Adult Use of Complementary and Integrative Approaches to Improve Athletic Performance.

Context • In the United States in 2007, approximately 38% of adults, or 4 in 10, used some form of complementary and alternative medicine (CAM). An area in which little is known is the personal integration of CAM therapies by those individuals seeking to improve athletic performance. Objectives • The study intended to assess the use of integrative care by adult athletes in the United States as well as their satisfaction with it, as reported in the 2012 National Health Interview Survey (NHIS). Design • A secondary analysis of the data from the Adult Alternative Health/Complementary Medicine file of the 2012 NHIS was performed. SETTING: The analysis was performed at the Research Institute of Parker University (Dallas, TX, USA). Participants • The NHIS survey was a representative sample of Americans, with more than 30 000 respondents. Outcome Measures • National population estimates were generated for all related variables. The study assessed the likelihood that a respondent who reported use of a specific complementary and integrative therapy as their first top therapeutic modality to enhance sport or athletic performance had perceived it helpful compared with those who used it for other non-sport-related reasons. Results • Complementary and integrative therapies were used by more than 14 million adults (20.5%) to improve athletic performance, with 97.6% of them perceiving therapies as helpful. The most used therapies were yoga, herbal supplements, manipulation, and massage. The median age of those reporting specific use to improve athletic performance was slightly less than 38 y, and women were almost 3 times as likely as men to report therapies as helpful. Conclusions • Complementary and integrative therapies were used for improvement of athletic performance by respondents of the 2012 NHIS, with high satisfaction among users. Future research could evaluate athletic-specific use, adverse effects, physiological mechanisms that may exist for the modalities, and ways to integrate these methods better with traditional medical care.

High-Risk Driving Behaviors Among 12th Grade Students: Differences Between Alcohol-Only and Alcohol Mixed With Energy Drink Users.

BACKGROUND: About 30% of high school students use energy drinks. Alcohol mixed with energy drinks (AmED) has been associated with higher rates of risky driving among college students. OBJECTIVES: The purpose of this study was to: (a) examine AmED-use in a sample of high school students and (b) to specifically investigate differences in risky driving behaviors between 12th grade students who engaged in AmED-use and those who consumed alcohol only. METHODS: Differences in risky driving behaviors were investigated by utilizing secondary data analyses of nationally representative data from the Monitoring the Future Study (N = 1305). RESULTS: 12th grade AmED users were significantly more likely to be in a motor vehicle accident (p <.001) and receive a ticket for a traffic violation (p <.05). Additionally, 12th grade AmED users were significantly less likely to wear a seatbelt as a driver or passenger (p <.001). Conclusions/Importance: Although this study does not link risky driving behaviors to specific drinking events, it does indicate a relationship between AmED-use and high-risk driving. Because traffic accidents are the highest cause of mortality among U.S. teenagers, drug education efforts to reduce high-risk driving behaviors should include information on the decision-making and synergistic effects of energy drinks when mixed with alcohol.

Effect of Energy Drink Consumption on Power and Velocity of Selected Sport Performance Activities.

Jacobson, BH, Hester, GM, Palmer, TB, Williams, K, Pope, ZK, Sellers, JH, Conchola, EC, Woolsey, C, and Estrada, C. Effect of energy drink consumption on power and velocity of selected sport performance activities. J Strength Cond Res 32(6): 1613-1618, 2018-Energy drinks (ED) comprise a multibillion dollar market focused on younger, active, and competitive individuals. Marketing includes claims of improved alertness and performance. The purpose of this study was to assess power (W) and velocity (m·s) of a simulated, isolated forehand stroke (FHS), and a countermovement vertical jump (CVJ) before and after ingestion of a commercially available energy shot (ES) or a placebo (PL). Healthy college-aged men and women (N = 36) volunteers were randomly placed in the ES or PL. Before and 30 minutes after ingesting either the ES or PL, participants performed 3 FHSs and CVJs. Power and velocity of each performance was measured using a linear velocity transducer and the highest value for each measure was used for subsequent analysis. The ES group demonstrated a significant (p = 0.05) increase in velocity and W for the FHS, but not for the CVJ. All measures remained unchanged in the PL group for both, the FHS and CVJ. Females demonstrated a significant increase in velocity over males in FHS, but not in CVJ. It was concluded that while the dose of stimulants in the ES was adequate to improve performance of smaller muscle groups, it may not have been sufficient to affect the larger muscle groups of the lower legs which contribute to the CVJ. While the ES used in the present study contained a caffeine dosage within the NCAA limit and did improve performance for the upper body, it must be noted that there are health risks associated with ED consumption.

Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.

BACKGROUND AND OBJECTIVES: Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study. METHODS: Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships. RESULTS: Significant differences were found in frequency of Ritalin (p < .001, Cohen's d = .23) and Adderall (p < .001, Cohen's d = .32) use between alcohol-only students and AmED students. Greater frequency of AmED use was also associated with greater frequency of Ritalin use (r = .293, p < .001) and Adderall use (r = .353, p < .001). Males (b = .138, OR = 1.148) were more likely to use prescription stimulants non-medically than females. DISCUSSION AND CONCLUSIONS: This study highlights the need to better understand influences on non-medical prescription stimulant, energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use. SCIENTIFIC SIGNIFICANCE: Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384).

A comparison of the combined-use of alcohol & energy drinks to alcohol-only on high-risk drinking and driving behaviors.

BACKGROUND: The combined-use of alcohol and energy drinks is an emerging public health issue. This investigation examined differences in drinking and driving behaviors among combined-users (CU) and participants who consumed alcohol-only (AO). OBJECTIVES: This study was specifically designed to investigate potential differences in drinker's perceptions of (a) what it means to them to drive over the .08 Blood Alcohol Content (BAC) driving limit and (b) what it means to drive after knowing they have had too much to drink to drive safely. METHODS: College students (N = 355) were surveyed to assess differences in drinking and driving-related behaviors between the AO (n = 174) and CU (n = 107) groups. RESULTS: CU were more likely than AO to drive over the .08 BAC driving limit (53% vs. 38%; p = .009) and after knowing they were too drunk to drive (57% vs. 44%; p = .025). CU were also more likely (56% vs. 35%; p = .000) to ride with an intoxicated driver while knowing it was unsafe. Conclusions/Importance: Combined-users are more likely to drive after drinking, drive while knowingly drunk, and participate in other high-risk behaviors such as heavy drinking that increase the potential for injury. Public policy makers and health professionals should focus prevention efforts to reduce high-risk combined-use behavior.

Increased Energy Drink Use as a Predictor of Illicit Prescription Stimulant Use.

BACKGROUND: The purpose of this study was to examine energy drink usage patterns and to investigate the relationship between energy drink use and illicit use of prescription stimulants among college students. METHODS: A sample of 605 undergraduate and graduate students (mean age±SD: 21.96±4.216) from a large midwestern university voluntarily participated in the study. RESULTS: Of the participants, 48.9% (n=296) reported using energy drinks in the past 30 days, whereas 25.3% (n=153) reported using prescription stimulant drugs in the past 30 days. Among prescription stimulant users without a valid medical prescription, Mann-Whitney U tests and logistic regression analysis revealed that the frequency of energy drink consumption was a significant predictor of illicit prescription stimulant use, with the odds for use increasing by 14% with each additional day of energy drink use (odds ratio for using=1.143, P≤.001). Analyses revealed statistically significant differences (P<.05) between prescription stimulant users and nonusers for all energy drink use variables, with the strongest predictors of prescription stimulant use being the number of days using energy drinks in the past 30 days and number of energy drink binges in the past 30 days. CONCLUSIONS: Results indicate that the frequency of energy drink use was a significant predictor of the illicit use of prescription stimulants.

Use of movement therapies and relaxation techniques and management of health conditions among children.

CONTEXT: Use of complementary and alternative medicine (CAM) by children under 18 y of age in the United States is becoming more prevalent. According to an analysis of procedures in chiropractic practices in 2010, more than 96% of chiropractors in the United States recommended use of movement therapies (MT) and relaxation techniques (RT) to their patients. The extent of use of these methods as treatment options for specific health conditions in children, however, has been underexplored in the United States. OBJECTIVES: The current study assessed use of MT and RT in children for treatment of various health conditions, as reported in the 2007 National Health Interview Survey (NHIS), and also examined variations in use across various sociodemographic categories. DESIGN: Secondary data from the 2007 National Health Interview Survey (NHIS) Child Alternative Medicine file were analyzed, and the research team generated weighted frequencies and inferential statistics. OUTCOME MEASURES: Odds ratios (OR) and 95% confidence intervals (CI) were computed through binary logistic regression to assess use of MT and RT as functions of various sociodemographic variables. RESULTS: Within the 12 mo prior to the survey, MT and RT use was reported by 2.5% and 2.9% of respondents, respectively. MT, primarily yoga, was used for the control and reduction of anxiety and stress (31.4%), asthma (16.2%), and back/neck pain (15.3%). Alternatively, RT, such as controlled breathing exercises (2.1%) and meditation (2.3%), was used for anxiety and stress (41.4%) and attention-deficit disorders (ADDs) (16.0%). Although data screening did not produce obvious predictors for RT use, age, gender, race/ethnicity, and parents' education levels were potential predictors of MT use. For example, respondents aged <10 y reported lower MT use than those >10 y (OR = 0.4; 95% CI, 0.3-0.6), and males reported lower MT use than females (OR = 0.5; 95% CI, 0.3-0.7). CONCLUSION: MT and RT are used by several million children in the United States each year. The current research suggests that early training on MT and RT can be seen as a useful tool that can help prevent or manage certain health problems. In addition to an examination of their role in primary prevention, the use of MT and RT should be explored further to determine how these therapies work with respect to specific health conditions.

Frequency of energy drink use predicts illicit prescription stimulant use.

BACKGROUND: The purpose of this study was to examine energy drink (ED) usage patterns and to investigate the illicit use of prescription stimulants among college students. METHODS: A sample of 267 undergraduate and graduate students (mean age of 22.48 among stimulant users) from a large midwestern university and its branch campus locations voluntarily participated in the study. RESULTS: Among prescription stimulant users without a valid medical prescription, Mann-Whitney U tests and logistic regression analysis revealed that the frequency of ED use was a significant predictor of the illicit use of prescription stimulants. Moreover, frequency of ED consumption was a significant predictor of the illicit use of prescription stimulant medications, with the odds for using increasing by .06 with each additional day of ED use past 0 day (odds for use = 1.06, P =.008). CONCLUSIONS: Results indicate that the frequency of ED use is a significant predictor of the illicit use of prescription stimulants. All prescription stimulant users with or without a valid script also used EDs. This finding is important to practitioners because of the harmful interactions (eg, serotonin syndrome) that can occur when ED ingredients (eg, ginseng, yohimbine, evodamine, etc) are mixed with prescription stimulants.

Energy Drink and Nutritional Supplement Beliefs Among Naval Aviation Candidates.

INTRODUCTION: The National Academy of Medicine called for increased research on nutritional supplement use among military members. Current research has suggested potential health risks posed by energy drink consumption. The purpose of this study was to examine the relationship of energy drink consumption and beliefs about nutritional supplements in a U.S. military population. METHODS: Data were collected by means of an anonymous 44-item survey that was administered to and completed by 302 naval aviation candidates (100% response rate) enrolled in aviation preflight indoctrination (API) at Naval Air Station Pensacola, FL. RESULTS: Bivariate correlations indicated a statistically significant relationship between beliefs regarding the safety of energy drinks, energy drink consumption frequency, and personal beliefs regarding supplements [r(202) = -0.23]. The negative correlational coefficient indicated an inverse relationship between favorable perceptions on supplements and energy drink consumption. DISCUSSION: This study assessed beliefs about the safety of nutritional supplements among API candidates and to examine if a relationship between nutritional supplement beliefs and energy drink consumption exists. Results indicated a significant inverse relationship between API candidates' beliefs regarding consumption frequency and safety of energy drinks as well as beliefs regarding supplement use. Results also suggested that the more positively an API candidate perceived nutritional supplements, the less frequently energy drinks were consumed. The findings of this study indicated a weak inverse relationship between the beliefs/use of energy drinks and beliefs regarding the effectiveness of nutritional supplement use among naval aviation candidates.Sather TE, Woolsey CL, Delorey DR, Williams RD Jr. Energy drink and nutritional supplement beliefs among naval aviation candidates. Aerosp Med Hum Perform. 2018; 89(8):731-736.

Caffeine Consumption Among Naval Aviation Candidates.

INTRODUCTION: Education frequently dictates students need to study for prolonged periods of time to adequately prepare for examinations. This is especially true with aviation preflight indoctrination (API) candidates who have to assimilate large volumes of information in a limited amount of time during API training. The purpose of this study was to assess caffeine consumption patterns (frequency, type, and volume) among naval aviation candidates attending API to determine the most frequently consumed caffeinated beverage and to examine if the consumption of a nonenergy drink caffeinated beverage was related to energy drink consumption. METHODS: Data were collected by means of an anonymous 44-item survey administered and completed by 302 students enrolled in API at Naval Air Station Pensacola, FL. RESULTS: Results indicated the most frequently consumed caffeinated beverage consumed by API students was coffee (86.4%), with daily coffee consumption being approximately 28% and the most frequent pattern of consumption being 2 cups per day (85%). The least frequently consumed caffeinated beverages reported were energy drinks (52%) and energy shots (29.1%). The present study also found that the consumption patterns (weekly and daily) of caffeinated beverages (coffee and cola) were positively correlated to energy drink consumption patterns. DISCUSSION: Naval aviation candidates' consumption of caffeinated beverages is comparable to other college and high school cohorts. This study found that coffee and colas were the beverages of choice, with energy drinks and energy shots being the least frequently reported caffeinated beverages used. Additionally, a relationship between the consumption of caffeinated beverages and energy drinks was identified.Sather TE, Williams RD, Delorey DR, Woolsey CL. Caffeine consumption among naval aviation candidates. Aerosp Med Hum Perform. 2017; 88(4):399-405.

Age of first use of energy beverages predicts future maximal consumption among naval pilot and flight officer candidates.

BACKGROUND: Energy drinks are popular beverages that can have adverse long-term health effects when consumed by children and adolescents. This study sought to determine if the age of first energy drink use in a U.S. military population is predictive of the maximum number of energy drinks consumed during a single day and/or single occasion (operationally defined as a couple of hours; e.g., a night out, during studying or sport session). METHOD: Student U.S. naval aviator and naval flight officers who reported past-year use of energy drinks (N = 239) were surveyed to determine various measures of energy drink consumption. RESULTS: Age of first consumption was predictive of the maximum number of energy drinks consumed during a single occasion within the past year. Within this sample, the age range between 13 and 16 years appeared to be a critical period with results indicating that people who began consuming energy drinks during this period were 4.88 times more likely to consume high quantities (four or more) of energy drinks during a single occasion when compared to those who started consuming energy drinks between the ages of 20-23. Likewise, persons who began to consume energy drinks between the ages of 13-16 are 2.48 times more likely to consume high quantities of energy drinks during a single occasion than those who started between the ages of 17-19. There was no difference between 17 and 19 year olds and 20-23 year olds. Age of first use was not correlated to daily average intake or daily maximal intake of energy drinks. CONCLUSIONS: A lower age of first energy drink use suggests higher risk of single-occasion heavy episodic consumption in this military population. Researchers should further explore the relationship of early onset energy drink consumption and potential future health risks.

Combined Use of Alcohol and Energy Drinks Increases Participation in High-Risk Drinking and Driving Behaviors Among College Students.

OBJECTIVE: A recent study suggested that college students who combined alcohol and energy drinks were more likely than students who consumed only alcohol to drive when their blood alcohol concentration (BAC) was higher than the .08% limit and to choose to drive despite knowing they had too much alcohol to drive safely. This study sought to replicate those findings with a larger sample while also exploring additional variables related to impaired driving. METHOD: College students (N = 549) completed an anonymous online survey to assess differences in drinking and driving-related behaviors between alcohol-only users (n = 281) and combined alcohol-energy drink users (n = 268). RESULTS: Combined users were more likely than alcohol-only users to choose to (a) drive when they perceived they were over the .08% BAC limit (35.0% vs. 18.1%, p < .001), (b) drive despite knowing they had too much alcohol to drive safely (36.3% vs. 17.0%, p < .001), and (c) be a passenger when they knew the driver had too much alcohol to drive safely (44.1% vs. 23.6%, p < .001). Combined users were significantly more likely (p < .001) to report indicators of high-risk alcohol use, such as larger number of drinks consumed, number of days drinking, number of days drunk, number of heavy episodic drinking episodes, greatest number of drinks on one occasion, and average hours of consumption. CONCLUSIONS: Combined use of alcohol and energy drinks may place drinkers at greater risk when compared with those who consume only alcohol. College students in this sample who combined alcohol and energy drinks were more likely to participate in high-risk driving behaviors than those who consumed only alcohol.

A comparison of the responsible drinking dimensions among underage and legal drinkers: examining differences in beliefs, motives, self-efficacy, barriers and intentions.

BACKGROUND: To date, scholarly discourse over the Amethyst Initiative has primarily debated the relative effectiveness of the 21 year-old Minimum Legal Drinking Age (MLDA). Unfortunately, this discourse has failed to account for the Amethyst Initiative's central tenet/mission: facilitating responsible drinking among college students. This investigation seeks to help fill this gap by quantitatively determining whether a random sample of underage (n = 158) and legal (n = 298) drinkers differed with regard to their alcohol-related behaviors, responsible drinking behaviors, and responsible drinking beliefs. FINDINGS: Compared to legal drinkers, underage drinkers reported: (a) significantly less confidence to perform responsible drinking behaviors during their next drinking episode [t(446) = -2.97, p < .003; d = -0.297], (b) significantly more perceived barriers to responsible drinking [t(388) = 3.44, p < .001; d = .368], and (c) significantly lower behavioral intentions to perform responsible drinking behaviors the next time they consumed alcohol [t(437) = -3.45, p < .001; d = -0.350]. Each of these differences remained statistically significant, even after controlling for sex and race, in three separate multiple linear regression models. CONCLUSION: While college students both above and below the 21 year-old MLDA have similar beliefs regarding what constitutes responsible drinking, students below the current MLDA have less intention to drink responsibly regardless of their behavioral beliefs and/or motives. College/university administrators should consider the negative repercussions that are possible if underage students who are less confident in their ability to drink responsibly are given the legal right to drink on campus.