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      Energy Drink Consumption among Adolescents Attending Schools in Lubumbashi, Democratic Republic of Congo

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          Abstract

          Background: The consumption of energy drinks (EDs) is increasing in the general population, but little is known about the consumption of EDs among pupils in Africa. This study was designed to assess the consumption of EDs among pupils between 10 and 17 years of age and to assess average caffeine concentrations contained in EDs sold in Lubumbashi. Methods: We conducted a cross-sectional survey in five schools using a standardised questionnaire taken face-to-face. Samples of locally purchased EDs were analysed by High Performance Liquid Chromatography with Ultra-Violet spectrometry (HPLC-UV). Results: Of 338 pupils (54% girls), 63% reported having consumed at least one ED in the last week and 34% drank at least one ED a day. The cheapest ED was the most widely consumed. Among pupils having consumed at least one ED in the last week, 79% reported consuming it for refreshment and 15% to get energy. For those who reported not consuming EDs, 40% reported that their parents or teachers forbade them to drink EDs. Some (14%) teenagers, mainly boys, mixed ED with alcohol. The concentrations of caffeine measured in twelve brands of EDs ranged from 7.6 to 29.4 mg/100 mL (median 23.3), giving caffeine contents of 37.5 to 160 mg (median 90 mg) per can or bottle. The estimated daily intake of caffeine through EDs was between 51.3 mg and 441.3 mg among those consuming EDs regularly. Conclusion: Our study convincingly demonstrates that caffeine-containing EDs are not only consumed by youngsters living in affluent societies. We documented widespread regular consumption of EDs among (pre-)adolescent schoolchildren living in Lubumbashi, a large city of the Democratic Republic of Congo (DRC). In view of the global market expansion of caffeinated EDs, it is reasonable to suspect that similar surveys in other urban areas of sub-Saharan Africa would yield similar findings. Pricing and advertising regulations and education on EDs are necessary to limit the regular consumption of EDs among adolescents.

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          Most cited references42

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          Health effects of energy drinks on children, adolescents, and young adults.

          To review the effects, adverse consequences, and extent of energy drink consumption among children, adolescents, and young adults. We searched PubMed and Google using "energy drink," "sports drink," "guarana," "caffeine," "taurine," "ADHD," "diabetes," "children," "adolescents," "insulin," "eating disorders," and "poison control center" to identify articles related to energy drinks. Manufacturer Web sites were reviewed for product information. According to self-report surveys, energy drinks are consumed by 30% to 50% of adolescents and young adults. Frequently containing high and unregulated amounts of caffeine, these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioral disorders or those who take certain medications. Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising. Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy drink use. In the short-term, pediatricians need to be aware of the possible effects of energy drinks in vulnerable populations and screen for consumption to educate families. Long-term research should aim to understand the effects in at-risk populations. Toxicity surveillance should be improved, and regulations of energy drink sales and consumption should be based on appropriate research.
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            Scientific Opinion on the safety of caffeine

            (2015)
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              Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children

              To date, one of the most heavily cited assessments of caffeine safety in the peer-reviewed literature is that issued by Health Canada (Nawrot et al., 2003). Since then, >10,000 papers have been published related to caffeine, including hundreds of reviews on specific human health effects; however, to date, none have compared the wide range of topics evaluated by Nawrot et al. (2003). Thus, as an update to this foundational publication, we conducted a systematic review of data on potential adverse effects of caffeine published from 2001 to June 2015. Subject matter experts and research team participants developed five PECO (population, exposure, comparator, and outcome) questions to address five types of outcomes (acute toxicity, cardiovascular toxicity, bone and calcium effects, behavior, and development and reproduction) in four healthy populations (adults, pregnant women, adolescents, and children) relative to caffeine intake doses determined not to be associated with adverse effects by Health Canada (comparators: 400 mg/day for adults [10 g for lethality], 300 mg/day for pregnant women, and 2.5 mg/kg/day for children and adolescents). The a priori search strategy identified >5000 articles that were screened, with 381 meeting inclusion/exclusion criteria for the five outcomes (pharmacokinetics was addressed contextually, adding 46 more studies). Data were extracted by the research team and rated for risk of bias and indirectness (internal and external validity). Selected no- and low-effect intakes were assessed relative to the population-specific comparator. Conclusions were drawn for the body of evidence for each outcome, as well as endpoints within an outcome, using a weight of evidence approach. When the total body of evidence was evaluated and when study quality, consistency, level of adversity, and magnitude of response were considered, the evidence generally supports that consumption of up to 400 mg caffeine/day in healthy adults is not associated with overt, adverse cardiovascular effects, behavioral effects, reproductive and developmental effects, acute effects, or bone status. Evidence also supports consumption of up to 300 mg caffeine/day in healthy pregnant women as an intake that is generally not associated with adverse reproductive and developmental effects. Limited data were identified for child and adolescent populations; the available evidence suggests that 2.5 mg caffeine/kg body weight/day remains an appropriate recommendation. The results of this systematic review support a shift in caffeine research to focus on characterizing effects in sensitive populations and establishing better quantitative characterization of interindividual variability (e.g., epigenetic trends), subpopulations (e.g., unhealthy populations, individuals with preexisting conditions), conditions (e.g., coexposures), and outcomes (e.g., exacerbation of risk-taking behavior) that could render individuals to be at greater risk relative to healthy adults and healthy pregnant women. This review, being one of the first to apply systematic review methodologies to toxicological assessments, also highlights the need for refined guidance and frameworks unique to the conduct of systematic review in this field.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                17 July 2021
                July 2021
                : 18
                : 14
                : 7617
                Affiliations
                [1 ]Department of Public Health, Faculty of Medicine and Public health, University of Kolwezi, Kolwezi 07301, Democratic Republic of Congo
                [2 ]Unit of Toxicology and Environment, School of Public Health, University of Lubumbashi, Lubumbashi 07601, Democratic Republic of the Congo; tatymuta17@ 123456gmail.com (T.M.M.); docteurpyana@ 123456gmail.com (J.P.K.); tonykayemb@ 123456gmail.com (T.K.-K.); arlene.kazadingoy@ 123456gmail.com (A.K.N.); musa.p.obadia@ 123456gmail.com (P.M.O.); clubabankulu2017@ 123456gmail.com (C.B.L.N.)
                [3 ]Ministry of Public Health, Haut-Katanga Provincial Inspection of Health, Lubumbashi 07601, Democratic Republic of the Congo
                [4 ]Occupational and Environmental Health Unit, Department of Public Health, University of Lubumbashi, Lubumbashi 07601, Democratic Republic of the Congo
                [5 ]Ministry of Public Health, Haut-Katanga Provincial Division of Health, Lubumbashi 07601, Democratic Republic of the Congo
                [6 ]Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
                [7 ]Physical and Chemical Health Risks, Sciensano, 1050 Brussels, Belgium; angelique.kamugisha@ 123456sciensano.be (A.K.); Eric.Deconinck@ 123456sciensano.be (E.D.); Joris.VanLoco@ 123456sciensano.be (J.V.L.)
                [8 ]Clinical and Experimental Endocrinology, Biomedical Sciences Group, KU Leuven, 3000 Leuven, Belgium
                Author notes
                [* ]Correspondence: tresor.carsikuhangana@ 123456gmail.com (T.C.K.); ben.nemery@ 123456kuleuven.be (B.N.); Tel.: +243-971-164-441 (T.C.K.); +32-16-330802 (B.N.); Fax: +32-16330-806 (B.N.)
                Author information
                https://orcid.org/0000-0002-8128-8768
                https://orcid.org/0000-0001-8059-6665
                https://orcid.org/0000-0001-6980-6684
                https://orcid.org/0000-0003-0571-4689
                Article
                ijerph-18-07617
                10.3390/ijerph18147617
                8304143
                34300068
                c6774a32-39a4-4850-a10d-d834a0741ab5
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 02 June 2021
                : 14 July 2021
                Categories
                Article

                Public health
                adolescent pupils,energy drink consumption,alcohol,caffeine
                Public health
                adolescent pupils, energy drink consumption, alcohol, caffeine

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