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Consumption Patterns and Side Effects of Energy Drinks Among University Students in Palestine: Cross- Sectional Study

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Consumption Patterns and Side Effects of Energy Drinks Among University Students in Palestine: Cross- Sectional Study MOJ Public Health Research Article Open Access Consumption patterns and side effects of energy drinks among university students in Palestine: cross- sectional study Abstract Volume 2 Issue 2 - 2015 This study describes the patterns of energy drinks consumption and associated factors Haleama Al Sabbah,1 NaimQamhia,2 Mustafa among University students in Palestine. A cross-sectional study was conducted at An-Najah 3 National University in Nablus, West Bank-Palestine. The study included 279 students of Younis 1Department of Public Health Nutrition, Zayed University, Dubai three colleges: Medicine, Physical Education and Engineering. Data were collected using 2Faculty of Medicine, An-Najah National University, Palestine a 25-item self-administered questionnaire. Energy-drink consumption was significantly 3Jackson State University, USA higher among male students, as 80.5% of energy-drink users involved in this study was males. It was higher among those with higher monthly expenditure. The most common Correspondence: W Haleama Al Sabbah, Assistant Professor, cause for using energy drinks among users was to stay awake at night (68.6%), while most Department of Public Health Nutrition, Zayed University, Dubai, of those who never tried energy drinks in their lives didn’t do so because they thought UAE, P.O. Box 19282, Tel +971569501179, energy drinks are unhealthy. About two thirds (64.4%) of the participants didn’t know the Email [email protected] main constituents of energy drinks and about half (53.6%) stated that they knew that there might be side effects associated with the use of energy drinks. More than half of the current Received: January 10, 2014 | Published: March 07, 2015 users (56.8%) consumed less than 1 bottle/day. Energy-drink usage is common among university students in Palestine and higher among males and those with higher monthly expenditure. Campaigns should be encouraged in order to spread awareness about the contents and possible side effects of energy drinks. Keywords: energy drinks, consumption, university, students, Palestine Abbreviations: BMI, body mass index; WHO, world health marketplace; 500 new varieties of energy drink were introduced to the organization worldwide market in 2006.9 The worldwide sales of the drinks rose from $ 3.5billion in 2006 to $ 4.7billion in 2007.10 Introduction Many companies continue to introduce new drinks, hoping Energy drinks are carbonated drinks that contain large amounts to capture a share of a growing consumer base. Responding to the of caffeine and sugar with additional ingredients, such as B vitamins, influx of new products with which they must compete, manufacturers amino acids (e.g. Taurine) and herbal stimulants such as Guarana.1–3 push the boundaries, producing drinks with increasingly complex The term “energy drinks” refers to beverages that contain caffeine combinations of medicinal ingredients, with ever higher levels of in combination with other ingredients such as Taurine, guarana, and caffeine, served in larger sizes.9 A dose of caffeine 85-250mg may B vitamins, and are purported to provide its consumers with extra result in feelings of alertness, decreased fatigue, and eased flow energy.4 Regarding the history of the Energy Drinks; the Scottish Irn- of thought. Whereas, excessive caffeine uses 250-500mgresulted Bru “Iron Brew” is considered to be the first energy drink produced in in restlessness, nervousness, insomnia, tremors, seizures and 1901, although not marketed as such. In the early 1960s, Japan started cardiovascular instability,11–15 in addition, it leads to hypokalemia.16,17 selling Lipovitan in small brown glass bottles. These bottles contained With the rising popularity of energy drinks and with more young a concentrated amount of the drink which was equivalent to a full- people ingesting higher levels of caffeine, more serious health sized can of the drink. Other drinks such as Gatorade were marketed problems are now being reported. Today, energy drinks have become to help improve performance in athletes.5 Athletes believe that energy available everywhere, their manufacturers say that, in addition to drinks can be used to enhance their performance during training and providing a boost in energy, the drinks promote wellness through competition due to their potentially ergogenic ingredients.6 medicinal properties (they usually contain vitamins and/or ingredients like ginseng, guarana and Taurine). Whatever their intended use and Energy drinks entered the North American beverage market with purported benefits, consumers today consume energy drinks for a exotic names, catchy slogans and expensive marketing campaigns and variety of reasons: to boost energy, keep awake at night, relief stress now occupy a significant portion of the industry. The first energy drink and other causes.10 to hit the shelves in North America was Jolt Cola in 1985. At the time, it was basically marketed as a cola with high-caffeine and high-sugar Energy drinks are marketed with colorful descriptions and contents. Jolt Cola’s original marketing strategy targeted students and provocative names that make them sound fun and exciting. “Rockstar, busy professionals.7 The Red Bull energy drink was introduced to Monster, Full Throttle, Throw Down and Sobe” are just a sampling Europe in 1987 and to the United States in 1997 was the forerunner of the inviting products that fill store shelves. Marketing slogans are of the modern energy drink and remains the most recognizable brand developed to stimulate interest in a product and distinguish it from in the industry.8 However, it has considerable competition in today’s its competition: “Get spiked” “Party like a Rockstar” and “Feel the Submit Manuscript | http://medcraveonline.com MOJ Public Health. 2015;2(2):36‒44. 36 © 2015 Sabbah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Consumption patterns and side effects of energy drinks among university students in Palestine: cross- 37 sectional study ©2015 Sabbah et al.= freak” are slogans representing the marketing strategies of energy They are totally taken by the deceiving stimulating effects of energy drink companies. The language and images of such advertising are drinks, causing them to feel less intoxicated than they actually are.1,28 not directed at mature adults. If anything, the marketing of energy This study aimed to: drinks removes all ambiguity about whom these products are meant i. Determine the patterns of energy drinks consumption and their to appeal to: teens and young adult’s.18 As a result, the consumption associations with socio-demographic characteristics (age, gender, of energy drinks is likely to become even more common and socially faculty and economic status) and body mass index among a group acceptable. of An-Najah National University students. Energy drinks drive their properties chiefly from sugar and caffeine. ii. Find out the occurrence of adverse side effects among energy drink Several studies suggest an association between sugar-sweetened users. beverage intake and weight.19,20 One way for people to reduce their intake of added sugars and help manage their weight is to reduce the iii. Verify the relationship between energy-drink consumption and amount of sugar-sweetened beverages they drink.21 Caffeine in energy certain daily habits of drinkers, such as cigarette smoking, sports, drinks will provide the consumer the desirable effects of increased breakfast and sleeping patterns. alertness, improved memory and enhanced mood. However, caffeine can have harmful physical consequences, including central nervous iv. Identify the main causes for using energy drinks and the occurrence system, cardiovascular, gastrointestinal and renal dysfunction22 of side effects amongst current energy drink users. Energy drinks contain between 14 and 31mg of caffeine per 100ml.23 Although their caffeine concentration (in milligrams per milliliter) may Methods be similar to coffee, energy drinks are often packaged in significantly Study design and settings higher volumes, resulting in increased caffeine intake.24 Many energy drinks would list the herbs as ingredients, but the caffeine in the herbs A cross-sectional study was conducted at AN-Najah National may not be listed as a separate ingredient. By law, caffeine does not University, Nablus and Palestine in the period between 8-2-2011 have to be listed on labels unless it has been added to the product and 7-3-2011. A written approval for this study was obtained from separately as a pure substance and so, consumers may be completely the university IRB. In addition, a letter of approval to conduct this unaware of the amount of caffeine they are ingesting.25 study was written by the dean of the faculty of medicine, which made it easier to acquire verbal approvals from deans of the other Various energy drinks are marketed with claims of performance two faculties. A brief summary about the study and its objectives enhancing effects although the existence and extent of such effects was provided at the top of the questionnaire’s first page along with a is subject to debate. Red Bull, for example, advertises several consent statement allowing the participant to freely choose whether to benefits of consumption including improved performance, endurance, participate in the study or not. The questionnaires were anonymous. concentration and reaction speed and increased metabolism.26
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