Energy Drink Consumption Among College Students: An Extended Theory of Planned Behavior Study

Objective To investigate energy drink (ED) consumption and the relationship between ED consumption and sensation seeking among college students and to provide suggestions for management on ED consumption in the students. Methods Using stratified cluster sampling, we conducted a self-administered survey among 2 200 students of grade one to three recruited in two universities in a city with a self-desinged questionnaire and the Sensation Seeking Scale. Results Among the 2 064 students with eligible information, 1 034 (50.1%) and 511 (24.8%) reported having ED and alcohol mixed with energy drink (AmED) consumption during previous one month, with significantly higher ratios of ED and AmED consumption among the boy students than among the girl students (59.2% vs. 40.9%, χ2 = 69.222 and 30.5% vs. 19.0%; χ2 = 36.358; both P Conclusion A half of the college students consume ED and nearly a quarter of college students consume AmED; sensation seeking may be one of the motivations for the students' ED and AmED consumption.

1. Kwabena L. Blankson, MD* 2. Amy M. Thompson, DO† 3. Dale M. Ahrendt, MD‡ 4. Vijayalakshmy Patrick, MD§ 1. *Maj, US Air Force, Adolescent Medicine, Naval Medical Center, Portsmouth, VA. 2. †Maj, US Army, Adolescent Medicine Fellow, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), San Antonio, TX. 3. ‡Lt Col, US Air Force, Program Director, Adolescent Medicine, Fellowship, SAUSHEC, San Antonio, TX. 4. §Psychiatrist, Brooke Army Medical Center Associate Professor, University of Texas Health Science Center, San Antonio, TX. Hundreds of different energy drinks are available and are marketed to adolescents, carrying the potential for substance abuse that involves caffeine and alcohol. Clinicians must be educated to deal with their patients’ use of these products. After reading this article, readers should be able to: 1. Understand the size and scope of the energy drink market and recognize common energy drink brands. 2. Know that adolescents are high consumers of energy drinks and use them as performance enhancers. 3. Know the contents of energy drinks and their adverse effects and safety concerns. 4. Know that energy drinks can be a cause of tachycardia, hypertension, obesity, and other medical problems in adolescents. 5. Know the dangers of mixing energy drinks with alcohol. 6. Understand the relationship between caffeine tolerance/dependence and alcohol tolerance/dependence. 7. Understand the importance of screening teenagers for energy drink use in the office setting and offering appropriate counseling. Energy drinks are caffeinated beverages advertised as boosting the immune system, enhancing performance, and creating a “buzz” or a “high.” Some of these drinks contain alcohol, and sometimes consumers mix them with alcoholic beverages. This article reviews current information about the content, benefits, and risks of the use of these energy drinks by adolescents. Adolescents are no strangers to energy drinks, and over the past 2 years, media reports have heightened the awareness of doctors, parents, and lawmakers. In 2010, nine university students in Washington State were hospitalized and one almost died; their illness was attributed to a fruit-flavored, caffeinated alcoholic drink. A month earlier, on a college campus in New Jersey, 23 students were hospitalized after becoming intoxicated, again reportedly after drinking the same …

To assess energy drink (ED) consumption, potential ED correlates, and ED-related motivations among a sample of college students to determine differences based on athlete status (student athlete vs. non-athlete). Six hundred and ninety-two college students completed surveys at a large private university in the United States. Participants completed a paper based questionnaire assessing ED and ED-related variables. Over thirty-six percent (197 non-athletes, 58 student athletes) of participants reported ED consumption in the preceding 30 days. Multivariately, there was no difference in ED consumption based on athlete status. Heavy episodic drinking and prescription stimulant misuse were both correlated with increased ED consumption. ED motivations differed based on the frequency of ED consumption. ED use was common among student athletes and non-athletes in our sample. It is important to be aware of the correlation between heavy episodic drinking, prescription stimulant misuse, and ED consumption among college student populations because of the adverse consequences associated with these behaviors.

BACKGROUND: Energy drink (ED) consumption has become a growing public health concern, particularly among young adults. Despite regulatory efforts in Saudi Arabia, limited research has explored the prevalence, perceptions, and factors influencing ED consumption in Riyadh. OBJECTIVE: This study aimed to assess the prevalence of ED consumption among young adults in Riyadh, examine associated sociodemographic factors, and evaluate awareness of health risks. METHOD: A cross-sectional study was conducted using a convenience sampling method with an online questionnaire distributed via social media. A total of 1,368 valid responses from participants aged 18–30 years were analyzed. The questionnaire covered sociodemographic characteristics, ED consumption patterns, influencing factors, and awareness of health risks. Descriptive statistics were used to summarize the data, and chi-square tests assessed associations between sociodemographic characteristics and ED consumption. RESULTS: Among participants, 37% consumed EDs, with the highest prevalence among males (47.63%) and individuals aged 18–22 years (76.09%). Fatigue (38.98%) and academic pressures (33.65%) were the triggers. 80.63% recognized health risks, 61.46% reported insufficient public health education. ED consumption was significantly associated with smoking (p < 0.0001) and higher income levels (p = 0.0464). RECOMMENDATION: This study recommends targeted health education campaigns for high-risk groups, including students (38.9%) and smokers (17.59%), to reduce energy drink consumption. Public awareness should emphasize ingredient label checking (55.5%) and stricter marketing regulations, as energy drinks are frequently consumed at home (30.34%). Promoting healthier alternatives in schools and workplaces can help mitigate health risks and decrease reliance on energy drinks. CONCLUSION: Despite widespread awareness of potential health risks, ED consumption remains high among young adults in Riyadh. These findings highlight the need for targeted public health campaigns, stricter regulations, and improved education efforts to mitigate excessive ED consumption.

It is recommended that youth aged 12-17 years achieve ≥60 min/day of moderate-to-vigorous physical activity (PA) and limit their recreational screen time (ST) to ≤2 h/day. However, whether unhealthy eating behavior is associated with adherence to PA and ST recommendations in youth is largely unknown. This study examined the associations between adherence to PA and ST recommendations with consumption of sugar-sweetened beverages (SSBs) and energy drinks (EDs) in a representative sample of adolescents. Data on 11-19-year-old Ottawa (Canada) students (n=1147) were analyzed using self-reported information on consumption of SSBs and EDs, and time devoted to PA and ST. Multivariable logistic regression analyses were conducted to examine the associations between adherence to PA and ST recommendations and consumption of SSBs and EDs. Adherence to the ST recommendation was inversely associated with consumption of SSBs [odds ratio (OR)=0.42; 95% confidence interval (CI)=0.21-0.86] and EDs (OR=0.54, 95% CI=0.31-0.92) in females only, independent of PA and relevant covariates. However, adherence to the PA recommendation was positively associated with consumption of EDs in females (OR=1.52, 95% CI=1.07-2.17) but not males, while it was not associated with consumption of SSBs in both sexes. Among female adolescents, adherence to the ST recommendation is inversely associated with consumption of SSBs and EDs, while adherence to the PA recommendation is positively associated with consumption of EDs. Future studies should clarify the observed sex differences and determine if decreasing ST can reduce the consumption of SSBs and EDs among adolescents.

ABSTRACTBackground: College students report high levels of stress, which may be exacerbated by the psychoactive ingredients in energy drinks. Little is understood about the relationship between daily hassles and energy drink consumption. Purpose: The purpose of this study was to explore the associations between energy drink consumption patterns and daily hassles among college students. Methods: College students (n = 449) completed an online survey evaluating energy drink consumption and daily hassles using the Revised University Student Hassles Scale (RUSHS). Results: The most common reasons reported for consuming energy drinks were lack of energy (90.3%), lack of sleep (87.0%), and feeling tired (85.4%). No significant differences in daily hassles were found between energy drink consumers and nonconsumers. Energy drink consumption and daily hassles subscores varied based on demographic characteristics. Discussion: Results of this study did not support a relationship between energy drink consumption and perceived daily hassles. Further research is needed to understand the potential association between energy drink consumption and other determinants of mental health. Translation to Health Education Practice: Health Education interventions should rectify misperceptions that energy drinks are effective when students miss sleep, need energy, and need to study for exams.

Background: Little is known about possible links between energy drink use and psychopathology among youth. This study examined cross-sectional and longitudinal associations between energy drink consumption and psychopathology among early adolescents. In addition, associations between psychopathology and coffee consumption were examined to assess whether findings were specific to energy drinks or also applied to another commonly used caffeinated beverage. Methods: One hundred forty-four youth who participated in the Camden Youth Development Study (72 males; mean age 11.9 at wave 1; 65% Hispanic, 30% African American) were assessed using self-report measures of frequency of energy drink and coffee consumption and depression, anxiety, conduct disorder (CD) symptoms, and teacher reports of attention-deficit hyperactivity disorder (ADHD). Youth (92%) were reassessed 16 months later. Results: Concurrently, energy drink and coffee consumption were associated with similar psychopathology symptoms; when the other beverage was adjusted for, energy drinks remained associated with CD and coffee remained associated with panic anxiety. Initial energy drink consumption predicted increasing ADHD and CD over time, though the association with CD dropped to a trend level of significance when coffee was adjusted for. Initial levels of hyperactive ADHD predicted increasing coffee consumption over time; this association remained when energy drinks were controlled. Social anxiety was associated with less increase in energy drink consumption over time, controlling for coffee. Conclusion: Energy drink and coffee consumption among early adolescents are concurrently associated with similar psychopathology symptoms. Longitudinally, the associations between these beverages and psychopathology differ, indicating that these substances have differing implications for development over time.

OBJECTIVES: We aim to investigate the knowledge towards Energy Drinks (EDs) consumption and related factors among young male athletes in the United Arab Emirates (UAE).
 
 SUBJECTS & METHODS: A cross-sectional study included 688 young male athletes from Al Ain sports club aged between 7 to 18 years. Data were collected using a modified version of a validated questionnaire from the European Food Safety Authority.
 
 RESULTS: Overall EDs consumption was 24%. About 44% of the athletes consumed EDs one to two times per month. Athletes who were training between 5-7 days per week consumed significantly more EDs compared to those who were training 3-4 days per week (81% vs. 15 %, P<0.001). Athletes aged 7-12 years were 2.4 times more likely to consume EDs than athletes aged 13-18 years (P<0.001). Moreover, athletes living with both parents were significantly less likely to consume EDs compared to those living with a single parent (P=0.01). Knowledge score about EDs consumption was significantly higher for non EDs consumers compared to EDs consumers (P<0.001). 
 
 CONCLUSIONS: EDs consumption among young male athletes was moderate. Educational programs are needed to increase the awareness regarding EDs consumption and its potential adverse effects among the young athletes. A regulation policy for EDs consumption should be addressed and consideration of labels with EDs contents and age identification is highly recommended.

Energy drinks (EDs) are non-alcoholic beverages that contain caffeine and other ingredients, marketed for their actual or perceived effects as stimulants, energizers and performance enhancers. The aim of this pilot study was to evaluate patterns of EDs consumption in leisure, sports, and academic activities over the last year among a group of pregraduate students of the University of Sarajevo, Bosnia and Herzegovina. A cross-sectional study conducted by an online questionnaire-based survey. An anonymous questionnaire was mainly based on a Consortium Nomisma-Areté questionnaire [background information and consumer profile, general EDs consumption practices and reasons; alcohol mixed with EDs (AmEDs) consumption, EDs consumption in sports, consumption of other caffeinated beverages], and an additional part to evaluate EDs consumption during academic activities. Out of 812 respondents from 22 faculties (participation rate of 23%), mean age 21.37 ± 1.98 years, 498 (61.7%) reported EDs consumption over the last year. Three main reasons for EDs consumption were to stay awake (58.2%), to enjoy the taste (46.8%), and to boost energy (38.0%). Energy drinks were mainly consumed less than once a month (70.5%), most frequently during academic activity (50.4%), less frequently mixed with alcohol for relaxation (21.5%), and only rarely in association with sports or other physical activity (10%). Drinking coffee (OR = 2.022; 95% CI 1.416-2.830; p < 0.001) and being a higher year student (OR = 0.723; 95% CI 0.639-0.819; p < 0.001) were independent predictors for EDs consumption; being single and living with parents (OR = 17.138; 95% CI 1.328-221.528; p = 0.030) for consumption of AmEDs; and being a man (OR = 2.251; 95% CI 1.493-3.392; p < 0.001) and living in urban environment (OR = 1.193; 95% CI 1.125-3.251; p = 0.017) for consuming EDs in association with sports or other physical activity. Based on these preliminary data and taking low participation rate into account, EDs consumption seems not to be alarming among university students in our region. EDs are most frequently consumed during academic activity, less frequently mixed with alcohol for relaxation, and only rarely in association with sports or other physical activity. However, as EDs are increasingly aggressively promoted and easily accessible, the larger study is warranted to provide more reliable and up to date conclusions, and if necessary, to inform measures preventing health risks associated with EDs consumption.

ObjectivesTo investigate the frequency of energy drink (ED) consumption, and the association between ED consumption and selected sleep characteristics and parameters in Norwegian college and university students. We also explored...

ABSTRACTPosition Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of energy drink (ED) or energy shot (ES) consumption on acute exercise performance, metabolism, and cognition, along with synergistic exercise-related performance outcomes and training adaptations. The following 13 points constitute the consensus of the Society and have been approved by the Research Committee of the Society: Energy drinks (ED) commonly contain caffeine, taurine, ginseng, guarana, carnitine, choline, B vitamins (vitamins B1, B2, B3, B5, B6, B9, and B12), vitamin C, vitamin A (beta carotene), vitamin D, electrolytes (sodium, potassium, magnesium, and calcium), sugars (nutritive and non-nutritive sweeteners), tyrosine, and L-theanine, with prevalence for each ingredient ranging from 1.3 to 100%. Energy drinks can enhance acute aerobic exercise performance, largely influenced by the amount of caffeine (> 200 mg or >3 mg∙kg bodyweight [BW−1]) in the beverage. Although ED and ES contain several nutrients that are purported to affect mental and/or physical performance, the primary ergogenic nutrients in most ED and ES based on scientific evidence appear to be caffeine and/or the carbohydrate provision. The ergogenic value of caffeine on mental and physical performance has been well-established, but the potential additive benefits of other nutrients contained in ED and ES remains to be determined. Consuming ED and ES 10-60 minutes before exercise can improve mental focus, alertness, anaerobic performance, and/or endurance performance with doses >3 mg∙kg BW−1. Consuming ED and ES containing at least 3 mg∙kg BW−1 caffeine is most likely to benefit maximal lower-body power production. Consuming ED and ES can improve endurance, repeat sprint performance, and sport-specific tasks in the context of team sports. Many ED and ES contain numerous ingredients that either have not been studied or evaluated in combination with other nutrients contained in the ED or ES. For this reason, these products need to be studied to demonstrate efficacy of single- and multi-nutrient formulations for physical and cognitive performance as well as for safety. Limited evidence is available to suggest that consumption of low-calorie ED and ES during training and/or weight loss trials may provide ergogenic benefit and/or promote additional weight control, potentially through enhanced training capacity. However, ingestion of higher calorie ED may promote weight gain if the energy intake from consumption of ED is not carefully considered as part of the total daily energy intake. Individuals should consider the impact of regular coingestion of high glycemic index carbohydrates from ED and ES on metabolic health, blood glucose, and insulin levels. Adolescents (aged 12 through 18) should exercise caution and seek parental guidance when considering the consumption of ED and ES, particularly in excessive amounts (e.g. > 400 mg), as limited evidence is available regarding the safety of these products among this population. Additionally, ED and ES are not recommended for children (aged 2-12), those who are pregnant, trying to become pregnant, or breastfeeding and those who are sensitive to caffeine. Diabetics and individuals with preexisting cardiovascular, metabolic, hepatorenal, and/or neurologic disease who are taking medications that may be affected by high glycemic load foods, caffeine, and/or other stimulants should exercise caution and consult with their physician prior to consuming ED. The decision to consume ED or ES should be based upon the beverage’s content of carbohydrate, caffeine, and other nutrients and a thorough understanding of the potential side effects. Indiscriminate use of ED or ES, especially if multiple servings per day are consumed or when consumed with other caffeinated beverages and/or foods, may lead to adverse effects. The purpose of this review is to provide an update to the position stand of the International Society of Sports Nutrition (ISSN) integrating current literature on ED and ES in exercise, sport, and medicine. The effects of consuming these beverages on acute exercise performance, metabolism, markers of clinical health, and cognition are addressed, as well as more chronic effects when evaluating ED/ES use with exercise-related training adaptions.

Energy drinks are an increasingly utilized beverage and are gaining popularity in recent years. The U.S. Air Force (USAF) represents a unique population where energy drink consumption may be higher than the general population. To better understand the safety and health impact of energy drinks, this large-scale comprehensive survey was conducted to study energy drink consumption patterns and its associated adverse effects. A survey was conducted across 12 USAF installations to assess self-reported energy drink consumption and adverse effects in the military population. This study was approved by the David Grant USAF Medical Center Institutional Review Board. A total of 9,655 participants participated in the survey. Energy drink consumption was reported in 76.7% of the participants, with 12.0% consuming ≥1 energy drink per day. Male gender, younger age, and enlisted military members are more likely to be high consumers; 58.6% of participants reported having at least once tried a premixed beverage that combines alcohol, caffeine, and other stimulants. Among energy drink users, 60.0% reported experiencing ≥1 adverse effect, and 0.92% reported needing to see a physician or going to the emergency department because of adverse effects from energy drinks. Higher energy drink or premixed combination beverage consumption frequency was associated with increased likelihood of physician or emergency department visits (P ≤ 0.002 for both). Approximately three in four USAF members reported ever consuming an energy drink. Caution should be exercised on the amount of energy drink consumed to limit the risk of serious adverse effects. Future studies should identify populations at greatest risk for adverse effects and alternative sources of energy maintenance to attain optimal mission readiness.

Background: Research indicates that energy drink consumption and the combined use of energy drinks and alcohol are popular among young adults, although this research has typically focused on college students. Because of the potential for harms associated with this combination, it is critical to understand use among adults in nightlife scenes who may be most at risk for harms associated with combined energy drink and alcohol consumption. Objectives: By focusing our sample on individuals in a range of nightlife scenes, we aim to gain a deeper understanding of the demographic factors associated with energy drink use and combined energy drink and alcohol consumption to benefit the targeting of intervention and prevention efforts beyond college campuses. Methods: Using a field-based survey in New York City to survey adults active in various nightlife scenes, this study reports on the survey results of 1476 venue patrons at venues in five nightlife scenes in addition to college bar scenes. Results: Men, younger individuals, Latinos, and sexual minority individuals reported higher prevalence of recent energy drink consumption. Younger individuals, men, and those recruited in gay venues reported higher prevalence of combining alcohol and energy drinks. Conclusion: These findings provide information useful to target education and prevention efforts. They also suggest the need for additional research to understand differences in motivations for use and in the behavioral and alcohol-related outcomes associated with consuming energy drinks and combining them with alcohol.

Consideration of future consequences (CFC) describes the extent to which individuals consider potential future outcomes of their present behaviors. This personality trait has been found to predict repetitive health behaviors. Research is yet to explore the role of health beliefs, which may mediate the relationship between CFC and self-directed health behaviors. Thus, this study examined how CFC affects energy drink-related health beliefs and consumption behavior. A cross-sectional correlational online survey with 1,050 college students was conducted. Key measures include the CFC Scale, health belief measures, and current energy drink consumption pattern. CFC was associated with energy drink consumption as well as several health beliefs. CFC had indirect effects on energy drink consumption through health beliefs, including perceived severity of consuming energy drinks (indirect effect estimate = -.191, 95% confidence interval [CI] [-.271, -.122]), perceived benefits of avoiding energy drinks (indirect effect estimate = -.108, 95% CI [-.174, -.050]), and perceived barriers in abstaining from energy drinks (energy level-related barriers, indirect effect estimate = -.274, 95% CI [-.387, -.181]; and socialization-related barriers, indirect effect estimate = .152, 95% CI [.078, .249]). As the first study to examine CFC's indirect effects on a self-directed health behavior through health beliefs, this study extended CFC's applicability by examining its role in the context of college students' energy drink consumption. (PsycINFO Database Record

Background Energy drinks (EDs) represent the fastest-growing non-alcohol beverage sector worldwide. Their caffeine content has raised concerns regarding potential adverse health effects. This study aimed to analyse the association between ED consumption and mental health problems among young adults, and to explore whether sleep duration mediates this relationship. Methods The study population included full-time students participating in the Norwegian national cross-sectional survey of health and wellbeing among students (SHOT2022). A total of 31,316 participants aged 18-24 years provided information on ED consumption frequency and mental health problems, measured using the Hopkins Symptom Checklist-25 (HSCL-25). Analyses were adjusted for sociodemographic and lifestyle covariates. Results Overall, 57.6% of participants reported any ED use, and 37.4% consumed EDs at least weekly. ED consumption frequency was positively associated with symptoms of anxiety and depression in a dose-response manner for both sexes. Compared to seldom/never consumers, daily ED use was associated with a significantly higher likelihood of poor mental health (HSCL ≥ 2.0) in females (adjusted OR 2.33) and males (adjusted OR 1.77). The mediation analysis indicated that shorter sleep duration partly explained the association between ED consumption and mental health problems. Conclusions Although a causal effect cannot be established, the findings suggest that regular ED consumption among young adults may constitute a risk behaviour associated with adverse mental health outcomes, partly mediated by reduced sleep duration. Health professionals could routinely assess ED and caffeine consumption in students presenting poor sleep or mental health problems. Public health efforts, including initiatives by student welfare associations and educational institutions, may also be warranted to reduce regular ED use and support better sleep and mental health in this vulnerable group. Key messages • Regular ED consumption among university students may constitute a risk behaviour associated with adverse mental health outcomes. • Shorter sleep duration may be a potential mediating factor for the association between ED consumption and mental health problems.