Caffeine,D-glucuronolactone and Taurine Content in Energy Drinks: Exposure and Risk Assessment

The consumption of energy drinks (EDs) is increasing globally while the evidence and concern about the potential health risks are also growing. Caffeine (generally 32 mg/100 mL) together with a wide variety of other active components such as taurine (usually 4000 mg/L) and D-glucuronolactone (generally 2400 mg/L) are the main ingredients of EDs. This study aims to assess the exposures to caffeine, taurine and D-glucuronolactone from EDs in various consumption scenarios and consumer profiles and to characterize the risks by evaluating caffeine and taurine intakes with their reference values and by calculating the margin of safety (MOS) for D-glucuronolactone. While the exposure assessment results showed that caffeine intakes from EDs ranged from 80 to 160 mg (1.14–4 mg/kg b.w.) for the considered scenarios, the risk characterization estimated some risks that could be managed with consumption recommendations such as limiting EDs in 40, 60 and 80 kg b.w. consumers to 175, 262.5 and 350 mL, respectively, to prevent sleep disturbances and to 375, 562.5 and 750 mL to prevent general caffeine adverse health risks, respectively. Dietary exposure to D-glucuronolactone from EDs ranged from 600 to 1200 mg (7.5–30 mg/kg b.w.). As D-glucuronolactone MOS ≥ 100 is only observed when EDs consumption is limited to 250 mL, for individuals weighing above 60 kg, some risks were observed in some of the studied scenarios. A taurine exposure from EDs varied from 1000 to 2000 mg (12.5–50 mg/kg b.w.) and consumptions over 500 mL were estimated to generate intakes above the reference value. In conclusion, the management of these risks requires a European legal framework for EDs with maximum limits for the active components, volume size limitations and labeling improvements along with the development of education and awareness programs and risk communication actions in collaboration with the industry and society.     

Energy Drinks and Sleep among Adolescents

Many adolescents worldwide have the problem of meeting recommended nightly sleep hours. The causes of sleep disturbance are multifactorial, but interest in food’s effect on sleep has dramatically increased lately. In this study, we investigated the association between regular energy drink (ED) intake (weekly or more frequent) and sufficient sleep (SS) (≥8 h) in adolescents. Additional objectives were to examine the relationship between health-related behaviors and SS, stratified by gender. A population-based cross-sectional study was conducted during the 2019/2020 school year from 12 schools in Belgrade. There were 1287 students aged 15 to 19 who participated (37.4% male). We used a modified version of the food frequency questionnaire adapted for Serbian adolescents. Logistic regression revealed that regular ED consumption was an independent risk factor negatively related to SS in both sexes. Additionally, daily vegetable and water intake (≥2 L) showed a positive correlation with SS in boys, while in girls, the odds of realizing SS decreased with statements of sedative use. In conclusion, we show that ED intake is negatively associated with SS in both sexes; daily vegetable and water intake (≥2 L) may raise the odds of SS in boys, while sedative use may decrease the chances of SS in girls.     

Prevalence and Amounts of Common Ingredients Found in Energy Drinks and Shots

Background: Energy drinks are one of the most popular packaged beverage products consumed within the United States (US). Energy drinks are considered a functional beverage, a category that also includes sports drinks and nutraceutical beverages. Purpose: The focus of the current study was to examine the nutrition fact panels of the top selling commercially available energy drink and energy shot products within the US to characterize common ingredient profiles to help establish a standard definition and ingredient profile of energy drinks and energy shots for consumers, health care practitioners, and researchers. Methods: The top 75 commercially available energy drinks and shots were identified and compiled from multiple commercial retail websites as of September 2021. For the purpose of this study, an energy drink must have met the following criteria: (A) marketed as an energy drink; (B) purported to improve energy, focus, or alertness; (C) not sold as a dietary supplement (no supplement fact panels); (D) manufactured as a pre-packaged and ready-to-drink beverage; and (E) contains at least three of (1) caffeine, (2) B-vitamins, (3) sugar, (4) taurine, (5) creatine, (6) quercetin, (7) guarana, (8) ginseng, (9) coenzyme Q10, or (10) branched chain amino acids. Energy shots must have met similar criteria to be included: (A) marketed as an energy shot; (B) purported to improve energy, focus, or alertness; (C) sold as a dietary supplement; (D) manufactured as a pre-packaged beverage with a small volume (<3.5 mL); and (E) contains at least three of the ingredients stated above. Results: Twenty energy shots and fifty-five energy drinks were included in this analysis. The number of ingredients per product (mean ± SD) was 18.2 ± 5.7, with 15 products containing proprietary blends with undisclosed ingredient amounts. The relative prevalence and average amounts of the top ingredients were as follows: caffeine (100%; 174.4 ± 81.1 mg), vitamin B6 (72%; 366.9 ± 648.1 percent daily value (%DV)), vitamin B3 (67%; 121.44 ± 69.9% DV), vitamin B12 (67%; 5244.5 ± 10,474.6% DV), vitamin B5 (37.3%; 113.6 ± 76.6% DV), and taurine (37.3%; amounts undisclosed). Conclusions: Our findings suggest a high prevalence of caffeine and B-vitamins in these energy products, with many of the formulations containing well above the recommended daily value of B-vitamins.     

Adolescent Consumption of Sports and Energy Drinks: Linkages to Higher Physical Activity,Unhealthy Beverage Patterns,Cigarette Smoking,and Screen Media Use

ObjectiveTo examine patterns of adolescent sports and energy drink (SED) consumption and identify behavioral correlates.DesignData were drawn from Eating and Activity in Teens, a population-based study.SettingAdolescents from 20 middle and high schools in Minneapolis/St Paul, MN completed classroom-administered surveys.ParticipantsA total of 2,793 adolescents (53.2% girls) in grades 6–12.Variables MeasuredBeverage patterns; breakfast frequency; moderate to vigorous physical activity (MVPA); media use; sleep; and cigarette smoking.AnalysisLinear and logistic regression models were used to estimate associations between health behaviors and SED consumption, adjusting for demographics.ResultsOver a third of adolescents consumed sports drinks and 14.7% consumed energy drinks at least once a week. Among boys and girls, both sports and energy drink consumption were related to higher video game use; sugar-sweetened beverage and fruit juice intake; and smoking (P < .05). Sports drink consumption was also significantly related to higher MVPA and organized sport participation for both genders (P < .01).Conclusions and ImplicationsAlthough sports drink consumption was associated with higher MVPA, adolescents should be reminded of recommendations to consume these beverages only after vigorous, prolonged activity. There is also a need for future interventions designed to reduce SED consumption, to address the clustering of unhealthy behaviors.     

Effects of Energy Drink Consumption on Physical Performance and Potential Danger of Inordinate Usage

The rise in energy drink (ED) intake in the general population and athletes has been achieved with smart and effective marketing strategies. There is a robust base of evidence showing that adolescents are the main consumers of EDs. The prevalence of ED usage in this group ranges from 52% to 68%, whilst in adults is estimated at 32%. The compositions of EDs vary widely. Caffeine content can range from 75 to 240 mg, whereas the average taurine quantity is 342.28 mg/100 mL. Unfortunately, exact amounts of the other ED elements are often not disclosed by manufacturers. Caffeine and taurine in doses 3–6 mg/kg and 1–6 g, respectively, appear to be the main ergogenic elements. However, additive or synergic properties between them seem to be implausible. Because of non-unified protocol design, presented studies show inconsistency between ED ingestion and improved physical performance. Potential side effects caused by abusive consumption or missed contraindications are the aspects that are the most often overlooked by consumers and not fully elucidated by ED producers. In this review, the authors aimed to present the latest scientific information on ED components and their possible impact on improving physical performance as well as to bring emphasis to the danger of inordinate consumption.     

Bibliometric Analysis of Studies on Coffee/Caffeine and Sport

This article provides an empirical overview of coffee/caffeine studies in relation to sport worldwide, an incipient but growing relationship that has existed since 1938, although systematized over time since 1999. The extracted articles were examined using a bibliometric approach based on data from 160 records stored in the Web of Science (JCR) between 1938 and August 2021, applying traditional bibliometric laws and using VOSviewer for data and metadata processing. Among the results, these articles highlight an exponential increase in scientific production in the last two decades, with a concentration in only 12 specific journals, the hegemony of the USA among the co-authorship networks of worldwide relevance, and the thematic and temporal segregation of the concepts under study. This article concludes a high fragmentation of the authors with the highest level of scientific production and an evolution of almost 20 years in relevant thematic topics, and a concurrent concentration in three large blocks: (1) coffee consumption and risk factors, (2) health and coffee consumption, and (3) metabolism and sport correlated with the intake of coffee, which are distanced in time, providing evidence of an evolution that gives way to the irruption of alternative visions in the relationship of coffee and caffeine with sport.     

Caffeinated Drinks and Physical Performance in Sport: A Systematic Review

Caffeine (1,3,7-trimethylxanthine) is one of the most common substances used by athletes to enhance their performance during competition. Evidence suggests that the performance-enhancing properties of caffeine can be obtained by employing several forms of administration, namely, capsules/tablets, caffeinated drinks (energy drinks and sports drinks), beverages (coffee), and chewing gum. However, caffeinated drinks have become the main form of caffeine administration in sport due to the wide presence of these products in the market. The objective of this systematic review is to evaluate the different effects of caffeinated drinks on physical performance in various sports categories such as endurance, power-based sports, team sports, and skill-based sports. A systematic review of published studies was performed on scientific databases for studies published from 2000 to 2020. All studies included had blinded and cross-over experimental designs, in which the ingestion of a caffeinated drink was compared to a placebo/control trial. The total number of studies included in this review was 37. The analysis of the included studies revealed that both sports drinks with caffeine and energy drinks were effective in increasing several aspects of sports performance when the amount of drink provides at least 3 mg of caffeine per kg of body mass. Due to their composition, caffeinated sports drinks seem to be more beneficial to consume during long-duration exercise, when the drinks are used for both rehydration and caffeine supplementation. Energy drinks may be more appropriate for providing caffeine before exercise. Lastly, the magnitude of the ergogenic benefits obtained with caffeinated drinks seems similar in women and men athletes. Overall, the current systematic review provides evidence of the efficacy of caffeinated drinks as a valid form for caffeine supplementation in sport.     

Sports and Energy Drink Consumption,Oral Health Problems and Performance Impact among Elite Athletes

Frequent consumption of sports and energy drinks among athletes is of concern due to its detrimental impact on oral health. The present study aimed to assess sports and energy drink consumption, oral health status and impacts on daily activities and sports performance among elite athletes from Pakistan. Data regarding socio-demographic characteristics, sports and energy drink consumption, oral health and hygiene practices, self-reported oral health and psychosocial and performance impact was assessed using a self-administered, structured questionnaire followed by clinical oral examination by a single, experienced dentist. A total of 104 athletes, a majority of whom were male (80.8%), participated in the study. Around two third of the participants reported consumption of sports and energy drinks, energy gels or bars at least once a week, the commonest being Sting. Despite good oral hygiene practices, the athletes generally had poor oral health with high prevalence of dental caries (63.5%), gingivitis (46.1%), irreversible periodontitis (26.9%) and erosive tooth wear (21.2%). More than a quarter (28.8%) of the athletes rated their oral health as fair—very poor. Four in five athletes (80%) also experienced at least one oral problem with negative impacts on daily activities (64.4%) and participation training and sports performance (36.5%). Regression analyses revealed a significant association between periodontal disease and impact on both daily activities and sports performance. To our knowledge, this is the first study reporting that high-prevalence sports and energy drink consumption and oral problems among elite athletes from Pakistan has a negative impact on daily activities and sports performance. These findings may have important implications for oral health education programs, and the need to create awareness among the athletes regarding the use of sports and energy drinks, as well as regular oral health screening of athletes to minimize the impact on performance.     

Chronic Intake of Energy Drinks and Their Sugar Free Substitution Similarly Promotes Metabolic Syndrome

Energy drinks containing significant quantities of caffeine, taurine and sugar are increasingly consumed, particularly by adolescents and young adults. The putative effects of chronic ingestion of either standard energy drink, Mother^TM (ED), or its sugar-free formulation (sfED) on metabolic syndrome were determined in wild-type C57BL/6J mice, in comparison to a soft drink, Coca-Cola (SD), a Western-styled diet enriched in saturated fatty acids (SFA), and a combination of SFA + ED. Following 13 weeks of intervention, mice treated with ED were hyperglycaemic and hypertriglyceridaemic, indicating higher triglyceride glucose index, which was similar to the mice maintained on SD. Surprisingly, the mice maintained on sfED also showed signs of insulin resistance with hyperglycaemia, hypertriglyceridaemia, and greater triglyceride glucose index, comparable to the ED group mice. In addition, the ED mice had greater adiposity primarily due to the increase in white adipose tissue, although the body weight was comparable to the control mice receiving only water. The mice maintained on SFA diet exhibited significantly greater weight gain, body fat, cholesterol and insulin, whilst blood glucose and triglyceride concentrations remained comparable to the control mice. Collectively, these data suggest that the consumption of both standard and sugar-free forms of energy drinks induces metabolic syndrome, particularly insulin resistance.     

Physical Activity and Sports Team Participation: Associations With Academic Outcomes in Middle School and High School Students

BACKGROUND: Previous studies have found that higher physical activity levels are associated with greater academic achievement among students. However, it remains unclear whether associations are due to the physical activity itself or sports team participation, which may involve requirements for maintaining certain grades, for example. The purpose of this study is to examine the associations between sports team participation, physical activity, and academic outcomes in middle and high school students. METHODS: Data were drawn from Project EAT (Eating Among Teens), a survey of middle and high school students (n = 4746). Students self-reported their weekly hours of physical activity, sports team participation, and academic letter grades. Two statistical models were considered: first, 2 separate regression analyses with grade point average (GPA) as the outcome and either sports team participation or physical activity as the predictor; second, a single regression with GPA as the outcome and both sports team participation and physical activity as the simultaneous predictors. RESULTS: For high school girls, both physical activity and sports team participation were each independently associated with a higher GPA. For high school boys, only sports team participation was independently associated with a higher GPA. For middle school students, the positive association between physical activity and GPA could not be separated from the relationship between sports team participation and a higher GPA. CONCLUSIONS: Regardless of whether academic success was related to the physical activity itself or to participation on sports teams, findings indicated positive associations between physical activity involvement and academic achievement among students.     

Hydration in sport and exercise: water,sports drinks and other drinks

There is evidence to suggest that exercise‐induced dehydration can have a negative impact on exercise performance, and restoration of fluid balance should be achieved after exercise. It is equally well known that muscle glycogen must be restored after exercise if subsequent performance is not to be negatively affected. Sports drinks are ideally placed to fill both these roles. However, while muscle glycogen restoration can be comfortably achieved by consumption of solid food, the same is not true for restoration of hydration status. Clear evidence is available that drinking during exercise can improve performance, provided that the exercise is of sufficient duration for the drink to be emptied from the stomach and absorbed in the intestine. Generally, drinking plain water is better than drinking nothing, but drinking a properly formulated carbohydrate–electrolyte ‘sports’ drink can allow for even better exercise performance. Of importance for rehydration purposes after exercise is consumption of both an adequate volume of fluid (greater than the net deficit of the sweat volume lost) and quantity of sodium. Without both of these, rehydration will be neither rapid nor complete and maintained. There is, however, no good evidence for the inclusion of any other electrolytes. The current generation of commercially available sports drinks are generally formulated to meet the needs of many athletes in many different situations.     

Determinants of the Consumption of Regular Soda,Sport, and Energy Beverages in Spanish Adolescents

Increasing sugar-sweetened beverages (SSB) consumption and associated health impacts warrant health-policy action. We assessed associations of socioeconomic and lifestyle variables with adolescents’ consumption of regular soda (RSD), sport (SD), and energy (ED) drinks. Cross-sectional study of 3930 Spanish adolescents (2089 girls, 1841 boys) aged 13–18 years). We compared frequency of consuming each SSB type (European Food Safety Authority questionnaire) with sociodemographic and lifestyle variables (standardized questions). RSD, SD, and ED were consumed at least weekly by 72.7%, 32.3%, and 12.3% of participants, respectively, and more frequently (p < 0.001) by boys, compared to girls. Multivariate ordinal logistic regression showed inverse association between RSD, SD, and ED consumption and parental occupation-based socioeconomic status (p < 0.01). Daily smoking was associated (p < 0.001) with higher ED (OR 3.64, 95% CI 2.39–5.55) and RSD (OR 2.15, 95% CI 1.56–2.97) consumptions. SD intake was associated inversely with smoking (OR 0.60, 95% CI 0.40–0.89, p = 0.012) and directly with physical activity (OR 2.93, 95% CI 2.18–3.95, p < 0.001). School performance was lower among ED (OR 2.14, 95% CI, 1.37–3.35, p = 0.001) and RSD (OR 1.81, 95% CI 1.24–2.64, p = 0.002) consumers, compared to SD. Maleness and low socioeconomic status predicted SSB consumption. Smoking and low school performance were associated with higher ED and RSD intakes.     

Development of a Caffeine Content Table for Foods,Drinks, Medications and Supplements Typically Consumed by the Brazilian Population

Background: The lack of a national table informing the caffeine contents in foods, drinks, dietary supplements, and medications sold in Brazil added to the noncompulsory disclosure of caffeine contents on labels of food products makes it difficult to estimate caffeine consumption in the Brazilian population. Therefore, this study aimed to develop the Brazilian Caffeine Content Table (BraCaffT). Methods: A systematic search for caffeine levels in foods, drinks, recipes, supplements, and medications was performed through a literature review, afterward collecting data from the United States Department of Agriculture Food Data Central, information from manufacturers’ and websites, and the Brazilian official medication guide. Subsequently, data systematization was performed in a spreadsheet with standardized values presented in mg of caffeine per 100 g or 100 mL of food or drink and a capsule or pill for medications and some dietary supplements. Results: The BraCaffT presents 57 items, divided into 11 categories: coffees, teas and infusions, cocoa powder, chocolates, cocoa-based beverages, desserts, soft drinks, energy drinks, guaraná powder, dietary supplements, and medications. Conclusions: The BraCaffT emerges as an instrument of great relevance and wide applicability in clinical contexts, in academic research, and as a database for the Brazilian population to better understand the amounts of caffeine in foods, drinks, dietary supplements, and medications consumed daily favoring a safe intake.     

The Consumption of Caffeine-Containing Products to Enhance Sports Performance: An Application of an Extended Model of the Theory of Planned Behavior

Caffeine is the most-used psychoactive substance in the world. About 80% of the world’s population consumes caffeine every day, including athletes and lifestyle users. Thus, it is important to understand the consumer drivers of caffeine-containing beverages and food. This research study aims to explore consumers’ behaviors, perceptions, attitudes, and drivers towards caffeine-containing products to enhance sports performance. The research applies the Theory of Planned Behavior (TPB) in order to understand consumers’ behavior, extended with utilitarian aspects for a comprehensive understanding of consumers’ behavior and attitudes. We interviewed consumers with the support of Qualtrics online software. The data were then processed with SPSS (statistical analysis software). The data elaboration includes a multivariate linear regression model to analyze the consumers’ intention to consume caffeine to enhance the sports performance, and to explore consumers’ preference of marketing leverages for this product category. The results contribute to an understanding of consumers’ consumption and purchasing behavior towards caffeine, and support the validity of the extended TPB to develop a more comprehensive picture of consumer behavior. Consumers have a positive attitude towards caffeine-containing products to enhance sports performance. The main consumer behavior drivers are subjective norms and utilitarian aspects. The present research results may support companies in the development of caffeine-containing products to enhance sports performance.     

HPLC测定饮料中安赛蜜、糖精钠和咖啡因含量的不确定度

目的对高效液相色谱法测定饮料中安赛蜜、糖精钠和咖啡因进行不确定度评定,确定引入测量不确定度的主要来源,以便在检测工作中引起重视并予以纠正。方法分析测量不确定度的来源,建立数学模型,并计算各分量引入的不确定度,合成标准不确定度和扩展不确定度。结果高效液相色谱法测定饮料中安赛蜜、糖精钠和咖啡因引入的扩展不确定度分别为0.43、0.44和0.31 mg/kg。结论标准和样品的重复测定以及回收率是测量不确定度的主要来源,故在测定时应对其加以控制。     

The impact of caffeine on mood, cognitive function, performance and hydration: a review of benefits and risks

Summary   The reputed benefits of moderate caffeine consumption include improvements in physical endurance, cognitive function, particularly alertness and vigilance, mood and perception of fatigue. In contrast, there are concerns that excessive intakes increase the risks of dehydration, anxiety, headache and sleep disturbances. This paper is a review of double-blind, placebo-controlled trials published over the past 15 years to establish what range of caffeine consumption would maximise benefits and minimise risks for cognitive function, mood, physical performance and hydration. Of the 41 human studies meeting the inclusion criteria, the majority reported benefits associated with low to moderate caffeine intakes (37.5 to 450 mg per day). The available studies on hydration found that caffeine intakes up to 400 mg per day did not produce dehydration, even in subjects undergoing exercise testing. It was concluded that the range of caffeine intake that appeared to maximise benefit and minimise risk is 38 to 400 mg per day, equating to 1 to 8 cups of tea per day, or 0.3 to 4 cups of brewed coffee per day. The limitations of the current evidence base are discussed.     

Trait Energy and Fatigue Modify the Effects of Caffeine on Mood,Cognitive and Fine-Motor Task Performance: A Post-Hoc Study

Multiple studies suggest that genetic polymorphisms influence the neurocognitive effects of caffeine. Using data collected from a double-blinded, within-participants, randomized, cross-over design, this study examined the effects of trait (long-standing pre-disposition) mental and physical energy and fatigue to changes in moods (Profile of Mood Survey-Short Form (POMS-SF), state mental and physical energy and fatigue survey), cognitive (serial subtractions of 3 (SS3) and 7 (SS7)), and fine-motor task (nine-hole peg test) performance after consuming a caffeinated beverage and a non-caffeinated placebo. Results indicate that trait mental and physical fatigue and mental energy modified the effects of caffeine on vigor, tension-anxiety, physical, and mental fatigue. Additionally, we report that those who were high trait physical and mental fatigue and low-trait mental energy reported the greatest benefit of caffeine on the SS3 and SS7, while those who were high trait mental and physical fatigue reported the greatest benefit of consuming caffeine on fine-motor task performance. The results of our study suggest that trait mental and physical fatigue and mental energy modify the acute effects of caffeine among a group of healthy, young adults and should be measured and controlled for by researchers who choose to study the effects of caffeine on acute moods and cognitive and fine-motor task performance.     

Differences in Cardiovascular Disease Risk Factor Management in Primary Care by Sex of Physician and Patient

PURPOSE The purpose of this study was to evaluate differences in the management of cardiovascular disease (CVD) risk factors based upon the sex of the patient and physician and their interaction in primary care practice.METHODS We evaluated CVD risk factor management in 4,195 patients cared for by 39 male and 16 female primary care physicians in 30 practices in southeastern New England.RESULTS Many of the sex-based differences in CVD risk factor management on crude analysis are lost once adjusted for confounding factors found at the level of the patient, physician, and practice. In multilevel adjusted analyses, styles of CVD risk factor management differed by the sex of the physician, with more female physicians documenting diet and weight loss counseling for hypertension (odds ratio [OR] = 2.22; 95% confidence interval [CI], 1.12–4.40) and obesity (OR = 2.14; 95% CI, 1.30–3.51) and more physical activity counseling for obesity (OR = 2.03; 95% CI, 1.30–3.18) and diabetes (OR = 6.55; 95% CI, 2.01–21.33). Diabetes management differed by the sex of the patient, with fewer women receiving glucose-lowering medications (OR = 0.49; 95% CI, 0.25–0.94), angiotensin-converting enzyme inhibitor therapy (OR = 0.39; 95% CI, 0.22–0.72), and aspirin prophylaxis (OR = 0.30; 95% CI, 0.15–0.58).CONCLUSION Quality of care as measured by patients meeting CVD risk factors treatment goals was similar regardless of the sex of the patient or physician. Selected differences were found in the style of CVD risk factor management by sex of physician and patient.