Skip to main content

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