Korean Journal of Health Promotion

Oh and Chung: Energy Drink Consumption and Dietary-, Lifestyle-, and Mental Health-Related Behaviors in Korean Adolescents: Based on the 10th–13th Korea Youth Risk Behavior Web-Based Survey

Original Article

Published online: September 30, 2019

DOI: https://doi.org/10.15384/kjhp.2019.19.3.145

Energy Drink Consumption and Dietary-, Lifestyle-, and Mental Health-Related Behaviors in Korean Adolescents: Based on the 10th–13th Korea Youth Risk Behavior Web-Based Survey

Jiwon Oh¹

, Jayong Chung²

¹Nutrition Education Major, Graduate School of Education, Kyung Hee University, Seoul, Korea.

²Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, Seoul, Korea.

Corresponding author: Jayong Chung, PhD. Department of Food and Nutrition, College of Human Ecology, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.
Tel: +82-2-961-0977, Fax: +82-2-961-0261, jchung@khu.ac.kr

Received September 09, 2019 Revised September 26, 2019 Accepted September 30, 2019

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: Energy drinks (EDs), functional beverages with high concentrations of caffeine, can cause health risks. This study examined the frequency of ED consumption and related factors in Korean adolescents.

Methods: Data from the 10th-13th Korea Youth Risk Behavior Web-based Survey was used, and a total of 137,101 boys and 130,806 girls were included in the final analyses. Differences in ED consumption and associated factors were analyzed using the Rao-Scott chi-square test and a multivariate logistic regression analysis, reflecting of the complex sample design.

Results: In total, 17.3% boys and 12.9% girls consumed EDs more than once a week (P<0.001). In particular, 24.2% of all high-school students in the 12th grade consumed more than three EDs a week. After adjusting for confounding factors, a multivariate logistic regression analysis indicated that higher ED consumption was significantly associated with a higher soda, sweet-drink, and fast food intake; skipping breakfast; a lower vegetable intake; depression; suicidal thoughts; sleep deprivation; and increased smoking and alcohol drinking.

Conclusions: ED consumption is associated with undesirable dietary-, lifestyle-, and mental health-related behaviors, suggesting the need for appropriate nutrition education in adolescents.

Key words: Adolescent; Energy drinks; Dietary habit; Life style; Mental health

NOTES

NOTES: This report was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government, NRF-2017R1A2B1009697.

REFERENCES

REFERENCES: 1. Lee HS, Kwon SO, Yon M, Kim D, Lee JY, Nam J, et al. Dietary total sugar intake of Koreans: based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. J Nutr Health 2014;47(4):268-276.
[Article]

2. Arria AM, Bugbee BA, Caldeira KM, Vincent KB. Evidence and knowledge gaps for the association between energy drink use and high-risk behaviors among adolescents and young adults. Nutr Rev 2014;72 Suppl 1:87-97.
[Article] [PubMed] [PMC]

3. Ministry of Food and Drug Safety. Study of establishment of recommended daily allowance for caffeine. Cheongju: Ministry of Food and Drug Safety; 2007. p. 136-158.

4. Yang YM, Huh W, Jeong E, Lee JJ, Choi EJ. An analysis of consumption patterns of high-caffeinated energy drinks and adverse effects by surveys from students at middle and high schools in Korea. Yakhak Hoeji 2014;58(6):387-396.

5. James JE, Baldursdottir B, Johannsdottir KR, Valdimarsdottir HB, Sigfusdottir ID. Adolescent habitual caffeine consumption and hemodynamic reactivity during rest, psychosocial stress, and recovery. J Psychosom Res 2018;110:16-23.
[Article] [PubMed]

6. Sanchis-Gomar F, Pareja-Galeano H, Cervellin G, Lippi G, Earnest CP. Energy drink overconsumption in adolescents: implications for arrhythmias and other cardiovascular events. Can J Cardiol 2015;31(5):572-575.
[Article] [PubMed]

7. Harris JL, Munsell CR. Energy drinks and adolescents: what’s the harm? Nutr Rev 2015;73(4):247-257.
[Article] [PubMed]

8. Ryu SH. Energy drink consumption status and associated factors among male and female high school students in Deajon area. Korean J Food Nutr 2016;29(6):899-910.
[Article]

9. Park EJ, Kim SY. Caffeinated food consumption patterns and level among high school students in Yongin region. J Korean Soc Food Sci Nutr 2017;46(9):1128-1136.

10. Park SH, Lee SH, Chang KJ. Intake-related factors and educational needs regarding energy drinks in female high school students in the Incheon area. J Nutr Health 2017;50(5):460-471.
[Article]

11. Ministry of Education, Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention. Korea youth risk behavior web-based survey [Internet]. Sejong: Ministry of Education, Ministry of Health & Welfare, Korea Centers for Disease Control and Prevention; 2019;Accessed Jun 5, 2019]. Available from: https://www.cdc.go.kr/yhs/home.jsp?id=m03_05

12. Korea Centers for Disease Control and Prevention. 2017 Korean national growth chart [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2017;Accessed Jun 12, 2019]. Available from: https://knhanes.cdc.go.kr/knhanes/sub08/sub08_01.do

13. Yoo HS, Sim KH. Survey on the high-caffeine energy drink consumption status of university students in Seoul. J East Asian Soc Diet Life 2014;24(3):407-420.
[Article]

14. Kim TY, Kim SM, Kim JY, Im JY, Yu H, Han YH, et al. Awareness and consumption of energy drinks and associated factors among college students in Cheongju. Korean J Community Nutr 2018;23(1):60-72.
[Article]

15. Jin MJ, Yoon CH, Ko HJ, Kim HM, Kim AS, Moon HN, et al. The relationship of caffeine intake with depression, anxiety, stress, and sleep in Korean adolescents. Korean J Fam Med 2016;37(2):111-116.
[Article] [PubMed] [PMC]

16. National Institute of Food and Drug Safety Evaluation. Sugar database compilation for commonly consumed foods. Cheongju: National Institute of Food and Drug Safety Evaluation; 2015. p. 226-236.

17. Bernabé E, Vehkalahti MM, Sheiham A, Aromaa A, Suominen AL. Sugar-sweetened beverage and dental caries in adult: a 4-year prospective study. J Dent 2014;42(8):952-958.
[PubMed]

18. Richelsen B. Sugar-sweetened beverages and cardio-metabolic disease risks. Curr Opin Clin Nutr Metab Care 2013;16(4):478-484.
[Article] [PubMed]

19. Lien L, Lien N, Heyerdahl S, Thoresen M, Bjertness E. Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway. Am J Public Health 2006;96(10):1815-1820.
[Article] [PubMed] [PMC]

20. World Health Organization (WHO). WHO Technical Report Series 916: Diet, nutrition and the prevention of chronic disease. Geneva: WHO; 2013. p. 57-60.

21. Keast RS, Swinburn BA, Sayompark D, Whitelock S, Riddell LJ. Caffeine increases sugar-sweetened beverage consumption in a free-living population: a randomised controlled trial. Br J Nutr 2015;113(2):366-371.
[Article] [PubMed] [PMC]

22. Libuda L, Alexy U, Buyken AE, Sichert-Hellert W, Stehle P, Kersting M. Consumption of sugar-sweetened beverages and its association with nutrient intakes and diet quality in German children and adolescents. Br J Nutr 2009;101(10):1549-1557.
[Article] [PubMed]

23. Lim YK. The effects of caffeinated beverage intake on serum iron(Fe) and total iron binding capacity(TIBC). Korean Association of Addiction Crime Review 2017;7(1):93-112.

24. Lim SA, Rho SN. Micro mineral responses to caffeine in serum and urine of healthy young females. Korean J Nutr 1993;26(9):1118-1128.

25. Hong KJ, Lee JW, Park MS, Cho YS. A study on the promotion of adolescents milk consumption (I): milk preference and intake pattern of urban adolescents. J Korean Diet Assoc 2007;13(1):61-72.

26. Utter J, Denny S, Teevale T, Sheridan J. Energy drink consumption among New Zealand adolescents: association with mental health, health risk behaviours and body size. J Paediatr Child Health 2018;54(3):279-283.
[PubMed]

27. Korea Consumer Agency. Survey on Safety of Energy Drink. Eumseong: The Consumer Safety Center; 2013. p. 61-63.

28. An SM, Park JS, Kim SH. Effect of energy drink dose on exercise capacity, heart rate recovery and heart rate variability after high-intensity exercise. J Exerc Nutrition Biochem 2014;18(1):31-39.
[Article] [PubMed] [PMC]

29. Aepli A, Kurth S, Tesler N, Jenni OG, Huber R. Caffeine consuming children and adolescents show altered sleep behavior and deep sleep. Brain Sci 2015;5(4):441-455.
[Article] [PubMed] [PMC]

30. Organisation for Economic Cooperation and Development (OECD). Suicide rates [Internet]. Paris: OECD; 2017;Accessed Sep 8, 2019]. Available from: https://data.oecd.org/healthstat/suicide-rates.htm

Figure 1

The distribution of energy drink consumption frequency in boys and girls. Differences between boys and girls were significantly different (P<0.001), calculated by Rao-Scott chi-square test.

Table 1

General characteristics of study subjects by gender

Values are presented as mean±standard error or number (%).

^aTotal numbers of some variables are different due to missing values.

^bCalculated by generalized linear model (GLM) for continuous variables or by Rao-Scott chi-square test for categorical variables.

Table 2

General characteristics according to energy drink consumption in boys and girls^a

Values are presented as mean±standard error or number (%).

^aDifferences between general characteristics and energy drink consumption in boys and girls were calculated by generalized linear model (GLM) for continuous variables and by Rao-Scott chi-square test for categorical variables, and all P values were less than 0.001, except for that of residential area in girls (P=0.001).

Table 3

Association between energy drink consumption and dietary- or lifestyle-related behavior in boys and girls

Values are presented as odds ratio and 95% confidence interval, calculated by multivariate logistic regression analysis.

Abbreviation: ref., reference.

^aDependent variables: fruit intake ≥3 vs. <3 times/wk (ref.); vegetables intake ≥1 vs. <1 time/d (ref.); milk intake ≥5 vs. <5 times/wk (ref.); soda intake ≥3 vs. <3 times/wk (ref.); sweet-drink intake ≥3 vs. <3 times/wk (ref.); fast food intake ≥1 vs. <1 time/wk (ref.); skipping breakfast ≥3 vs. <3 days/wk (ref.); underweight vs. normal weight (ref.); overweight and obesity vs. normal weight (ref.); smoking yes vs. no (ref.); drinking yes vs. no (ref.); moderate exercise ≥5 vs. <5 times/wk (ref.); vigorous exercise ≥3 vs. <3 times/wk (ref.); and muscular exercise ≥3 vs. <3 times/wk (ref.).

^bAdjusted for age, grade, academic achievement, paternal education, maternal education, economic status, residential area and residential type.

Table 4

Association between energy drink consumption and mental health-related behavior in boys and girls

Values are presented as odds ratio and 95% confidence interval, calculated by multivariate logistic regression analysis.

Abbreviation: ref., reference.

^aDependent variables: sleep hours ≥8 vs. <8 hours/d (ref.); sleep quality satisfactory vs. non-satisfactory (ref.); excessive stress yes vs. no (ref.); sadness or depression yes vs. no (ref.); suicide ideation yes vs. no (ref.); perceived health yes vs. no (ref.); perceived happiness yes vs. no (ref.).

^bAdjusted for age, grade, academic achievement, paternal education, maternal education, economic status, residential area and residential type.