Energy Drinks and Their Adverse Health Effects: A Systematic Review and Meta-analysis

Context: Energy drinks are the fastest growing product in the beverage industry. However, there is concern regarding potential for adverse effects with use. Objective: To evaluate the reported adverse effects of energy drink consumption. Data Sources: The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from inception to November 2019, and pertinent data were abstracted. Study Selection: Only clinical studies reporting adverse events after energy drink consumption were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data regarding sample size characteristics, energy drink characteristics, comparators, and all adverse events were extracted in duplicate and recorded. Results: A total of 32 studies and 96,549 individuals were included. Frequently reported adverse events in the pediatric population were insomnia (35.4%), stress (35.4%), and depressive mood (23.1%). Frequently reported adverse events in the adult population were insomnia (24.7%), jitteriness/restlessness/shaking hands (29.8%), and gastrointestinal upset (21.6%). Alcohol mixed with energy drinks significantly reduced the likelihood of sedation effects but increased the likelihood of stimulatory effects. Energy drink consumption significantly increased the odds of insomnia (OR, 5.02; 95% CI, 1.72-14.63) and jitteriness/activeness (OR, 3.52; 95% CI, 1.28-9.67) compared with the control group. Conclusion: The authors recommend that individuals avoid frequent energy drink consumption (5-7 energy drinks/week) and avoid co-consumption with alcohol; increased regulatory standards should be placed in the sale of energy drinks, particularly with regard to the pediatric population.

Download Full-text

Hepatic & Renal Toxicity of Energy Drinks, a Serious Health Risk, Wistar Albino Rats Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i730459 ◽

2020 ◽

pp. 48-53

Author(s):

Fahad I. Al-Saikhan

Keyword(s):

Body Weight ◽

Public Health Education ◽

Energy Drinks ◽

Energy Drink ◽

Control Group ◽

Albino Rats ◽

The Public ◽

Energy Drink Consumption ◽

Wistar Albino Rats ◽

The Individual

The recent years have seen a significant increase in the individual consumption of energy drinks across the globe. As a result, notable concerns continue to rise both among the public and among the scientific community, concerning the health effects that energy drinks pose to individuals. This study therefore examines the adverse effects of energy drinks on health, using ten normal albino rats as specimens. The specimen was then divided into two groups consisting of five rats each, with one group was given energy drinks while the control group was given normal drinking water days for a period of 21 days. The specimen was then sacrificed and their blood samples used for biochemical and histological studies. The study findings reveal that energy drink consumption significantly increased the serum aspartate amino transferase (AST), alanine amino transferase (ALT), urea and creatinine levels when compared with the control group. In addition, the study demonstrates that energy drink consumption significantly decreased body weight and organ to body weight ratios when compared with the control group. The study further recognizes that the consumption of energy drink is associated with significant alterations in serum toxicity markers, bodyweight, organ body weight and histopathological changes. The study therefore recommends that need for public health education to educate individuals; especially youths about the risks of consuming highly caffeinated energy drinks. The study also recommends the need for further studies in order to minimize the harm excess and long-term consumption of energy drinks presented to the public.

Download Full-text

A Survey of Energy Drink Consumption and Associated Adverse Effects in Air Force Personnel

Military Medicine ◽

10.1093/milmed/usaa362 ◽

2020 ◽

Author(s):

Nicholas A Milazzo ◽

Diana X Cao ◽

Gunjeeta Diwaker ◽

Jennifer A Thornton ◽

Sachin A Shah

Keyword(s):

Emergency Department ◽

Adverse Effects ◽

Air Force ◽

Large Scale ◽

Medical Center ◽

Energy Drinks ◽

Energy Drink ◽

Emergency Department Visits ◽

Military Population ◽

Energy Drink Consumption

ABSTRACT Introduction Energy drinks are an increasingly utilized beverage and are gaining popularity in recent years. The U.S. Air Force (USAF) represents a unique population where energy drink consumption may be higher than the general population. To better understand the safety and health impact of energy drinks, this large-scale comprehensive survey was conducted to study energy drink consumption patterns and its associated adverse effects. Materials and Methods A survey was conducted across 12 USAF installations to assess self-reported energy drink consumption and adverse effects in the military population. This study was approved by the David Grant USAF Medical Center Institutional Review Board. Results A total of 9,655 participants participated in the survey. Energy drink consumption was reported in 76.7% of the participants, with 12.0% consuming ≥1 energy drink per day. Male gender, younger age, and enlisted military members are more likely to be high consumers; 58.6% of participants reported having at least once tried a premixed beverage that combines alcohol, caffeine, and other stimulants. Among energy drink users, 60.0% reported experiencing ≥1 adverse effect, and 0.92% reported needing to see a physician or going to the emergency department because of adverse effects from energy drinks. Higher energy drink or premixed combination beverage consumption frequency was associated with increased likelihood of physician or emergency department visits (P ≤ 0.002 for both). Conclusion Approximately three in four USAF members reported ever consuming an energy drink. Caution should be exercised on the amount of energy drink consumed to limit the risk of serious adverse effects. Future studies should identify populations at greatest risk for adverse effects and alternative sources of energy maintenance to attain optimal mission readiness.

Download Full-text

Energy Drink Consumption, Depression, and Salutogenic Sense of Coherence Among Adolescents and Young Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17041290 ◽

2020 ◽

Vol 17 (4) ◽

pp. 1290

Author(s):

Ákos Tóth ◽

Rita Soós ◽

Etelka Szovák ◽

Noemi M. Najbauer ◽

Dalma Tényi ◽

...

Keyword(s):

Logistic Regression ◽

Adverse Effects ◽

Sense Of Coherence ◽

Regression Models ◽

Energy Drinks ◽

Energy Drink ◽

Strong Sense ◽

Depression Symptoms ◽

Logistic Regression Models ◽

Energy Drink Consumption

The prevalence of energy drink consumption has increased in Hungary over the past 10–15 years. This study assesses the frequency, motivations, and adverse effects of energy drink consumption, and examines how the process of becoming a regular consumer is connected with sense of coherence and depression symptoms. A total of 631 high school and college students were assessed using the Depression Scale (BDS-13) and Sense of Coherence Scale (SOC-13). Logistic regression models were fit to test the effect of and links between factors influencing addiction to energy drink use. A total of 31.1% (95% CI: 27.4–34.7) of those surveyed consumed energy drinks, 24.0% of those affected consumed the energy drink with alcohol, 71.4% (95% CI: 64.7–77.3) experienced adverse effects following energy drink consumption, and 10.2% (95% CI: 6.7–15.2) experienced at least four symptoms simultaneously. The most common motivations of consumption were fatigue, taste, and fun. Obtained by multivariate logistic regression models, after adjustment for sex and age, SOC and tendency to depression had a significant influence on the respondents’ odds of addiction. The tendency to depression increases the chances of addiction, while a strong sense of coherence diminishes the effects of depression. Young people in Hungary have been shown to consume energy drinks in quantities that are detrimental to their health. Complex preventive measures and programs are needed to address the problem. Families and educators should strive to instill a strong sense of coherence in children from an early age.

Download Full-text

Incidence of Adverse Effects of Propofol for Procedural Sedation/Anesthesia in the Pediatric Emergency Population: A Systematic Review and Meta-Analysis

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/3160154 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Pengfei Guo ◽

YingChun Ran ◽

Xiaoxiao Ao ◽

Qing Zou ◽

Liping Tan

Keyword(s):

Systematic Review ◽

Sensitivity Analysis ◽

Adverse Effects ◽

Adverse Events ◽

Subgroup Analysis ◽

Pediatric Population ◽

Meta Analysis ◽

Relevant Literature ◽

Pediatric Emergency ◽

Cochrane Library

Background. To investigate the incidence of adverse effects of propofol among pediatric population for sedation or anesthesia. Methods. We performed Cochrane Library, PubMed, CNKI, VIP, and Wanfang databases to research relevant literature. We did sensitivity analysis to assess the incidence of adverse effects of propofol among pediatric population for sedation or anesthesia. Results. In 132 studies, eight RCTs were included in this analysis. The result showed that adverse events (bradypnea, hypotension, hypertension, and apnea) were significantly improved in the pediatric emergency population in the propofol group, but it had no effect on the incidence of cough attacks, desaturation, agitation, stridor, and laryngospasm. Furthermore, the subgroup analysis showed that those who received propofol for had decreased adverse effects compared with the patients who received ketamine treatment ( SMD = 0.44 , 95 % CI = 0.28 , 0.67 , I 2 = 0 %, and P = 0.0002 ), which demonstrated that propofol could decrease the incidence of adverse effects compared with ketamine and ketofol. Conclusions. The study demonstrated that propofol may decrease the incidence of bradypnea, hypotension, hypertension, and apnea, but it had no effect on the incidence of cough attacks, desaturation, agitation, stridor, and laryngospasm. Furthermore, more large RCTs are needed to assess incidence of adverse effects of propofol among pediatric population.

Download Full-text

Risk-Taking Behavior and the Consumption of Alcohol Mixed with Energy Drink among Australian, Dutch and UK Students

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105315 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5315

Author(s):

Sean J. Johnson ◽

Sarah Benson ◽

Andrew Scholey ◽

Chris Alford ◽

Joris C. Verster

Keyword(s):

Alcohol Consumption ◽

The Netherlands ◽

Risk Taking ◽

Positive Relationship ◽

Energy Drinks ◽

Energy Drink ◽

Energy Drink Consumption ◽

Risk Taking Behavior ◽

The Relationship ◽

Level Of Risk

The relationship between risk-taking behavior, alcohol consumption and negative alcohol-related consequences is well known. The current analyses were conducted to investigate whether alcohol mixed with energy drink (AMED) is related to risk-taking behavior and if there is a relationship between the amount of energy drink mixed with alcohol consumed, risk-taking behavior and negative alcohol-related consequences. Data from N = 1276 AMED consuming students from the Netherlands, UK and Australia who completed the same survey were evaluated. The analysis revealed that, compared to AMED occasions, on alcohol only (AO) occasions significantly more alcohol was consumed and significantly more negative alcohol-related consequences were reported. On both AO and AMED occasions, there was a strong and positive relationship between amount of alcohol consumed, level of risk-taking behavior and number of reported negative alcohol-related consequences. In contrast, the level of risk-taking behavior was not clearly related to energy drink consumption. Across risk-taking levels, differences in the amount of energy drink consumed on AMED occasions did not exceed one 250 mL serving of energy drink. When correcting for the amount of alcohol consumed, there were no statistically significant differences in the number of energy drinks consumed on AMED occasions between the risk-taking groups. In conclusion, alcohol consumption is clearly related to risk-taking behavior and experiencing negative alcohol-related consequences. In contrast, energy drink intake was not related to level of risk-taking behavior and only weakly related to the number of experienced negative alcohol-related consequences.

Download Full-text

AB0864 DO CORTICOSTEROIDS AND HYALURONIC ACID INJECTIONS CAUSE INFECTIONS? A SYSTEMATIC REVIEW OF LITERATURE ON ADVERSE EFFECTS AND INFECTION RATES OF INTRA-ARTICULAR CORTICOSTEROID AND HYALURONIC ACID INJECTIONS IN PATIENTS WITH KNEE OSTEOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5799 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1739.2-1739

Author(s):

C. Hatzantonis

Keyword(s):

Systematic Review ◽

Hyaluronic Acid ◽

Adverse Effects ◽

Adverse Events ◽

Knee Osteoarthritis ◽

Adverse Reactions ◽

Infection Rates ◽

Management Options ◽

Cochrane Reviews ◽

Number Of Patients

Background:Knee osteoarthritis has been a leading cause of chronic pain and disability in our increasingly aging population. Conservative management options of physiotherapy and oral analgesics offer some relief, but delivery of intra-articular injections such as corticosteroids or hyaluronic acid has increasingly become the mainstay of pain management of knee osteoarthritis. In a clinical setting, intra-articular injections offer a means to delay a total knee replacement. Despite the abundance of literature on corticosteroids and hyaluronic acid, there is no known percentage of infection rates or adverse effects that clinicians may use to inform patients prior to obtaining consent for the injection.Objectives:To determine a rate of adverse events and infection rates in patients undergoing intra-articular injections of corticosteroids or hyaluronic acid.Methods:A systematic review of current literature including studies involving patients ranging from 45 patients (Carmona L, 2018) to Cochrane reviews of 1767 patients (Campbell Kirk, 2015). From these studies, the number of patients, adverse reactions (i.e. pain, erythema) and serious adverse reactions (infections) were calculated.Results:Within our study, there was a large variation of numbers of adverse effects of hyaluronic acid and corticosteroids amongst studies, with percentages as variable as 0-9.3%. Corticosteroids demonstrated 11-26% reduction of adverse events compared to hyaluronic acid. However, confidence intervals were found to not be statistically significant.Conclusion:Intra-articular injections of corticosteroids and hyaluronic acid, although deemed clinically effective, continue to demonstrate variable rates of adverse effects and infection amongst patients with progressive knee osteoarthritis.Disclosure of Interests:None declared

Download Full-text

Abstract 12689: Cardiovascular Responses to Energy Drinks in a Healthy Population: The C-energy Study

Circulation ◽

10.1161/circ.132.suppl_3.12689 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Teri M Kozik ◽

Mouchumi Bhattacharyya ◽

Teresa T Nguyen ◽

Therese F Connolly ◽

Walther Chien ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Vital Signs ◽

Cardiovascular Responses ◽

Energy Drinks ◽

Energy Drink ◽

Emergency Department Visits ◽

Qtc Interval ◽

Cardiac Responses ◽

Energy Drink Consumption

Introduction: Energy drinks are presumed to enhance energy, physical endurance, mood, and boost metabolism. Serious health risks have been reported with energy drink consumption such as myocardial infarction, cardiac arrest, stroke, seizures, and arrhythmias. More than 20,000 emergency department visits related to energy drink consumption were reported in 2011. Little is known about the possible pathophysiological mechanisms and adverse events associated with energy drinks. Unlike the tobacco and alcohol industry, there are limited restrictions regulating the purchasing and marketing of these drinks. Purpose: To determine if consumption of energy drinks alter; vital signs (blood pressure, temperature), electrolytes (magnesium, potassium, calcium), activated bleeding time (ACT), or cardiac responses measured with a 12-lead electrocardiographic (ECG) Holter. Method: Subjects consumed two-16 ounce cans of an energy drink within one hour and remained in the lab where data was collected at base line (BL) and then during four hours post consumption (PC). Vital signs were taken every 30 minutes; blood samples were collected at BL, one, two and four hours PC and ECG data was collected throughout the entire study period. Paired students t-test and a corresponding non-parametric test (Wilcoxon signed rank) were used for analysis of the data. Results: Fourteen healthy young subjects were recruited (mean age 28.6 years). Systolic blood pressure (BL=132, ±7.83; PC= 151, ±11.21; p=.001); QTc interval (BL=423, ±22.74; PC=503, ±24.56; p<.001); magnesium level (BL 2.04, ± 0.09; PC=2.13, ±0.15; p=.05); and calcium level (BL=9.31, ±.28; PC=9.52, ±.22; p=.018) significantly increased from BL. While potassium and ACT fluctuated (increase and decrease) no significant changes were observed. Eight of the fourteen subjects (57%) developed a QTc >500 milliseconds PC. Conclusions: In our sample, consumption of energy drinks increased systolic blood pressure, serum magnesium and calcium, and resulted in repolarization abnormalities. Because these physiological responses can lead to arrhythmias and other abnormal cardiac responses, further study in a larger sample is needed to determine the effects and possible consequences of energy drink consumption.

Download Full-text

Energy drink - the prevalence of consumption and awareness regarding its associated potential health problems among commercial bus drivers in Ho, Ghana

10.21203/rs.3.rs-18668/v1 ◽

2020 ◽

Author(s):

Emmanuella Yayra Saku ◽

Peter Nuro-Ameyaw ◽

Priscilla Cecilia Amenya ◽

Fidelis Mawunyo Kpodo ◽

Paul Esua Amoafo ◽

...

Keyword(s):

Side Effects ◽

Public Health Problem ◽

Energy Drinks ◽

Energy Drink ◽

Health Problems ◽

Bus Drivers ◽

Long Distance ◽

Potential Health ◽

Poor Knowledge ◽

Energy Drink Consumption

Abstract Background Consumption of energy drinks has become an escalating global public health problem. The work schedule and irregular sleeping habits of commercial bus drivers make them highly susceptible to getting fatigued, hence most of them consume energy drinks as a fatigue management strategy. However, consumption of energy drinks produces numerous psychomotor side effects that if consumed among drivers puts the traveling public in danger of road accidents. This study sought to assess the prevalence of energy drink consumption and awareness of associated potential health problems among commercial long-distance bus drivers operating from the Ho municipality. Methods This was a cross-sectional study involving 132 participants who completed a structured questionnaire on the participants' socio-demographic characteristics, frequency of consumption and reasons for consumption. It also included questions to assess the knowledge of the ingredients and side effects of energy drinks. Results A majority (62.1%) of the drivers had more than 10 years of commercial driving experience. A 75% energy drink consumption prevalence was recorded with driving performance enhancement (78.8%) as the predominant reason for consumption. 7 - 10 bottles per week were consumed by most (32.2%) of the drivers with the most consumed brand being Rush energy drink (54.5%). Also, 72.0% had poor knowledge of the side effects linked with energy drink intake likewise the ingredients in them. Conclusion Energy drinks were consumed by the majority of the drivers at the Ho main bus terminal of which most of the drivers had poor knowledge of the potential health problems linked with the consumption of these drinks. The consumption of energy drinks was observed to be higher among the drivers with lower education levels, higher monthly income and those who worked long hours in a day. The Ghana National Road Safety Commission (GNRC) in collaboration with other private road transport unions in Ghana should organize regular seminars for commercial bus drivers on the potential dangers and effects associated with energy drink consumption.

Download Full-text

Nervous and Muscular Adverse Events after COVID-19 Vaccination: A Systematic Review and Meta-Analysis of Clinical Trials

Vaccines ◽

10.3390/vaccines9080939 ◽

2021 ◽

Vol 9 (8) ◽

pp. 939

Author(s):

Jiaxin Chen ◽

Yuangui Cai ◽

Yicong Chen ◽

Anthony P. Williams ◽

Yifang Gao ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Adverse Events ◽

Fixed Effects ◽

Meta Analysis ◽

Phase 1 ◽

Cochrane Library ◽

Categorical Variables ◽

Control Group ◽

Open Label

Background: Nervous and muscular adverse events (NMAEs) have garnered considerable attention after the vaccination against coronavirus disease (COVID-19). However, the incidences of NMAEs remain unclear. We aimed to calculate the pooled event rate of NMAEs after COVID-19 vaccination. Methods: A systematic review and meta-analysis of clinical trials on the incidences of NMAEs after COVID-19 vaccination was conducted. The PubMed, Medline, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched from inception to 2 June 2021. Two independent reviewers selected the study and extracted the data. Categorical variables were analyzed using Pearson’s chi-square test. The pooled odds ratio (OR) with the corresponding 95% confidence intervals (CIs) were estimated and generated with random or fixed effects models. The protocol of the present study was registered on PROSPERO (CRD42021240450). Results: In 15 phase 1/2 trials, NMAEs occurred in 29.2% vs. 21.6% (p < 0.001) vaccinated participants and controls. Headache and myalgia accounted for 98.2% and 97.7%, and their incidences were 16.4% vs. 13.9% (OR = 1.97, 95% CI = 1.28–3.06, p = 0.002) and 16.0% vs. 7.9% (OR = 3.31, 95% CI = 2.05–5.35, p < 0.001) in the vaccine and control groups, respectively. Headache and myalgia were more frequent in the newly licensed vaccines (OR = 1.97, 95% CI = 1.28–3.06, p = 0.02 and OR = 3.31, 95% CI = 2.05–5.35, p < 0.001) and younger adults (OR = 1.40, 95% CI = 1.12–1.75, p = 0.003 and OR = 1.54, 95% CI = 1.20–1.96, p < 0.001). In four open-label trials, the incidences of headache, myalgia, and unsolicited NMAEs were 38.7%, 27.4%, and 1.5%. Following vaccination in phase 3 trials, headache and myalgia were still common with a rate of 29.5% and 19.2%, although the unsolicited NMAEs with incidence rates of ≤ 0.7% were not different from the control group in each study. Conclusions: Following the vaccination, NMAEs are common of which headache and myalgia comprised a considerable measure, although life-threatening unsolicited events are rare. NMAEs should be continuously monitored during the ongoing global COVID-19 vaccination program.

Download Full-text

Abstract 12640: Energy Drinks Prolong Early Repolarization (J-T Peak ) Phase in a Healthy Population

Circulation ◽

10.1161/circ.142.suppl_3.12640 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Samuel R Kaplan ◽

Ghufran Syed ◽

Teri Kozik

Keyword(s):

Torsade De Pointes ◽

Energy Drinks ◽

Energy Drink ◽

Healthy Population ◽

Specific Marker ◽

Qtc Interval ◽

Qtc Prolongation ◽

Early Repolarization ◽

Increased Risk ◽

Energy Drink Consumption

Introduction: Energy drinks continue to be the fastest growing beverage market with sales expected to reach $60 billion in the next few years, yet have demonstrated adverse cardiovascular effects such as prolongation of the QTc interval on EKG. While QTc prolongation observed with certain drugs has long been used as an indicator of increased risk of torsade de pointes, recent data has identified the early repolarization interval J-T peak (JTp) as a more specific marker for proarrhythmic potential. Drugs that selectively block the human ether-a-go-go related (hERG) potassium ion channel prolong QTc by prolonging both early repolarization (JTp) and late repolarization (T peak -T end [Tpe] interval), and are associated with an increased risk of torsade. In contrast, drugs that additionally block inward late sodium and L-type calcium prolong QTc by prolonging Tpe but not JTp, and have demonstrated reduced risk of torsade. In 2018, the C-Energy-X study demonstrated QTc prolongation in 22 healthy subjects (mean age 28 ± 7yrs) who consumed energy drink while at rest and following short periods of exercise. Our study provides a secondary analysis of this data in terms of its effect on JTp, a potentially more specific marker for torsade risk. Methods: Using H-Scribe software, two evaluators independently measured JTp and RR intervals from C-Energy-X subjects pre- and post-energy drink consumption in the rest and exercise phases. Values were corrected for heart rate using the linear correction formula JTpc=JTp + 0.150(1-RR), where RR is R-to-R interval. Mean JTpc values from each phase were analyzed using a paired sample two-tailed t -test. Results: In the resting phase following energy drink consumption (PCr), there was a statistically significant increase in JTpc intervals for 77% of subjects by a mean of 10.5ms (baseline=234 ± 21.3ms; PCr=245 ± 22.0ms; p =0.015). In the exercise phase following energy drink consumption (PCe), 64% of subjects increased JTpc intervals by a mean of 0.8ms which was not significant (baseline=225 ± 15.7ms; PCe=226 ± 17.9ms; p =0.845). Conclusion: In the resting phase, energy drink consumption was associated with statistically significant prolongation of JTpc, suggesting a theoretical increased risk of torsade de pointes.

Download Full-text