The Dark Side of Energy Drinks: A Comprehensive Review of Their Impact on the Human Body

Dose and timing effects of caffeine on subsequent sleep: a randomized clinical crossover trial

STUDY OBJECTIVES

To investigate the effect of a typical dose of caffeine and a high dose of caffeine consumed in the morning, afternoon, and evening on subsequent sleep.

METHODS

Using a placebo-controlled, double-blind, randomized crossover design, 23 males (25.3 ± 5.0 years) with a moderate habitual caffeine intake (<300 mg∙day-1) completed seven conditions: placebo, and 100 and 400 mg of caffeine consumed 12, 8, and 4 hours prior to bedtime, with a 48-hour washout. In-home partial polysomnography and sleep diaries were used to assess sleep. Linear mixed models estimated the effect of each condition.

RESULTS

No significant effect on objective or subjective sleep occurred with the 100 mg dose of caffeine compared with the placebo (p > .05), but significant effects occurred with the 400 mg dose (p < .05). Significant delays in sleep initiation and alterations to sleep architecture were observed when 400 mg was consumed within 12 hours of bedtime (p < .05), and significantly greater sleep fragmentation occurred when 400 mg was consumed within 8 hours of bedtime (p < .05). Additionally, perceived sleep quality was significantly reduced when 400 mg was consumed 4 hours prior to bedtime (-34.02%, p = .006) but not at 8 or 12 hours.

CONCLUSIONS

A 100 mg dose of caffeine can be consumed up to 4 hours prior to bedtime, but 400 mg may negatively impact sleep when consumed as one dose within 12 hours of bedtime, with the adverse influence on sleep increasing the closer consumption occurs to bedtime. The discrepancy between objective and subjective sleep quality suggests that individuals may have difficulty accurately perceiving the influence of caffeine on sleep quality.

CLINICAL TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registry, registration number: ACTRN12621001625864, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001625864.

Regulatory Efforts and Health Implications of Energy Drink Consumption by Minors in Poland

From 1 January 2024, the sale of energy drinks (EDs) containing caffeine (CAF) and taurine (TA) was legally banned in Poland for minors (under age 18 years). EDs pose a significant public health concern, with their consumption steadily rising among young people globally. These beverages are rich in CAF, sugar, and other stimulants, making them particularly attractive to adolescents seeking energy boosts during physical or mental exertion. ED consumption patterns vary based on sociodemographic factors, with gender playing a notable role. The consumption of EDs by children and adolescents has been linked to adverse health effects and risky behaviors, potentially affecting their overall well-being. Excessive ED consumption is a widespread issue, prompting numerous countries to implement regulatory measures, such as sales restrictions for under those under age 18 years, warning labels, and mandatory disclosure of CAF content. This review examines ED consumption among people under age 18 years in Poland, focusing on the associated health and regulatory challenges of the newly introduced sales prohibition. Despite the growing popularity of EDs among young people, Poland lacks systematic studies on their consumption, particularly among children, adolescents, and young adults. Beyond legal restrictions, coordinated health policies and education about the risks of ED consumption and natural alternatives are crucial to addressing this issue. This article aims to review the background to the reasons for the ban of sale of energy drinks to young people in Poland from January 2024.

Factors Influencing Energy Drink Usage Amongst Pupils in the Mahikeng Sub-District, Northwest

Background/Objectives: The high consumption rate of energy drinks among pupils is a serious public health concern in various countries, including South Africa. Excessive consumption of energy drinks that contain elevated caffeine and sugar levels has the potential to lead to the development of addictions, strokes, dehydration, sleeping disorders, mental health and central nervous disorders, hypertension, digestive problems, and anxiety. Most pupils regard energy drinks as regular soft drinks and lack knowledge of the active ingredients contained in energy drinks and their side effects. The objective of this study was to investigate factors influencing energy drink usage amongst pupils in the Mahikeng sub-district, Northwest Province. Methods: A quantitative cross-sectional survey was conducted amongst 505 pupils in the Mahikeng sub-district, Northwest, using self-administered questionnaires. Data were analysed using STATA software version 18 to examine associations between variables. Results: The energy drinks consumed most by pupils were Dragon (38.21%), Switch (28.97%), and Red Bull (14.62%). Factors and reasons influencing energy drink usage among pupils include all-night parties (3.1%), concentration (20.3%), being awake (43.1%), curiosity (2.2%), energy levels (23.1%), exams (13.8%), sports (8.7%), fatigue (6.9%), and health (2.3%). There was a strong association (p ≤ 0.05) between energy drink usage and sports activities amongst pupils. Conclusions: It is concluded that health education and promotion intervention programmes are required to educate pupils about the dangers of energy drink usage to prevent public health risks. Further studies, including research on primary school pupils, are necessary, considering that a substantial number of pupils were exposed to energy drinks at an early age.

Effect of energy drinks on the surface microhardness of bulk fill resins. In vitro study

Background

The study aimed to compare the surface changes of Filtek Z350XT, Filtek Bulk Fill, and Opus Bulk Fill resins immersed in Maltin Power® and Volt® energy drinks using surface microhardness testing.

Material and Methods

This experimental study evaluated two types of bulk fill resins and Filtek resin (control). Forty-eight resin discs measuring 4x4 mm were prepared and soaked in 20 ml of an energy drink for 10 minutes daily for 7 and 30 days. Surface microhardness was assessed using the Vickers microhardness method. Repeated samples were analyzed using the ANOVA test, and multiple comparisons were conducted using the Bonferroni test. Finally, the Kruskal-Wallis test also was applied (P< 0.05).

Results

The decrease in surface microhardness of the three resins exposed to the two energy drinks was significant (P<0.05). After immersion in the Volt energy drink over 30 days, the Filtek Z350XT, Filtek Bulk Fill, and Opus Bulk Fill resins showed decreases in surface microhardness of 3.89±1.94; 7.74±4.66 and 5.86±3.17, respectively, while the respective decreases after immersion in the Maltin Power energy drink were 3.67±4.08, 5.70±0.99, and 3.23±1.76.

Conclusions

Immersion in the energy drinks changed the surface microhardness of bulk fill resins after 7 and 30 days. Both clinicians and patients should consider these findings when determining the consumption frequency of these beverages. Key words:Energy drink, hardness test, composite resins.

Altered gut microbial profiles in drug-treated rats with alcoholic heart disease

Introduction. Alcohol abuse can lead to significant cardiac injury, resulting in Alcoholic heart disease (AHD). The interplay between cardiac health and gut microbiota composition in the context of alcohol consumption is not well understood.Hypothesis. Shen Song Yang Xin (SSYX) capsule and amiodarone are common drugs used to treat alcoholic heart disease, but little is known about their microbial regulatory mechanisms in alcoholic heart disease.Aim. To investigate the effects of SSYX and amiodarone on cardiac injury and gut microbiota composition in a rat model of AHD induced by alcohol consumption.Methodology. We evaluated body weight, cardiac function, changes in gut morphology, and gut microbiota composition to assess the effects of SSYX and amiodarone on AHD.Results. Alcohol consumption significantly reduced body weight and aggravated cardiac fibrosis. However, SSYX attenuated fibrosis and improved cardiac function. SSYX also improved intestinal morphological changes caused by chronic alcoholism and activated the expression of ZO-1 and occludin, which are important in maintaining intestinal barrier function. The gut microbiota composition was altered in rats with AHD, with an increase in Actinobacteria abundance. Both SSYX and amiodarone affected the gut microbiota composition, and their effects were positively correlated. SSYX plays a protective role against heart injury caused by alcohol consumption. It improves cardiac function, intestinal morphological changes and gut microbiota composition.Conclusion. SSYX and amiodarone may have potential therapeutic options for AHD. Actinobacteria/Firmicutes ratio and the abundance of Christensenellaceae R7 group, norank_flachnospiraceae and Roseburia may serve as potential biomarkers for detecting alcoholic heart disease.

Thermogenic preworkout supplement induces alveolar bone loss in a rat model of tooth movement via RANK/RANKL/OPG pathway

The aim of this study was to investigate the effect of thermogenic supplementation on the bone tissue of rats subjected to orthodontic movement. A total of 38 male Wistar rats underwent orthodontic movement of the left permanent maxillary first molars for 21 days. The rats were assigned to three groups: Control group: water; Thermogenic 1: C4 Beta Pump thermogenic; or Thermogenic 2: PRE-HD/Pre-workout. Micro-computed tomography (micro-CT) was used to investigate the dynamic changes in the microstructure of alveolar bone during orthodontic tooth movement in rats. Histopathologic analysis was performed by hematoxylin and eosin (H&E) staining, whereas tartrate-resistant acid phosphatase (TRAP) was employed for osteoclast count. Maxillary tissue was collected and evaluated by immunohistochemistry for receptor activator of NF-κB (RANK), receptor activator of NF-κB ligand (RANKL), and osteoprotegerin (OPG). The Thermogenic 2 group exhibited a significantly lower percentage of bone volume fraction (BV/TV) (68.21% ± 17.70%) compared to the control (86.84% + 12.91%) and Thermogenic 1 groups (86.84% + 15.94%) (p < 0.05). The control group had a significantly higher mean orthodontic movement in the mesial direction (0.2143 mm + 0.1513 mm) than the Thermogenic 2 group (0.0420 mm + 0.05215 mm) (p < 0.05). The Thermogenic 2 and Thermogenic 1 groups showed a stronger immunostaining for RANKL when compared to the control group (p < 0.05). The supplementation used in the Thermogenic 2 group (PRE-HD/Pre-workout) induced alveolar bone loss in rats subjected to orthodontic movement, which can be related to the regulation of the RANK/RANKL/OPG signaling pathway. This suggests the influence of thermogenic supplements on bone metabolism seems to depend on their composition.

Nutritional Risks of Heavy Metals in the Human Diet-Multi-Elemental Analysis of Energy Drinks

Background: In recent years, the consumption of energy drinks (EDs) by adolescents and young adults has increased significantly, so concerns have been raised about the potential health risks associated with excessive ED consumption. Most analyses on EDs focus on the caffeine content. Research on the content of minerals (essential and toxic) in energy drinks can be considered scarce. Therefore, there is a need for research stating the actual status of heavy metal content in commercially available energy drinks. Methods: This research presents the determination of the total concentrations of macro-elements and trace elements (TEs), such as Na, K, Mg, Ca, Al, Cr, Co, Cu, Fe, Mn, Ni, B, Zn, V, Sr, Ba, Pb, Cd, and As in nine samples of energy drinks using inductively coupled plasma optical emission spectrometry (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS) techniques. Results: The order in the content of macro-minerals in the EDs was as follows: Na > K > Mg > Ca. The results showed that ED 1, ED 3, and ED 7 samples had the highest micro-mineral concentrations. All the samples had a hazard quotient and hazard index < 1, indicating no non-carcinogenic risk from exposure to single or multiple heavy metals in both the adolescent and adult age groups. Some samples exceeded the threshold limit of acceptable cancer risk for As, Ni, and Cr in both adolescents and adults. Conclusions: This assessment showed that in addition to health implications based on the caffeine content of EDs, there might be a carcinogenic risk associated with the toxic element content of these beverages. This research also highlights notable differences in the TE levels among various ED brands, which may have important implications for consumer well-being and health.

Taurine stimulation of planarian motility: a role for the dopamine receptor pathway

Taurine, a normal dietary component that is found in many tissues, is considered important for a number of physiological processes. It is thought to play a particular role in eye development and in the maturation of both the muscular and nervous systems, leading to its suggested use as a therapeutic for Alzheimer's and Parkinson's diseases. Taurine increases metabolism and has also been touted as a weight loss aid. Due to its possible benefits to health and development, taurine is added as a supplement to a wide array of products, including infant formula and energy drinks. Despite its pervasive use as a nutritional additive and implied physiological actions, there is little consensus on how taurine functions. This is likely because, mechanistically, taurine has been demonstrated to affect multiple metabolic pathways. Simple models and straightforward assay systems are required to make headway in understanding this complexity. We chose to begin this work using the planarian because these animals have basic, well-understood muscular and nervous systems and are the subjects of many well-tested assays examining how their physiology is influenced by exposure to various environmental, nutritional, and therapeutic agents. We used a simple behavioral assay, the planarian locomotor velocity test (pLmV), to gain insight into the stimulant properties of taurine. Using this assay, we observed that taurine is a mild stimulant that is not affected by sugars or subject to withdrawal. We also provide evidence that taurine makes use of the dopamine D1 receptor to mediate this stimulant effect. Given the pervasiveness of taurine in many commercial products, our findings using the planarian system provide needed insight into the stimulant properties of taurine that should be considered when adding it to the diet.

[Successful resuscitation after energy drink consumption in a patient with unknown right ventricular dysplasia]

This case report describes a 28-year-old man who successfully underwent cardiopulmonary resuscitation (CPR) for ventricular fibrillation after consuming an energy drink containing a nonlethal dose of caffeine. The caffeine-naive patient, without previously known diseases, had rapidly drunk 3 cans of an energy drink (480 mg caffeine, i.e., an amount he had never consumed before according to his own statement) after a football training before he collapsed lifelessly and required resuscitation. After successful CPR, the patient was admitted to the intensive care unit and extubation was carried out on the following day. In parallel, differential diagnostic cardiological procedures were carried out. These revealed a previously unknown right ventricular dysplasia, so that after exclusion of an accessory atrioventricular conduction pathway in the electrophysiological examination, a single chamber implantable cardioverter defibrillator (ICD) for secondary prevention was implanted. The patient was discharged home without neurological deficits on day 14 after hospital admission. This case presentation is intended to show that the consumption of caffeine-containing energy drinks, even in a nonlethal dose, can be potentially dangerous in the presence of an unknown cardiac disease, even if physical performance is not impaired.

Consumption of energy drinks among medical university students in Kazakhstan

OBJECTIVES

Due to lack of information and deceptive advertising, young people widely consume energy drinks, although they should be careful because of their contents. Energy drinks contain high amounts of caffeine, sugar, and other additives that can stimulate the body. They can cause irritability, anxiety, insomnia and can increase heart rate, blood pressure and respiratory rate. Aim of this research was to study consumption of energy drinks among medical university students in Kazakhstan.

METHODS

Cross-sectional study was conducted. A web-based questionnaire was used to collect information. Students enrolled in various courses at the medical university, including interns and residents, were invited to participate. A total of 764 respondents took part in the survey.

RESULTS

Among the trainees, 41.4 % had consumed caffeinated energy drinks in the past six months, and at the time of the survey, 16.2 % of the respondents had consumed these drinks. Respondents who do not drink alcohol are 3 times (p<0.001) more likely not to use energy drinks compared to those who drink alcohol. Those who do not exercise are 4.7 times (p<0.001) more likely not to consume energy drinks compared to active athletes. Participants who had not consumed caffeinated energy drinks in the past six months were 1.8 times (p<0.001) more likely not to consume energy drinks compared to those who drank them.

CONCLUSIONS

Consumption of energy drinks by students can temporarily increase physical and mental performance, improve mood and raise energy levels, while at the same time, they also come with serious health risks. Therefore, educating students about the potential risks and the importance of a healthy lifestyle is essential.

Dietary Strategies in the Prevention and Treatment of Hypertension in Children and Adolescents: A Narrative Review

This study aims to gather information on effective dietary strategies for the prevention and treatment of hypertension (HTN) in children and adolescents. It discusses specific nutritional models such as the Diet Approaches to Stop Hypertension (DASH diet), traditional Asian diets, plant-based diets, the Southern European traditional Atlantic diet, and the Mediterranean diet, highlighting the benefits of these approaches. The manuscript also addresses dehydration resulting from insufficient fluid intake among children, as well as the consumption of inappropriate beverages, like soft drinks and energy drinks, which contributes to the development of HTN. Additionally, it examines the role of oxidative stress in the pathomechanism of HTN in children, particularly in relation to the antioxidant potential of food components such as selenium, magnesium, and selected vitamins. The relationship between sodium and potassium intake from food and the development of HTN in children is also explored. Finally, this study discusses public health strategies for the prevention of HTN in children. A comprehensive search was performed across multiple databases, such as PubMed/MEDLINE, the Cochrane Library, Science Direct, and EBSCO. This search focused on locating English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies from around the globe.

Effects of Energy Drink Consumption on Specific Cardiovascular and Psycho-Behavioral Parameters Among Medical Students at the University of Zakho

Background The consumption of energy drinks (EDs) among university students has become a prevalent trend, raising concerns about potential health risks. EDs are beverages containing various ingredients, most notably caffeine, taurine, and vitamins, that are consumed by the general public and athletes to reduce exhaustion, boost energy, and improve performance. Objectives This study aimed to investigate the prevalence of ED consumption and evaluate the effects of ED use on cardiovascular health and behavioral patterns in a sample of students at the University of Zakho. Methods This cross-sectional study involved a sample of 438 medical students aged 18-25 at the University of Zakho. Data were collected using a closed-ended questionnaire assessing socio-demographic characteristics, ED consumption habits, awareness of ED-related health risks, and cardiovascular measures such as blood pressure, pulse rate, presence of chest pain, and palpitation. Results The prevalence of consuming caffeine-content EDs was surprisingly high (70%, n=307) among the University of Zakho's medical students. Further categorization revealed that the prevalence was 42% (n=187) among low-frequency drinkers, 22.2% (n=95) among those who drank once a day, and 5.8% (n=25) among the frequent group. A higher percentage of ED drinkers (30%, n=92) developed tachycardia compared to students with a normal pulse (19.2%, n=59). Additionally, ED drinkers had significantly higher rates of elevated blood pressure (56.4%, n=173), palpitations (63.1%, n=194), and chest discomfort (73.2%, n=225) compared to non-drinkers (p <0.0001). Concerning behavioral characteristics, ED drinkers had a significantly higher rate of fatigability (79.3%, n=243) compared to non-drinkers (p <0.0001). They were more likely to experience somnolence (60.8%, n=187) compared to non-drinkers (p <0.05). Furthermore, the percentage of students with aggressive behavior was substantially higher (p <0.001) among ED drinkers (86.2%, n=265). Conclusion The findings collectively highlight the significant negative impact of energy drink consumption on health in general and cardiovascular and behavioral variables in particular. It also underscores the need for public health strategies and campus interventions to reduce ED consumption and raise awareness about their potential risks.

Acute Cardiovascular Effects of Simultaneous Energy Drink and Alcohol Consumption in Young Adults: A Review of Case Reports

(1) Background: The aim of this review was to identify and summarize adverse cardiovascular health events associated with the simultaneous consumption of energy drinks (ED) and alcohol. Potential prevention strategies and the implementation of research toward the underlying mechanisms for these pathologies were highlighted to emphasize the need for further investigation and to encourage more attention to this field. (2) Methods: The PubMed database was searched for case reports linked with adverse cardiovascular events after simultaneous ED and alcohol consumption. Inclusion criteria were: the reported age of the patient is between 16 and 35 years and confirmed co-consumption of EDs and alcohol. All relevant articles that met the inclusion criteria were fully read and all relevant data was extracted. The extracted data was summarized and presented in this review of cases. (3) Results: In total, 10 cases were identified. The analysis showed that mainly young adults (median age = 24.5 years), in particular men (80%) were affected. The three parts of the cardiovascular system affected were heart rhythm (42%), myocardial function (33%), and coronary arteries (25%). In 3 cases the outcome was fatal. Moreover, preexisting health conditions and/or potential trigger factors were present in 60% of selected cases. (4) Conclusions: This review of case reports suggests that the simultaneous consumption of EDs and alcohol can lead to adverse cardiovascular health events and even incidents with fatal outcomes were reported. Potential trigger factors and preexisting health conditions seem to increase the probability of adverse cardiovascular health events. Consumers should be informed about the potential risks and follow responsible consumption behavior to prevent future health events. More systematic studies are needed to determine the acute effects on the cardiovascular system in young adults.

Soft and energy drinks consumption and associated factors in Saudi adults: a national cross-sectional study

Introduction

The consumption of soft and energy drinks poses a significant risk for non-communicable diseases, such as diabetes and heart disease. Studies in Saudi Arabia have reported elevated consumption of soft/energy drinks, but nation-wide data is not available. Therefore, this study aims to explore the prevalence of soft and energy drinks consumption and its associated factors among a representative sample of Saudi adults.

Methods

The present research is a secondary data analysis of the 2021 Sharik Diet and Health National Survey (SDHNS). Current analysis used data on socio-demographics, anthropometrics, physical activity, and soft and energy drink consumption. The frequency of soft and energy drinks consumption is assessed on a weekly basis.

Results

Of the 5,194 Saudi adults, 3,928 were analyzed. Overall, 67% consumed soft drinks weekly, while 30% consumed energy drinks weekly. In multiple logistic regression, consumption of either soft drinks or energy drinks was associated with males, a younger age, lower income, and lower physical activity. Individuals with overweight or obesity were less likely to consume energy drinks [OR (95%CI): 0.83 (0.71, 0.99) and 0.73 (0.60, 0.90), respectively] than those with healthy weight. However, education level was not associated with either soft or energy drink consumption. These findings highlight the need for targeted interventions designed to reduce soft and energy drinks consumption in Saudi adults.