A scoping review of policies related to reducing energy drink consumption in children.

BACKGROUND: Frequent consumption of Energy Drinks (EDs) is associated with numerous health problems, including overweight and obesity, particularly among children and adolescents. The extensive promotion, wide accessibility, and relatively low cost of EDs have significantly increased their popularity among this age group. This paper examines policies/programs that, directly and indirectly, contribute to reducing ED consumption in children and adolescents and shares global experiences to help policymakers adopt evidence-based policies. METHODS: A systematic search was performed using PubMed, Scopus, and Web of Science databases from January 2000 to June 2024, along with reputable international organization websites, to find literature on policies aimed at reducing ED consumption among children and adolescents. All sources meeting the inclusion criteria were included without restrictions. Titles and abstracts were initially screened, followed by a full-text review. After evaluating the quality of the selected studies, data were extracted and, along with information from the selected documents, compiled into a table, detailing the country, policy type, and the effectiveness and weaknesses of each policy. RESULTS: Out of 12166 reviewed studies and documents, 84 studies and 70 documents met the inclusion criteria. 73 countries and territories have implemented policies like taxation, sales bans, school bans, labeling, and marketing restrictions on EDs. Most employ fiscal measures, reducing consumption despite enforcement challenges. Labeling, access restrictions, and marketing bans are common but face issues like black markets. CONCLUSION: This scoping review outlines diverse strategies adopted by countries to reduce ED consumption among children and teenagers, such as taxation, school bans, sales restrictions, and labeling requirements. While heightened awareness of ED harms has reinforced policy efforts, many Asian and African nations lack such measures, some policies remain outdated for over a decade, and existing policies face several challenges. These challenges encompass industry resistance, governmental disagreements, public opposition, economic considerations, and the intricacies of policy design. Considering this, countries should tailor policies to their cultural and social contexts, taking into account each policy's strengths and weaknesses to avoid loopholes. Inter-sectoral cooperation, ongoing policy monitoring, updates, and public education campaigns are essential to raise awareness and ensure effective implementation.

[Substance abuse and cardiovascular risk: energy drinks]. / Sostanze d'abuso e rischio cardiovascolare: gli energy drinks.

The consumption of energy drinks (ED) has become a growing public health issue, since potentially ED-related serious adverse cardiovascular events, including arrhythmias, myocardial infarction, cardiomyopathies, and sudden cardiac death, have been reported in recent years. The substances contained in ED include caffeine, taurine, sugars, B group vitamins and phyto-derivatives, which, especially if taken in large quantities and in a short amount of time, could cause serious side effects through various mechanisms of action, such as increased blood pressure and QT interval prolongation. Although there are still many open questions on ED that require further specific investigations, there is an urgent need for information and educational plans to the population, as well as for regulatory actions, particularly regarding transparency of substances and possible adverse effects.

Sudden cardiac arrest occurring in temporal proximity to consumption of energy drinks.

BACKGROUND: Energy drinks potentially can trigger life-threatening cardiac arrhythmias. It has been postulated that the highly stimulating and unregulated ingredients alter heart rate, blood pressure, cardiac contractility, and cardiac repolarization in a potentially proarrhythmic manner. OBJECTIVE: The purpose of this study was to describe our experience regarding sudden cardiac arrest (SCA) occurring in proximity to energy drink consumption in patients with underlying genetic heart diseases. METHODS: The electronic medical records of all SCA survivors with proven arrhythmias referred to the Mayo Clinic Windland Smith Rice Genetic Heart Rhythm Clinic for evaluation were reviewed to identify those who consumed an energy drink before their event. Patient demographics, clinical characteristics, documented energy drink consumption, and temporal relationship of energy drink consumption to SCA were obtained. RESULTS: Among 144 SCA survivors, 7 (5%; 6 female; mean age at SCA 29 ± 8 years) experienced an unexplained SCA associated temporally with energy drink consumption. Of these individuals, 2 had long QT syndrome and 2 had catecholaminergic polymorphic ventricular tachycardia; the remaining 3 were diagnosed with idiopathic ventricular fibrillation. Three patients (43%) consumed energy drinks regularly. Six patients (86%) required a rescue shock, and 1 (14%) was resuscitated manually. All SCA survivors have quit consuming energy drinks and have been event-free since. CONCLUSION: Overall, 5% of SCA survivors experienced SCA in proximity to consuming an energy drink. Although larger cohort studies are needed to elucidate the incidence/prevalence and quantify its precise risk, it seems prudent to sound an early warning on this potential risk.

Chronic Pancreatitis Pain Associated With Energy Drink Consumption: A Case Report.

Chronic pancreatitis is commonly associated with heavy alcohol use and cigarette smoking, though many cases of chronic pancreatitis are idiopathic. Energy drink consumption has been on the rise over the last decade, with an adverse health risk profile including gastrointestinal symptoms such as dyspepsia, reflux, and gastritis. There have been several case reports linking energy drink consumption to presentations of acute pancreatitis in adult patients. To our knowledge, the association between energy drinks and episodes of chronic pancreatitis flares has not been well studied. This article explores a case of chronic pancreatitis pain related to excessive energy drink consumption in an adult male patient. This study aims to shed light on energy drinks as a potential etiology of chronic pancreatitis flares, and emphasizes the importance of counseling patients on the potential risks of excessive energy drink consumption.

Mixing energy drinks and alcohol during adolescence impairs brain function: A study of rat hippocampal plasticity.

In the last decades, the consumption of energy drinks has risen dramatically, especially among young people, adolescents and athletes, driven by the constant search for ergogenic effects, such as the increase in physical and cognitive performance. In parallel, mixed consumption of energy drinks and ethanol, under a binge drinking modality, under a binge drinking modality, has similarly grown among adolescents. However, little is known whether the combined consumption of these drinks, during adolescence, may have long-term effects on central function, raising the question of the risks of this habit on brain maturation. Our study was designed to evaluate, by behavioral, electrophysiological and molecular approaches, the long-term effects on hippocampal plasticity of ethanol (EtOH), energy drinks (EDs), or alcohol mixed with energy drinks (AMED) in a rat model of binge-like drinking adolescent administration. The results show that AMED binge-like administration produces adaptive hippocampal changes at the molecular level, associated with electrophysiological and behavioral alterations, which develop during the adolescence and are still detectable in adult animals. Overall, the study indicates that binge-like drinking AMED adolescent exposure represents a habit that may affect permanently hippocampal plasticity.

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.

The Association between High-Caffeine Drink Consumption and Anxiety in Korean Adolescents.

BACKGROUND: As excessive caffeine intake may be associated with anxiety disorders, one of the most prevalent mental illnesses among adolescents globally, this study investigated the association between high caffeine consumption and anxiety in a nationally representative sample of South Korean adolescents. METHODS: 46,873 participants from the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2022 were included. The Generalized Anxiety Disorder-7 (GAD-7) questionnaire was used to evaluate anxiety symptoms. Survey questions determined the number of times each participant consumed high-caffeine drinks per week. The chi-square test was used to investigate and compare the general characteristics of the study population, and a modified Poisson regression was used to analyze the relationship. RESULTS: Both male and female participants reporting excessive high-caffeine drink consumption exhibited higher anxiety levels (adjusted prevalence ratio [aPR]: 1.19, 95% confidence interval [CI]: 1.08-1.31 in males; aPR: 1.14, CI: 1.05-1.23 in females). This association remained statistically significant in subgroup analyses, particularly among high school students and those with a shorter sleep duration. The relationship between high-caffeine drink consumption and anxiety strengthened with increasing anxiety levels. Additionally, there was a dose-dependent relationship between the prevalence of anxiety and high-caffeine drinks. CONCLUSION: High caffeine consumption increases anxiety in South Korean adolescents. This association proved consistent regardless of sex or other socioeconomic factors.

Changes in biochemical and sperm parameters of rats drinking energy drinks.

Tiger energy drink is used in this research to see the effect on serum lipid profile, liver enzymes, and kidney function, also observing changes in sperm parameters. Sixteen male rats were divided into four groups, each consisting of four rats. The control group was given water and rat feed, while groups 1, 2, and 3 were given water with Tiger energy drink (25%, 50%, and 75%, respectively) for eight weeks. The results showed that the effect of energy drinks on lipid profile decreased cholesterol, TG, and LDL, while there was a slight increase in HDL. Treatment with wild Tiger energy drink generally caused insignificant increases in GOT and GPT in both G2 and G3 groups as compared to the control. However, in the G1 group, GPT and GOT significantly increased. Accordingly, ALP concentration was significantly increased in all experimental groups compared to the control group. Sperm quality declined as the concentration of energy drinks consumed increased. The potential adverse effects of energy drinks, at their specific dosages, have been determined to include hepatic and renal impairment, as well as alterations in serum lipids. Additional research is required to investigate the specific mechanism by which energy drinks impact spermatogenesis, either through the modulation of endocrine hormones or other metabolic pathways.

Strict regulations on energy drinks to protect Minors' health in Europe - It is never too late to set things right at home.

The consumption of energy drinks poses significant risks to minors' health, and strict regulations are urgently needed to protect them. The high caffeine, high sugar, and high caloric content of energy drinks have drawn concern from health professionals. The consumption of energy drinks has been linked to unhealthy dietary behaviors, obesity, and mental health problems in adolescents. The psychoactive and stimulant effects of energy drinks are particularly worrisome, and the marketing of these drinks on social media platforms is also a cause for alarm. In light of these concerns, we strongly recommend policy measures, such as restrictions on the sale of energy drinks to minors, to prevent their health risks. The evidence clearly suggests that energy drinks pose significant risks to minors' health and well-being, and regulatory standards must be implemented without further delay.

Caffeine Intoxication, in Which the Theophylline Level Served as an Indicator of the Treatment Course and the Caffeine Level Could Be Measured.

A 51-year-old man presented with sudden-onset palpitations and dyspnea that had started 8 h earlier. The patient was restless and tachypneic and had persistent vomiting upon arrival. His sensorium and oxygen saturation levels rapidly declined three hours after arrival, and he was placed on a ventilator. On hospitalization day 2, he was removed from the ventilator and claimed that he had consumed a large amount of energy drinks (oral caffeine intake, approximately 1 g). The theophylline level on arrival had been elevated (9.0 µg/mL). Caffeine intoxication should be considered in patients presenting with restlessness, tachypnea, frequent vomiting, lactic acidosis, and electrolyte abnormalities.

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

OBJECTIVE: To update an earlier review, published in 2016, on the health and other outcomes associated with children and young people's consumption of energy drinks (EDs). STUDY DESIGN: Review article. SYSTEMATIC REVIEW: Systematic searches of nine databases (ASSIA, CINAHL, Cochrane Library, DARE, Embase, ERIC, MEDLINE, PsycINFO and Web of Science) retrieved original articles reporting the effects of EDs experienced by children and young people up to the age of 21 years. Searches were restricted by publication dates (January 2016 to July 2022) and language (English). Studies assessed as being weak were excluded from the review. Included studies underwent narrative synthesis. RESULTS: A total of 57 studies were included. Boys consumed EDs more than girls. Many studies reported a strong positive association between ED consumption and smoking, alcohol use, binge drinking, other substance use and the intentions to initiate these behaviours. Sensation-seeking and delinquent behaviours were positively associated with ED consumption, as were short sleep duration, poor sleep quality and low academic performance. Additional health effects noted in the updated review included increased risk of suicide, psychological distress, attention-deficit hyperactivity disorder symptoms, depressive and panic behaviours, allergic diseases, insulin resistance, dental caries and erosive tooth wear. CONCLUSIONS: This review adds to the growing evidence that ED consumption by children and young people is associated with numerous adverse physical and mental health outcomes. Where feasible and ethical, additional longitudinal studies are required to ascertain causality. The precautionary principle should be considered in regulatory policy and restriction of ED sales to this population. PROSPERO REGISTRATION: CRD42021255484.

Knowledge, attitude, and perception of energy drinks consumption among university students in Jordan.

Energy drinks gained popularity after the launch of Red Bull in 1997. Different brands are now available and young adults mainly consume these drinks. This study assesses the knowledge, attitude, and perception of energy drink consumption among university students in Jordan. A validated online survey was used to collect the required data, extracted from Google Forms into an Excel spreadsheet and statistically analysed using Statistical Package for Social Sciences version 24.0. A nationally representative sample of university students with a mean age of 22⋅2 ± 3⋅9 years (n 749) was obtained. The participating students demonstrated a neutral level of knowledge about energy drinks, as the mean score of knowledge = 7⋅1 ± 2⋅2 (out of 12), with 66 % (n 498) of them having consumed energy drinks and experienced their effects. Generally, the study's participants demonstrated a neutral attitude towards energy drinks and 70⋅5 % (n 528) acknowledged that energy drinks increase activity, but more than 70 % of them believed that energy drinks have harmful side effects. It was found that there is a significant (P-value <0⋅5) positive correlation between knowledge score and female gender, studying a medical major, and monthly income. The main reasons for consuming energy drinks were reported to be: to stay awake for longer, help study, and become more energetic. There is a need for more structured awareness campaigns to warn students about the possible side effects of these products in order to reduce the consumption and popularity of these drinks among students.