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Aonso-Diego G, Krotter A, García-Pérez Á. Prevalence of energy drink consumption world-wide: A systematic review and meta-analysis. Addiction 2024; 119:438-463. [PMID: 37967848 DOI: 10.1111/add.16390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/27/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND AND AIMS The increasing market for energy drinks (EDs) in recent years, as well as the health risks caused by their consumption, prompt calls to estimate the prevalence of ED use among different countries. This systematic review and meta-analysis aimed to synthesize the prevalence of ED use in different continents and age groups. METHOD We searched two databases (i.e. PubMed and PsycInfo) on 31 March 2023 to identify studies reporting the prevalence of ED use. A total of 192 studies (196 distinct samples; n = 1 120 613; 53.37% males) from the United States, Europe, Asia, Oceania and Africa were included in the analysis. A random-effects model was applied to estimate the overall pooled prevalence at several time-periods. Subgroup analyses were performed to provide prevalence based on continent and age group. The quality of articles was assessed using Joana Brigg's Institute (JBI) critical appraisal checklist. Measurements included prevalence of ED use (i.e. life-time, past 12 months, past 30 days, past 7 days and daily use), continent and age group (i.e. children, adolescents, young adults and adults). RESULTS The life-time ED use world-wide-pooled prevalence was estimated to be 54.7% [95% confidence interval (CI) = 48.8-60.6; I2 = 99.80], 43.4% (95% CI = 36.1-50.6; I2 = 99.92) in the past 12 months, 32.3% (95% CI = 28.8-35.8; I2 = 99.82) in the past 30 days, 21.6% (95% CI = 18.7-24.5; I2 = 99.95) in the past 7 days and 8.82% (95% CI = 6.3-11.4; I2 = 99.95) daily ED use. Subgroups analyses showed significant differences in ED life-time use within age groups (P = 0.002) and continents (P = 0.035). CONCLUSIONS The world-wide prevalence of energy drink use appears to be high, particularly among adolescents and young adults.
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Affiliation(s)
| | - Andrea Krotter
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Ángel García-Pérez
- Department of Psychology, Sociology and Philosophy, University of León, León, Spain
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Chabal S, Folstein JR, Chinoy ED, Markwald RR, Lieberman HR. Caffeine consumption and sleep in a submarine environment: An observational study. J Sleep Res 2023; 32:e13901. [PMID: 37020175 DOI: 10.1111/jsr.13901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 04/07/2023]
Abstract
Submariners face many environmental and operational challenges to maintaining good sleep, including suboptimal lighting, shift work, and frequent interruptions. Anecdotally, many Sailors consume caffeine to alleviate the effects of poor sleep on alertness, mood, and performance; however, caffeine itself may also degrade sleep quantity and/or quality. This study provides the first exploration of the potential relationship between caffeine use and sleep onboard submarines. Objective measures (wrist actigraphy, available from 45 participants), self-report sleep metrics, and self-reported caffeine consumption were collected from 58 US Navy Sailors before and during a routine submarine underway at sea lasting 30 days. Contrary to expectations, less caffeine was reportedly consumed at sea (232.8 ± 241.1 mg) than on land prior to the underway (M = 284.4 ± 251.7 mg; X2 (1) = 7.43, p = 0.006), positive rather than negative relationships were observed between caffeine consumption and sleep efficiency (F = 6.11, p = 0.02), and negative relationships were observed between caffeine consumption and wake after sleep onset (F = 9.36, p = 0.004) and sleep fragmentation (F = 24.73, p < 0.0001). However, in contrast, higher caffeine consumption was also negatively related to self-reported sleep duration while at sea (F = 4.73, p = 0.03). This observational study is the first to measure relationships between caffeine consumption and sleep quantity and/or quality in a submarine environment. We propose that the unique submarine environment and the unique caffeine consumption patterns of submariners should be considered in the development of potential countermeasures for sleepiness.
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Affiliation(s)
- Sarah Chabal
- Naval Submarine Medical Research Laboratory, Groton, Connecticut, USA
- Leidos, Inc., Reston, Virginia, USA
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA
| | - Jonathan R Folstein
- Naval Submarine Medical Research Laboratory, Groton, Connecticut, USA
- Leidos, Inc., Reston, Virginia, USA
| | - Evan D Chinoy
- Leidos, Inc., Reston, Virginia, USA
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA
| | - Rachel R Markwald
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, California, USA
| | - Harris R Lieberman
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
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3
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Gonzalez DE, McAllister MJ, Waldman HS, Ferrando AA, Joyce J, Barringer ND, Dawes JJ, Kieffer AJ, Harvey T, Kerksick CM, Stout JR, Ziegenfuss TN, Zapp A, Tartar JL, Heileson JL, VanDusseldorp TA, Kalman DS, Campbell BI, Antonio J, Kreider RB. International society of sports nutrition position stand: tactical athlete nutrition. J Int Soc Sports Nutr 2022; 19:267-315. [PMID: 35813846 PMCID: PMC9261739 DOI: 10.1080/15502783.2022.2086017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Drew E. Gonzalez
- Exercise & Sport Nutrition Laboratory, Human Clinical Research Facility, Department of Health & Kinesiology Texas A&M University, College Station, TX, USA
| | - Matthew J. McAllister
- Texas State University, Metabolic and Applied Physiology Laboratory, Department of Health & Human Performance, San Marcos, TX, USA
| | - Hunter S. Waldman
- University of North Alabama, Department of Kinesiology, Florence, AL, USA
| | - Arny A. Ferrando
- University of Arkansas for Medical Sciences, Department of Geriatrics, Little Rock, AR, USA
| | - Jill Joyce
- Oklahoma State University, Department of Nutritional Sciences, Stillwater, OK, USA
| | - Nicholas D. Barringer
- US. Army-Baylor Master’s Program in Nutrition, Department of Nutrition, San Antonio, TX, USA
| | - J. Jay Dawes
- Oklahoma State University, Department of Kinesiology, Applied Health, and Recreation, Stillwater, OK, USA
| | - Adam J. Kieffer
- Brooke Army Medical Center, Department of Nutritional Medicine, San Antonio, TX, USA
| | - Travis Harvey
- United States Special Operations Command, Preservation of the Force and Family, Tampa, FL, USA
| | - Chad M. Kerksick
- Lindenwood University, Exercise and Performance Nutrition Laboratory, College of Science, Technology, and Health, St. Charles, MO, USA
| | - Jeffrey R. Stout
- University of Central Florida, Institute of Exercise Physiology and Rehabilitation Sciences, School of Kinesiology and Physical Therapy, Orlando, FL, USA
| | | | | | - Jamie L. Tartar
- Nova Southeastern University, Department of Psychology and Neuroscience, Fort Lauderdale, FL, USA
| | - Jeffery L. Heileson
- Baylor University, Department of Health, Human Performance, and Recreation, Waco, TX, USA
| | | | - Douglas S. Kalman
- Dr. Kiran C Patel College of Osteopathic Medicine, Nova Southeastern University, Nutrition Department, Davie, FL, USA
| | - Bill I. Campbell
- University of South Florida, Performance & Physique Enhancement Laboratory, Exercise Science Program, Tampa, FL, USA
| | - Jose Antonio
- Fight Science Laboratory, Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Richard B. Kreider
- Exercise & Sport Nutrition Laboratory, Human Clinical Research Facility, Department of Health & Kinesiology Texas A&M University, College Station, TX, USA
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Knapik JJ, Steelman RA, Trone DW, Farina EK, Lieberman HR. Prevalence of caffeine consumers, daily caffeine consumption, and factors associated with caffeine use among active duty United States military personnel. Nutr J 2022; 21:22. [PMID: 35421992 PMCID: PMC9008906 DOI: 10.1186/s12937-022-00774-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Although representative data on caffeine intake in Americans are available, these data do not include US service members (SMs). The few previous investigations in military personnel largely involve convenience samples. This cross-sectional study examined prevalence of caffeine consumers, daily caffeine consumption, and factors associated with caffeine use among United States active duty military service members (SMs).
Methods
A stratified random sample of SMs were asked to complete an on-line questionnaire on their personal characteristics and consumption of caffeinated products (exclusive of dietary supplements). Eighteen percent (n = 26,680) of successfully contacted SMs (n = 146,365) completed the questionnaire.
Results
Overall, 87% reported consuming caffeinated products ≥1 time/week. Mean ± standard error per-capita consumption (all participants) was 218 ± 2 and 167 ± 3 mg/day for men and women, respectively. Caffeine consumers ingested 243 ± 2 mg/day (251 ± 2 mg/day men, 195 ± 3 mg/day women). On a body-weight basis, men and women consumed respectively similar caffeine amounts (2.93 vs 2.85 mg/day/kg; p = 0.12). Among individual caffeinated products, coffee had the highest use (68%), followed by sodas (42%), teas (29%), energy drinks (29%) and gums/candy/medications (4%). In multivariable logistic regression, characteristics independently associated with caffeine use (≥1 time/week) included female gender, older age, white race/ethnicity, higher body mass index, tobacco use or former use, greater alcohol intake, and higher enlisted or officer rank.
Conclusion
Compared to National Health and Nutrition Examination Survey data, daily caffeine consumption (mg/day) by SMs was higher, perhaps reflecting higher mental and physical occupational demands on SMs.
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Baygi F, Mohammadi-Nasrabadi F, Zyriax BC, Jensen OC, Bygvraa DA, Oldenburg M, Nielsen JB. Global overview of dietary outcomes and dietary intake assessment methods in maritime settings: a systematic review. BMC Public Health 2021; 21:1579. [PMID: 34419000 PMCID: PMC8379789 DOI: 10.1186/s12889-021-11593-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 08/03/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Seafaring is a risky occupation with high prevalence of risk factors for non-communicable diseases. Food intake and eating habits are important cornerstones regarding health and health promotion. The aim of this study was to provide an overview of dietary intake and dietary intake assessment methods of seafarers and suggestions for applicable assessment tools. METHODS We systematically searched PubMed and NLM Gateway (for MEDLINE), Web of Science, and SCOPUS up to February 2020 using standard keywords including nutrition OR diet OR meal AND maritime settings. Two independent reviewers extracted the data. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal checklist. RESULTS From 4449 studies initially identified, 26 articles were included in the final review. Qualitative data (e.g. on unhealthy eating) had been gathered using in-depth individual or group interviews, participant observations, and phone-based chats. Composition of menu analysis, 24 h dietary recall, food diaries/ diet records, dietary habits questionnaire, food stores and food waste of the ship were used to assess the quantitative outcomes (e.g. dietary intakes). Access to meat, processed meat and egg, frozen and canned food items, sugary drinks, alcohol, greasy and salty food was high. In contrast, consumption of fruit, vegetables, dairy products, and cereals was lower than recommended. CONCLUSIONS Eating habits and dietary intakes in maritime settings are unhealthy. Subjective dietary assessment methods combining menu analysis with new technologies (e.g. mobile-based) might be an applicable method in this hard to reach setting which is the vessels.
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Affiliation(s)
- Fereshteh Baygi
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - Fatemeh Mohammadi-Nasrabadi
- Food and Nutrition Policy and Planning Research Department, National Nutrition and Food Technology Research Institute (NNFTRI), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Birgit-Christiane Zyriax
- Midwifery Science - Health Care Research and Prevention, IVDP, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf Chresten Jensen
- Centre of Maritime Health and Society, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Despena Andrioti Bygvraa
- School of Community Medicine and Public Health, Department of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Marcus Oldenburg
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jesper Bo Nielsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Chaudhary NS, Taylor BV, Grandner MA, Troxel WM, Chakravorty S. The effects of caffeinated products on sleep and functioning in the military population: A focused review. Pharmacol Biochem Behav 2021; 206:173206. [PMID: 34000324 DOI: 10.1016/j.pbb.2021.173206] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
Military personnel rely on caffeinated products such as coffee or energy drinks (ED) to maintain a maximal level of vigilance and performance under sleep-deprived and combat situations. While chronic caffeine intake is associated with decreased sleep duration and non-restful sleep in the general population, these relationships are relatively unclear in the military personnel. We conducted a focused review of the effects of caffeinated products on sleep and the functioning of military personnel. We used a pre-specified search algorithm and identified 28 peer-reviewed articles published between January 1967 and July 2019 involving military personnel. We classified the findings from these studies into three categories. These categories included descriptive studies of caffeine use, studies evaluating the association between caffeinated products and sleep or functioning measures, and clinical trials assessing the effects of caffeinated products on functioning in sleep-deprived conditions. Most of the studies showed that military personnel used at least one caffeine-containing product per day during active duty and coffee was their primary source of caffeine. Their mean caffeine consumption varied from 212 to 285 mg/day, depending on the type of personnel and their deployment status. Those who were younger than 30 years of age preferred ED use. Caffeine use in increasing amounts was associated with decreased sleep duration and increased psychiatric symptoms. The consumption of caffeinated products during sleep deprivation improved their cognitive and behavioral outcomes and physical performance. Caffeine and energy drink consumption may maintain some aspects of performance stemming from insufficient sleep in deployed personnel, but excessive use may have adverse consequences.
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Affiliation(s)
- Ninad S Chaudhary
- University of Alabama at Birmingham School of Public Health, Birmingham 35233, USA
| | - Brittany V Taylor
- Liberty University College of Osteopathic Medicine, Lynchburgh, VA 24502, USA
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ 85724-5002, USA
| | - Wendy M Troxel
- RAND Corporation, Pittsburgh, PA 15213, USA; University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Subhajit Chakravorty
- Cpl. Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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7
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Lieberman HR, Agarwal S, Caldwell JA, Fulgoni VL. Demographics, sleep, and daily patterns of caffeine intake of shift workers in a nationally representative sample of the US adult population. Sleep 2021; 43:5599823. [PMID: 31628471 DOI: 10.1093/sleep/zsz240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/26/2019] [Indexed: 01/30/2023] Open
Abstract
STUDY OBJECTIVE Caffeine is the most widely consumed stimulant in the world, and sociodemographic factors including occupation are associated with intake. Shift work, required in various occupations, is associated with poor sleep, inadequate diet, and adverse health effects. Using a large nationally representative database, demographics, sleep, and caffeine intake of US adults working various shifts were assessed. METHODS The 24-hour dietary recall data from NHANES 2005-2010 (N = 8,500) were used to estimate caffeine intake from foods and beverages. Work shifts were self-reported as follows: regular day shift; evening shift; night shift; rotating shift; or other shift. Regression analyses assessed associations of shift work with caffeine intake after adjustment for sociodemographic factors. RESULTS Approximately 74% of employed adults were day-shift workers and 26% were nonday-shift workers. Night-shift workers slept for 6.25 ± 0.09 hours per day, somewhat less than day-shift workers who only slept 6.83 ± 0.02 hours (p < .0001). Mean 24-hour weekday caffeine intake of evening-, night-, and rotating-shift workers (217 ± 23, 184 ± 19, and 206 ± 15 mg, respectively) was similar (p > .3) to day-shift workers (203 ± 5 mg). Regardless of work schedule, individuals consumed the most caffeine during morning hours. Evening- and night-shift workers reported consuming 36%-46% less caffeine during their work hours and 72%-169% more during nonwork hours than day-shift workers (p < .01). CONCLUSIONS Total daily caffeine intake of shift workers is similar to nonshift workers; most caffeine is consumed in the morning regardless of shift. Because shift workers consume less caffeine during regular work hours and more during nonwork hours than day workers, they may be using caffeine to, in part, optimize off-duty alertness.
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Affiliation(s)
- Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Sanjiv Agarwal
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
| | - John A Caldwell
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
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8
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Pizzey FK, Tourula E, Pearson J. Tolerance to Central Hypovolemia Is Greater Following Caffeinated Coffee Consumption in Habituated Users. Front Physiol 2020; 11:50. [PMID: 32116762 PMCID: PMC7013032 DOI: 10.3389/fphys.2020.00050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/21/2020] [Indexed: 11/13/2022] Open
Abstract
We investigated the influence of caffeinated coffee consumption on cardiovascular responses and tolerance to central hypovolemia in individuals habituated to caffeine. Thirteen participants completed three trials, consuming caffeinated coffee, decaffeinated coffee or water before exposure to central hypovolemia via lower body negative pressure (LBNP) to pre syncope. Tolerance to central hypovolemia was quantified as cumulative stress index (CSI: LBNP level multiplied by time; mmHg × min). Prior to the consumption of caffeinated coffee, decaffeinated coffee, and water, heart rate (HR: 62 ± 10, 63 ± 9 and 61 ± 8 BPM, respectively), stroke volume (SV: 103 ± 23, 103 ± 17 and 102 ± 18 mL/beat, respectively), and total peripheral resistance (TPR: 14.2 ± 3.0, 14.0 ± 3.0, and 14.3 ± 2.7 mmHg/L/min, respectively), were not different between trials (all P > 0.05). Mean arterial pressure (MAP) increased following consumption of all drinks (Post Drink) (Caffeinated coffee: from 86 ± 8 to 97 ± 7; Decaffeinated coffee: from 88 ± 10 to 94 ± 7; and Water: from 87 ± 10 to 96 ± 6 mmHg; all P = 0.0001) but was not different between trials (P = 0.247). During LBNP, HR increased (P = 0.000) while SV decreased (P = 0.000) relative to post drink values and TPR as unchanged (P = 0.109). HR, SV, and TPR were not different between trials (all P > 0.05). MAP decreased at pre syncope in all trials (60 ± 5, 60 ± 7, and 61 ± 6 mmHg; P < 0.001). LBNP tolerance was greater following caffeinated coffee (914 ± 309 mmHg × min) relative to decaffeinated coffee and water (723 ± 336 and 769 ± 337 mmHg × min, respectively, both P < 0.05). Tolerance to central hypovolemia was greater following consumption of caffeinated coffee in habituated users.
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Affiliation(s)
- Faith K Pizzey
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Erica Tourula
- Department of Biology, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - James Pearson
- Department of Human Physiology and Nutrition, University of Colorado Colorado Springs, Colorado Springs, CO, United States
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Patocka J, Navratilova Z, Krejcar O, Kuca K. Coffee, Caffeine and Cognition: a Benefit or Disadvantage? LETT DRUG DES DISCOV 2019. [DOI: 10.2174/1570180816666190620142158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Coffee, one of the world’s most consumed products, is extracted from the roasted seeds of
Coffea sp., a plant native to Africa. The effects of coffee on the human body have been recognized
for centuries and have now become the subject of systematic research. Caffeine’s impact on a
person’s cognitive ability was reviewed through a large set of literature related to the subject.
Learning and memory tasks are not typically influenced by caffeine when it comes to performance.
However, in some cases, it has been used to produce inhibitory or facilitatory effects on learning
and/or memory. Caffeine facilitates performance in tasks involving the working memory, but it has
been seen that tasks that rely on working memory may be hindered because of it. Moreover, caffeine
can augment the performance of memory during times where a person’s alertness is suboptimal at
best. However, a large body of research points to an improvement in reaction time. Consuming it has
little to no impact on long-term memory. Caffeine can be taken as a mild stimulant, proven by its
effect on performance in the context of subjects who are tired or fatigued. In some cases, it has been
observed that caffeine prevents cognitive decline, specifically when it comes to healthy subjects;
however, these results are heterogeneous at best. While drinking coffee positively influences both
physical and mental capacity, caffeine cannot and should not be viewed as an “absolute” enhancer of
cognitive function. Existing literature shows that the impact it causes on an individual is complex,
and can alter, for example, anxiety, performance and arousal.
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Affiliation(s)
- Jiri Patocka
- Faculty of Health and Social Studies,, University of South Bohemia Ceske Budejovice, Institute of Radiology, Toxicology and Civil Protection, Ceske Budejovice, Czech Republic
| | - Zdenka Navratilova
- Department of Botany, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Ondrej Krejcar
- University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Biomedical Research Centre, University Hospital, Hradec Kralove, Czech Republic
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McLean CP, Zandberg L, Roache JD, Fitzgerald H, Pruiksma KE, Taylor DJ, Dondanville KA, Litz BT, Mintz J, Young-McCaughan S, Yarvis JS, Peterson AL, Foa EB, Strong Star Consortium FT. Caffeine Use in Military Personnel With PTSD: Prevalence and Impact on Sleep. Behav Sleep Med 2019; 17:202-212. [PMID: 28609150 DOI: 10.1080/15402002.2017.1326920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Caffeine use is highly prevalent among active duty military personnel and can be beneficial to performance in the short term. However, regular caffeine use has been found to contribute to sleep disturbances, which are elevated among the significant number of military personnel with posttraumatic stress disorder (PTSD). The current study is the first to examine caffeine use and its relationship with sleep disturbances in military personnel seeking treatment for PTSD. Participants: Active duty military personnel (N = 366) who had returned from deployments to Afghanistan or Iraq and were seeking treatment for PTSD. Methods: Pearson correlations were used to examine the relationships between caffeine use, sleep disturbances, and PTSD symptom clusters. Results: The majority of the sample (89%) reported some caffeine use, with coffee being the largest contributor to total caffeine intake. Contrary to hypotheses, higher caffeine use was associated with lower insomnia symptom severity; follow-up analysis indicated that this was due to elevated insomnia symptom severity in those reporting no caffeine use. Caffeine use was not associated with any other measures of sleep disturbance or with PTSD symptoms. Conclusions: Caffeine use was not associated with greater reported sleep disturbances in this sample, possibly because those with elevated insomnia symptom severity abstained from any caffeine, or because insomnia symptoms were elevated in this sample.
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Affiliation(s)
- Carmen P McLean
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laurie Zandberg
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John D Roache
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Hayley Fitzgerald
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kristi E Pruiksma
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, Texas
| | - Katherine A Dondanville
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Brett T Litz
- Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System, Boston, Massachusetts.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.,Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Jim Mintz
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Department of Epidemiology & Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Stacey Young-McCaughan
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jeffrey S Yarvis
- Headquarters, Carl R. Darnall Army Medical Center, Fort Hood, Texas
| | - Alan L Peterson
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, Texas.,Research & Development Service, South Texas Veterans Health Care System, San Antonio, Texas.,Department of Psychology, University of Texas at San Antonio, San Antonio, Texas
| | - Edna B Foa
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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11
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Sanjakdar SS, Flerlage WJ, Kang HS, Napier DA, Dougherty JR, Mountney A, Gilsdorf JS, Shear DA. Differential Effects of Caffeine on Motor and Cognitive Outcomes of Penetrating Ballistic-Like Brain Injury. Mil Med 2019; 184:291-300. [PMID: 30901408 DOI: 10.1093/milmed/usy367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/07/2018] [Indexed: 11/13/2022] Open
Abstract
This study assessed the effect of caffeine on neurobehavioral recovery in the WRAIR penetrating ballistic-like brain injury (PBBI) model. Unilateral frontal PBBI was produced in the right hemisphere of anesthetized rats at moderate (7%-PBBI) or severe (10%-PBBI) injury levels. Animals were randomly assigned to pretreatment groups: acute caffeine (25 mg/kg CAF gavage, 1 h prior to PBBI), or chronic caffeine (0.25 g/L CAF drinking water, 30 days prior to PBBI). Motor function was evaluated on the rotarod at fixed-speed increments of 10, 15, and 20 RPM. Cognitive performance was evaluated on the Morris water maze. Acute caffeine showed no significant treatment effect on motor or cognitive outcome. Acute caffeine exposure prior to 10%-PBBI resulted in a significantly higher thigmotaxic response compared to vehicle-PBBI groups, which may indicate caffeine exacerbates post-injury anxiety/attention decrements. Results of the chronic caffeine study revealed a significant improvement in motor outcome at 7 and 10 days post-injury in the 7%-PBBI group. However, chronic caffeine exposure significantly increased the latency to locate the platform in the Morris water maze task at all injury levels. Results indicate that chronic caffeine consumption prior to a penetrating TBI may provide moderate beneficial effects to motor recovery, but may worsen the neurocognitive outcome.
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Affiliation(s)
- Sarah S Sanjakdar
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
| | - William J Flerlage
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
| | - Hyun S Kang
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
| | - Douglas A Napier
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
| | | | - Andrea Mountney
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
| | - Janice S Gilsdorf
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
| | - Deborah A Shear
- Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD
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Daily Patterns of Caffeine Intake and the Association of Intake with Multiple Sociodemographic and Lifestyle Factors in US Adults Based on the NHANES 2007-2012 Surveys. J Acad Nutr Diet 2018; 119:106-114. [PMID: 30446428 DOI: 10.1016/j.jand.2018.08.152] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/19/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Caffeine increases alertness when consumed in single servings of various products including coffee, tea, soft drinks, and energy drinks. Although not a nutrient, caffeine is consumed by 90% of the adult population in the United States. OBJECTIVE This study examined the daily pattern of caffeine intake and its relationship to multiple demographic variables. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2012 (adults aged 19+ years; n=16,173) were used to determine the time of day at which caffeine is consumed and demographic factors associated with intake. Regression analyses characterized factors associated with caffeine intake including sex, age, ethnicity, education, smoking status, physical activity, employment status, total work hours, alcohol, and energy intake. RESULTS Mean adult per capita caffeine intake was 169±4 mg/d (mean±standard error). Most caffeine (70%) was consumed before noon, often at breakfast, and intake decreased progressively over the day, with little consumed after 9:00 pm. Intake was associated with age, ethnicity, smoking status, total calorie intake, and work hours (P<0.01) but not physical activity, economic status, education level, or employment status. Variables with the largest associations with intake were, respectively, ethnicity and age. Non-Hispanic black individuals consumed the smallest amounts (80±2 mg/d), non-Hispanic white individuals consumed the greatest amounts (194±3 mg/d), and Asian individuals (126±7 mg/d) and Hispanic individuals consumed intermediate amounts (127±3 mg/d). Middle-aged individuals (aged 50 to 54 years) consumed more caffeine (211±6 mg/d) than younger (107±4 mg/d, aged 20 to 24 years) and older individuals (153±4 mg/d, aged 75 to 79 years). CONCLUSION Most caffeine is consumed in the morning, when alertness is lowest, and very little in the evening before sleep. Ethnicity and age were the variables most strongly associated with intake; work hours, occupation, energy and alcohol intake, and smoking were also associated with intake. Because caffeine increases alertness, it is not surprising that its pattern of consumption and factors associated with its intake vary from those of most other food constituents.
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13
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Kullen C, Prvan T, O’Connor H. Dietary Supplement Use in Australian Army Personnel. Mil Med 2018; 184:e290-e297. [DOI: 10.1093/milmed/usy266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/26/2018] [Accepted: 09/19/2018] [Indexed: 02/04/2023] Open
Affiliation(s)
- Charina Kullen
- Australian Regular Army, Randwick Barracks, Sydney, NSW, Australia
- Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
| | - Tania Prvan
- Department of Statistics, Faculty of Science and Engineering, Macquarie University, Sydney, NSW, Australia
| | - Helen O’Connor
- Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
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14
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Caldwell JA, McGraw SM, Thompson LA, Lieberman HR. A Survey Instrument to Assess Intake of Dietary Supplements, Related Products, and Caffeine in High-Use Populations. J Nutr 2018; 148:1445S-1451S. [PMID: 31505679 DOI: 10.1093/jn/nxy124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/25/2018] [Accepted: 05/16/2018] [Indexed: 11/14/2022] Open
Abstract
Substantial data on the use of dietary supplements by the general adult population are available, but many population subgroups have not been extensively studied. Because military service members and young people consume large amounts of dietary supplements, including for enhancement of physical performance, weight control, and bodybuilding, which can be dangerous, we developed a comprehensive questionnaire to characterize patterns of supplement use in these and other populations. The questionnaire has been used to study >7000 military service members and 1000 college students. This supplement article presents a detailed description of the questionnaire, which contains comprehensive questions on demographic characteristics, exercise habits, attitudes with regard to dietary supplements, and amount of money spent on supplements. Intakes of specific dietary supplements and caffeine, frequency of use, and reasons for use are assessed. The questionnaire was designed for studying dietary supplement and caffeine intake patterns with the use of paper-and-pencil administration to military populations and was modified for use with college students and for computer and Web administration. It is available online at https://go.usa.gov/xn9FP and in the Supplemental File for this publication. It can be used to study other populations if minor modifications are made. The online version of the questionnairewill be updated periodically as newversions become available. In conclusion, a validated, detailed, noncopyrighted questionnaire designed to assess the use of dietary supplements, energy drinks (and related products), and caffeine is available for use in diverse populations. The format of the questionnaire is adaptable to computer administration and scoring, and it can be customized for specific subpopulations, locations, and product categories including updates that reflect changes in the availability of supplements or availability of new products.
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Affiliation(s)
| | - Susan M McGraw
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Lauren A Thompson
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA
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15
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McLellan TM, Riviere LA, Williams KW, McGurk D, Lieberman HR. Caffeine and energy drink use by combat arms soldiers in Afghanistan as a countermeasure for sleep loss and high operational demands. Nutr Neurosci 2018. [DOI: 10.1080/1028415x.2018.1443996] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Lyndon A. Riviere
- Military Psychiatry Branch, Center for Military Psychiatry and Neurosciences Research, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - Dennis McGurk
- United States Army Medical Research and Materiel Command, Ft Detrick, MD, USA
| | - Harris R. Lieberman
- Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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16
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Verster JC, Benson S, Johnson SJ, Alford C, Godefroy SB, Scholey A. Alcohol mixed with energy drink (AMED): A critical review and meta-analysis. Hum Psychopharmacol 2018; 33:e2650. [PMID: 29417616 PMCID: PMC5901036 DOI: 10.1002/hup.2650] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/21/2017] [Accepted: 12/15/2017] [Indexed: 01/27/2023]
Abstract
The purpose of this systematic review and meta-analysis was to critically review the (1) prevalence of alcohol mixed with energy drink (AMED) consumption, (2) motives for AMED consumption, (3) correlates of AMED consumption, and (4) whether AMED consumption has an impact on (a) alcohol consumption, (b) subjective intoxication, and (c) risk-taking behavior. Overall a minority of the population consumes AMED, typically infrequently. Motives for AMED consumption are predominantly hedonistic and social. Meta-analyses revealed that AMED consumers drink significantly more alcohol than alcohol-only (AO) consumers. Within-subject comparisons restricted to AMED consumers revealed that alcohol consumption does not significantly differ between typical AMED and AO occasions. On past month heaviest drinking occasions, AMED users consume significantly less alcohol on AMED occasions when compared to AO occasions. AMED consumers experience significantly fewer negative consequences and risk-taking behavior on AMED occasions compared with AO occasions. Meta-analyses of subjective intoxication studies suggest that AMED consumption does not differentially affect subjective intoxication when compared to AO consumption. In conclusion, when compared to AO consumption, mixing alcohol with energy drink does not affect subjective intoxication and seems unlikely to increase total alcohol consumption, associated risk-taking behavior, nor other negative alcohol-related consequences. Further research may be necessary to fully reveal the effects of AMED.
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Affiliation(s)
- Joris C. Verster
- Division of PharmacologyUtrecht UniversityUtrechtThe Netherlands
- Institute for Risk Assessment SciencesUtrecht UniversityUtrechtThe Netherlands
- Centre for Human PsychopharmacologySwinburne UniversityMelbourneAustralia
| | - Sarah Benson
- Centre for Human PsychopharmacologySwinburne UniversityMelbourneAustralia
| | - Sean J. Johnson
- Psychological Sciences Research GroupUniversity of the West of EnglandBristolUK
- Centre for Research in BiosciencesUniversity of the West of EnglandBristolUK
| | - Chris Alford
- Psychological Sciences Research GroupUniversity of the West of EnglandBristolUK
- Centre for Research in BiosciencesUniversity of the West of EnglandBristolUK
| | - Samuel Benrejeb Godefroy
- Department of Food Sciences, Food Risk Analysis and Regulatory Excellence Platform (FRAREP)Institute of Nutrition and Functional Foods (INAF), Université LavalQuebec CityQCCanada
- Institute for Global Food SecurityQueen's UniversityBelfastUK
| | - Andrew Scholey
- Centre for Human PsychopharmacologySwinburne UniversityMelbourneAustralia
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Temple JL, Hostler D, Martin-Gill C, Moore CG, Weiss PM, Sequeira DJ, Condle JP, Lang ES, Higgins JS, Patterson PD. Systematic Review and Meta-analysis of the Effects of Caffeine in Fatigued Shift Workers: Implications for Emergency Medical Services Personnel. PREHOSP EMERG CARE 2018; 22:37-46. [PMID: 29324066 DOI: 10.1080/10903127.2017.1382624] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Emergency Medical Services (EMS) workers may experience fatigue as a consequence of shift work. We reviewed the literature to determine the impact of caffeine as a countermeasure to fatigue in EMS personnel and related shift workers. METHODS We employed the GRADE methodology to perform a systematic literature review and search multiple databases for research that examined the impact of caffeine on outcomes of interest, such as patient and EMS personnel safety. For selected outcomes, we performed a meta-analysis of pooled data and reported the pooled effect in the form of a Standardized Mean Difference (SMD) with corresponding 95% confidence intervals. RESULTS There are no studies that investigate caffeine use and its effects on EMS workers or on patient safety. Four of 8 studies in shift workers showed that caffeine improved psychomotor vigilance, which is important for performance. Caffeine decreased the number of lapses on a standardized test of performance [SMD = 0.75 (95% CI: 0.30 to 1.19), p = 0.001], and lessened the slowing of reaction time at the end of shifts [SMD = 0.52 (95% CI: 0.19 to 0.85); p = 0.002]. Finally, 2 studies reported that caffeine reduced sleep quality and sleep duration. CONCLUSIONS Although the quality of evidence was judged to be low to moderate, when taken together, these studies demonstrate that caffeine can improve psychomotor performance and vigilance. However, caffeine negatively affects sleep quality and sleep duration. More systematic, randomized studies need to be conducted in EMS workers in order to address the critical outcomes of health and safety of EMS personnel and patients. The risk/benefit ratio of chronic caffeine use in shift workers is currently unknown.
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