Research ArticleAdolescent Consumption of Sports and Energy Drinks: Linkages to Higher Physical Activity, Unhealthy Beverage Patterns, Cigarette Smoking, and Screen Media Use
Introduction
Adolescent consumption of sugar-sweetened beverages is of concern because consumption is associated with increased risk for dental caries, excess weight gain, and poor diet quality.1, 2, 3, 4 Although recent evidence showed a decline from 1999 to 2008 in the prevalence of soft drink and fruit drink consumption among US adolescents, sports and energy drink consumption tripled.5 Sports and energy drinks are considered to be sugar-sweetened beverages along with soft drinks and flavored juice drinks, but their ingredients and purported functions differ. Sports drinks are noncarbonated, flavored drinks that contain added sugars, minerals, and electrolytes to help replenish the body during vigorous exercise.6 Energy drinks contain high amounts of caffeine, often coupled with other natural stimulants that enhance caffeine's effects, and may also contain vitamins, minerals, protein, and added sugars. Beverages marketed as energy drinks are purported to increase mental concentration as well as physical performance.6
The US Food and Drug Administration considers energy drinks to be dietary supplements not subject to food marketing or ingredient regulations.7, 8 Therefore, whereas the average caffeine content per fluid ounce for the 4 top-selling soft drinks in the US was 3.5 mg from 2002 to 2006, the average caffeine content for the 4 top-selling energy drinks was 9.6 mg.8 Little information is available on the effects of the supplements or stimulants in energy drinks, especially among children and adolescents. The high caffeine content of energy drinks, as well as the high sugar and calorie content of many sports and energy drinks, has drawn much concern from health professionals as their consumption among adolescents has increased.9
In June, 2011, the American Academy of Pediatrics (AAP) issued a report examining the marketing, ingredients, and possible negative effects of sports and energy drinks.9 They concluded that small amounts of sports drinks could be appropriate for young people participating in vigorous physical activity in hot, humid weather. However, for the average young athlete, sports drinks are unnecessary and could contribute to negative health outcomes, such as excess weight gain and tooth decay.9 With regard to energy drinks, the AAP concluded that there is no benefit provided, and because these drinks create a risk for overstimulation of the nervous system, they should not be consumed by adolescents. Consumption of energy drinks by young people has resulted in cases of seizure, myocardial arrhythmia, and even death.7, 8, 9, 10
Although soft drink and overall sugar-sweetened beverage consumption among adolescents has been well studied, few studies in adolescent populations have examined the consumption of sports and energy drinks or factors associated with their consumption. One study found that sports and fruit drink consumption were unrelated to weight status and were associated with higher levels of physical activity as well as consumption of milk, fruit, and vegetables, but were also associated with negative health behaviors, such as higher consumption of energy-dense foods and sedentary behavior.11 In addition, a recent study found that sports and energy drink consumption were lower among black and low-income adolescents.5 To the best of the current authors' knowledge, no study has specifically examined other factors that may be associated with sports and energy drink consumption among adolescents. To address this gap in the literature, and to inform public health efforts targeting consumption, the current study used data from a population-based survey to describe patterns of sports and energy drink consumption among adolescents, and to examine associations with dietary factors, physical activity, media use, hours of sleep, and cigarette smoking. These factors were selected for consideration based on their potential for modification to improve overall health if addressed as part of interventions targeting sports and energy drink consumption along with other risk behaviors.
Section snippets
Study Design and Population
Data were drawn from Eating and Activity in Teens (EAT 2010), a population-based study designed to examine dietary intake, physical activity, weight control behaviors, weight status, and factors associated with these outcomes in adolescents.12, 13 Surveys and anthropometric measures were completed by 2,793 adolescents during the 2009–2010 academic year. The study population included adolescents from 20 public middle schools and high schools in the Minneapolis/St Paul metropolitan area of
Frequency of Consumption and Associations With Demographic Characteristics
Overall, sports and energy drinks were consumed regularly (at least 1/wk) by 37.9% and 14.7% of the adolescent sample, respectively. Regular consumption of sports drinks among boys was 44.9% and 31.6% among girls (P < .001). For energy drinks, regular consumption was 17.1% among boys and 12.5% among girls (P < .001). There was a moderate to low correspondence between intake of sports and energy drinks, with 10.6% of adolescents regularly consuming both sports and energy drinks, 26.8% regularly
Discussion
The results of this study indicate that at least weekly consumption of both sports and energy drinks among adolescents is significantly associated with higher consumption of other sugar-sweetened beverages, cigarette smoking, and screen media use. The observed associations between consumption of sports and energy drinks and these unhealthy behaviors are troubling because they may indicate a clustering of problem behaviors among some adolescents. Given these findings, evidence of increasing
Implications for Research and Practice
Although this study used a comprehensive survey with reliable measures to examine characteristics associated with sports and energy drink consumption among adolescents, not all survey measures were validated and additional research is needed to address certain limitations. Single items were used to separately assess overall intake of sports and energy drinks for the current study, but there are numerous types of these drinks on the market that vary considerably in nutritional composition (eg,
Acknowledgment
This work was supported by Grant R01HL084064 from the National Heart, Lung, and Blood Institute (PI: Dianne Neumark-Sztainer). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.
References (28)
- et al.
Consumption patterns of sugar-sweetened beverages in the United States
J Acad Nutr Diet
(2013) - et al.
Caffeinated energy drinks—a growing problem
Drug Alcohol Depend
(2009) - et al.
Secular trends in weight status and weight-related attitudes and behaviors in adolescents from 1999 to 2010
Prev Med
(2012) - et al.
Development and reproducibility of a food frequency questionnaire to assess diets of older children and adolescents
J Am Diet Assoc
(1995) - et al.
Validation of a youth/adolescent food frequency questionnaire
Prev Med
(1997) - et al.
Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk
Circulation
(2010) - et al.
A randomized trial of sugar-sweetened beverages and adolescent body weight
N Engl J Med
(2012) - et al.
Sugar-added beverages and adolescent weight change
Obes Res
(2004) - et al.
Soft drink consumption and caries risk in children and adolescents
Gen Dent
(2003) Sports drinks and energy drinks for children and adolescents—are they appropriate? A summary of the clinical report
NASN Sch Nurse
(2011)
Energy drinks: what is all the hype? The dangers of energy drink consumption
J Am Acad Nurse Pract
Sports drinks and energy drinks for children and adolescents: are they appropriate?
Pediatrics
Health effects of energy drinks on children, adolescents, and young adults
Pediatrics
Dietary and activity correlates of sugar-sweetened beverage consumption among adolescents
Pediatrics
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