How many college students regularly consume energy drinks?
A recently published study in nutrition evaluated the consumption patterns of university students’ energy drinks (EDs).
EDs are promoted to improve focus, energy, metabolism, athletic performance and to stimulate mental activity. Caffeine is the main ingredient in EDs at 50-550mg per can or bottle. EDs contain more caffeine than traditional caffeinated drinks and may have more active ingredients than other soft drinks.
Acute caffeine consumption increases arterial blood pressure and decreases insulin sensitivity. Chronic caffeine consumption is associated with disorders of the gastrointestinal tract, cardiovascular system, kidneys and central nervous system. Athletes can use caffeinated supplements after caffeine was removed from the World Anti-Doping Agency’s list of banned substances.
About the study
In the present systematic review and meta-analysis, researchers assessed ED use among university students. The PubMed, Web of Science and Scopus databases were searched for articles with the search terms “energy drink”, “consumption” and “university/college/undergraduate students”. Studies were eligible if they reported data on ED use among college students regardless of age and gender.
Studies that included subjects other than university students were excluded. Only observational studies were included and commentaries, editorials, case studies, meta-analyses, reviews, clinical studies, and experimental studies were excluded. Five authors independently reviewed study titles and abstracts.
The Newcastle-Ottawa Scale (NOS) was used to assess quality, and each study was assigned a rating of good, fair, or poor quality. The prevalence of ED use and associated 95% confidence intervals (CIs) were extracted. The heterogeneity of the studies was assessed with the I2 Statistics and Cochran’s Q-Test.
Publication bias was estimated using the Egger test and the funnel chart. Subgroup and meta-regression analyzes were performed to identify the source of the expected heterogeneity in meta-analyses. For subgroup and meta-regression analysis, World Health Organization (WHO) regions, sample size, age, gender, year of publication, and methodological quality of the studies were considered.
Of the 502 identified articles from the three databases, 317 were retained for subsequent analysis after deduplication. Title and abstract screening removed 183 studies, leaving 134 articles for full-text analysis. Sixty-one articles were removed based on exclusion criteria. Finally, 71 studies were included in the analysis. These studies were conducted in several countries and published between 2007 and 2021.
Twenty-seven studies were from the United States (USA), eight from Saudi Arabia, six from Turkey and five from Italy. 25 studies were published in journals without an impact factor. All studies included men and women aged 16 to 53; most had large sample sizes and high ethnic variation. The prevalence of ED use among subjects varied between 9% and 90% in the selected studies.
The prevalence of ED use was higher than 86% in studies from South America, although only three studies analyzed it. Twenty-one studies assessed the prevalence of ED use by gender, and 18 reported higher use of ED among men. Thirty studies examined the adverse effects of taking ED; Participants in more than 20 studies mainly reported sleep disturbances and cardiac dysfunction.
Health-related behaviors associated with the use of EDs were analyzed in 35 studies. Alcohol use or abuse, smoking, and physical activity were commonly reported behaviors associated with ED use. Most studies (37) found that ED use was for learning and testing. In some studies, the reasons (for using ED) were to stay alert or awake and to improve physical activity or sport.
Overall, the prevalence of ED use among university students was estimated at 42.9%, with significant inter-study heterogeneity. Furthermore, the overall prevalence of ED use was not different in sensitivity analyses. The meta-regression analysis revealed that the prevalence of ED use remained independent of the proportion of women, mean age, or methodological quality.
Also, ED consumption decreased with increasing sample size. Subgroup analysis by WHO region showed the highest prevalence of ED use in the Southeast Asia region at 62%, followed by the European region (50%), the Eastern Mediterranean region (49%), the Americas region (42%) and the African region (58%).
The prevalence of ED use showed significant differences between studies. Differences in estimates of ED use were associated with geographic location and sample size, regardless of age, gender, and methodological quality.
In summary, college students, especially males, consume EDs for improved academic performance and athletic or physical activity. Nevertheless, this can lead to health problems, especially in relation to sleep and the nervous or cardiovascular system.
- Protano C, Valeriani F, De Giorgi A, et al. (2022). Energy drink consumption patterns among university students: A systematic review and meta-analysis. nutrition. doi: 10.1016/j.nut.2022.111904
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