Influence of energy drink use on body composition in healthy children: Interim results from Hand aufs Herz Study

Background Energy drinks (ED) are commonly consumed by young individuals, often for increased alertness and energy during physical activities. Understanding the impact of ED consumption on body composition is important, as it can influence overall health and development in children and adolescents. Purpose This study aims to investigate the effects of ED use on body composition in healthy children to better understand potential health implications. Methods This cross-sectional assessment was conducted using data from an ongoing prospective study, which includes comprehensive information on addiction behaviors alongside demographic, lifestyle, and cardiovascular variables. The influence of ED consumption (yes/no) and frequency of ED consumption (frequent, occasional, never) on continuous outcomes (body mass index [BMI z-score], tri-ponderal index [TMI], and body fat percentage) were analyzed using t-tests and linear regression, while categorical outcomes (waist-to-hip ratio >95th percentile, overweight/obesity [BMI z-score >2SD]) were assessed with chi-square tests and logistic regression, adjusting all models for age and sex. All analysis was done in R v4.5.0. Results Of 1,445 included pupils, 57.4% had consumed ED at least once. ED consumers were older than non-consumers (14 ± 2 vs. 12 ± 2 years, p < 0.001) and included a higher proportion of males (55.7% vs. 48.3%, p = 0.007). ED consumers had a higher weight (57.4 ± 14.7 vs. 45.1 ± 13.6 kg, p < 0.001), BMI z-score (0.22 ± 1.19 vs. 0.04 ± 1.21, p = 0.006), TMI (12.3 ± 2.2 vs. 11.9 ± 1.9, p = 0.001), hip-to-waist ratio (0.85 ± 0.08 vs. 0.87 ± 0.07, p = 0.001), and waist circumference (73.6 ± 10.4 vs. 68.1 ± 9.3 cm, p < 0.001) as well as hip circumference (86.6 ± 10.8 vs. 78.9 ± 10.6 cm, p < 0.001) compared to non-consumers. Similar patterns were observed across different frequencies of ED consumption, with weekly consumers showing the highest body weight, waist, and hip measurements. Interestingly, consuming ED weekly was related to a 2.2-fold (95% CI: 1.2 – 4.0) increased risk of being overweight/obese compared to non-consumers. Conclusion This study provides evidence that ED consumption is associated with higher adiposity and altered body composition in children and adolescents. These findings fill an important research gap by demonstrating that even in a healthy pediatric population, ED intake may contribute to early cardiometabolic risk, highlighting the need for preventive strategies and public health guidance to limit ED use among youth.