and perceived reasons for using the products are similar. The findings provide little support for regulating energy shots differently than energy drinks.

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

OBJECTIVE

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

DESIGN

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

SETTING

Community groups and secondary schools in Perth, Western Australia.

PARTICIPANTS

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

PHENOMENON OF INTEREST

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

ANALYSIS

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

RESULTS

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

CONCLUSION AND IMPLICATIONS

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

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.

Characteristics of university students who mix alcohol and energy drinks

OBJECTIVE

Research has identified correlates (eg, drug use, risky sex, smoking) of using alcohol mixed with energy drinks (AMEDs). Few studies have investigated common mental health-related concerns (eg, depression, sleep).

PARTICIPANTS

Alcohol-using college students (n = 380 never used AMEDs, n = 180 used AMEDs) were recruited in the study during the fall 2011 semester.

METHODS

The study examined demographics, substance use, depressive symptoms, and sleep problems in association with AMED use.

RESULTS

Multivariable logistic regression indicated that alcohol use severity (AOR = 1.24; 95% CI = 1.14+1.34), drug use severity (AOR = 1.20; 95% CI = 1.04-1.39), depressive symptoms (AOR = 1.06; 95% CI = 1.01-1.12), and smoking (AOR = 2.12; 95% CI = 1.22-3.68) were independently associated with AMED use; sleep problems were non-significant.

CONCLUSIONS

Administrators may consider policies regarding energy drink availability on campus, and campus health personnel may increase screening and education surrounding AMED use to reduce risks among students.

Exposure to digital marketing enhances young adults' interest in energy drinks: An exploratory investigation

Young adults experience faster weight gain and consume more unhealthy food than any other age groups. The impact of online food marketing on "digital native" young adults is unclear. This study examined the effects of online marketing on young adults' consumption behaviours, using energy drinks as a case example. The elaboration likelihood model of persuasion was used as the theoretical basis. A pre-test post-test experimental research design was adopted using mixed-methods. Participants (aged 18-24) were randomly assigned to control or experimental groups (N = 30 each). Experimental group participants' attitudes towards and intended purchase and consumption of energy drinks were examined via surveys and semi-structured interviews after their exposure to two popular energy drink brands' websites and social media sites (exposure time 8 minutes). Exposure to digital marketing contents of energy drinks improved the experimental group participants' attitudes towards and purchase and consumption intention of energy drinks. This study indicates the influential power of unhealthy online marketing on cognitively mature young adults. This study draws public health attentions to young adults, who to date have been less of a focus of researchers but are influenced by online food advertising.

Energy Drink Use Patterns Among Young Adults: Associations with Drunk Driving

BACKGROUND

Highly caffeinated "energy drinks" (ED) are commonly consumed and sometimes mixed with alcohol. Associations between ED consumption, risk-taking, and alcohol-related problems have been observed. This study examines the relationship between ED consumption-both with and without alcohol-and drunk driving.

METHODS

Data were derived from a longitudinal study of college students assessed annually via personal interviews. In Year 6 (modal age 23; n = 1,000), participants self-reported their past-year frequency of drunk driving, ED consumption patterns (frequency of drinking alcohol mixed with energy drinks [AmED] and drinking energy drinks without alcohol [ED]), alcohol use (frequency, quantity), and other caffeine consumption. Earlier assessments captured suspected risk factors for drunk driving. Structural equation modeling was used to develop an explanatory model for the association between ED consumption patterns and drunk driving frequency while accounting for other suspected risk factors.

RESULTS

More than half (57%) consumed ED at least once during the past year. Among ED consumers, 71% drank AmED and 85% drank ED alone; many (56%) engaged in both styles of ED consumption while others specialized in one or the other (29% drank ED alone exclusively, while, 15% drank AmED exclusively). After accounting for other risk factors, ED consumption was associated with drunk driving frequency in 2 ways. First, a direct path existed from ED frequency (without alcohol) to drunk driving frequency. Second, an indirect path existed from AmED frequency through alcohol quantity to drunk driving frequency.

CONCLUSIONS

Among this sample, ED consumption with and without alcohol was common, and both styles of ED consumption contributed independently to drunk driving frequency. Results call for increased attention to the impact of different patterns of ED consumption on alcohol-related consequences, such as drunk driving.

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.

Alcohol mixed with energy drink: Use may be a consequence of heavy drinking

AIMS

In recent years, studies have indicated that consumers of alcohol mixed with energy drink (AmED) are more likely to drink heavily and experience more negative consequences than consumers who avoid these beverages. Although researchers have identified a number of plausible hypotheses that explain how alcohol-energy drink co-ingestion could cause greater alcohol consumption, there has been no postulation about reverse causal relations. This paper identifies several plausible hypotheses for the observed associations between AmED consumption and greater alcohol consumption, and provides initial evidence for one such hypothesis suggesting that heavy drinking may be a determinant of AmED use.

METHOD

Data collected from 511bar patrons were used to examine the plausibility of one of the proposed hypotheses, i.e., AmED is an artifact of heavy drinking. Associations between the consumption of an assortment of alcoholic beverage types and total alcohol consumption were examined at the event-level, to assess whether AmED is uniquely related with greater alcohol consumption.

RESULTS

Increased alcohol consumption was associated with greater odds of consuming most alcoholic beverage types; this association was not unique to AmED.

CONCLUSIONS

Results support the overlooked hypothesis that AmED use is an artifact of heavy drinking. Thus, AmED consumption may be a consequence or marker of heavier drinking. Much of the existing research on alcoholic beverage types is limited in its ability to implicate any specific type of drink, including AmED, as a cause of increased alcohol consumption and related harm. More rigorous study designs are needed to examine causal relationships.

Caffeine intake from carbonated beverages among primary school-age children

AIM

The aim of the study was to assess caffeine intake from cola beverages and energy drinks, as well as the consumption frequency among primary-school-age children in relation to other dietary habits.

MATERIAL AND METHODS

The study included 329 children (aged 11-13 years) from five randomly selected schools in Warsaw. Caffeine intake was assessed from a food frequency questionnaire. The face-to-face interview method was selected.

RESULTS

89.7% of the children consumed carbonated beverages whom caffeine, of which nearly 24% consumed energy drinks. The median caffeine intake from carbonated beverages was 0.12 mg/kg body weight/day, accounting for 4.8% of the recommended maximum daily intake from all dietary sources. Frequent consumers of cola drinks were often found to eat fast foods, as well as salty snacks.

CONCLUSIONS

Caffeine intake in the studied group of children turned out to be at a safe level. The safe dose of caffeine does not mean that consumption of carbonated drinks should not raise any concerns. The recently established legal ban on selling unhealthy foods at school is a good idea, since the school should not be a place for improper dietary models.

Sources of Caffeine in Diets of US Children and Adults: Trends by Beverage Type and Purchase Location

New sources of caffeine, besides coffee and tea, have been introduced into the US food supply. Data on caffeine consumption age and purchase location can help guide public health policy. National Health and Nutrition Examination Surveys (NHANES) were used to estimate population-level caffeine intakes, using data from 24-h dietary recall. First, caffeine intakes by age-group and beverage type were estimated using the most recent 2011-2012 data (n = 7456). Second, fourteen years trends in caffeine consumption, overall and by beverage type, were evaluated for adults and children. Trend analyses were conducted by age groups. Last, trends in caffeine intakes by purchase location and beverage type were estimated. In 2011-2012, children aged four to eight years consumed the least caffeine (15 mg/day), and adults aged 51-70 years consumed the most (213 mg/day). The population mean (age ≥ four years) was 135 mg/day, driven largely by coffee (90 mg/day), tea (25 mg/day), and soda (21 mg/day). For the 14-19 years and 20-34 years age-groups, energy drinks contributed 6 mg/day (9.9%) and 5 mg/day (4.5%), respectively. The bulk of caffeine came from store-bought coffee and tea. Among both children and adults combined, caffeine intakes declined from 175 mg/day (1999-2000) to 142 mg/day (2011-2012), largely driven by a drop in caffeine from soda (41 mg/day to 21 mg/day). Store-bought coffee and tea remain principal drivers of caffeine intake in the US. Sodas and energy drinks make minor contributions to overall caffeine intakes.

Beverage consumption in an Alaska Native village: a mixed-methods study of behaviour, attitudes and access

BACKGROUND

American Indians/Alaska Natives (AI/AN) have the highest prevalence of obesity for any racial/ethnic group. Previous studies examining risk factors for obesity have identified excessive sugar-sweetened beverage (SSB) and inadequate water consumption as major risk factors for this population group. The historical scarcity of water in rural Alaska may explain consumption patterns including reliance on SSBs and other packaged drinks.

METHODS

Our study was designed to assess SSB, water and other beverage consumption and attitudes towards consumption in Alaska Native children and adults residing in rural Alaska. During summer 2014, 2 focus groups were conducted employing community members in a small rural village more than 200 air miles west of Fairbanks, Alaska. Interviews were completed with shop owners, Early Head Start and Head Start program instructors (n=7). SSB and total beverage intakes were measured using a modified version of the BEVQ-15, (n=69).

RESULTS

High rates of SSB consumption (defined as sweetened juice beverages, soda, sweet tea, energy drink or sports drinks) and low rates of water consumption were reported for all age groups in the village. All adolescents and 81% of children reported drinking SSBs at least once per week in the last month, and 48% of adolescents and 29% of younger children reported daily consumption. Fifty-two per cent of adults reported consuming SSBs at least once per week and 20% reported daily consumption. Twenty-five per cent of adolescents reported never drinking water in the past month, and 19% of younger children and 21% of adults did not consume water daily.

CONCLUSION

Alaska Native children and adults living in the Interior Alaska consume high amounts of SSBs including energy drinks and insufficient amounts of water. Interventions targeting beverage consumption are urgently needed for the Alaska Native population in rural Alaska.

Who uses alcohol mixed with energy drinks? Characteristics of college student users

OBJECTIVE

To examine characteristics associated with alcohol mixed with energy drink (AmED) use in a sample of college students.

PARTICIPANTS

College students (N = 614, 53% female) in their second year of college participated during the fall of 2008.

METHODS

Students completed a cross-sectional survey with questions regarding AmED use.

RESULTS

AmED use in the last 30 days was reported by 27% of participants. Logistic regression analyses found that risk factors for AmED included participating in a fraternity/sorority; participating in athletics; living off-campus; having greater fun/social, relax, and image motives for alcohol consumption; and binge drinking. Protective factors included early morning classes, honors program participation, and greater physical/behavioral motives for not drinking.

CONCLUSIONS

Risk factors for AmED use can identify college students most likely to consume AmEDs and thereby inform screening and intervention efforts to reduce negative AmED-related consequences.

Influence of Price and Labeling on Energy Drink Purchasing in an Experimental Convenience Store

OBJECTIVE

To examine the impact of energy drink (ED) pricing and labeling on the purchase of EDs.

METHODS

Participants visited a laboratory-based convenience store 3 times and purchased a beverage under different ED labeling (none, caffeine content, and warning labels) and pricing conditions. The 36 participants (aged 15-30 years) were classified as energy drink consumers (≥ 2 energy drinks/wk) and nonconsumers (< 1 energy drink/mo). Data were log transformed to generate elasticity coefficients. The authors analyzed changes in elasticity as a function of price and labeling using mixed-effects regression models.

RESULTS

Increasing the price of EDs reduced ED purchases and increased purchasing of other caffeinated beverages among ED consumers. Energy drink labels affected ED sales in adolescents.

CONCLUSIONS AND IMPLICATIONS

These data suggest that ED pricing and labeling may influence the purchasing of ED, especially in adolescent consumers.

Energy Drinks, Alcohol, Sports and Traumatic Brain Injuries among Adolescents

Importance

The high prevalence of traumatic brain injuries (TBI) among adolescents has brought much focus to this area in recent years. Sports injuries have been identified as a main mechanism. Although energy drinks, including those mixed with alcohol, are often used by young athletes and other adolescents they have not been examined in relation to TBI.

Objective

We report on the prevalence of adolescent TBI and its associations with energy drinks, alcohol and energy drink mixed in with alcohol consumption.

Design, Settings and Participants

Data were derived from the Centre for Addiction and Mental Health’s 2013 Ontario Student Drug Use and Health Survey (OSDUHS). This population-based cross-sectional school survey included 10,272 7^th to 12^th graders (ages 11–20) who completed anonymous self-administered questionnaires in classrooms.

Main Outcome Measures

Mild to severe TBI were defined as those resulting in a loss of consciousness for at least five minutes, or being hospitalized for at least one night. Mechanism of TBI, prevalence estimates of TBI, and odds of energy drink consumption, alcohol use, and consumption of energy drinks mixed with alcohol are assessed.

Results

Among all students, 22.4% (95% CI: 20.7, 24.1) reported a history of TBI. Sports injuries remain the main mechanism of a recent (past year) TBI (45.5%, 95% CI: 41.0, 50.1). Multinomial logistic regression showed that relative to adolescents who never sustained a TBI, the odds of sustaining a recent TBI were greater for those consuming alcohol, energy drinks, and energy drinks mixed in with alcohol than abstainers. Odds ratios were higher for these behaviors among students who sustained a recent TBI than those who sustained a former TBI (lifetime but not past 12 months). Relative to recent TBI due to other causes of injury, adolescents who sustained a recent TBI while playing sports had higher odds of recent energy drinks consumption than abstainers.

Conclusions and Relevance

TBI remains a disabling and common condition among adolescents and the consumption of alcohol, energy drinks, and alcohol mixed with energy drinks further increase the odds of TBI among adolescents. These associations warrant further investigation.

An Examination of the Prevalence, Consumer Profiles, and Patterns of Energy Drink Use, With and Without Alcohol, in Australia

BACKGROUND

There has been a significant growth in the energy drink (ED) market in Australia and around the world; however, most research investigating the popularity of ED and alcohol and energy drink (AED) use has focused on specific subpopulations such as university students. The aim of this study was to estimate the prevalence, consumption patterns, and sociodemographic correlates of ED and combined AED use among a representative Australian population sample.

METHODS

A computer-assisted telephone interview survey (n = 2,000) was undertaken in March-April 2013 of persons aged 18 years and over. Half of the interviews were obtained through randomly generated landline telephone numbers and half through mobile phones. Approximately half of the sample was female (55.5%; n = 1,110) and the mean age of participants was 45.9 (range 18 to 95, SD 20.0).

RESULTS

Less than 1 in 6 Australians reported ED use (13.4%, n = 268) and 4.6% (n = 91) reported AED use in the past 3 months. Majority of ED and AED users consumed these beverages monthly or less. ED and AED users are more likely to be aged 18 to 24 years, live in a metropolitan area, and be moderate risk or problem gamblers. AED consumers are more likely to report moderate levels of psychological distress.

CONCLUSIONS

Our findings in relation to problem gambling and psychological distress are novel and require further targeted investigation. Health promotion strategies directed toward reducing ED and AED use should focus on young people living in metropolitan areas and potentially be disseminated through locations where gambling takes place.

Analysis of the Consumption of Caffeinated Energy Drinks among Polish Adolescents

Background: Energy drinks (EDs) are extremely popular among adults and adolescents. Regular intake of EDs may lead to an overdose of caffeine, loss of bone mass, overweight, hypertension and, in older age, osteoporosis and cardiovascular diseases. Some people mix EDs with alcohol, which adversely affects their health. The objective of this study was to analyze the consumption of EDs by adolescents. Methods: The study consisted of a questionnaire surveying amounts of drinks, preferences and product awareness among younger consumers. The study was carried out in junior and senior high schools in Poland (n = 2629). Results: EDs were consumed by 67% of students (quite frequently by 16%). Students who practiced sports were more willing to drink EDs. Also, boys drank them more often than girls. When selecting a particular ED, young people looked at the taste, price and effect. Most respondents consumed one ED (250 mL) daily, although there were individuals consuming two or more drinks daily. Most respondents knew the ingredients of EDs, and 24% admitted to mixing EDs with alcohol. Conclusions: EDs are extremely popular among adolescents. Young people drinking EDs every day are potentially at risk of taking an overdose of caffeine.

Child and Caregiver Attitudes About Sports Drinks and Weekly Sports Drink Intake Among U.S. Youth

PURPOSE

To examine caregiver and youth attitudes about sports drinks (SDs) and the association of those attitudes with youth SD intake.

DESIGN

Study design was cross-sectional. The online YouthStyles survey was sent to youth (ages 12-17 years) whose caregivers completed the online Summer ConsumerStyles survey for adults.

SETTING

The 2011 Styles survey data comprised the setting.

SUBJECTS

The sample was composed of 815 U.S. caregiver-youth dyads.

MEASURES

The outcome variable is youth SD consumption, and exposure variables are youth and caregivers' attitudes that SDs are healthy for children, and caregivers' attitude that children need SDs for hydration. Covariates are youth demographic and physical activity variables.

ANALYSIS

Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) for youth SD consumption one or more times per week after controlling for covariates.

RESULTS

About one in five youth consumed SDs one or more times per week. Caregiver attitudes about the healthfulness of SDs and children's need of SDs for hydration both significantly differed by race and caregiver education level. The odds of youth SD consumption one or more times per week were significantly higher among youth of caregivers who agreed that SDs are good, healthy drinks for children (OR, 2.72 vs. disagreed) and among youth of caregivers who agreed that children need SDs for hydration (OR, 3.15 vs. disagreed). Youth attitude about SD healthfulness was not associated with intake.

CONCLUSION

Caregivers, particularly minority and less educated caregivers, may need more education about SD use.

Energy drinks and youth self-reported hyperactivity/inattention symptoms

OBJECTIVE

To describe patterns in sweetened beverage consumption by race/ethnicity and sex, documenting both the amount and types of sweetened beverages consumed; and to examine the association of sweetened beverage consumption with hyperactivity/inattention symptoms among middle school students in a single urban school district.

METHODS

Middle school students (n = 1649; 47% Hispanic and 38% black, non-Hispanic) from 12 schools, randomly selected out of 27 district schools, completed health behavior surveys in fall 2011. Students reported quantity and types of sweetened beverages consumed in the past 24 hours and completed the 5-item Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire to measure symptoms.

RESULTS

Amount and variety of reported sweetened beverage consumption (including energy drinks) were greater among boys versus girls and among black and Hispanic versus white students. Risk of hyperactivity/inattention increased by 14% for each additional sweetened beverage consumed, adjusting for age, race/ethnicity, sex, school lunch eligibility, family structure, and sugary food consumption. Students reporting consumption of energy drinks were 66% more likely to be at risk for hyperactivity/inattention after adjusting for number of drinks, other types of drinks consumed, and other potential confounders.

CONCLUSIONS

Results support recommendations to limit consumption of sweetened beverages and to avoid consumption of energy drinks among children. Interventions to reduce sweetened beverage consumption should explicitly focus on energy drinks and other emerging sweetened beverages such as sports and sweetened coffee drinks. More research is needed to understand the direction of effects and the mechanisms behind the association between sweetened beverages and hyperactivity/inattention symptoms.

Energy drink consumption and later alcohol use among early adolescents

INTRODUCTION

Little is known about the association between energy drink and other substance use in early adolescence despite the fact that the consumption of energy drinks during this developmental period is becoming increasingly common. The aim of this study was to examine concurrent and longitudinal associations between energy drink and alcohol use among middle school students. In addition, sensation seeking and parental monitoring were examined as factors that could potentially explain any associations found.

METHODS

A sample of 144 youth participating in the Camden Youth Development Study was utilized. Self-report questionnaire data was collected over a 16-month period.

RESULTS

Frequency of energy drink use at the initial assessment predicted increases in frequency of alcohol use 16 months later (adjusting for initial frequency of alcohol use). Levels of parental monitoring partially accounted for this association; in contrast, there was no evidence that sensation seeking was related to this association.

CONCLUSION

Youth who consume energy drinks in early adolescence are at risk for alcohol use later; this may be partially related to low levels of parental monitoring being associated with the consumption of both substances. Future research is needed to further explain this association; this may lead to opportunities for early intervention for youth at high risk for alcohol use.

Alcohol and energy drink use among adolescents seeking emergency department care

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

[Epidemiologic aspects of energy drink intake in Russian Federation]

Article examines the impact of 'energy" drinks that have become so popular in recent decades on people. As a research tool a short structured questionnaire was used. It included questions about whether the respondent used "energy" drinks and, if yes, how often; whether he/she had an experience of using it with alcohol; if one is informed about the affect of substances that are included in the drink on the organism; reason of using; the reason of debut consumption; primary feeling during and after consumption; primary feeling after taking a large dose of "energy" drink. Each respondent also pointed out sex and noted whether he/she wanted to learn more about "energy" drinks and effects of their use on the organism. Within 3 years of study 1377 people (682 men and 695 women) aged 12 to 42 were surveyed. The results showed that 89.0% of respondents consumed energy drinks in some to some degree, and from these 7.4% used it constantly (at least 1 can a day). 24,0% of respondents had an experience of taking "energy" drinks with alcohol. With that, the number of men who used "energy" drinks with alcohol, prevails over the same number of women: 60.3% (n = 199) and 39.7% (n = 131), respectively (p = 0.003). Relationship between age of respondents and features of using as well as effects of "energy drinks" was also statistically proven. The elder the group is the less is the number of responders who drinks energetics constantly (Rs = -0.88, p < 0.001), who knows about the affect of caffeine and other substances on the organism (Rs = -0.93, p < 0.001), who drinks energetics forced by desire to get new feelings (Rs = -0.78, p < 0.001), exams (Rs = -0.73, p < 0.001), who feels fatigue (Rs = -0.79, p < 0.001), and get headache (Rs = -0.8, p < 0.001), the more is the number of responders who noticed that the primal feeling after energetics drinking was rising of working efficiency (Rs = 0.76, p < 0.001) and excessive motional activity (Rs = 0.59, p = 0.01). Basing on the data obtained basic principles of reducing the rate of use of energy drinks program were developed.

Association of smoking and snuffing with dental caries occurrence in a young male population in Finland: a cross-sectional study

OBJECTIVE

The aim of this study was to investigate the prevalence of smoking and snuffing habits in association with dental caries occurrence in a male cohort born in the early 1990s in Finland. The impact of health behaviours and factors related to the place of residence were included in analyses.

MATERIALS AND METHODS

Oral health of 8537 conscripts was screened in a cross-sectional study. In the same occasion they also answered a questionnaire covering their smoking and snuffing habits and other background factors. The residence-related factors were obtained from the Defence Forces' database. Cross-tabulation together with chi-squared test and generalized linear mixed models were used for analyses.

RESULTS

Almost forty per cent (39.4%) of the men reported smoking daily and 9.0% reported daily snuffing. Restorative treatment need of those who reported frequent smoking was more than 2-fold (mean DT = 2.22) compared to the non-smokers (mean DT = 1.07). Smoking was statistically significantly associated with other harmful health behaviours. The snuffers reported more snacking than the non-smokers, but were most frequent brushers. The result from the statistical modelling showed that smoking, low tooth brushing frequency, eating sweets and consuming energy drinks frequently were significantly associated with restorative treatment need.

CONCLUSION

In this cross-sectional study, association between smoking and dental caries was distinct. The high rate of restorative treatment need among smokers may be explained by their poor health behaviours. Dietary habits of the snuffers seem harmful too, but are compensated by good tooth brushing frequency.

Association of sports drinks with weight gain among adolescents and young adults

OBJECTIVE

Sales of regular soda were declining, but sales of other sweetened beverages, such as sports drinks, were increasing. Our objective was to determine the prospective associations between sports drinks and body mass index (BMI) gains among adolescents and young adults.

METHODS

4121 females and 3438 males in the Growing Up Today Study II, aged 9-16 in 2004, from across the United States were followed prospectively. Data were collected by questionnaire in 2004, 2006, 2008, and 2011. Servings per day of various beverages were assessed with a food frequency questionnaire.

RESULTS

Among the girls, each serving per day of sports drink predicted an increase of 0.3 BMI units (95% confidence interval (CI) CI 0.03-0.54) more than their peers over the next 2-3 years. Among the males, each serving of sports drinks predicted a 0.33 BMI (95% CI 0.09, 0.66) increase. In addition, boys who increased their intake over the 2-3 year interval gained significantly more than their peers during the same time interval.

CONCLUSIONS

Intake of sports drinks predicted larger increases in BMI among both females and males. Our results suggest that school policies focused on obesity prevention should be augmented to restrict sports drinks.