Binge-like administration of alcohol mixed to energy drinks to male adolescent rats severely impacts on mesocortical dopaminergic function in adulthood: A behavioral, neurochemical and electrophysiological study

A growing body of evidence indicates that the practice of consuming alcohol mixed with energy drinks (ED) (AMED) in a binge drinking pattern is significantly diffusing among the adolescent population. This behavior, aimed at increasing the intake of alcohol, raises serious concerns about its long-term effects. Epidemiological studies suggest that AMED consumption might increase vulnerability to alcohol abuse and have a gating effect on the use of illicit drugs. The medial prefrontal cortex (mPFC) is involved in the modulation of the reinforcing effects of alcohol and of impulsive behavior and plays a key role in the development of addiction. In our study, we used a binge-like protocol of administration of alcohol, ED, or AMED in male adolescent rats, to mimic the binge-like intake behavior observed in humans, in order to evaluate whether these treatments could differentially affect the function of mesocortical dopaminergic neurons in adulthood. We did so by measuring: i) physiological sensorimotor gating; ii) voluntary alcohol consumption and dopamine transmission before, during, and after presentation of alcohol; iii) electrophysiological activity of VTA dopaminergic neurons and their sensitivity to a challenge with alcohol. Our results indicate that exposure to alcohol, ED, or AMED during adolescence induces differential adaptive changes in the function of mesocortical dopaminergic neurons and, in particular, that AMED exposure decreases their sensitivity to external stimuli, possibly laying the foundation for the altered behaviors observed in adulthood.

Recent advances in hepatitis A virus research and clinical practice guidelines for hepatitis A virus infection in Japan

In 2018, there was a hepatitis A outbreak in Japan, and hepatitis A virus (HAV) infection is considered a sexually transmitted disease. In general, patients with hepatitis A should be given attention, and this disease should be prevented more than ever. The Japan Agency for Medical Research and Development (AMED) Hepatitis A and E viruses (HAV and HEV) Study Group has worked on the project to create "Recent Advances in Hepatitis A Virus (HAV) Research and Clinical Practice Guidelines for HAV Infection in Japan". The group consists of expert hepatologists and virologists who gathered at virtual meeting on August 5, 2023. Data about the pathogenesis, infection routes, diagnosis, complications, several factors for the severities, vaccination, and current and future treatments for hepatitis A were discussed and debated for a draft version. The participants assessed the quality of cited studies. The finalized recommendations are presented in this review. The recent advances in HAV research and clinical practice for HAV infection in Japan, have been reviewed by the AMED HAV and HEV Study Group.

Associations of healthy dietary patterns with mortality among people with prediabetes

PURPOSE

To examine the associations of healthy dietary patterns with cardiometabolic biomarkers and all-cause mortality among individuals with prediabetes.

METHODS

This cohort study included 8363 adults with prediabetes from the National Health and Nutrition Examination Survey 1999-2014. Healthy dietary patterns including Alternate Healthy Eating Index-2010 (AHEI-2010), Alternate Mediterranean Diet score (AMED), Dietary Approaches to Stop Hypertension score (DASH), and Healthy Eating Index-2015 (HEI-2015) were calculated based on 24-h dietary recall data. Mortality status was obtained by linkage to National Death Index records. Cardiometabolic biomarkers, including blood glucose, insulin, HbA1c, C-reactive protein (CRP), and lipids, were measured at recruitment.

RESULTS

During 61,991 person-years of follow-up, 991 deaths occurred. Comparing the extreme quartiles, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were 0.65 (0.49, 0.85) for AHEI-2010 (P-trend = 0.002), 0.68 (0.50, 0.92) for AMED (P-trend = 0.004), 0.72 (0.53, 0.98) for DASH (P-trend = 0.03), and 0.78 (0.58, 1.05) for HEI-2015 (P-trend = 0.08). Besides, the HRs (95% CIs) for all-cause mortality per 20-percentile increment in scores were 0.78 (0.67, 0.90) for AHEI-2010 (P = 0.001), 0.73 (0.62, 0.86) for AMED (P < 0.001), 0.84 (0.69, 1.02) for DASH (P = 0.08), and 0.86 (0.74, 1.00) for HEI-2015 (P = 0.04). In addition, higher dietary scores were associated with favorable blood glucose, insulin, HOMA-IR, blood lipids, and CRP (all P-trend < 0.05). The high-density lipoprotein cholesterol and CRP explained 1.53-9.21% of the associations between dietary patterns and all-cause mortality (P < 0.05).

CONCLUSIONS

Diets with higher AHEI-2010, AMED, DASH, and HEI-2015 were associated with improved cardiometabolic factors and lower all-cause mortality among individuals with prediabetes. These findings suggest that multiple healthy dietary patterns instead of a one-size-fits-all diet plan might be beneficial and acceptable for individuals with prediabetes.

Alcohol and energy drinks: individual contribution of common ingredients on ethanol-induced behaviour

Since energy drinks (EDs) were sold to the general public as soft drinks and recreational beverages, mixing EDs with ethanol has grown in popularity, particularly among younger people. Given the research that links these drinks with higher risk behaviors and increased ethanol intake, ethanol combined with EDs (AmEDs) is a particularly worrying combination. EDs generally commonly include a variety of ingredients. Sugar, caffeine, taurine, and B-group vitamins are almost always present. Studies on the combined effect of ethanol and sugar and caffeine on ethanol-induced behaviors are extensive. Not so much in regards to taurine and vitamins. This review briefly summarises available information from research on the isolated compounds on EtOH-induced behaviors first, and secondly, the combination of AmEDs on EtOH effects. The conclusion is that additional research is needed to fully comprehend the characteristics and consequences of AmEDs on EtOH-induced behaviors.

An on-premise study to investigate the effects of mixing alcohol with caffeinated beverages

OBJECTIVE

The purpose of this on-premise study was to determine if mixing alcohol with caffeinated mixers had an impact on objective and subjective intoxication.

METHODS

The study was conducted across eight drinking occasions in the City of Bristol, UK. Participants (N = 1041) were recruited outside popular night-time entertainment venues and interviewed regarding their alcohol consumption for that particular evening, including whether or not they had consumed caffeinated beverages with alcohol. Subjective intoxication was rated on an 11-point scale and objective intoxication determined with a breath alcohol test. Depending on their consumption on the night of the interview, participants also reported whether they consumed alcohol mixed with caffeinated mixers or alcohol-only on other consumption occasions.

RESULTS

Between-subjects analyses found that alcohol-caffeine consumers consumed more alcohol and had higher objective and subjective intoxication than those who consumed alcohol-only. These results remained significant regardless of whether or not they mixed alcohol with caffeinated mixers or consumed alcohol-only on the night of the interview. Within-subject analyses revealed that alcohol-caffeine consumers drank the same or less alcohol on alcohol-caffeine occasions compared to alcohol-only occasions.

CONCLUSIONS

These findings provide support that alcohol-caffeine use does not increase overall alcohol consumption, and may be one manifestation of a high risk-taking personality.

Qualitative analysis of actual Standard for Exchange of Nonclinical Data (SEND) datasets for Data Domains: Proposition from Japan Pharmaceutical Manufacturers Association SEND Taskforce Team on standardization of nonclinical data

The Standard for Exchange of Nonclinical Data (SEND) has been adopted by the US FDA, which has required pharmaceutical companies who are developing new drugs for the US market to implement SEND. The Japan Pharmaceutical Manufacturers Association (JPMA) SEND Taskforce Team responded to this situation by starting a project to better understand the contents of SEND datasets. The project focused on domains generally included in the SEND domains for single- and repeat-dose general toxicology studies, and surveyed what kind of information are populated in which domains and in what way. The qualitative analysis of the results indicated that variations exist based on whether or not an individual variable was populated and on how the variable was populated. The Taskforce Team recommends reducing variations not only in the SEND datasets but also in the descriptions in the study protocol and/or final study report. Reduction of such variations should lead to higher quality datasets with powerful and increased searchability so that accumulated SEND datasets should become more valuable. These efforts would provide regulatory agencies with easier review of SEND datasets, which contributes to efficient development of new drug candidates.

Consumption Patterns of Alcohol and Alcohol mixed with Energy Drinks in Australian Students and Non-Students

Studies assessing alcohol mixed with energy drink (AMED) use and drinking behaviors have been largely restricted to student-only cohorts. Thus, it is not known whether evidence from these studies is applicable to non-student populations. This study examined alcohol consumption and involvement in negative alcohol-related consequences among AMED and alcohol-only (AO) users, with the aim of determining whether drinking behaviors differ according to student status. An online survey was conducted in Australia to assess alcohol consumption and alcohol-related consequences following AMED and AO consumption, according to student status. The final sample consisted of 1369 participants. Between-subjects analyses comparing AMED and AO users, confirmed previous findings in that, compared with AO users, AMED users consumed significantly more alcohol, consumed alcohol more frequently and were involved in a greater number of alcohol-related consequences. Within-subjects analyses of AMED users comparing AMED and AO drinking occasions revealed that significantly less alcohol was consumed and involvement in negative alcohol-related consequences was lower during AMED compared with AO drinking occasions. Regardless of drink type, compared with students, non-students consumed more alcohol, consumed alcohol more frequently and were involved in a greater number of negative alcohol-related consequences. These findings provide further evidence that AMED use is one manifestation of a risk-taking personality and suggest that non-students drink more alcohol, drink more frequently and are involved in a greater number of negative alcohol-related consequences than students.

The effects of alcohol mixed with energy drink (AMED) on subjective intoxication and alertness: results from a double-blind placebo-controlled clinical trial

OBJECTIVE

The purpose of this double blind placebo controlled study was to examine if specific effects on subjective intoxication and alertness-sleepiness ratings could be demonstrated after consuming alcohol mixed with energy drink (AMED) when compared to consuming alcohol only (AO).

METHODS

56 healthy volunteers rated their subjective intoxication on a scale ranging from 0 (sober) to 10 (highly intoxicated) at baseline, breath alcohol concentration (BAC) of 0%, and at BAC 0.08%, 0.05%, and 0.02%. Alertness-sleepiness was assessed with the Karolinska sleepiness scale. Scores of the AMED and AO condition, at each BAC level, were compared.

RESULTS

Subjective intoxication for AMED and AO did not differ significantly from each other at any BAC level, except for BAC 0.02%. A significant increase in sleepiness scores was found in the AO condition, whereas scores remained stable in the AMED condition. Sleepiness scores at BAC0.08% and 0.05% were significantly lower after AMED when compared to AO. However, the observed differences between AMED and AO were small and have no clinical relevance.

CONCLUSION

Mixing alcohol with energy drink had no overall masking effect on subjective intoxication caused by alcohol, nor had a relevant effect on subjective alertness-sleepiness ratings. Copyright © 2016 John Wiley & Sons, Ltd.

Mixing alcohol with energy drink (AMED) and total alcohol consumption: a systematic review and meta-analysis

It has been suggested that consuming alcohol mixed with energy drink (AMED) may increase total alcohol consumption. Aims of this systematic review and meta-analysis were (i) to compare alcohol consumption of AMED consumers with alcohol only (AO) consumers (between-group comparisons), and (ii) to examine if alcohol consumption of AMED consumers differs on AMED and AO occasions (within-subject comparisons). A literature search identified fourteen studies. Meta-analyses of between-group comparisons of N = 5212 AMED consumers and N = 12,568 AO consumers revealed that on a typical single drinking episode AMED consumers drink significantly more alcohol than AO consumers (p = 0.0001, ES = 0.536, 95%CI: 0.349 to 0.724). Meta-analyses of within-subject comparisons among N = 2871 AMED consumers revealed no significant difference in overall alcohol consumption on a typical drinking episode between AMED and AO occasions (p = 0.465, ES = -0.052, 95%CI: -0.192 to 0.088). In conclusion, between-group comparisons suggest that heavy alcohol consumption is one of the several phenotypical differences between AMED and AO consumers. Within-subject comparisons revealed, however, that AMED consumption does not increase the total amount of alcohol consumed on a single drinking episode.

Motives for mixing alcohol with energy drinks and other non-alcoholic beverages and its effects on overall alcohol consumption among UK students

INTRODUCTION

A UK student survey examined the motivations for consuming energy drinks alone and mixed with alcohol, and aimed to determine whether the type of motive had a differential effect on overall alcohol consumption.

METHODS

The online survey (N = 1873) assessed alcohol consumption and motivations for consumption when mixed with energy drinks (AMED) and mixed with other non-alcoholic beverages (AMOB) using a within-subject design.

RESULTS

The most frequent neutral motives reported for AMED consumption included "I like the taste" (66.5%), and "to celebrate a special occasion" (35.2%). 52.6% of AMED consumers reported consuming AMED for at least one of five negative motives, primarily "to get drunk" (45.6%). Despite these negative motives those students reported consuming significantly less alcohol and fewer negative alcohol-related consequences on AMED occasions compared to alcohol-only (AO) occasions. Although the motives for consuming AMED and AMOB were comparable, more participants reported consuming AMED "to celebrate a special occasion", "to get drunk", because they "received the drink from someone else" or "because others drink it as well". However, significantly more students reported consuming AMOB than AMED because "It feels like I can drink more alcohol". Alcohol consumption was significantly less on AMED occasions compared to AMOB occasions, and both occasions significantly less than AO occasions.

CONCLUSION

The majority of reasons for consuming AMED relate to neutral motives. Although 52.6% of students reported one or more negative motives for AMED consumption (predominantly "to get drunk") this had no differential effect on total alcohol consumption. The differences in motives suggest AMED is consumed more to enjoy special occasions and as a group-bonding experience, however alcohol consumption is significantly lower on such occasions in comparison to when AMOB or AO are consumed.

Motives for mixing alcohol with energy drinks and other nonalcoholic beverages, and consequences for overall alcohol consumption

Introduction

The aim of this survey was to assess the motives for energy drink consumption, both alone and mixed with alcohol, and to determine whether negative or neutral motives for consuming alcohol mixed with energy drinks (AMED) have a differential effect on overall alcohol consumption.

Methods

Demographics, alcohol and energy drink consumption-related questions, and motives for the consumption of energy drinks (alone or mixed with alcohol) were assessed. The motives to mix alcohol with energy drinks were compared with those for mixing alcohol with other nonalcoholic beverages.

Results

A total of 2,329 students who completed the study consumed energy drinks. The motives for consuming energy drinks (without alcohol) included “I like the taste” (58.6%), “To keep me awake” (54.3%), “It gives me energy” (44.3%), “It helps concentrating when studying” (33.9%), “It increases alertness” (28.8%), “It helps me concentrate better” (20.6%), and “It makes me less sleepy when driving” (14.2%). A total of 1,239 students reported occasionally consuming AMED (AMED group). The most frequent motives included “I like the taste” (81.1%), “I wanted to drink something else” (35.3%), and “To celebrate a special occasion” (14.6%). No relevant differences in motives were observed for using an energy drink or another nonalcoholic beverage as a mixer. A minority of students (21.6%) reported at least one negative motive to consume AMED. Despite these negative motives, students reported consuming significantly less alcohol on occasions when they consumed AMED compared to alcohol-only occasions.

Conclusion

The majority of students who consume energy drinks (without alcohol) do so because they like the taste, or they consume these drinks to keep them awake and give them energy. AMED consumption is more frequently motivated by neutral as opposed to negative motives. No relevant differences in drinking motives and overall alcohol consumption were observed between the occasions when energy drinks or other nonalcoholic beverages were mixed with alcohol.

Effects of consuming alcohol mixed with energy drinks versus consuming alcohol only on overall alcohol consumption and negative alcohol-related consequences

BACKGROUND

The aim of this study was to examine differences in alcohol consumption and its consequences when consumed alone and when mixed with energy drinks.

METHODS

A survey was conducted among Dutch students at Utrecht University and the College of Utrecht. We collected data on alcohol consumption and alcohol-related consequences of alcohol consumed alone and/or alcohol mixed with energy drinks (AMED). The data were analyzed using a retrospective within-subject design, comparing occasions when subjects consumed AMED with those when they consumed alcohol only in the past 30 days.

RESULTS

A representative sample of 6002 students completed the survey, including 1239 who consumed AMED. Compared with consuming alcohol only, when consuming AMED, students consumed significantly fewer alcoholic drinks on an average drinking day (6.0 versus 5.4, respectively), and reported significantly fewer drinking days in the previous month (9.2 versus 1.4), significantly fewer days being drunk (1.9 versus 0.5), and significantly fewer occasions of consuming more than four (female)/five (male) alcoholic drinks (4.7 versus 0.9). The maximum number of mixed alcoholic drinks (4.5) in the previous month was significantly lower when compared with occasions when they consumed alcohol only (10.7). Accordingly, the mean duration of a drinking session was significantly shorter when mixing alcoholic drinks (4.0 versus 6.0 hours). Finally, when consuming AMED, significantly fewer alcohol-related consequences were reported (2.6) for the previous year, including driving a car while intoxicated, taking foolish risks, or being injured or hurt, as compared with alcohol-related consequences when consuming alcohol only (4.9).

CONCLUSION

Mixing alcohol with energy drinks decreases overall alcohol consumption, and decreases the likelihood of experiencing negative alcohol-related consequences.