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Consuming energy drinks at the age of 14 predicted legal and illegal substance use at 16

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Aim: This study examined whether consuming energy drinks at the age of 14 predicted substance use at 16. Methods: We followed 621 youths from an area of Switzerland who completed a longitudinal online survey in both 2012 and 2014 when they were 14 and 16 years of age. At 14, participants, who were divided into non-energy drink users (n=262), occasional users (n=183) and regular users (n=176), reported demographic, health-related and substance use data. Substance use at 16 was assessed through logistic regression using non-users as the reference group and controlling for significant variables at 14. Results: At the bivariate level, energy drink consumption was associated with substance use at both 14 and 16. Energy drink consumers were also more likely to be male, older, less academic, sleep less on schooldays and live in an urban area. In the multivariate analysis, smokers, alcohol misusers and cannabis users at the age of 16 were significantly more likely to have been regular energy drink users at the age of 14. Conclusion: Consuming energy drinks at 14 years of age predicted using legal and illegal substances at 16. Health providers should screen young adolescents for energy drink use and closely monitor weekly users. This article is protected by copyright. All rights reserved.

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... High levels of consumption of caffeinated drinks have been reported among adolescents and young persons in Slovakia [11], Poland [12], Saudi Arabia [13], Benin and Nigeria [14]. This has led to growing public health concerns about the increasing popularity of caffeinated beverages among adolescents and youth around the world along with the associated deleterious effects on human health especially in countries with lax regulations [7,15]. ...
... Several researchers have reported an increased risk of substance use and other behavioral problems in addition to negative school outcomes among regular and heavy consumers of some caffeinated drinks. Excessive use of caffeine has been associated with anxiety, cardiac conduction anomaly, restlessness, insomnia and gut dysfunction [11,15,17]. Many adolescents are easily influenced by peers, media icons and adverts. ...
... This may be due to the availability of several other alternatives in those places. Similar to findings from previous studies, a few more males consumed caffeinated drinks than females, even though there was no significant difference between them [9,11,15,18] which may be due to an increased propensity for adventure among adolescent boys than girls. The higher prevalence of caffeinated drinks consumption among older adolescents in this study is in agreement with findings from Switzerland [15], Slovakia [11] and Saudi Arabia [13]. ...
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Introduction: the mental and physical stimulating effects of caffeine have led to an increase in consumption of caffeinated beverages. Adolescents are at an increased risk of excessive caffeine consumption and its associated adverse health consequences. This study therefore assessed the pattern of caffeinated drink consumption among in-school adolescents in Sagamu, Ogun State, Nigeria. Methods: a descriptive, cross-sectional study was carried out among 350 adolescents in Sagamu Township, selected via multistage sampling. Data were collected using a semi-structured self-administered questionnaire and analyzed with SPSS version 20.0. Relevant descriptive and inferential statistics were calculated with level of significance (p) set at <0.05. Results: respondents' mean age was 14.49 ± 1.37 years; 60.2% of respondents were male. Over 90% of respondents consumed caffeinated beverages; 19.2% consumed greater than 3 cans in a day; 67.8% always felt a strong urge to consume caffeinated drinks. Reasons for consumption include: to aid personal study (64.4%), thirst (47.1%), performance enhancement (34.1%), alertness (30.6%) and hunger (17.7%). Reported side effects include: nervousness (40.4%); mood swings (16.5%); palpitations (30.1%); insomnia (51.6%). Conclusion: consumption of caffeinated beverages was high among adolescents in Sagamu. Adequate caffeine control measures, with behavior change communication, will help to address this public health challenge among adolescents.
... Dawodu and Cleaver (Dawodu and Cleaver, 2017) reported in their literature review, which mainly included cross-sectional studies, that ED consumption was related to SU in adolescence, including alcohol use (Azagba et al., 2014;Emond et al., 2014;Evren and Evren, 2015;Gallimberti et al., 2013;Hamilton et al., 2013;Terry-McElrath et al., 2014), tobacco use (Azagba et al., 2014;Evren and Evren, 2015;Gallimberti et al., 2013;Hamilton et al., 2013;Larson et al., 2014), marijuana use and amphetamine use (Azagba et al., 2014;Hamilton et al., 2013;Terry-McElrath et al., 2014). In addition to these findings, several prospective cohort studies were conducted to clarify the causal relationships between ED consumption and SU in adolescence (Barrense-Dias et al., 2016;Marmorstein, 2019). Marmostein et al. (Marmorstein, 2019) reported that ED consumption at baseline had a significant association with alcohol use 16 months later after adjusting for risk factors for alcohol use such as initial perceived peer alcohol use, initial perceived best friends' alcohol use, initial social behaviour expectancies, initial sensation-seeking, and initial parental monitoring. ...
... Marmostein et al. (Marmorstein, 2019) reported that ED consumption at baseline had a significant association with alcohol use 16 months later after adjusting for risk factors for alcohol use such as initial perceived peer alcohol use, initial perceived best friends' alcohol use, initial social behaviour expectancies, initial sensation-seeking, and initial parental monitoring. Barrense-Dias et al. (Barrense-Dias et al., 2016) also found that regular ED users at the age of 14 were significantly more likely to have been alcohol users, smokers, and cannabis users at the age of 16. From these findings, ED consumption may be associated with SU in adolescence. ...
... Table 1 shows the characteristics of the included studies. Five studies met the eligibility criteria Barrense-Dias et al., 2016;Choi et al., 2016;Marmorstein, 2019;Miyake and Marmorstein, 2015). All studies were done after 2010. ...
Article
Background It is unclear whether energy drink (ED) consumption is associated with substance use (SU) in adolescence. The purpose of this study is to clarify the association. Methods A systematic review was conducted using a wide range of electronic bibliographic databases to search for published prospective cohort studies on the topic from inception to 14th August 2019. The risk of bias was addressed by using the Risk Of Bias In Non-randomised Studies – of Interventions; ROBINS-I. Studies targeting adolescents were collected. Additionally, we collected studies that examined an association between the extent of energy drink consumption as exposure variables and any substance use as outcome variables. Results Five studies met the eligibility criteria. ED consumption was associated with adolescent use of alcohol, tobacco, cannabis, prescription stimulants, and analgesics. However, the overall risk of bias in the included studies was severe. Conclusion ED consumption may be associated with SU in adolescence, particularly alcohol use. The results, however, were still inconclusive due to the relatively low methodological quality in the included studies. Evidence from more well-designed trials is needed in future research.
... Consistently, the use of energy drinks is more common among male students in Canada. 28,29 Similarly, the number of boys who consumed these drinks every day has been found to be 2-2.3 times the number of girls who do so in North America and Europe, 24 Iceland, 25 and Finland. ...
... were consumed by 67% of Polish adolescents and 58% of Switzerland adolescents were occasional users or regular users. 24,29 There are a number of motives for using energy drinks: insufficient sleep, to increase energy while studying, driving long periods, drinking alcohol, and to treat a hangover. 30 In the current study's analysis, users of highly caffeinated drinks were more likely than non-users to perceive the severity of risk as below average and more likely than non-users to perceive the likelihood of risk occurrence as below average. ...
... were consumed by 67% of Polish adolescents and 58% of Switzerland adolescents were occasional users or regular users. 23,29 There are a number of motives for using energy drinks: insufficient sleep, to increase energy while studying, driving long periods, drinking alcohol, and to treat a hangover. 30 In the current study's analysis, users of highly caffeinated drinks were found to be more likely than non-users to perceive the severity of risk as below average, and were also more likely than nonusers to perceive the likelihood of risk occurrence as below average. ...
... Previous research, mostly cross-sectional, has identified demographic and psychosocial correlates of ED consumption among adolescents. Most studies suggest that ED consumption is more prevalent among males (Azagba et al., 2014;Barrense-Dias, Berchtold, Akre, & Surís, 2016;Costa et al., 2016;Gallimberti et al., 2013;Poulos & Pasch, 2015;Reid et al., 2015Reid et al., , 2017, compared to females, and increases with age ( Barrense-Dias et al., 2016;Emond, Gilbert-Diamond, Tanski, & Sargent, 2014;Gallimberti et al., 2013). The association between ED use and peer use has not been addressed, yet one study showed that 14% of adolescents learned about EDs from their friends (Attila & Çakir, 2011). ...
... Previous research, mostly cross-sectional, has identified demographic and psychosocial correlates of ED consumption among adolescents. Most studies suggest that ED consumption is more prevalent among males (Azagba et al., 2014;Barrense-Dias, Berchtold, Akre, & Surís, 2016;Costa et al., 2016;Gallimberti et al., 2013;Poulos & Pasch, 2015;Reid et al., 2015Reid et al., , 2017, compared to females, and increases with age ( Barrense-Dias et al., 2016;Emond, Gilbert-Diamond, Tanski, & Sargent, 2014;Gallimberti et al., 2013). The association between ED use and peer use has not been addressed, yet one study showed that 14% of adolescents learned about EDs from their friends (Attila & Çakir, 2011). ...
... The association between ED use and peer use has not been addressed, yet one study showed that 14% of adolescents learned about EDs from their friends (Attila & Çakir, 2011). Studies have shown that those adolescents from a single parent family (Terry-McElrath, O'Malley, & Johnston, 2014) are more likely, while those adolescents with higher academic averages ( Barrense-Dias et al., 2016), more educated parents (Terry-McElrath et al., 2014), and with higher levels of parental monitoring (Miyake & Marmorstein, 2015) are less likely to consume EDs. ED use has also been linked to depression (Azagba et al., 2014), sensation seeking (Azagba et al., 2014;Emond et al., 2014;Hamilton, Boak, Ilie, & Mann, 2013;Miyake & Marmorstein, 2015), and poor eating habits (i.e., regular junk or fast food consumption) (Kumar, Park, & Onufrak, 2015;Poulos & Pasch, 2015;Richards & Smith, 2016). ...
... Barrense-Dias Y et al. 28 Switzerland 2016 ...
... The presence of both tend to generate severe depressive episodes that increase the risk of suicide. 22 In longitudinal studies such as Barrense-Dias Y et al., 28 Marmorstein NR 29 and Choi HJ et al., 30 it has been observed that adolescents who frequently consume EDs, begin to abuse alcohol, tobacco and cannabis long before the rest. This exposes them to assume high-risk behaviours with serious consequences for their health, especially for those who mix them with alcohol. ...
... [20][21][22][23][24][25]27 Likewise, the review by Richards G et al., 26 which postulates that this type of discovery could be linked to the prejudicial effect that EDs have on adolescents' rest. Longitudinally, the ingestion of EDs predicts an abuse of alcohol, tobacco and marijuana, as well as an initiation to substance use before the age of 14. [28][29][30] That is, it is a risk factor, whether it is mixed with EDs. 40 Although, AmED remains being one of the greatest current risks of alcoholic dependence, alcohol intoxication and binge-drinking among adolescents. ...
... Binge drinking [20,24,28,38,66,70,74] and drunkenness [16,39,55]: positive association, with significant results from regression models in any study design in [16,38,39,55,66,70,74]; as to the 2 available longitudinal studies [16,20], regular weekly -but not occasional -ED consumption predicted past-month drunkenness at follow-up [16], but the same was not true for past-month ED and binge drinking [20]; ...
... Binge drinking [20,24,28,38,66,70,74] and drunkenness [16,39,55]: positive association, with significant results from regression models in any study design in [16,38,39,55,66,70,74]; as to the 2 available longitudinal studies [16,20], regular weekly -but not occasional -ED consumption predicted past-month drunkenness at follow-up [16], but the same was not true for past-month ED and binge drinking [20]; ...
... Binge drinking [20,24,28,38,66,70,74] and drunkenness [16,39,55]: positive association, with significant results from regression models in any study design in [16,38,39,55,66,70,74]; as to the 2 available longitudinal studies [16,20], regular weekly -but not occasional -ED consumption predicted past-month drunkenness at follow-up [16], but the same was not true for past-month ED and binge drinking [20]; ...
Article
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Increasing concerns have been raised on the health-related risks connected with energy drink (ED) consumption in children and adolescents, with high acute or chronic consumers exceeding 10% in either age group in Europe in 2011. Preliminary evidence has suggested a common pattern of ED and substance use, especially alcohol. Additional evidence has been accumulating very fast; in addition, other lifestyle and risky behaviors may contribute to shed light on the complex interplay of factors involved in ED consumption. We have undertaken a comprehensive systematic review of the evidence on psychosocial correlates of ED consumption in 0–18 years subjects, as published up to April 1, 2021, in MEDLINE/PubMed, PsycINFO, and Cochrane Reviews and Central Register of Controlled Trials, which allowed to select 104 original articles. Only ~ 10% of the papers provided results based on longitudinal analyses. A common pattern of ED consumption and polysubstance use, including alcohol, tobacco, and soft and hard drugs, was still confirmed in adolescents; violent and risky behaviors were also related to a higher ED consumption. In addition, frequent ED consumers are more likely to have bad dietary habits, including consumption of sugar-sweetened beverages and junk foods. A generally inconclusive evidence was found for sport/physical activities, although sedentary behaviors were generally related to ED consumption. Conclusions: Frequent ED consumption might be a screening indicator to identify students at risk of substance use or other risky/problem behaviors; enquiring about an adolescent’s recent ED consumption could create opportunities for early intervention/prevention by informed pediatricians. What is Known: • Substances, especially alcohol, are associated with energy drinks in most cross-sectional studies. What is New: • Violent behaviors are associated with energy drink consumption, in the absence of longitudinal studies; problematic use of internet/videogames deserves further investigation; unhealthy dietary patterns are related to energy drinks; evidence on physical activity is inconclusive, but sedentary behaviors are related to energy drinks.
... Barrense-Dias Y et al. 28 Switzerland 2016 ...
... The presence of both tend to generate severe depressive episodes that increase the risk of suicide. 22 In longitudinal studies such as Barrense-Dias Y et al., 28 Marmorstein NR 29 and Choi HJ et al., 30 it has been observed that adolescents who frequently consume EDs, begin to abuse alcohol, tobacco and cannabis long before the rest. This exposes them to assume high-risk behaviours with serious consequences for their health, especially for those who mix them with alcohol. ...
... [20][21][22][23][24][25]27 Likewise, the review by Richards G et al., 26 which postulates that this type of discovery could be linked to the prejudicial effect that EDs have on adolescents' rest. Longitudinally, the ingestion of EDs predicts an abuse of alcohol, tobacco and marijuana, as well as an initiation to substance use before the age of 14. [28][29][30] That is, it is a risk factor, whether it is mixed with EDs. 40 Although, AmED remains being one of the greatest current risks of alcoholic dependence, alcohol intoxication and binge-drinking among adolescents. ...
... The available evidence indicates that among adolescents, higher energy drink consumption is linked to male gender [3,6,[15][16][17], and older adolescence [13,15]. It has also been linked to rural residency [13], lower socioeconomic status [13,18], lower school achievement [17,19,20], and lower parental monitoring [21]. ...
... The available evidence indicates that among adolescents, higher energy drink consumption is linked to male gender [3,6,[15][16][17], and older adolescence [13,15]. It has also been linked to rural residency [13], lower socioeconomic status [13,18], lower school achievement [17,19,20], and lower parental monitoring [21]. ...
... The responses were regrouped into three categories: weekly consumption, less than weekly consumption, and no consumption. For the regression analyses, the responses were also dichotomized as two categories, i.e. as weekly and less than weekly/no consumption, in line with the European Food Safety Authority categories [3], and with previous studies [15,17,31], on the rationale that weekly energy drink consumption indicates more regular consumption of energy drinks. ...
Article
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Objectives: Energy drink consumption among adolescents has become a notable global phenomenon, and has been associated with numerous negative health outcomes. In order to understand the popularity of energy drinks among adolescents, and to target interventions, it is important to identify the determinants underpinning consumption. Methods: The nationally representative data (cross-sectional) were drawn from the Health Behaviour in School-aged Children (HBSC) surveys, conducted in 2014 and 2018, each comprising 13- and 15-year-old Finnish adolescents (n = 7405). Results: Weekly energy drink consumption increased among Finnish adolescents between 2014 (18.2%) and 2018 (24.4%), especially among girls. In 2018, boys typically consumed more than girls, and 15-year-olds more than 13-year-olds. Moreover, in 2018, weekly energy drink consumption was more prevalent among 15-year-old adolescents with a non-academic educational aspiration (46.0%) than among adolescents with an academic aspiration (18.3%). Gender (boys more than girls), older age (only in 2018), less parental monitoring, lower school achievement, and a lower level of health literacy explained around 28% of the variance in weekly energy drink consumption in both years. Conclusion: According to the findings, interventions to decrease the energy drink consumption, should be targeted at all adolescents, but especially at those with fewer individual resources. The interventions should also pay attention to family-level factors.
... Globally, there has been some research into the factors associated with energy drink consumption in adolescents. In addition to sociodemographic factors, studies have most commonly examined the association between energy drink consumption and risky behaviours, such as substance use [9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39], while a smaller number of studies have investigated the association between energy drink consumption and dietary and lifestyle behaviours [31,37,[39][40][41][42][43]. For example, a 2016 review reported that energy drink consumption was consistently linked to alcohol use and cigarette smoking, and appeared to be positively related to various other unhealthy behaviours, such as skipping breakfast, consumption of junk food and other sugary drink varieties, and regular video game use [44]. ...
... Importantly, it was also associated with short sleep duration. Consistent with previous studies in Australia [62] and elsewhere [9,25,32,44,67,70], we found regular energy drink consumption was significantly higher among males at 8%. This is unsurprising given marketing for these products is heavily directed towards males, such as through sports and video games [20,21,71], and the gender difference in consumption is also observed in adults [72]. ...
... Similarly, the few studies that have examined adolescents' energy drink consumption as a function of geographic location or socioeconomic factors have generated mixed findings. For example, a study using a sample of Swiss adolescents found energy drink consumption was higher among those living in urban areas [25], while one US study reported past 24-h energy drink use was lower among adolescents from low-income families [75], and another found consumption was lower among those with more educated parents and higher among those living outside of metropolitan locations [28]. Data from the UK indicated weekly consumption was more prevalent among students eligible for welfare (i.e., free school meals) [41,67], and some research has not found a significant association between consumption and socio-economic area [26]. ...
Article
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Background Non-alcoholic energy drinks (‘energy drinks’) are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption. Methods Participants were 8942 students in Years 8 to 11 (aged 12 to 17 years) who participated in the 2018 National Secondary Students’ Diet and Activity (NaSSDA) cross-sectional survey. A multistage stratified random sampling procedure was used. Within the school setting, students self-completed an online questionnaire assessing their dietary, physical activity and sedentary behaviours. A multilevel logistic regression model was used to examine associations between energy drink consumption and sociodemographic and behavioural factors. Results Overall, 8% of students reported consuming energy drinks on a weekly basis (‘regular consumers’). A further 16% indicated they consume less than one cup per week of these types of drinks, while around three-quarters (76%) reported they do not consume energy drinks. Regular consumption of energy drinks was independently associated with being male, having greater weekly spending money, high intakes of snack foods, fast food, other sugar-sweetened beverages and fruit juice, as well as short sleep duration. There was no independent association with other sociodemographic characteristics (i.e., year level, level of disadvantage, geographic location), consumption of vegetables and fruit, physical activity level, or sedentary recreational screen time. Conclusions While most Australian adolescents do not consume energy drinks, regular consumption is more prevalent among males, and consumption appears to cluster with other unhealthy dietary behaviours and short sleep duration. Findings support the need for policies that will reach identified at-risk groups (e.g., increased regulation of the marketing and sale of energy drinks), as well as suggest opportunities for interventions targeting energy drink consumption alongside other unhealthy dietary behaviours.
... In some studies, acceptable or recommended caffeine consumption limits for adolescents were defi ned as 50 mg/day to 200 mg/day, as well as a commonly used limit of 2.5 mg/kg per day (Barrense-Dias et al., 2016;Evren & Evren, 2015;Wikoff et al., 2017). According to one criterion of use per day, for typical 12-year-old children, the upper limit is between 118.75 mg/day and 121.25 mg/day, whereas for 15-year-old adolescents it is between 132.5 mg/day and 147.5 mg/day (Turel, 2018). ...
... Some studies have shown that children as young as 10 years old consume energy drinks (Marmorstein, 2019;Zucconi et al., 2013); however, only one report in the current systematic review explored the age of initiation of consumption (Barrense-Dias et al., 2016) and highlighted a higher consumption of energy drinks in participants aged 15 to 19 years compared to those aged 11 to 15 years. Longitudinal or prospective studies coincide in the gradual increase in consumption according to advances in age (Kim et al., 2018), which may fl uctuate from 25% per year (Galimov et al., 2019) to up to 70% in 5 years (Leal & Jackson, 2018). ...
... It was also found that adolescents who used energy drinks (at any frequency) were significantly more likely to engage in risky and sensation-seeking behaviors (Evren & Evren, 2015;Marmorstein, 2019), such as using motorized vehicles; consuming substances, such as alcohol, tobacco, or drugs; being involved in fi ghts; and engaging in risky sexual behaviors (Butler et al., 2019;Hammond et al., 2018;Utter et al., 2018). In some studies, the use of energy drinks was found to be a predictor (Barrense-Dias et al., 2016;Leal & Jackson, 2018;Mann et al., 2016;Miyake & Marmorstein, 2015) of substance use through patterns or screenings that evaluated psychological well-being and tendency for risky and sensation-seeking behaviors (Miller, 2008). ...
Article
The aim of the current review was to analyze primary studies about energy drink consumption patterns in adolescents and their relationship with mental health. PubMed, PLOS ONE, PsycINFO, and ScienceDirect databases were searched to identify articles related to adverse effects of energy drinks in adolescents and young adults aged 11 to 18 years. Psychological and behavioral measures were based on validated screening tools used in various contexts, and bias was detected in energy drink consumption patterns. In regard to sex, boys consumed more energy drinks than girls, and a strong, positive association was reported between consumption and probability of risky behaviors; tendency for anxiety, depression, and impulsivity; poor academic performance; and sleep disturbances. A progressive increase in consumption was also noted of 25% to 75% within 5 years. Findings suggest that standardized consumption pattern assessment be included in evaluations of mental health to determine potential causal relationships. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
... Concerns over the various health risks related to energy drink consumption have been well documented ( Barrense-Dias, Berchtold, Akre, & Suris, 2016;Harris & Munsell, 2015;Williams, Housman, Odum, & Rivera, 2017). In 2013, both the American Medical Association and the U.S. Senate Commerce Committee proposed a prohibition on marketing of energy drink products to adolescents (AMA, 2013;Mitka, 2013); yet, a recent study revealed that energy drink manufacturers continue to advertise through mediums that primarily target adoles- cents (Emond, Sargent, & Gilbert-Diamond, 2015). ...
... Participants in the Woolsey et al. (2017) study reported a mean age-at-first-use of energy drinks of 16.13 years which is consistent with international studies (Alsunni & Badar, 2011;Ibrahim et al., 2014). However, research has shown that some adolescents consume energy drinks at much lower ages and that early use can predict future health and behavioral risks (Barrense-Dias, Berchtold, Akre, & Suris, 2016;Mann, Smith, & Kristjansson, 2016). ...
Article
Background: About 30% of high school students use energy drinks. Alcohol mixed with energy drinks (AmED) has been associated with higher rates of risky driving among college students. Objectives: The purpose of this study was to: (a) examine AmED-use in a sample of high school students and (b) to specifically investigate differences in risky driving behaviors between 12th grade students who engaged in AmED-use and those who consumed alcohol only. Methods: Differences in risky driving behaviors were investigated by utilizing secondary data analyses of nationally representative data from the Monitoring the Future Study (N = 1305). Results: 12th grade AmED users were significantly more likely to be in a motor vehicle accident (p <.001) and receive a ticket for a traffic violation (p <.05). Additionally, 12th grade AmED users were significantly less likely to wear a seatbelt as a driver or passenger (p <.001). Conclusions/Importance: Although this study does not link risky driving behaviors to specific drinking events, it does indicate a relationship between AmED-use and high-risk driving. Because traffic accidents are the highest cause of mortality among U.S. teenagers, drug education efforts to reduce high-risk driving behaviors should include information on the decision-making and synergistic effects of energy drinks when mixed with alcohol.
... In addition, energy drink users were more likely to report indulging in risk-taking behaviors, including risky driving behaviors (e.g., fast driving and seat belt omission), sexual risk taking, tobacco use, marijuana use, psychedelic drug use, cocaine use, alcohol/binge drinking, other illegal drug use, mixing alcohol and energy drinks, and nonmedical use of prescription stimulants (Arria et al., 2014;Cofini et al., 2016;Miyake and Marmorstein, 2015). Energy drinks may serve as a gateway to other forms of drug dependence (Barrense-Dias et al., 2016;Reissig et al., 2009). Energy drinks are often combined with alcohol, and young adults who mix alcohol with energy drinks consume more alcohol and experience more related harm than do others who drink energy beverages (Holubcikova et al., 2016;. ...
... The health concerns regarding energy drinks are further highlighted in the adolescent population (Barrense-Dias et al., 2016;Hampton, 2016). Energy drink use is rapidly growing in this population (From the American Academy of Pediatrics, 2011;Terry-McElrath et al., 2014). ...
Chapter
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Nitric oxide (NO) is a gaseous signaling molecule with a short half-life that's known to exert its biological functions through cyclic guanosine monophosphate. In our system, nitric oxide is produced by nitric oxide synthase enzymes, which use substrates l-arginine, reduced nicotinamide adenine dinucleotide phosphate (NADPH), and oxygen by producing citrulline, nicotinamide adenine dinucleotide phosphate (NADP⁺), and NO. Nitric oxide can react with superoxide to produce peroxynitrite (ONOO?), which can cause irreversible modification and inhibition of different biological molecules, including mitochondrial membrane complexes and antioxidant defense enzymes through oxidizing reactions. This chapter focuses on the direct and indirect role of NO in terms of energy metabolism. Nitric oxide in this context governs and regulates metabolism, heat production, and body composition, which overall change the tissue distribution of oxygen, adenosine triphosphate production, blood flow, glucose utilization, and supply of other nutrients by resulting in altered tissue functions and physical activities.
... We then examine the potential mediating role of soft drug use across age, gender, and race groups. Prior literature suggests that males (Friis et al., 2014;Trapp et al., 2014;Barrense-Dias et al., 2016;Polak et al., 2016;Evren and Evren, 2015;Poulos and Pasch, 2015;Holubcikova et al., 2017), older adolescents (Holubcikova et al., 2017), and non-minorities (Poulos and Pasch, 2015;Miller, 2008) are more likely to consume energy drinks and consume them more often. However, no study has examined whether the influence of energy drink use on adolescent drug use varies by age, gender, or race. ...
... Additionally, prior literature has generally overlooked whether the relationship between energy drink consumption and drug use varies by age, gender, or race. Prior work has suggested that males (Friis et al., 2014;Trapp et al., 2014;Barrense-Dias et al., 2016;Polak et al., 2016;Evren and Evren, 2015;Poulos and Pasch, 2015;Holubcikova et al., 2017), older adolescents (Holubcikova et al., 2017), and non-minorities (Poulos and Pasch, 2015;Miller, 2008) are more likely to consume energy drinks and use them to a greater degree, but how these demographic factors impact the link between energy drinks and drug use is not typically examined. The current study revealed that energy drink consumption is more strongly associated with drug use among younger adolescents, and that the mediating role of soft drug use in the link between energy drink consumption and hard drug use varies somewhat across age cohorts partitioned by race and gender. ...
Article
The aim of the current study is to determine whether energy drink consumption contributes to drug use and, more specifically, an escalation in the severity of drug use. We first examine the association between energy drink use and hard drug use, and subsequently investigate whether soft drug use mediates this relationship. Potential moderating influences are also investigated by testing whether the degree of mediation varies by age, gender, and race. The current study uses a nationally representative sample of 8th (ages 13-14), 10th (ages 15-16), and 12th (ages 17-18) grade adolescents from the 2015 Monitoring the Future survey. Negative binomial regression is employed to examine associations between energy drink consumption and soft and hard drug use. Mediation results indicate that energy drink consumption is significantly associated with increased soft drug use, which is, in turn, associated with significant increases in hard drug use. This cascading effect of energy drink consumption on drug use appears to be stronger among younger females and older males. Results for the moderating effect of race are mixed. Energy drinks appear to pose an important threat to adolescent health in the form of soft and hard drug use. The United States may want to consider adopting energy drink policies similar to European countries and Canada, which require warning labels on beverages with high caffeine content.
... implications. Previous studies investigating general caffeine consumption or the intake of typical 20 caffeinated beverages like energy drinks have suggested that frequent intake of caffeine in 21 adolescence is related to later substance use (Barrense-Dias et al., 2016;Leal & Jackson, 2019). 22 ...
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While the negative impacts of caffeinated soda on children’s physical health have been well documented, it remains unexplored if habitual caffeinated soda intake is associated with intellectual capacities in children. Here, we investigated the behavioral and neural correlates of daily consumption of caffeinated soda on neurocognitive functions including working memory, impulsivity, and reward processing. We rigorously tested the link between caffeinated soda intake and the neurocognitive functions by applying machine learning and hierarchical linear regression to a large dataset from the Adolescent Brain Cognitive Development (ABCD) Study ( N =3,966; age=9-10 years). The results showed that daily consumption of caffeinated soda in children was associated with impaired working memory and higher impulsivity, and increased amygdala activation during the emotional working memory task. The machine learning results also showed hypoactivity in the nucleus accumbens and the posterior cingulate cortex during reward processing. These results findings have significant implications for public health recommendations. Statement of Relevance Is caffeinated soda bad for children’s brain development? If so, which specific intellectual capacity is affected? It is a question that many parents and caregivers are asking but surprisingly there is no clear guideline. Caffeinated soda is the most preferred route of caffeine intake in childhood and known to have physical side effects on children, but the link between habitual drinking of caffeinated soda in children and intellectual capacities remains largely unknown. Here, by applying machine learning and hierarchical regression approaches to a large dataset, we demonstrate that daily intake of caffeinated soda is associated with neurocognitive deficits including impaired working memory and higher impulsivity. These results have significant implications for public health recommendations.
... Several studies report a consistent association between ED consumption and substance abuse, although the evidence base consists primarily of cross-sectional studies, which does not allow for establishing directionality of the association (29)(30)(31)(32)(33)(34). For example, in a nationally representative sample of U.S. middle-and high-school students, significant associations were found between ED frequency and 30-day frequency of use of alcohol, cigarettes, marijuana, or amphetamines (32). ...
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As energy drink consumption continues to grow worldwide and within the United States, it is important to critically examine the nutritional content and effects on population health of these beverages. This mini-review summarizes the current scientific evidence on health consequences from energy drink consumption, presents relevant public health challenges, and proposes recommendations to mitigate these issues. Emerging evidence has linked energy drink consumption with a number of negative health consequences such as risk-seeking behaviors, poor mental health, adverse cardiovascular effects and metabolic, renal, or dental conditions. Despite the consistency in evidence, most studies are of cross-sectional design or focus almost exclusively on the effect of caffeine and sugar, failing to address potentially harmful effects of other ingredients. The negative health effects associated with energy drinks are compounded by a lack of regulatory oversight and aggressive marketing by the industry towards adolescents. Moreover, the rising trend of mixing energy drinks with alcohol presents a new challenge which researchers and public health practitioners must address further. In order to curb this growing public health issue, policy makers should consider creating a separate regulatory category for energy drinks, setting an evidence-based upper limit on caffeine, restricting sales of energy drinks, and regulating existing ED marketing strategies, especially among children and adolescents.
... Mladostniki, ki torej poročajo o uporabi PAS, tudi do neke mere bolj verjetno poročajo o tem, da pojedo več hitre hrane, pogosteje pijejo gazirane pijače in več časa presedijo za računalnikom ali igrajo igrice na računalniku (124,125), kar potrjuje, da so nagnjeni k temu, da prevzamejo več tveganih vedenj skupaj (124). Raziskave tudi kažejo, da je uporaba PAS povezana z rednim pitjem energijskih pijač (126)(127)(128)(129)(130). ...
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INTRODUCTION: During adolescence, an individual can develop behaviours, which will affect his/her health, wellbeing and prosperity in adulthood. These behaviours include the use of psychoactive substances, which generally starts in adolescence. Foreign data show that tobacco, alcohol and cannabis use is common among adolescents; a substantial share of them is using more than one psychoactive substance. Many of them continue with the use of psychoactive substances in adult age, depending on the type of the substance. The use and co-use of psychoactive substances in adolescence are related to numerous short- and long-term unfavourable health, socioeconomic, psychosocial, cognitive and educational outcomes, as well as to higher probability of other risk behaviours, harmful use of psychoactive substances, and addiction. Several different factors influence the initiation, continuation and frequency of the psychoactive substances use among adolescents. These factors are related to individual’s characteristics, as well as their family, social and physical environment. Studies in Slovenia showed that tobacco, alcohol and cannabis use among adolescents represents a public health issue and wider social problem; many indicators place us above the international averages. There are few available data on tobacco, alcohol and cannabis co-use, and on the factors related to their use and co-use. Thorough knowledge on the prevalence of the problem and on risk and protective factors related to use and co-use of psychoactive substances is key for effective prevention and reduction of psychoactive substances use. The objective of this publication is to improve knowledge in this area in Slovenia. The aim of the publication is to present the current state and factors related to tobacco, alcohol and cannabis use and co-use among 15-year-olds in Slovenia. In the beginning, there is a review of findings from foreign literature on factors related to tobacco, alcohol and cannabis use and co-use among adolescents. This is followed by data from analyses among Slovenian 15-year-olds. METHODS: The publication presents data analyses for Slovenian 15-year-olds, which were obtained from international cross-sectional study Health-related Behaviour in School-aged Children from 2014. The questionnaire includes a set of questions on demographic, behavioural and psychosocial aspects of health including tobacco, alcohol and cannabis use. Based on the questions on tobacco, alcohol and cannabis use at any time in life, we have first calculated the shares of those, who have used tobacco, alcohol and/or cannabis at any time in life and presented the age at first use. After that, we are presenting the data on 15-year-olds who have reported on the more frequent/more risky use of at least one psychoactive substance (tobacco, alcohol, cannabis), and on those, who have reported on the frequent/more risky use of all three psychoactive substances. Frequent/more risky tobacco, alcohol and cannabis use was defined as smoking tobacco at least weekly or more frequent, drinking alcohol weakly or more frequent and/or being drunk at least twice in life; and the use of cannabis at least three days in the last 12 months. We have included numerous factors from different groups (individual, family, school, peer factors, mental health, (un)healthy lifestyle and early sexual intercourse, socioeconomic position) into the analyses on the relation between tobacco, alcohol and cannabis use and co-use. Using the logistic regression, we have then prepared seven individual models, one for each individual group of factors (individual, family, school, peer factors, mental health, (un)healthy lifestyle and early sexual intercourse, socioeconomic status), to identify those that are importantly related to tobacco, alcohol and/or cannabis use and co-use. Afterwards, we have included only factors that were statistically significantly related to tobacco, alcohol and/or cannabis use and co-use into the joint model of logistic regression. KEY RESULTS:  Most 15-year-olds (84%) have used tobacco, alcohol and/or cannabis at least once in life (44% one, 22% two and 18% all three analysed psychoactive substances).  Most frequently, they have used alcohol and least frequently cannabis.  Tobacco, alcohol and/or cannabis use started at age 11 or less, while the shares rapidly increased with age.  Most frequently, they first drank alcohol, most often at age 12.  40% of 15-year-olds have reported on frequent/more risky use of at least one psychoactive substance – 25% of one (most frequently alcohol), 10% of two (most frequently tobacco and alcohol) and 5% of all three psychoactive substances.  Frequent/more risky use of at least one or all three psychoactive substances (tobacco, alcohol and cannabis) was related mainly to peer factors (peer tobacco and cannabis use, less with peer alcohol consumption and with frequent socializing with friends after 8 PM), and with (un)healthy lifestyle factors (irregular breakfast, every-day energy drinks consumption) and with early sexual intercourse, as well as with bullying, frequent fighting, feelings of depression and perceived lower support from teachers.  Our research showed the importance of family and school factors in tobacco, alcohol and cannabis use/co-use to a lesser degree than foreign sources, which could be due to the availability of variables in the study and to the combination of variables in the models. Limitations of our research are related to the type of research (it is a cross-sectional study, which does not enable conclusions regarding causality and chronological order), self-reporting of data and the fact that only school-attending 15-year-olds are included in the study and not also school dropouts. CONCLUSIONS: As the first of the kind published in Slovenia, our study showed the selected data on the initiation of tobacco, alcohol and cannabis co-use and on the factors related to frequent/more risky tobacco, alcohol and/or cannabis use and co-use on a representative sample of school-attending adolescents. A substantial share (15%) of 15-year-olds in Slovenia are frequent/more risky tobacco, alcohol and cannabis co-users; in these adolescents, we are detecting also other health-harming behaviours. Every tenth 15-year-old is frequently/more risky using at least two out of three analysed psychoactive substances (tobacco, alcohol, cannabis), whereas every twentieth uses all three. According to the scope of the problem, it is key to immediately plan and implement adequate measures. We propose the preparation of a joint national strategy for the prevention and reduction of addictions and risky behaviours. It is important that the strategy ensures the systemic implementation of measures, with this sustainable implementation and financing are established, as well as the activities in all key population groups, which will prevent health inequalities. It is essential to enable and encourage healthy choices in each individual since the early beginnings. Habits, obtained in childhood and adolescence, will be maintained in adulthood, and thus healthy individuals will be able to actively contribute to the development and welfare of the society. It is important to strengthen healthy lifestyles of adolescents and implement effective programmes for preventing use and further use of psychoactive substances. Programmes should be focused on several different psychoactive substances or risky behaviours; however, if they are focused on one individual psychoactive substance or risky behaviour, they should be harmonized with other programmes. Programmes need to be implemented early and adjusted to the age of children or adolescents. It is important to ensure their systemic implementation and activities in different environments (school, family, local community, etc.). With the implementation of legislative, economic and physical measures, it is necessary to change different environments in a way to reduce the exposure of children and adolescents to unhealthy, risky choices and to offer variety of healthy choices. One of the most important/effective ways is legislative action in this field, namely the introduction of comprehensive programmes and measures for the prevention and reduction of tobacco, alcohol and cannabis use. Next to the reduction of risk factors, we also need to strengthen protective factors, which reduce the risk of psychoactive substance use and co-use among adolescents. Regular monitoring of the state and further research are also among key activities in this field in Slovenia.
... The possible role of ingredients other than caffeine (e.g., taurine) in the effects of EDs remains unclear [6]. Moreover, frequent consumption of EDs has been associated with unhealthy behaviours, such as use of alcohol, tobacco, illicit drugs, sexual risk-taking and violence among adolescents and young adults [7][8][9][10][11][12]. Mixing EDs with alcohol has been shown to be common among high school seniors [13]. ...
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Background: The consumption of energy drinks (EDs) is increasing in the general population, but little is known about the consumption of EDs among pupils in Africa. This study was designed to assess the consumption of EDs among pupils between 10 and 17 years of age and to assess average caffeine concentrations contained in EDs sold in Lubumbashi. Methods: We conducted a cross-sectional survey in five schools using a standardised questionnaire taken face-to-face. Samples of locally purchased EDs were analysed by High Performance Liquid Chromatography with Ultra-Violet spectrometry (HPLC-UV). Results: Of 338 pupils (54% girls), 63% reported having consumed at least one ED in the last week and 34% drank at least one ED a day. The cheapest ED was the most widely consumed. Among pupils having consumed at least one ED in the last week, 79% reported consuming it for refreshment and 15% to get energy. For those who reported not consuming EDs, 40% reported that their parents or teachers forbade them to drink EDs. Some (14%) teenagers, mainly boys, mixed ED with alcohol. The concentrations of caffeine measured in twelve brands of EDs ranged from 7.6 to 29.4 mg/100 mL (median 23.3), giving caffeine contents of 37.5 to 160 mg (median 90 mg) per can or bottle. The estimated daily intake of caffeine through EDs was between 51.3 mg and 441.3 mg among those consuming EDs regularly. Conclusion: Our study convincingly demonstrates that caffeine-containing EDs are not only consumed by youngsters living in affluent societies. We documented widespread regular consumption of EDs among (pre-)adolescent schoolchildren living in Lubumbashi, a large city of the Democratic Republic of Congo (DRC). In view of the global market expansion of caffeinated EDs, it is reasonable to suspect that similar surveys in other urban areas of sub-Saharan Africa would yield similar findings. Pricing and advertising regulations and education on EDs are necessary to limit the regular consumption of EDs among adolescents.
... Without fully following the gateway theory [6,7], we may say that adolescents commonly experiment with several substances, either successively or simultaneously, and specific patterns of substance initiation can be identified [8]. Moreover, the number of different substances (especially synthetic ones) and their availability seem to have increased during the last few decades [9], and the development of products such as energy drinks, alcopops (mixes of soda with strong alcohol), e-cigarettes and legal cannabis (cannabis without THC) is considered by experts to provide new ways of introducing young people to substance use [10,11]. ...
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Adolescence is a period of life during which many people experiment with different kinds of legal and illegal substances. However, young people practising physical activities at a high level should avoid taking such substances. On the basis of a large sample of Swiss male recruits (C-SURF baseline data), we explore the consumption of substances among three subgroups of young adults, defined according to level of physical activity: high, medium, and low. Our results show that respondents classified into the high level of physical activity group went through the same experimentation processes with substances as respondents in the other groups, but that they reduced their overall consumption level, as indicated by measures regarding the last 12 months only. However, substantial differences are observed when we look at each substance separately. In particular, smokeless tobacco products are consumed more in the high group, and alcohol consumption is high in all groups. Physical activity, even at a high level, is not a protective factor against substance consumption. Therefore, physicians should not forget to investigate substance use among people with high levels of physical activity, especially since their consumption can (1) differ from the general population; and (2) have important consequences on their physical performance.
... Even after controlling for other potential explanatory factors, energy drink consumption remained a strong predictive factor for subsequent smoking, alcohol and cannabis use. The authors, Yara Barrense-Dias et al (5), suggest that health providers should screen young adolescents for energy drink use and closely monitor those using them on a weekly basis. ...
Article
Previous research has demonstrated that caffeinated beverage consumption predicts alcohol consumption among early adolescents. This study aimed to investigate this association in two ways: (1) by examining if this association remained significant once other established risk factors for alcohol were adjusted for statistically; and (2) by considering three possible moderators of this association: gender, sensation-seeking, and parental monitoring. Data from the Camden Youth Development Study, a longitudinal, community-based study of middle-school students, were used. Youth were initially assessed in 6th and 7th grade and followed-up 16 months later. Self-reports of frequency of energy drink, coffee, and alcohol consumption, as well as sensation-seeking, perceived peer and best friend alcohol use, alcohol expectancies, and parental monitoring, were used. Results indicated that both energy drink and coffee consumption predicted later alcohol consumption, even after adjusting for other risk factors for alcohol consumption. Parental monitoring was a significant moderator of this link, such that youth who consumed energy drinks and reported low parental monitoring were particularly at risk for later alcohol consumption. These findings indicate that the link between earlier caffeine consumption and later alcohol consumption is not simply due to the co-occurrence of caffeine consumption with other risk factors for alcohol use. In addition, risk associated with early energy drink consumption appears to be particularly pronounced for youth in families characterized by low parental monitoring.
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Energy drinks (EDs) are non-alcoholic beverages providing an extra boost in physical/cognitive performance and mood. Besides the physiological effects related to the high-caffeine content of EDs, long-term emotional, social, and behavioral effects have been recently receiving attention. However, a few systematic reviews have focused on the critical yet understudied periods of childhood and adolescence. We have undertaken a comprehensive systematic review of the evidence on any psychosocial correlates of ED consumption in 0–18-year-old subjects, as published up to April 1, 2021, in MEDLINE/PubMed, PsycINFO, and Cochrane Reviews and Central Register of Controlled Trials. Of the initial 789 records, 104 original articles were included in the systematic review. Seventy percent of them were published from 2016 onwards; among investigated topics, substance use ranked first, followed by psychological and socio-educational factors; the less investigated topic was risky behaviors. Taste and energy-seeking were the main drivers of consumption, which generally happened at home or during sport/recreational activities, without perception of health-related risks. Positive associations with ED consumption were found for sensation seeking, irritability/anger, and suicide ideation, plan, or attempts. Finally, participants with lower grades, a low parental monitoring, or bad influences from peers were more likely to consume EDs. Conclusion: With ~ 70% of papers published since the 2 comprehensive reviews on children/adolescents were carried out, an update of the literature with a broad focus is of great importance. Consumption of EDs by children/adolescents lies in the potential interplay between personality traits, school performance, and influences by family members and peers. What is Known: • Taste and energy-seeking are the main drivers of energy drink consumption, which mostly happened at home or in sport/recreational activities. What is New: • Perception of risks related to energy drinks is associated with a lower consumption, as based on cross-sectional studies. • As mostly based on cross-sectional studies: 1. energy drink consumption is related to sensation seeking, irritability/anger, and suicide ideation or attempts; 2. students with a lower school performance, low parental monitoring, or bad peer influence, are more likely to consume energy drinks.
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Objectives Concerns about the use of highly caffeinated energy drinks among Korean adolescents remains. We compared adolescents’ perceptions regarding the use of drinks to their behaviours and factors. Design A structured questionnaire based on the Health Belief Model was administered to 850 freshmen and sophomores at three high schools in Bucheon, South Korea. Benefits were defined as beneficial effects from the use of highly caffeinated energy drinks (eg, awakening from sleepiness) and harms as adverse effects of the drinks (eg, cardiac palpitation). Likelihood of action represents the likelihood of taking actions that are perceived to be more beneficial after comparison of the benefits and harms of caffeine use. Descriptive analysis was used to quantify the relationship between their beliefs about highly caffeinated energy drinks and their use. We conducted hierarchical logistic regression to compute ORs and 95% CIs for: (1) demographic factors, (2) health threat, (3) likelihood of action and (4) cues to act. Results Altogether, 833 students responded to the questionnaire (effective response rate=98.0%). About 63.0% reported use of highly caffeinated energy drinks and 35.2% had used them as needed and habitually. The more susceptible the respondents perceived themselves to be to the risk of using these drinks, the less likely they were to use them (OR: 0.73, 95% CI 0.50 to 1.06). The more severe the perception of a health threat, the less that perception was associated with use (OR: 0.44, 95% CI 0.29 to 0.67). Likelihood of action was the strongest predictor of use, explaining 12.5% in use. Benefits and harms (OR: 4.43, 95% CI 2.77 to 7.09; OR: 1.86, 95% CI 1.16 to 2.99) also were significant predictors. Conclusions Enhancing adolescents’ perceptions of benefits and harms regarding using highly caffeinated energy drinks could be an effective way to influence the use of these drinks.
Chapter
Over the past decade, energy drinks have been consumed with increasing frequency by the general population. They have been marketed to improve athletic performance, endurance, and concentration. Currently, reports of increased complications are surfacing revealing increased national emergency room visits from acute complications related to consumption, as well as reports summarizing cases in which energy drink consumption was associated with morbidity and mortality. Furthermore, certain populations seem to be vulnerable to these adverse effects, including those aged under 18. years, pregnant or breastfeeding women, caffeine-naive or sensitive individuals, individuals taking stimulant or other caffeine-based medications, and those with certain cardiovascular or medical conditions and/or heavy consumption patterns (two or more energy drinks in one session). This is of particular concern because most energy drinks are not as strictly regulated by the Food and Drug Administration owing to their supplement classification.In this chapter, we aim to describe the various constituents found in energy drinks. In addition, the extracardiac and cardiac side effects are discussed in detail. Extracardiac effects include those involving the neurologic, gastrointestinal, renal, and endocrine systems, as well as psychiatric problems. The cardiovascular side effects encompass a broad spectrum and include vascular dysfunction, abrupt hemodynamic changes, electrical instability, cardiomyopathies, coronary disease, and sudden cardiac death. These potential acute adverse effects should be diligently recognized by the physician, and those planning to consume energy drinks should be warned. The long-term effects of exposure to energy drinks have not been adequately researched. More safety and efficacy research needs to be conducted to establish more fully dose safety for consumption, whether energy drinks truly benefit mental or physical performance, and which individuals should avoid them because of the potential for excess risk. Until this research is complete, we recommend individuals avoid consuming energy drinks.
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Objectives To investigate sex differences in sociodemographic and lifestyle correlates of frequent energy drink (ED) consumption in adolescents. Study design This study was based on data collected among French-speaking Belgian adolescents aged 11–20 years (n = 8137) within the 2018 Health Behaviour in School-aged Children study. Methods Multiple logistic analyses stratified by sex were performed to estimate the associations between consuming EDs more than once a week, and various sociodemographic and lifestyle characteristics. Results Overall, 14.0% of boys and 7.6% of girls consumed ED more than once a week. For both genders, the likelihood of consuming ED more than once a week was higher among adolescents consuming soft drinks daily (vs. < daily), alcohol weekly (vs. < weekly), spending at least 5 h/day in front of screens (vs. < 5 h/day), and going to bed later than 11:30 PM (vs. ≤ 10:00 PM). Among boys, adolescents reporting at least 1 h of moderate-to-vigorous physical activity (MVPA) daily (vs. < 1 h/day MVPA) were more likely to consume ED more than once a week (adjusted odd ratio (aOR) = 1.49 (95% confidence interval [CI] 1.11–2.01)). Among girls, adolescents from low affluence families (vs. high affluence) (aOR = 2.03 (95% CI 1.19–3.48)) and immigrants (vs. natives) (2nd generation: aOR = 1.75 (95% CI 1.31–2.32); 1st generation: aOR = 1.90 (95% CI 1.20–3.03)) were more likely to consume ED more than once a week. Conclusions We identified different patterns of ED consumption in boys and girls. These results suggest that sex-tailored interventions could be relevant to reduce ED consumption in adolescents.
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With the worldwide consumption of energy drinks increasing in recent years, concerns have been raised both in the scientific community and among the general public about the health effects of these products. Recent studies provide data on consumption patterns in Europe; however, more research is needed to determine the potential for adverse health effects related to the increasing consumption of energy drinks, particularly among young people. A review of the literature was conducted to identify published articles that examined the health risks, consequences, and policies related to energy drink consumption. The health risks associated with energy drink consumption are primarily related to their caffeine content, but more research is needed that evaluates the long-term effects of consuming common energy drink ingredients. The evidence indicating adverse health effects due to the consumption of energy drinks with alcohol is growing. The risks of heavy consumption of energy drinks among young people have largely gone unaddressed and are poised to become a significant public health problem in the future.
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Objective: This study examines the use of alcohol mixed with energy drinks (AmED) as a predictor of alcohol problems and alcohol-related consequences and accidents two years later in a college student sample. Method: Longitudinal data on AmED use, alcohol consequences, and alcohol problems were collected from the fall of students' second year of college to the fall of their fourth year (N = 620, 49% male). Results: After we controlled for demographic indicators and heavy episodic drinking, AmED use was a consistent predictor of negative alcohol-related outcomes 2 years later. Compared with no AmED use, both infrequent (i.e., one to three times per month) and frequent (i.e., one or more times per week) AmED use were associated with an increased risk of negative alcohol consequences and harmful/hazardous alcohol use (≥8 on Alcohol Use Disorders Identification Test [AUDIT]). Frequent AmED use was also associated with serious alcohol problems ≥16 on AUDIT) and an increased risk of alcohol-related accidents in the subsequent 2 years. Conclusions: Prospective risks of alcohol consequences related to AmED use suggest a continued need for research and policy to address the surveillance, etiology, and prevention of AmED use.
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Unlabelled: The aim of this study was to investigate the prevalence of energy drink consumption in children and very young adolescents and to study the sociodemographic and environmental-behavioral factors associated with regular, at least once a week, energy drink consumption in early adolescence. This survey was conducted during the 2011-2012 school year in the Province of Rovigo, in the Veneto Region (northeastern Italy), and involved a sample of 916 students. The usage of energy drinks increased significantly with age, from 17.8 % among sixth graders to 56.2 % among eighth graders. Among the male student population, 16.5 % of those in the eighth grade and 6.21 % of those in the sixth grade, respectively, drank them at least once a week. The independent variables conferring a higher likelihood of being at least once-a-week energy drink consumers were smoking and alcohol consumption. Awareness of the damage caused by energy drinks emerged as a protective factor that reduced the likelihood of young students consuming such drinks. Conclusions: This study showed that energy drink consumption is rising steadily in children and early adolescents. Energy drink consumption was found associated with the abuse of other substances, such as tobacco and alcohol.
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Caffeine is the most widely used psychoactive substance in the world and currently the only one legally available to children and adolescents. The sale and use of caffeinated beverages has increased markedly among adolescents during the last decade. However, research on caffeine use and behaviors among adolescents is scarce. We investigate the relationship between adolescent caffeine use and self-reported violent behaviors and conduct disorders in a population-based cross-sectional sample of 3,747 10th grade students (15-16 years of age, 50.2 % girls) who were enrolled in the Icelandic national education system during February 2012. Through a series of multiple regression models, while controlling for background factors, Attention Deficit Hyperactivity Disorder symptoms and current medication and peer delinquency, and including measures on substance use, our findings show robust additive explanatory power of caffeine for both violent behaviors and conduct disorders. In addition, the association of caffeine to the outcomes is significantly stronger for girls than boys for both violent behaviors and conduct disorders. Future studies are needed to examine to what extent, if at all, these relationships are causal. Indication of causal connections between caffeine consumption and negative outcomes such as those reported here would call into question the acceptability of current policies concerning the availability of caffeine to adolescents and the targeting of adolescence in the marketing of caffeine products.
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The market and degree of consumption of energy drinks have exponentially expanded while studies that assess their psychological effects and impact on quality of life remain in the early stages, albeit on the rise. This review aims to examine the literature for evidence of the psychological effects of energy drinks and their impact on the sense of well-being and quality of life. Studies were identified through Pubmed, Medline, and PsycINFO searches from the dates of 1990 to 2011, published in English, using the keywords energy or tonic drinks, psychological effects, caffeine and cognitive functions, mood, sleep, quality of life, well-being, and mental illness. Three authors agreed independently on including 41 studies that met specific selection criteria. The literature reveals that people most commonly consume energy drinks to promote wakefulness, to increase energy, and to enhance the experience of alcohol intoxication. A number of studies reveal that individuals who consume energy drinks with alcohol were more inclined to be involved in risk-taking behaviors. There was also excessive daytime sleepiness the day following energy drink consumption. Contrary to expectations, the impact of energy drinks on quality of life and well-being was equivocal. Energy drinks have mixed psychological and well-being effects. There is a need to investigate the different contexts in which energy drinks are consumed and the impact on mental health, especially in the psychiatrically ill.
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To review the effects, adverse consequences, and extent of energy drink consumption among children, adolescents, and young adults. We searched PubMed and Google using "energy drink," "sports drink," "guarana," "caffeine," "taurine," "ADHD," "diabetes," "children," "adolescents," "insulin," "eating disorders," and "poison control center" to identify articles related to energy drinks. Manufacturer Web sites were reviewed for product information. According to self-report surveys, energy drinks are consumed by 30% to 50% of adolescents and young adults. Frequently containing high and unregulated amounts of caffeine, these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioral disorders or those who take certain medications. Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising. Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy drink use. In the short-term, pediatricians need to be aware of the possible effects of energy drinks in vulnerable populations and screen for consumption to educate families. Long-term research should aim to understand the effects in at-risk populations. Toxicity surveillance should be improved, and regulations of energy drink sales and consumption should be based on appropriate research.
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Energy drinks are highly caffeinated beverages that are increasingly consumed by young adults. Prior research has established associations between energy drink use and heavier drinking and alcohol-related problems among college students. This study investigated the extent to which energy drink use might pose additional risk for alcohol dependence over and above that from known risk factors. Data were collected via personal interview from 1,097 fourth-year college students sampled from 1 large public university as part of an ongoing longitudinal study. Alcohol dependence was assessed according to DSM-IV criteria. After adjustment for the sampling design, 51.3%(wt) of students were classified as "low-frequency" energy drink users (1 to 51 days in the past year) and 10.1%(wt) as "high-frequency" users (≥52 days). Typical caffeine consumption varied widely depending on the brand consumed. Compared to the low-frequency group, high-frequency users drank alcohol more frequently (141.6 vs. 103.1 days) and in higher quantities (6.15 vs. 4.64 drinks/typical drinking day). High-frequency users were at significantly greater risk for alcohol dependence relative to both nonusers (AOR = 2.40, 95% CI = 1.27 to 4.56, p = 0.007) and low-frequency users (AOR = 1.86, 95% CI = 1.10, 3.14, p = 0.020), even after holding constant demographics, typical alcohol consumption, fraternity/sorority involvement, depressive symptoms, parental history of alcohol/drug problems, and childhood conduct problems. Low-frequency energy drink users did not differ from nonusers on their risk for alcohol dependence. Weekly or daily energy drink consumption is strongly associated with alcohol dependence. Further research is warranted to understand the possible mechanisms underlying this association. College students who frequently consume energy drinks represent an important target population for alcohol prevention.
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Using academic achievement as the key outcome variable, 7377 Icelandic adolescents were surveyed for cigarette smoking, alcohol use, daytime sleepiness, caffeine use, and potential confounders. Structural equation modeling (SEM) was used to examine direct and indirect effects of measured and latent variables in two models: the first with caffeine excluded and the second with caffeine included. A substantial proportion of variance in academic achievement, which might otherwise have been attributed to the harmful effects of cigarette smoking and alcohol use, was found to be attributable to caffeine. Evidence was obtained that daytime sleepiness, which was found to be independently associated with usage of licit substances (nicotine and alcohol) and caffeine, may be an important mediator of the negative impact of those substances on academic achievement. Findings suggest the importance of including measurements of caffeine consumption in future studies of adolescent substance use.
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This longitudinal study examined the prevalence and correlates of energy drink use among college students, and investigated its possible prospective associations with subsequent drug use, including nonmedical prescription drug use. Participants were 1,060 undergraduates from a large, public university who completed three annual interviews, beginning in their first year of college. Use of energy drinks, other caffeinated products, tobacco, alcohol, and other illicit and prescription drugs were assessed, as well as demographic and personality characteristics. Annual weighted prevalence of energy drink use was 22.6%(wt) and 36.5%(wt) in the second and third year of college, respectively. Compared to energy drink non-users, energy drink users had heavier alcohol consumption patterns, and were more likely to have used other drugs, both concurrently and in the preceding assessment. Regression analyses revealed that Year 2 energy drink use was significantly associated with Year 3 nonmedical use of prescription stimulants and prescription analgesics, but not with other Year 3 drug use, holding constant demographics, prior drug use, and other factors. A substantial and rapidly-growing proportion of college students use energy drinks. Energy drink users tend to have greater involvement in alcohol and other drug use and higher levels of sensation-seeking, relative to non-users of energy drinks. Prospectively, energy drink use has a unique relationship with nonmedical use of prescription stimulants and analgesics. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance use problems.
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Energy drink consumption has continued to gain in popularity since the 1997 debut of Red Bull, the current leader in the energy drink market. Although energy drinks are targeted to young adult consumers, there has been little research regarding energy drink consumption patterns among college students in the United States. The purpose of this study was to determine energy drink consumption patterns among college students, prevalence and frequency of energy drink use for six situations, namely for insufficient sleep, to increase energy (in general), while studying, driving long periods of time, drinking with alcohol while partying, and to treat a hangover, and prevalence of adverse side effects and energy drink use dose effects among college energy drink users. Based on the responses from a 32 member college student focus group and a field test, a 19 item survey was used to assess energy drink consumption patterns of 496 randomly surveyed college students attending a state university in the Central Atlantic region of the United States. Fifty one percent of participants (n = 253) reported consuming greater than one energy drink each month in an average month for the current semester (defined as energy drink user). The majority of users consumed energy drinks for insufficient sleep (67%), to increase energy (65%), and to drink with alcohol while partying (54%). The majority of users consumed one energy drink to treat most situations although using three or more was a common practice to drink with alcohol while partying (49%). Weekly jolt and crash episodes were experienced by 29% of users, 22% reported ever having headaches, and 19% heart palpitations from consuming energy drinks. There was a significant dose effect only for jolt and crash episodes. Using energy drinks is a popular practice among college students for a variety of situations. Although for the majority of situations assessed, users consumed one energy drink with a reported frequency of 1 - 4 days per month, many users consumed three or more when combining with alcohol while partying. Further, side effects from consuming energy drinks are fairly common, and a significant dose effect was found with jolt and crash episodes. Future research should identify if college students recognize the amounts of caffeine that are present in the wide variety of caffeine-containing products that they are consuming, the amounts of caffeine that they are consuming in various situations, and the physical side effects associated with caffeine consumption.
Article
Little is known about the association between energy drink and other substance use in early adolescence despite the fact that the consumption of energy drinks during this developmental period is becoming increasingly common. The aim of this study was to examine concurrent and longitudinal associations between energy drink and alcohol use among middle school students. In addition, sensation seeking and parental monitoring were examined as factors that could potentially explain any associations found. A sample of 144 youth participating in the Camden Youth Development Study was utilized. Self-report questionnaire data was collected over a 16-month period. Frequency of energy drink use at the initial assessment predicted increases in frequency of alcohol use 16months later (adjusting for initial frequency of alcohol use). Levels of parental monitoring partially accounted for this association; in contrast, there was no evidence that sensation seeking was related to this association. Youth who consume energy drinks in early adolescence are at risk for alcohol use later; this may be partially related to low levels of parental monitoring being associated with the consumption of both substances. Future research is needed to further explain this association; this may lead to opportunities for early intervention for youth at high risk for alcohol use. Copyright © 2014 Elsevier Ltd. All rights reserved.
Article
The popularity of energy drinks has increased rapidly in the past decade. One of the main reasons people use energy drinks is to counteract effects of insufficient sleep or sleepiness. Risks associated with energy drink use, including those related to sleep loss, may be disproportionately borne by racial minorities and those of lower socioeconomic status. In this review, a brief introduction to the issue of health disparities is provided, population-level disparities and inequalities in sleep are described, and the social-ecological model of sleep and health is presented. Social and demographic patterns of energy drink use are then presented, followed by discussion of the potential ways in which energy drink use may contribute to health disparities, including the following: 1) effects of excessive caffeine in energy drinks, 2) effects of energy drinks as sugar-sweetened beverages, 3) association between energy drinks and risk-taking behaviors when mixed with alcohol, 4) association between energy drink use and short sleep duration, and 5) role of energy drinks in cardiometabolic disease. The review concludes with a research agenda of critical unanswered questions.
Article
Objective To examine the prevalence, patterns, and correlates of energy drinks use among adolescents, and determine whether more frequent use of energy drinks is associated with poorer health and behavioral outcomes. Methods Data were from a 2012 cross-sectional survey of 8,210 students in grades 7, 9, 10 and 12 attending public schools in Atlantic Canada. Multinomial logistic regression analysis was used to examine correlates of energy drinks use patterns, including substance use, sensation seeking, risk of depression, and socioeconomic status. Results Nearly two-thirds of survey respondents (62%) reported consuming energy drinks at least once in the previous year, with about 20% reporting use once or more per month. Sensation seeking, depression, and substance use were all higher among energy drinks users relative to non-users, and in higher frequency users relative to lower frequency users. Conclusions The prevalence of energy drinks consumption among high school students was high. The association of energy drinks with other potential negative health and behavioral outcomes suggest that use of these products may represent a marker for other activities that may negatively affect adolescent development, health and well-being.
Article
To explore associations between energy drink consumption and alcohol use among college students. Participants included 585 students (m age=18.7; 47.0% White, 21% Hispanic, 25% Asian, 7% other race/ethnicity; 56.0% female). Energy drink behaviors included past month and past week consumption. Alcohol use behaviors included past month and past two week consumption, as well as heavy drinking and quantity of alcohol consumed. Consumption of energy drinks mixed with alcohol was also measured. Linear and logistic regression analyses between energy drink consumption and alcohol use were run controlling for gender, age, and race/ethnicity. For each one unit increase in past month (i.e., additional day used) energy drink use, the likelihood of past month alcohol use increased by 80%, heavy drinking by 80% and past month energy drinks mixed with alcohol use by 90%. Similar results were found for past week energy drink use. A positive relationship between energy drink use and quantity of alcohol consumed during a single episode of drinking was also found (p<0.001). Significant gender interactions between energy drink consumption and alcohol use as well as quantity of alcohol consumed were found, with relationships stronger among males than females. There were no significant interactions by race/ethnicity. Energy drinks are readily available to students and pose potential health risks. Students who report greater energy drink consumption also consume more alcohol, are more likely to mix energy drinks and alcohol, and experience heavy episodes of drinking, which is problematic given the potential negative consequences of these drinks.
Article
We examined the sociodemographic correlates of energy drink use and the differences between those who use them with and without alcohol in a representative community sample. A random-digit-dial landline telephone survey of adults in the Milwaukee, Wisconsin area responded to questions about energy drink and alcohol plus energy drink use. Almost one-third of respondents consumed at least one energy drink in their lifetime, while slightly over 25% used energy drinks in the past year and 6% were past-year alcohol plus energy drink users. There were important racial/ethnic differences in consumption patterns. Compared to non-users, past-year energy drink users were more likely to be non-Black minorities; and past-year alcohol plus energy drink users when compared to energy drink users only were more likely to be White and younger. Alcohol plus energy drink users also were more likely to be hazardous drinkers. Our results which are among the first from a community sample suggest a bifurcated pattern of energy drink use highlighting important population consumption differences between users of energy drinks only and those who use alcohol and energy drinks together.
Article
Caffeine is a widely used psychoactive substance in both adults and children that is legal, easy to obtain, and socially acceptable to consume. Although once relatively restricted to use among adults, caffeine-containing drinks are now consumed regularly by children. In addition, some caffeine-containing beverages are specifically marketed to children as young as 4 years of age. Unfortunately, our knowledge of the effects of caffeine use on behavior and physiology of children remains understudied and poorly understood. The purpose of this article is to review what is known about caffeine use in children and adolescents, to discuss why children and adolescents may be particularly vulnerable to the negative effects of caffeine, and to propose how caffeine consumption within this population may potentiate the rewarding properties of other substances. The following topics are reviewed: (1) tolerance and addiction to caffeine, (2) sensitization and cross-sensitization to the effects of caffeine, (3) caffeine self-administration and reinforcing value, and (4) conditioning of preferences for caffeine-containing beverages in both adults and children.
Article
This study examined relationships between energy drink consumption and problem behaviors among adolescents and emerging adults. It was hypothesized that frequent consumption of energy drinks would be positively associated with substance abuse and other risky behaviors, and that these relationships would be moderated by race. Cross-sectional, self-report survey data were collected from 602 Western New York undergraduate students in the spring of 2006. Differences in problem behaviors by frequency of energy drink consumption were assessed with multivariate linear and logistic regressions, controlling for gender, race, age, parental education, and college grade point average. Follow-up regressions were conducted to test for a moderating effect of race. Frequency of energy drink consumption was positively associated with marijuana use, sexual risk-taking, fighting, seatbelt omission, and taking risks on a dare for the sample as a whole, and associated with smoking, drinking, alcohol problems, and illicit prescription drug use for white students but not for black students. These findings suggest that energy drink consumption is closely associated with a problem behavior syndrome, particularly among whites. Frequent consumption of energy drinks may serve as a useful screening indicator to identify students at risk for substance use and/or other health-compromising behavior.
Article
Since the introduction of Red Bull in Austria in 1987 and in the United States in 1997, the energy drink market has grown exponentially. Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle. Regulation of energy drinks, including content labeling and health warnings differs across countries, with some of the most lax regulatory requirements in the U.S. The absence of regulatory oversight has resulted in aggressive marketing of energy drinks, targeted primarily toward young males, for psychoactive, performance-enhancing and stimulant drug effects. There are increasing reports of caffeine intoxication from energy drinks, and it seems likely that problems with caffeine dependence and withdrawal will also increase. In children and adolescents who are not habitual caffeine users, vulnerability to caffeine intoxication may be markedly increased due to an absence of pharmacological tolerance. Genetic factors may also contribute to an individual's vulnerability to caffeine-related disorders including caffeine intoxication, dependence, and withdrawal. The combined use of caffeine and alcohol is increasing sharply, and studies suggest that such combined use may increase the rate of alcohol-related injury. Several studies suggest that energy drinks may serve as a gateway to other forms of drug dependence. Regulatory implications concerning labeling and advertising, and the clinical implications for children and adolescents are discussed.
Article
Two prospective longitudinal surveys based on New York State high school students indicate well-defined steps underlying adolescent progression and regression in drug use. At least four stages of involvement with drugs can be identified: (1) beer or wine; (2) cigarettes or hard liquor; (3) marijuana; and (4) other illicit drugs. Two stages of legal drugs are necessary intermediates between nonuse and marijuana. Very few youths progress to other illicit drugs without prior experience with marijuana. This sequence is found in- each year of high school and in- the year following graduation. Progression to a higher-ranked drug is directly related to intensity of use at the prior stage. The identification of stages in drug behavior has implications regarding the optimum strategy for studying factors that predict, differentiate, or result from drug use.
Article
The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high-risk drinking behavior, and alcohol-related consequences. In Fall 2006, a Web-based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina. A total of 697 students (24% of past 30-day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p < 0.001) and twice as many episodes of weekly drunkenness (1.4 days/week vs. 0.73 days/week; p < 0.001). Students who reported consuming AmED had significantly higher prevalence of alcohol-related consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p < 0.05). The effect of consuming AmED on driving while intoxicated depended on a student's reported typical alcohol consumption (interaction p = 0.027). Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol-related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk.
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[Health and lifestyles of adolescents between the ages of 16 and 20 in Switzerland.] SMASH 2002: Swiss multicenter adolescent survey on health 2002 Lausanne Institut universitaire de médecine sociale et préventive
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Rapport final de l'étude longitudinale Ado@Internet.ch Ado@Internet
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Energy Drinks, and Youth: A Dangerous Mix
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Santé et styles de vie des adolescents âgés de 16 à 20 ans en Suisse (2002). [Health and lifestyles of adolescents between the ages of 16 and 20 in Switzerland.] SMASH 2002: Swiss multicenter adolescent survey on health 2002
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Alcohol, Energy Drinks, and Youth: A Dangerous Mix
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Analysis of the study Health Behavior in School-Aged Children (HBSC) in terms of diet and physical activity. Secondary analysis under mandate from the Federal Office of Public Health
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A The ESPAD report 2003: alcohol and other drug use among students in 35 European countries Sweden The Swedish Council for Information on
  • S Hibell B Andersson B Bjarnason T Ahlström
  • O Balakireva
  • Kokkevi
Analysis of the study Health Behavior in School-Aged Children (HBSC) in terms of diet and physical activity. Secondary analysis under mandate from the Federal Office of Public Health
  • H Stamm
  • Gebert
  • M Wiegand D Lamprecht
A Santé et styles de vie des adolescents âgés de 16 à 20 ans en Suisse (2002). [Health and lifestyles of adolescents between the ages of 16 and 20 in Switzerland
  • A Narring F Tschumper A Inderwildi Bonivento L Jeannin
  • V Addor
  • Bütikofer
Rapport final de l'étude longitudinaleAdo@Internet.ch
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  • Zimmermanng Surisj
The ESPAD report 2003: alcohol and other drug use among students in 35 European countries.Sweden:The Swedish Council for Information on Alcohol and Other Drugs
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Santé et styles de vie des adolescents âgés de 16 à 20 ans en Suisse (2002). [Health and lifestyles of adolescents between the ages of 16 and 20 in Switzerland
  • Narringf Tschumpera Inderwildi Boniventol Jeannina Addorv Bütikofera