+Studies have indicated reported symptoms among energy drinks consumers to include palpitations, agitation, tremor, gastrointestinal upset, serious cardiac toxicities such as arrhythmias or cardiac ischaemia, and serious neurological toxicities such as hallucinations and seizures (Gunja, & Brown, 2012). Excessive use of caffeine enriched energy drinks is averred to have a significant capacity to cause an increased blood pressure, promote sleep deprivation, exacerbate mental health disorders, encourage physiologic dependence and addiction (Itany et al., 2014). A study by Huhtinen, Lindfors & Rimpelä (2013), posits that the daily use of energy drinks is strongly associated with four major health symptoms: headache, sleeping problems, irritation and tiredness/fatigue. As cited in Seifert, et al., (2011), self-reported surveys have shown that energy drinks are consumed by 30% to 50% of adolescents and young adults. Many adolescents have reported a feeling of tachycardia after consuming energy drinks that are either free of alcohol or mixed with alcohol (Itany et al., 2014). The presence of above recommended amount of caffeine in some energy drinks may predispose susceptible individuals to acute intoxication effects (Sankararaman, Syed, Medici, & Sferra, 2018). Acute energy drink intoxication characterized by cardiac arrhythmias, vomiting, seizures, tachycardia or death presents when caffeine rich energy drinks are consumed beyond the recommended daily dose (Wolk, Ganetsky & Babu, 2012). Insomnia, restlessness, tremors, depressive mood, stress and gastrointestinal upset are largely presented among people of differing ages who consume energy drinks (Nadeem, et al., 2020). With a frequency of high and unregulated concentration of caffeine, these drinks have been reported to produce serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioural disorders or those who take certain medications (Seifert, et al., 2011).
The famous study by Alford, Cox, & Wescott (2001), evidenced the role that energy drinks play on psychomotor performance (memory, reaction time and concentration), subjective alertness and physical endurance. Using 36 volunteers in a controlled trial study, they discovered that energy drinks increased aerobic endurance (i.e., maintaining 65-75% maximum heart rate) and anaerobic activity (i.e., maintaining maximum speed) on cycle ergometers. The study further showed that energy drinks enhance intellectual performance including choice reaction time, concentration (number cancellation) and memory (immediate recall), which are indicative of increased subjective alertness. The study by Warburton, Bersellini, & Sweeney (2001), also revealed that drinks containing caffeine and taurine improve attention, information processing and verbal reasoning. Caffeine, taurine and glucuronolactone, which are very key ingredients in energy drinks, have beneficial effects on human mental performance and mood (Seidl, et al., 2000). These effects may be instigated by the effects of caffeine on purinergic (adenosinergic) receptors and taurine mediation of receptors (Seidl, et al., 2000). According to Jeffers, Vatalaro Hill, & Benotsch, (2014), reasons for energy drink consumption among a cohort of 856 undergraduate students included desire to lose weight, a perception of poor body image, and losing weight without engaging in unhealthy weight loss behaviours such as bulimia and anorexia nervosa. A meta-analysis of randomised control trial studies on weight loss using caffeine rich beverages by Tabrizi, et al., (2019), concluded that caffeine consumption may improve weight loss, and may also decrease Body Mass Index (BMI) and overall body. Collado-Mateo, et al., (2020), have suggested that pre-exercise drinking of a moderate dose of caffeinated drink may increase optimally fat utilisation during aerobic exercise of submaximal intensity that is undertaken after a fasting period. As ginger is one of the ingredients available in some energy drinks, studies have demonstrated that ginger contributes significantly in reducing Body Mass Index (BMI), Waist-to-Hip Ratio, Hip-Ratio, Fasting Glucose Levels, and Insulin Resistance Index, and also promotes an increase in High Density Lipoproteins (HDL) cholesterol levels (Maharlouei, et al., 2019).
Research Design
The research design that was used for this study was the descriptive design because the study was factored to understand the perceived benefits of consuming energy drinks by consumers and also understand the adverse effects of energy drinks that consumers of energy drinks were aware of.
Ethical Consideration
All subjects respondents were duly informed about the research topic and the purpose of the research. Each respondent was given a consent form to fill and sign willingly without coercion to signify evidence that they willingly obliged to serve as subject respondents to the study. Every single subject respondent was also informed that they can withdraw from participating in the study at any stage of the study. In instances where the respondents were below the age of 18, their parents/guardians were informed about the details of the study and they granted consent on behalf of the minor.
Sample and Sampling Technique
A total of 384 respondents participated in the study, where 192 respondents came from Ayawaso North and the same number of respondents from Ayawaso East. Multistage sampling technique was used to select the respondents who participated in the study.
Data Collection Instrument
A self-administered questionnaire that contained closed ended questions and rating scales was used to collect the needed data for the study.
Data Collection Procedure
Four Bachelor’s Degree holders served as research assistants who were trained by the Lead Investigator. The Lead Investigator alongside that Research Assistants administered the questionnaires and consent forms to the respondents and collected them after they have been filled out by the respondents. A total of 384 questionnaires were administered and all were filled and retrieved from the respondents.
Inclusion and Exclusion Criteria
A subject respondent must have taken energy drink at least within the last six months prior to the study. He or she must be of age 11 years and above within the study settings. Subject respondent must also speak any of English, Hausa, Twi and Ga languages. Any person who did not meet all of these criteria was excluded from the study
Data Analysis
Microsoft Office Excel 2013 and Visual Basic for Application (VBA) were used for data entry and processing of the data that were collected from the respondents. The R programing language tool was then used for data visualization and analysis.
Demographic Data
Age range of Respondents
Table 1.Age Group Breakdown
Age range
|
Respondents
|
Percentage (%)
|
11-15 years
|
24
|
6.25
|
16-20 years
|
78
|
20.31
|
21-25 years
|
101
|
26.30
|
26-30 years
|
63
|
16.41
|
31-35 years
|
39
|
10.16
|
36-40 years
|
38
|
9.90
|
41-45 years
|
16
|
4.17
|
46-50 years
|
16
|
4.17
|
51-55 years
|
5
|
1.30
|
60 years and above
|
4
|
1.04
|
Total
|
384
|
100
|
Table 1. gives relevance to the age groups of energy drinks consumers who participated in the study. There were twenty-four respondents who were within the age range of 11 – 15 years, seventy-eight of them were within the age range of 16 – 20 years, one hundred and one of them were within the age range of 21 – 25 years, sixty-three of them were within the age range of 26 – 30 years, thirty-nine of them were between the age range of 31 – 35 years, thirty eight of them were within the age range of 36 – 40 years, sixteen of them were within the age range of 41 – 45 years, another 16 of the respondents were within the age range of 46 – 50 years, five of them were within the age range if 5- - 56 years and only four of them were within the age range of 60 years and above. The mean age is 38.4± years.
Respondents Sex Distribution
Figure 1. above discribes the percentage of male and female respondents who participated in the study. They were 76% of male respondents and 24% of female respondents. This slearly indicates that the number of male respondents who consume energy drinks and agreed to particpate in the study are more than the number of female energy drinks consumers who agreed to participate in the study.
Marital Status of Respondents
Figure 2. gives a reflection of the marital status of the respondents who agreed to participate in the study. One hundred of them were married, six of them were separated, two-hundred and seventy-five of them were single and only three of them were widowed. It is important to note that, going by the marital status of the respondents who participated in the study, the number of unmarried (single) respondents who consume energy drinks and agreed to participate in the study were higher than those who were married, and those who were married were higher than those who were separated, and those who were separated were higher than those who were widowed.
Respondents Religious Affiliation
Considering that the residents of people in the Ayawaso North and Ayawaso East were religious and belongs to at least one religious faith, it was important to ascertain the religious affiliation of the respondents. Figure 3. as presented shows that one hundred of the responds were Christians, two hundred and fifty of them were Muslims, two of them were idol worshippers and four of them belong to other faiths.
Respondents Level of Education
From figure 4. as seen, there were a total of fifty respondents whose highest educational qualification is primary education, one hundred and two of them have attained senior high education as their highest educational qualification and two hundred and thirty-wo of them have attained at least a tertiary education. Clearly, there were more subject respondents in the study who had attained tertiary education than those who had attained secondary education. Those with secondary education were more than those with primary education, and those with primary education were the least number of respondents who participated in the study.
Employment Status
Figure 5. as seen gives an impression of the employment status of the respondents who participated in the study. One hundred and forty-two of them were gainfully employed, one hundred and three of them were unemployed, and one hundred and thirty-nine of them were employed.
How frequent do you consume energy drinks?
Table 2: Respondents’ frequency of Energy Drinks Consumption
Frequency
|
Respondents
|
Percentage (%)
|
Irregular/Unusual
|
148
|
38.54
|
At least 1 bottle per day
|
135
|
35.16
|
More than 1 bottle 2 to 3 times a week
|
41
|
10.68
|
More than one bottle per day
|
32
|
8.33
|
More than 1 bottle 4 to 7 times a week
|
28
|
7.29
|
TOTAL
|
384
|
100
|
Table 2. above describes the frequency of energy drinks consumption among the respondents who participated in the study. One hundred and forty-eight of the respondents described their frequency of energy drinks as irregular, one hundred and thirty-five of them described their frequency of consumption as at least one (1) bottle per day, forty-one of them described their frequency level as more than 1 bottle two to three times a week, thirty-two of them described their frequency of energy drinks consumption as more than one (1) bottle per day and twenty eight of them described their frequency of consumption as more than one (1) bottle, four (4) to seven (7) times per week.
Why do you consume energy drinks?
Table 3. Respondents’ reasons for consuming Energy Drinks.
Variable
|
Population
|
Percentage (%)
|
Only 1 reason for consuming energy drinks
|
245
|
63.80
|
Only two reasons for consuming energy drinks
|
43
|
11.20
|
Consumes energy drinks based on 3 or more reasons
|
65
|
16.93
|
No reason
|
30
|
7.81
|
No response
|
1
|
0.26
|
TOTAL
|
384
|
100
|
Table 3 above shows a summary of respondents’ responses about why they consume energy drinks. Response options as indicated on the questionnaire that respondents respondent to as the reasons for which they consume energy drinks include, to give company to friends, to remain awake and alert, for more energy and vitality, nice taste, for better performance in driving, for better sex performance, for better performance in sports/gym, for better performance in examinations, fantasy, to quench thirst, as a favourite drink, to alleviate tiredness, to be able to dance at parties, to complete tasks, to counter hypoglycemia, to prevent dehydration and no reason at all.
Evidently from this data, it can be established that while 7.81% of the respondents consume energy drinks for no substantive reason, about 63.80% of them consume energy drinks for at least one reason. Forty-three respondents, representing 11.20% of the respondents consume energy drinks for at least, two reasons and 65 of them, representing 16.93% of the of the population of consumers in Nima and Mamobi, consume energy drinks for at least, three or more reasons.
Which of these benefits do you derive from consuming energy drinks?
Table 4. Benefits derived from energy drinks.
Variable
|
Population
|
Percentage (%)
|
At least 1 benefit
|
183
|
48
|
2 benefits
|
97
|
25
|
3 benefits
|
79
|
20
|
4 or more benefits
|
22
|
6
|
No response
|
3
|
1
|
TOTAL
|
384
|
100
|
Table 4 shows respondents’ responses when they were asked about the kind of benefits they derive whenever they consume energy drinks. The benefits on the questionnaire to which the respondents were to respond to included, ability to stay awake longer, increased work performance, improved mental performance, increased alertness, Increased power in sport/ exercise, increased mental alertness, improved digestion, replacement of body fluids, increase blood sugar, improved rehydration, less tiredness, increased fun with friends, improved sexual performance.
Analytically, about forty-eight percent of the respondents who consume energy drinks in Nima and Mamobi consume energy drinks because it aids them in achieving at least one specific benefit. Twenty-five percent of them indicated that they consume energy drinks due to at least two different benefits that they accrue from them. Twenty percent of them indicated that they consume energy drinks to derive at least three benefits from them. Six percent of them indicated that they consume energy drinks to reap four or more benefits from them, and only one percent of them declined to indicate any benefit they derive from consuming energy drinks.
This results from the respondents suggests that, a vast majority of the population of energy drinks consumers consume energy drinks for one or more perceived benefits that are derivable from consuming them.
What is the maximum number of energy drinks you have ever drunk in a day?
Table 5. Maximum number of Energy Drinks ever consumed in a Day
Maximum number of drinks ever taken in a day
|
Respondents
|
Percentage (%)
|
1
|
156
|
40.63
|
2
|
110
|
28.65
|
Less than one bottle
|
58
|
15.10
|
3
|
31
|
8.07
|
More than 5
|
21
|
5.47
|
4
|
7
|
1.82
|
5
|
1
|
0.26
|
TOTAL
|
384
|
100
|
Table 5 above shows the counts in responses and percentage representation of respondents when they were asked about the maximum number of energy drinks they have ever drunk in a day. A total of one-hundred and fifty-six (156) respondents representing 40.63% indicated that the maximum number of energy drink they have ever consumed in a day is 1 bottle. One-hundred and ten (110) respondents representing 28.65% indicated that the maximum number of energy drink they have ever consumed in a day is just 2 bottles. Fifty-eight (58) respondents representing 15.10% indicated that the maximum amount they have ever consumed in a day is less than 1 bottle. Thirty-one respondents representing 8.07% indicated that the maximum number of energy drinks they have ever consumed in a day is 3 bottles. Twenty-one respondents, representing 5.47% indicated that they have ever consumed more than five bottles in a day. Seven respondents representing 1.82% indicated that the maximum number of energy drinks they have ever drunk in a day is 4 bottles. One respondent representing 0.26% indicated that the maximum number of energy drinks he/she has ever consumed in a day is 5 bottles, and twenty-one respondents representing 5.47% indicated that they have ever consumed more than 5 bottles of energy drinks in a day.
This informs that about 55.73% of the population of energy drinks consumers have never exceeded one bottle of energy drink in a day. Whereas, 44.27% of the population of energy drinks consumers have ever consumed two or more bottles of energy drinks in a day. This is instructive to also note that those who have ever consumed two or more energy drinks in a day were probably ignorant of the recommended daily amount of caffeine that must not be exceeded and are also at risk of many negative health impacts that are associated with energy drinks.
Which of these adverse health effects of energy drinks are you aware of?
Table 6. Respondents’ awareness of adverse health effects of energy drinks.
Variable
|
Respondents
|
Percentage (%)
|
Awareness of only 1 adverse effect
|
160
|
41.67
|
Awareness of 2 adverse effects
|
126
|
32.81
|
Awareness of 3 adverse effects
|
59
|
15.36
|
Awareness of 4 or more adverse effects
|
36
|
9.38
|
No response
|
3
|
0.78
|
TOTAL
|
384
|
100
|
Table 6 shows respondents responses about the adverse health effects of energy drinks that they are aware are of. The side effects to which respondents responded to from the questionnaire include, increased urination, electrolyte imbalance, abnormal heart beat, increased blood pressure, hardening of blood vessels, peptic ulcer disease, kidney disease, liver disease, dependence, abdominal cramps, insomnia (difficulty in sleeping), headache, confusion, poor vision (sight), seizures (epilepsy), nausea, poor appetite, muscle cramps, decreased performance and dehydration
Instructive from the data is that although there are many adverse health effects associated with energy drinks, majority of consumers are unaware of them. This is because, respondents’ responses shows that 41.67% of the respondents are aware of at least only one adverse health effect of energy drinks, 32.81% of the respondents are aware of at least two adverse effects, 15.36% are aware of at least three adverse effects, and only 9.38% of the respondents are aware of four or more adverse effects of energy drinks.
This finding indicates that awareness of the adverse effects of energy drinks among consumers in Nima and Mamobi is very low.
How would you rate your level of awareness about the health effects of the ingredients in energy drinks?
Respondents Rating of their Awareness of the Health Effects of Energy Drinks.
Figure 8 above shows respondents rating of their own level of awareness of the health effects of energy drinks. A proportionate 45.80% claimed that they can rate their level of awareness of the health effects of energy drinks as high, 19.50% claimed that they can rate their level of awareness about the health effects of energy drinks as very high, 18.30% of them claimed that they can rate their level of awareness about the health effects of energy drinks as low, and 16.40% claimed that they can rate their level of awareness as very low.
Energy drinks have both positive and negative health effects.
Respondents Level of Agreement with Energy Drinks having Both Positive and Negative Health Effects
Figure 6 indicates the responses of respondents on a rating scale about whether they are aware that energy drinks have both posistive and negative health effects. As can be seen in the pie chart, 38.30% of the population indicated that they strongly agree with the assertion that the positive health effects associated with energy drinks consumption far outweighs the negative health effects. A preponderant percentage (47.90%) of the population however, indicated that they agree with this assertion but not strongly, 5.70% indicated that they strongly disagree with this assertion, and 8.10% indicated that they disagree with this assertion but not in very strong terms.
The Health Benefits of Energy Drinks are Higher than the Negative Health Effects.
Figure 7 above shows respondents’ perception about whether the health benefits of energy drinks far outweigh the negative health effects associated with their consumption. A significant percentage (34.60%) of the population indicated that they agree that the health benefits of energy drinks are higher than the negative health effects, 9.70% said that they strongly agree with this assertion, 34.60% said that they disagree with this assertion, another proportionate 20.60% said that they strongly disagree with this assertion, and 0.50% of them refrained from providing any answer.
Which of these diseases are you aware can be caused by long term consumption of energy drinks?
Table 7. Respondents’ awareness of diseases that can be caused by long-term consumption of energy drinks.
Variable
|
Respondents
|
Percentage (%)
|
1 disease
|
187
|
48.7
|
2 diseases
|
150
|
39.06
|
3 diseases
|
27
|
7.03
|
4 or more diseases
|
17
|
4.43
|
No response
|
3
|
0.78
|
TOTAL
|
384
|
100
|
Table 7 shows respondent responses when they were asked about the diseases that they are aware can be caused by energy drinks consumption. The diseases that the respondents responded to include, hypertension, kidney failure, liver failure, heart failure, seizures and dependence.
The summary of analysis as presented in table 13 shows that 48.70% of the population are aware of only one disease that can be precipitated by long-term consumption of energy drinks, 39.06% of them are aware of only two diseases that a person may develop as a result of long-term use of energy drinks, 7.03% of them indicated that they are aware of only three diseases that may arise as a result of long-term use of energy drinks, and only 4.43% of them are those who can be described as being aware of four or more diseases that may arise as a result of long-term consumption of energy drinks. In essence, the awareness about the diseases that can arise from the long-term use of energy drinks is very low among consumers.