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Table 4 Studies on caffeine-related effects associated with SSB consumption

From: The negative impact of sugar-sweetened beverages on children’s health: an update of the literature

Author, Year Setting Sample Size Sample Age Method of Diet Assessment SSB Unit of Analysis Primary Outcome Direction of Association Findings
Cross-Sectional Studies
Azagba, 2014 Adolescents attending public schools in Atlantic Canada 8210 Grades 7, 9, 10 and 12 Self-reported survey with question asking about consumption of caffeinated energy drinks in past year Energy drink more than once a month vs. one to two times Odds of depression, sensation seeking, substance use Positive Sensation Seeking
OR = 1.17 [95%CI: 1.11, 1.22]*
Depressive symptoms, very elevated
OR = 1.95 [95%CI: 1.36, 2.79]*
Depressive symptoms, somewhat elevated
OR = 1.08 [95%CI: 0.80, 1.47]
Cigarette use
OR = 2.58 [95%CI: 1.71, 3.89]*
Marijuana use
OR = 1.87 [95%CI: 1.37, 2.56]*
Alcohol use
OR = 2.48 [95%CI: 1.83, 3.36]*
Other drug use
OR = 1.80 [95%CI: 1.26, 2.57]*
Bashir, 2016 Convenience sample of patients in waiting areas of emergency department in U.S. 612 12-18 years Questionnaire asking about frequency of energy drink consumption Frequent (at least once a month) vs. Infrequent (less than once a month) consumers of energy drinks Proportion of frequent vs. infrequent consumers experience of headache, anger and increased urination Positive Headache
76% [95%CI: 69-81] vs. 60% [95%CI: 55-64]*
Anger
47% [95%CI: 40-54] vs. 32% [95%CI: 27-36]*
Increased urination
24 [95%CI: 18-30] vs. 13 [95%CI: 10-16]*
Study provides a number of outcomes. See paper for full results.
Koivusilta, 2016 Classroom survey of 7th grade students in Finland 9446 13 years Self-reported online survey asking about frequency of energy drink consumption Several times a day vs. not at all Odds of headache, sleeping problems, irritation, tiredness/fatigue, late bedtime Positive Headache
OR = 4.6 [95%CI: 2.8, 7.7]
Sleeping problems
OR = 3.6 [95%CI: 2.2, 5.8]
Irritation
OR= 4.1 [95%CI: 2.7, 6.1]
Tiredness/ fatigue
OR=3.7 [95%CI: 2.4, 5.7]
Late bedtime
OR = 7.9 [95%CI: 5.7, 10.9]
Kristjansson, 2013 School survey of children in Iceland 11,267 10-12 years Questions on population-based survey asking about frequency of energy drink and cola consumption ≥1 cola/day vs. none
≥1 energy drink/ day vs. none
Odds of headaches, stomachaches, sleeping problems, low appetite Positive Colas
Headaches
Females:
OR = 1.13 [95%CI: 0.87, 1.47]
Males:
OR = 1.29 [95%CI: 1.03, 1.62]*
Stomachaches
Females:
OR = 1.40 [95%CI: 1.08, 1.80]*
Males:
OR = 1.31 [95%CI: 1.03, 1.67]*
Sleeping problems
Females:
OR = 1.55 [95%CI: 1.21, 1.98]*
Males:
OR = 1.34 [95%CI: 1.09, 1.66]*
Low appetite
Females
OR = 1.37 [95%CI: 1.03, 1.83]*
Males
OR = 1.44 [95%CI: 1.12, 1.86]*
Energy Drinks
Headaches
Females:
OR = 1.68 [95%CI: 1.17, 2.41]*
Males:
OR = 1.87 [95%CI: 1.43, 2.46]*
Stomachaches
Females:
OR = 1.76 [95%CI: 1.21, 2.54]*
Males:
OR = 2.45 [95%CI: 1.86, 3.23]*
Sleeping problems
Females:
OR = 1.56 [95%CI: 1.07, 2.25]*
Males:
OR = 1.63 [95%CI: 1.25, 2.12]*
Low appetite
Females
OR = 2.31 [95%CI: 1.58, 3.39]*
Males
OR = 1.30 [95%CI: 0.95, 1.78]
Park, 2016 Nationally representative cohort of Korean adolescents 68,043 12-18 years Web-based survey with questions on energy drink consumption Highly frequent energy drink consumer (≥5 times/week) vs. infrequent energy drink consumer (<1 time/week)
Moderate frequent energy drink consumer (1-4 times/week) vs. infrequent energy drink consumer
Odds of sleep dissatisfaction, perceived stress, persistent depressive mood, suicidal ideation, suicide plan, suicide attempt Positive Highly frequent energy drink consumer vs. infrequent energy drink consumer
Sleep dissatisfaction
OR = 1.64 [95%CI 1.61, 1.67]*
Perceived stress
OR = 2.23 [95%CI: 2.19, 2.27]*
Depressive mood
2.59 [95%CI: 2.54, 2.65]*
Suicidal ideation
3.14 [95%CI: 3.07, 3.21]*
Suicidal plan
4.65 [95%CI: 4.53, 4.78]*
Suicide attempt
6.79 [95%CI: 6.59, 7.00]*
Moderate frequent energy drink consumer vs. infrequent energy drink consumer
Sleep dissatisfaction
OR = 1.25 [95%CI: 1.25, 1.26]*
Perceived stress
OR = 1.38 [95%CI: 1.37, 1.39]*
Depressive mood
OR=1.51 [95%CI: 1.49, 1.52]*
Suicidal ideation
OR=1.43 [95%CI: 1.42, 1.45]*
Suicidal plan
OR=1.78 [95%CI: 1.75, 1.81]*
Suicide attempt
OR=1.91 [95%CI: 1.87, 1.95]*
Richards, 2015 Adolescents from three secondary schools in the South West of England 2307 11-17 years DABS survey (assesses intake of common dietary variables), including questions on energy drink and cola consumption High consumption (≥1 can of energy drink or cola) vs. no consumption
Low consumption (<1 can of energy drink or cola) vs. no consumption
Odds of stress, anxiety and depression Mixed High consumption vs. no consumption
Energy Drinks
Stress
OR = 1.10 [95%CI: 0.80, 1.50]
Anxiety
OR = 1.05 [95%CI: 0.77, 1.43]
Depression
OR = 1.11 [95%CI: 0.81, 1.52]
Cola
Stress
OR = 0.68 [95%CI: 0.52, 0.90]*
Anxiety
0.83 [95%CI: 0.64, 1.09]
Depression
1.23 [95%CI: 0.93, 1.62]
Low consumption vs. no consumption
Energy Drinks
Stress
1.38 [95%CI: 1.05, 1.80]*
Anxiety
1.26 [95%CI: 0.97, 1.64]
Depression
0.99 [95%CI: 0.76, 1.31]
Cola
Stress
0.72 [95%CI: 0.56, 0.94]*
Anxiety
0.86 [95%CI: 0.67, 1.10]
Depression
1.18 [95%CI: 0.91, 1.54]
Longitudinal Studies
Marmorstein, 2016 Cohort of middle-school students in the U.S. 144 10-14 years, followed-up 16 months later Self-reported questionnaire with questions on energy drink consumption Energy drink consumption at baseline Change in ADHD inattention, ADHD hyperactive, conduct disorder, depression, panic, anxiety at follow-up (controlling for coffee) Mixed ADHD inattention
β = 0.20*
ADHD hyperactive
β = 0.20*
Conduct disorder
β = 0.18
Depression
β = 0.08
Panic
β = 0.17
Generalized anxiety
β = 0.09
Social Anxiety
β = -0.02
  1. Note: * indicates statistical significance (p<0.05) as reported by each study