Adverse Effects of Energy Drink Consumption Among Adolescents

Abstract

This research paper explores the adverse effects of energy drink consumption among adolescents. It examines existing studies and evidence to inform of the risks associated with energy drinks, including health issues such as cardiovascular complications, academic performance issues, and psychological or societal issues such as psychiatric interactions and psychophysiological disorders. In addition, it emphasizes the need for policy reforms, educational initiatives, and increased awareness in clinical practice to protect adolescent health. 

Adverse Effects of Energy Drink Consumption Among Adolescents

Introduced in the late 20th century, energy drinks (EDs) have long since increased in popularity alongside their controversial advertising of enhancing cognitive performance, relieving fatigue or tiredness, and extending attention spans (Ehlers et al., 2019; Kaur et al., 2022). With approximately one-third of adolescents (ages 12-17) in the United States consuming EDs (NCCIH, 2018), many medical professionals and health organizations have expressed concern over ED consumption and its short-term and long-term harmful, potentially fatal effects.

Through existing studies and bodies of research, this archival research paper seeks to spread awareness of health risks related to energy drink consumption among teenagers, from cardiac risk or arrhythmia (Gutiérrez-Hellín & Varillas-Delgado, 2021) to effects on academic performance and psychological issues (Richards & Smith, 2015; Ruiz & Scherr, 2018). Furthermore, I will also evaluate regulatory measures.

In other words, I intend to address the concerns of energy drink consumption among teenagers, encourage alternative solutions, and question what policy changes are needed to protect adolescent health.

Body: Analysis and Evidence

Health Risks

Energy drinks have multifarious ingredients such as taurine, glucuronolactone, inositol, various B vitamins, herbal supplements (most commonly guarana), and particular amino acids (Ehlers et al., 2019; Ruiz & Scherr, 2018). Contrary to the statistical claims of EDs and their ingredients having beneficial effects, it is shown to have short timespans and no substantial nutritional or supplemental value to an individual (Alsunni, 2015). 

Further suggesting against the statistics, there have been multiple adverse cases of cardiovascular effects upon ED consumption. For example, Kaur et al. (2022) elaborated that extraneous caffeine intake can cause “supraventricular and ventricular arrhythmias, coronary vasospasms, myocardial ischemia/infarctions, and sudden cardiac death in otherwise healthy patients.” Their studies have also measured that caffeine is involved in “blocking the vasodilation of vascular beds, increase in sympathetic tone, and positive inotropic action on the myocardium,” explaining the increase in blood pressure, heart rate, and other effects on the circulatory and cardiovascular systems. 

On a more individual scale, a case report by Kelsey et al. (2019) described a patient diagnosed with caffeine-related psychosis and acute kidney injury (AKI) caused by extreme ED use. More in-depth, Ferré (2018, as cited in Kelsey et al., 2019) provides that pharmacological studies suggest caffeine applies its stimulant effects through the antagonism of adenosine A2A receptors, leading to the inhibition of Dopamine D2 receptor heteromers within striatal neurons, potentially causing the caffeine-related psychosis symptoms depicted in the case study.

Academic Performance

A study by Mahoney et al. (2017) concluded that 92% of students selected across five United States universities consumed caffeine. 79% of these students ingested caffeine to feel awake, 31% to improve concentration, and 9% to alleviate stress. In a comparison of a mean caffeine intake of 173 mg per day (mg/d), 80 mg/d from males and females combined were from energy drinks. The use of energy drinks for academic aid is demonstrated by numerous similar analyses (see, e.g., Lazarus, 1993; Thoits, 1995; as cited in Richards & Smith, 2015). 

In addition, a study by Orbeta et al. (2006) concluded that adolescents with a high caffeine intake, the primary ingredient in EDs, commonly woke up more tired or had difficulty sleeping. Moreover, it is a supported correlation that inadequate sleep can result in negative academic performance through extensive research conducted by Urrila et al. (2017). To attribute caffeine usage to academics, 7,377 Icelandic adolescents were surveyed on their illicit substance and caffeine use, using structural equation modeling (SEM) to find proportions (James & Sigfúsdóttir, 2011).

Societal/Psychological Effects

ED ingredients, specifically caffeine, interact both positively and negatively with various disorders such as attention-deficit/hyperactivity disorder (ADHD) (Vázquez et al.,  2022), anxiety, and depression and can also counteract psychiatric medications/treatments (Broderick et al., 2005). Looking back into the case study of Kelsey et al. (2019), caffeine is a stimulant metabolized by the CYP1A2 enzyme while also acting as a CYP1A2 inhibitor. As this enzyme metabolizes antipsychotic medications such as clozapine, the studies indicate that caffeine can potentiate its side effects (Odom-White & de Leon, 1996, as cited in Winston et al., 2005). 

Another study of caffeine to sleep proportions further reinforces the correlation between caffeine use and sleep quality (Pollak & Bright, 2003). Various other studies suggest that insufficient sleep, alongside the potential outcome of insomnia (Ruiz & Scherr, 2018), consequently leads to mood disorders, aggression, or unstable cognitive processes (see, e.g., Saghir et al., 2018; Killgore, 2010; Pires, 2016). It’s also noteworthy that increased caffeine intake can contribute to psychophysiological disorders, depression, and anxiety (Gilliland & Andress, 1981).

Additionally, through the reviews of studies of how ED ingredients react to other substances, research can deduce that consumption of EDs/caffeine is attributed to impulsive behaviors, giving adolescents a “gateway” to substance abuse, usually through dependence or co-ingestion with other drugs (Cappelletti et al., 2015; Wolk et al., 2012). Various studies conclude that interactions between caffeine and alcohol increase physical and psychological harm (Kaur et al., 2022).

The influence of illicit substance use (alcohol and drugs) usually stems from peer pressure or the need to fit in socially through social media (Moreno & Whitehill, 2014). Concerning influence, controversial marketing is also a severe issue within ED consumption (Stacey et al., 2017).

Conclusion

In conclusion, the evidence presented highlights many adverse effects of adolescent energy drink consumption. These effects carry serious health risks, including cardiovascular and psychiatric consequences. Furthermore, energy drinks can detrimentally affect academic performance by disrupting sleepiness and increasing fatigue. The social implications are equally problematic, with energy drinks potentially serving as a gateway to substance abuse, especially when consumed alongside other drugs. Energy drinks pose a significant danger to adolescent health, and there is a crucial need for stricter regulation and policies, extensive education, and encouragement of healthier alternatives to alleviate these risks.

Discussion: What Needs to be Changed?

After reviewing the risks of energy drink consumption in adolescents, I have formed a list of possible solutions. Firstly, stricter regulations and more comprehensive policies are necessary. In other words, the current restrictions are inadequate to protect adolescents from the hazards presented. Reform options are limiting the accessibility of EDs to teenagers, restricting marketing practices, and regulating caffeine content in beverages and intake for those with pre-existing health conditions. 

Secondly, updated educational resources for schools, healthcare providers, athletes, and parents are essential. These should provide details and data on ED consumption effects in addition to promoting responsible caffeine intake and healthier alternatives such as sleep habits, physical fitness, and nutritional plans. 

Lastly, healthcare professionals and organizations should further research the risks of caffeine and ED use to contribute to prevention, in-depth statistical analytics, substance interaction information, and intervention strategies.

Applications and Limitations

The mentioned evidence and analyses can be instrumental in advocating for policy changes, stricter regulations, utilization by educational institutions to inform about the risks associated with energy drink consumption, clinical practice for healthcare professionals, parental awareness to recognize dangers, and open discussions on responsible consumption in adolescents.

However, there are limitations; most of the conducted studies are within specific regions and populations, precise reporting of ED consumption is also varied and challenging for reliable reproducibility, and confounding factors make relationships or correlations unclear in some research.

References

[1] Alsunni A. A. (2015). Energy Drink Consumption: Beneficial and Adverse Health Effects. International journal of health sciences, 9(4), 468–474.

[2] Broderick, P. J., Benjamin, A. B., & Dennis, L. W. (2005). Caffeine and psychiatric medication interactions: a review. The Journal of the Oklahoma State Medical Association, 98(8), 380–384.

[3] Cappelletti, S., Piacentino, D., Sani, G., & Aromatario, M. (2015). Caffeine: cognitive and physical performance enhancer or psychoactive drug?. Current neuropharmacology, 13(1), 71–88. https://doi.org/10.2174/1570159X13666141210215655

[4] Ehlers, A., Marakis, G., Lampen, A., & Hirsch-Ernst, K. I. (2019). Risk assessment of energy drinks with focus on cardiovascular parameters and energy drink consumption in Europe. Food and Chemical Toxicology, 130, 109–121. https://doi.org/10.1016/j.fct.2019.05.028

[5] Gilliland, K., & Andress, D. (1981). Ad lib caffeine consumption, symptoms of caffeinism, and academic performance. The American journal of psychiatry, 138(4), 512–514. https://doi.org/10.1176/ajp.138.4.512

[6] Gutiérrez-Hellín, J., & Varillas-Delgado, D. (2021). Energy Drinks and Sports Performance, Cardiovascular Risk, and Genetic Associations; Future Prospects. Nutrients, 13(3), 715. https://doi.org/10.3390/nu13030715

[7] James, J. E., Kristjánsson, A. L., & Sigfúsdóttir, I. D. (2011). Adolescent substance use, sleep, and academic achievement: evidence of harm due to caffeine. Journal of Adolescence, 34(4), 665–673. https://doi.org/10.1016/j.adolescence.2010.09.006

[8] Kaur, A., Yousuf, M. H., Ramgobin-Marshall, D., Jain, R., & Jain, R. (2022). Energy drink consumption: a rising public health issue. Reviews in Cardiovascular Medicine, 23(3), 083. https://doi.org/10.31083/j.rcm2303083

[9] Kelsey, D. S., Berry, A., Swain, R. A., & Lorenz, S. (2019, July 24). A Case of Psychosis and Renal Failure Associated with Excessive Energy Drink Consumption. Case Reports in Psychiatry; Hindawi Publishing Corporation. https://doi.org/10.1155/2019/3954161

[10] Killgore W. D. (2010). Effects of sleep deprivation on cognition. Progress in brain research, 185, 105–129. https://doi.org/10.1016/B978-0-444-53702-7.00007-5

Mahoney, C. R., Giles, G. E., Marriott, B. P., Judelson, D. A., Glickman, E. L., Geiselman, P. J., & Lieberman, H. R. (2019). Intake of caffeine from all sources and reasons for use by college students. Clinical nutrition (Edinburgh, Scotland), 38(2), 668–675. https://doi.org/10.1016/j.clnu.2018.04.004

[11] Moreno, M. A., & Whitehill, J. M. (2014). Influence of Social Media on Alcohol Use in Adolescents and Young Adults. Alcohol research : current reviews, 36(1), 91–100.

NCCIH. (2018). Energy Drinks. https://www.nccih.nih.gov/health/energy-drinks/

[12] Orbeta, R. L., Overpeck, M. D., Ramcharran, D., Kogan, M. D., & Ledsky, R. (2006). High caffeine intake in adolescents: associations with difficulty sleeping and feeling tired in the morning. The Journal of adolescent health: official publication of the Society for Adolescent Medicine, 38(4), 451–453. https://doi.org/10.1016/j.jadohealth.2005.05.014

[13] Pires, G. N., Bezerra, A. G., Tufik, S., & Andersen, M. L. (2016). Effects of acute sleep deprivation on state anxiety levels: a systematic review and meta-analysis. Sleep medicine, 24, 109–118. https://doi.org/10.1016/j.sleep.2016.07.019

[14] Pollak, C. P., & Bright, D. (2003). Caffeine consumption and weekly sleep patterns in US seventh-, eighth-, and ninth-graders. Pediatrics, 111(1), 42–46. https://doi.org/10.1542/peds.111.1.42

[15] Richards, G., & Smith, A. (2015). Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children. Journal of psychopharmacology (Oxford, England), 29(12), 1236–1247. https://doi.org/10.1177/0269881115612404

[16] Ruiz, L. D., & Scherr, R. E. (2018). Risk of Energy Drink Consumption to Adolescent Health. American journal of lifestyle medicine, 13(1), 22–25. https://doi.org/10.1177/1559827618803069

[17] Saghir, Z., Syeda, J. N., Muhammad, A. S., & Balla Abdalla, T. H. (2018). The Amygdala, Sleep Debt, Sleep Deprivation, and the Emotion of Anger: A Possible Connection?. Cureus, 10(7), e2912. https://doi.org/10.7759/cureus.2912

[18] Stacey, N., van Walbeek, C., Maboshe, M., Tugendhaft, A., & Hofman, K. (2017). Energy drink consumption and marketing in South Africa. Preventive medicine, 105S, S32–S36. https://doi.org/10.1016/j.ypmed.2017.05.011

[19] Urrila, A. S., Artiges, E., Massicotte, J., Miranda, R., Vulser, H., Bézivin-Frere, P., Lapidaire, W., Lemaître, H., Penttilä, J., Conrod, P. J., Garavan, H., Paillère Martinot, M. L., Martinot, J. L., & IMAGEN consortium (2017). Sleep habits, academic performance, and the adolescent brain structure. Scientific reports, 7, 41678. https://doi.org/10.1038/srep41678

[20] Vázquez, J. C., Martin de la Torre, O., López Palomé, J., & Redolar-Ripoll, D. (2022). Effects of Caffeine Consumption on Attention Deficit Hyperactivity Disorder (ADHD) Treatment: A Systematic Review of Animal Studies. Nutrients, 14(4), 739. https://doi.org/10.3390/nu14040739

[21] Winston, A. P., Hardwick, E., & Jaberi, N. (2005). Neuropsychiatric effects of caffeine. Advances in Psychiatric Treatment, 11(6), 432–439. https://doi.org/10.1192/apt.11.6.432

[22] Wolk, B. J., Ganetsky, M., & Babu, K. M. (2012). Toxicity of energy drinks. Current opinion in pediatrics, 24(2), 243–251. https://doi.org/10.1097/MOP.0b013e3283506827