Adverse effects of caffeinated energy drinks among youth and young adults in Canada: a Web-based survey.
ABSTRACT: BACKGROUND:Energy drink consumption has increased dramatically among young Canadians, with anecdotal evidence of adverse health effects. There is a lack of population-based studies to examine the prevalence of adverse events from energy drinks, particularly among young people. The current study sought to assess adverse events from energy drinks among a population-based sample of youth and young adults in Canada. METHODS:An online survey was conducted in 2015 with a national sample of youth (aged 12-17 yr) and young adults (aged 18-24 yr) recruited from a consumer panel. Respondents reported prior consumption of energy drinks as well as adverse outcomes, concurrent activities associated with the outcomes and whether medical attention was sought or considered. Adverse events from coffee were also assessed for comparison. Weighted analyses are reported. RESULTS:Of the 2055 respondents, 1516 (73.8%) reported having ever consumed an energy drink, and 1741 (84.7%) reported having ever consumed coffee (unweighted). Overall, 55.4% of respondents who had ever consumed an energy drink reported that they had experienced at least 1 adverse event, including fast heartbeat (24.7%), difficulty sleeping (24.1%), headache (18.3%), nausea/vomiting/diarrhea (5.1%), chest pain (3.6%) and seizures (0.2%); 3.1% had sought or had considered seeking medical help for an adverse event. The prevalence of reported adverse events was significantly greater among energy drink consumers than among coffee consumers (36.0%) (odds ratio [OR] 2.67 [95% confidence interval (CI) 2.01-2.56]), as was the proportion who reported seeking or considering seeking medical help for adverse events (3.1% v. 1.4%) (OR 2.18 [95% CI 1.39-3.41]). INTERPRETATION:More than half of youth and young adults who had consumed energy drinks reported adverse outcomes, some serious enough to warrant seeking medical help. The adverse outcomes were consistent with the physiologic effects of caffeine but were significantly more prevalent than with other sources of caffeine such as coffee, consistent with data from national adverse event databases.
Project description:Physicians and policy makers are increasingly interested in caffeine intake among children and adolescents in the advent of increasing energy drink sales. However, there have been no recent descriptions of caffeine or energy drink intake in the United States. We aimed to describe trends in caffeine intake over the past decade among US children and adolescents.We assessed trends and demographic differences in mean caffeine intake among children and adolescents by using the 24-hour dietary recall data from the 1999-2010 NHANES. In addition, we described the proportion of caffeine consumption attributable to different beverages, including soda, energy drinks, and tea.Approximately 73% of children consumed caffeine on a given day. From 1999 to 2010, there were no significant trends in mean caffeine intake overall; however, caffeine intake decreased among 2- to 11-year-olds (P < .01) and Mexican-American children (P = .003). Soda accounted for the majority of caffeine intake, but this contribution declined from 62% to 38% (P < .001). Coffee accounted for 10% of caffeine intake in 1999-2000 but increased to nearly 24% of intake in 2009-2010 (P < .001). Energy drinks did not exist in 1999-2000 but increased to nearly 6% of caffeine intake in 2009-2010.Mean caffeine intake has not increased among children and adolescents in recent years. However, coffee and energy drinks represent a greater proportion of caffeine intake as soda intake has declined. These findings provide a baseline for caffeine intake among US children and young adults during a period of increasing energy drink use.
Project description:The prevalence of energy drink consumption has increased in Hungary over the past 10-15 years. This study assesses the frequency, motivations, and adverse effects of energy drink consumption, and examines how the process of becoming a regular consumer is connected with sense of coherence and depression symptoms. A total of 631 high school and college students were assessed using the Depression Scale (BDS-13) and Sense of Coherence Scale (SOC-13). Logistic regression models were fit to test the effect of and links between factors influencing addiction to energy drink use. A total of 31.1% (95% CI: 27.4-34.7) of those surveyed consumed energy drinks, 24.0% of those affected consumed the energy drink with alcohol, 71.4% (95% CI: 64.7-77.3) experienced adverse effects following energy drink consumption, and 10.2% (95% CI: 6.7-15.2) experienced at least four symptoms simultaneously. The most common motivations of consumption were fatigue, taste, and fun. Obtained by multivariate logistic regression models, after adjustment for sex and age, SOC and tendency to depression had a significant influence on the respondents' odds of addiction. The tendency to depression increases the chances of addiction, while a strong sense of coherence diminishes the effects of depression. Young people in Hungary have been shown to consume energy drinks in quantities that are detrimental to their health. Complex preventive measures and programs are needed to address the problem. Families and educators should strive to instill a strong sense of coherence in children from an early age.
Project description:Caffeinated beverages are a part of daily life. Caffeinated beverages such as coffee, tea, energy drinks, and soft drinks are easy to purchase and are frequently consumed by young college students. Moreover, smoking influences the consumption of caffeinated beverages. The concentration of caffeine in these products is an attractive factor for individuals that desire the effects of caffeine; however, abusing such products may lead to poor sleep quality. The motivations that drive caffeinated beverage consumption were investigated in this study through a survey. Self-reported questionnaires were distributed on campus to students enrolled at a university in Korea. The motivations of the students for consuming each caffeinated beverage and their sleep quality were investigated. The results of exploratory factor analysis showed the motivations for caffeinated beverage consumption were alertness, taste, mood, socialization, health benefits, and habit. The motivations for consuming each caffeinated beverage product were different. For instance, coffee consumption was motivated by a desire for alertness (B = .107, SE = .049, t = 2.181, p < 0.05) and by habit (B = .345, SE = .046, t = 7.428, p < 0.001), whereas tea consumption was influenced by socialization (B = .142, SE = .060, t = 2.357, p < 0.05). Energy drink consumption was motivated by a desire for alertness (B = .100, SE = .034, t = 2.966, p < 0.01) and health benefits (B = .120, SE = .051, t = 2.345, p < 0.05), while the consumption of soft drinks was not motivated by any specific factors. Caffeinated beverage consumption did not show a significant relationship with sleep quality, although the general sleep quality of the respondents was poor. Smoking status showed significant differences in coffee and tea consumption as well as sleep quality. Smokers had a higher intake of coffee and a lower intake of tea than non-smokers. No interaction effect between smoking and coffee on sleep quality was found. Labeling detailing the amount of caffeine in products is necessary and a cautionary statement informing consumers that smoking cigarettes enhances the effects of caffeine should be included.
Project description:BACKGROUND:Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. METHODS:The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours"). Negative alcohol outcomes included past-30-day binge drinking, past-30-day alcohol use disorder, and drinking-related consequences. RESULTS:Just over half (50.5%) reported no use of energy drinks,18.3% reported using energy drinks without concurrent alcohol use, and 31.2% reported concurrent use of energy drinks and alcohol. Relative to those who reported concurrent use of energy drinks with alcohol, and controlling for background characteristics and frequency of alcohol consumption, those who didn't use energy drinks and those who used without concurrent alcohol use had significantly lower binge drinking, negative consequences, and rates of alcohol use disorder (P < .05 for all outcomes). There were no significant differences between the no-use and energy drink without concurrent alcohol groups on any alcohol-related measure (P > .10 for all outcomes). CONCLUSIONS:Concurrent energy drink and alcohol use is associated with increased risk for negative alcohol consequences in young adults. Clinicians providing care to young adults could consider asking patients about concurrent energy drink and alcohol use as a way to begin a conversation about risky alcohol consumption while addressing 2 substances commonly used by this population.
Project description:<h4>Context</h4>Energy drinks are the fastest growing product in the beverage industry. However, there is concern regarding potential for adverse effects with use.<h4>Objective</h4>To evaluate the reported adverse effects of energy drink consumption.<h4>Data sources</h4>The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from inception to November 2019, and pertinent data were abstracted.<h4>Study selection</h4>Only clinical studies reporting adverse events after energy drink consumption were included.<h4>Study design</h4>Systematic review.<h4>Level of evidence</h4>Level 4.<h4>Data extraction</h4>Data regarding sample size characteristics, energy drink characteristics, comparators, and all adverse events were extracted in duplicate and recorded.<h4>Results</h4>A total of 32 studies and 96,549 individuals were included. Frequently reported adverse events in the pediatric population were insomnia (35.4%), stress (35.4%), and depressive mood (23.1%). Frequently reported adverse events in the adult population were insomnia (24.7%), jitteriness/restlessness/shaking hands (29.8%), and gastrointestinal upset (21.6%). Alcohol mixed with energy drinks significantly reduced the likelihood of sedation effects but increased the likelihood of stimulatory effects. Energy drink consumption significantly increased the odds of insomnia (OR, 5.02; 95% CI, 1.72-14.63) and jitteriness/activeness (OR, 3.52; 95% CI, 1.28-9.67) compared with the control group.<h4>Conclusion</h4>The authors recommend that individuals avoid frequent energy drink consumption (5-7 energy drinks/week) and avoid co-consumption with alcohol; increased regulatory standards should be placed in the sale of energy drinks, particularly with regard to the pediatric population.
Project description:Objective:To quantify energy drink consumption and influences affecting consumption in those who participate in or watch extreme sports. Methods:An online survey, informed by focus groups, was administered via Quadrics®. Advertisement was via social media, emailing extreme sport clubs, flyers at extreme sport locations, and word of mouth. Participation was limited to those >18?y who watched and/or participated in extreme sports. The study was conducted in New Zealand, with international online availability. Variables measured comprised age, sex, energy drink consumption, reasons for their use, extreme sport viewing, advertising, and sponsorship. Logistic regression models were utilised. Results:Amongst participants who completed the questionnaire (n?=?247), the mean (SD) age was 26.2 (8.2) y, 40.5% were female, 57.9% consumed energy drinks, and 25.5% consumed >one per week. For every year older, odds of consuming energy drinks were 3.1% lower (p=0.04). A 31% increase in energy drink consumption for every single increase of viewing extreme sport per week was observed (p=0.009); however, reported viewing of advertising was not associated with increased consumption. Conclusions:A large proportion of extreme sport enthusiasts regularly consume energy drinks, especially younger adults. Extreme sport viewing, where energy drink sponsorship is common, appears to increase their consumption, even if not considered advertising by the viewers themselves.
Project description:<h4>Background</h4>The contribution of beverages to overall diet is of increasing interest to researchers and policymakers, particularly in terms of consumption of drinks high in added sugars; however, few tools to assess beverage intake have been developed and evaluated. This study aimed to evaluate the relative validity of a new online Beverage Frequency Questionnaire (BFQ) among young adults in Canada.<h4>Methods</h4>A cross-sectional relative validation study was conducted among young adults aged 16-30 years (n = 50). Participants completed a 17-item BFQ, a 7-day food record (7dFR), and a single-item measure of sugary drink intake. Pearson correlations and paired t-tests were used to evaluate correlation and agreement between the measures for 17 individual beverage categories, total drink consumption, total alcoholic beverage consumption, and two definitions of drinks with excess sugars. Cognitive interviews were conducted to examine participant interpretation and comprehensiveness of the BFQ.<h4>Results</h4>Estimates of beverage intake based on the BFQ and the 7dFR were highly correlated, specifically for the total number and volume of beverages consumed, total alcoholic beverage consumption, sugary drink intake, and each of the 17 beverage categories with 3 exceptions: coffee or tea with sugar or cream, specialty coffees, and hard alcohol with caloric mix. Paired t-tests between the BFQ and the 7dFR indicated that the average reported volume was significantly different only for sweetened fruit drinks. The single-item measure of sugary beverage intake was not significantly correlated with the 7dFR. Cognitive interviewing demonstrated high comprehension levels, and confirmed the appropriateness of the BFQ beverage categories and sizes.<h4>Conclusions</h4>Overall, the results suggest that the BFQ performed well relative to a 7dFR and had high usability among this study population, indicating its promise for collecting population-level data on beverage intake, including sugar-sweetened beverages, which are known indicators of diet and health.
Project description: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.
Project description:Energy drinks containing significant quantities of caffeine and sugar are increasingly consumed, particularly by adolescents and young adults. Chronic ingestion of energy drinks may potentially regulate vascular risk factors. This study investigated the effects of chronic ingestion of energy drinks on blood-brain barrier (BBB) integrity and neuroinflammation. Male C57BL/6J mice were maintained on water (control), Mother<sup>TM</sup> (ED), sugar-free Mother<sup>TM</sup> (sfED), or Coca Cola<sup>TM</sup> soft drink (SD) for 13 weeks. The BBB integrity and neuroinflammation were analyzed with semi-quantitative immunofluorescent microscopy. Blood pressure, plasma inflammatory cytokine levels and blood glucose were also considered. Following 13 weeks of intervention, mice treated with ED, sfED, and SD showed significant disruption of BBB. However, marked neuroinflammation was observed only in sfED group mice. The consumption of ED and sfED significantly altered the blood pressure and plasma concentrations of inflammatory cytokines, TNF-a, IL-4, IL-6, and IL-10, and both increased plasma glucose. Correlation analyses showed significant associations between BBB dysfunction and hypotension, hyperglycaemia and cytokine dyshomeostasis. The intake of energy drink, particularly the sugar free formulation, may compromise the integrity of BBB and induce neuroinflammation via hypotension, hyperglycaemia and inflammatory pathways.
Project description:<h4>Background</h4>Against expert recommendations, sugar-sweetened beverages, especially fruit drinks, are consumed by young children. Misperceptions about drink ingredients and healthfulness can contribute to caregivers' provision.<h4>Objectives</h4>To assess caregivers' reasons for serving sweetened fruit-flavored drinks and unsweetened juices to their young children (1-5 y) and perceptions of product healthfulness and drink ingredients.<h4>Methods</h4>A cross-sectional online survey assessed participants' (<i>n </i>= 1614) perceptions of sweetened fruit-flavored drinks (fruit drinks and flavored water) and unsweetened juices (100% juice and water/juice blends) provided to their child in the past month, including product healthfulness, reasons for providing, and knowledge of product ingredients [added sugar, nonnutritive sweeteners (NNSs), percentage juice]. One-factor ANOVA compared perceived healthfulness of drink categories and types of sugar and NNSs, and differences between participants who could compared with those who could not accurately identify drink ingredients.<h4>Results</h4>Participants' top reasons for providing sweetened drinks included child liking it, being inexpensive, child asking for it, and being a special treat. Participants perceived 100% juice as healthiest, followed by juice/water blends, flavored waters, and, lastly, fruit drinks (<i>P </i>< 0.05). Many participants inaccurately believed the fruit drink or flavored water they served their child most often did not contain NNSs (59.0% and 64.9%) and/or added sugars (20.1% and 42.2%), when in fact they did, and 81.3-91.1% overestimated the percentage juice in the drink. Perceived healthfulness of fruit drinks was associated with caregivers' belief that the drink contained added sugar (<i>P </i>< 0.05), but not with their belief that it contained NNS; increased accuracy was associated with decreased perceived healthfulness (<i>P </i>< 0.05).<h4>Conclusions</h4>Inaccurate understanding of added sugar, NNSs, and percentage juice in drinks served to young children was common and could contribute to sugary drink provision. Public health efforts should seek to improve labeling practices and revise nutrition education messages.