Unhealthy eating behaviors linked to energy drink use in pupils: Interim results from Hand aufs Herz Study

Background Energy drinks (ED) are increasingly consumed by young people, despite concerns about their poor nutritional profile, which typically includes high sugar content, additives, and stimulants such as caffeine. Such beverages may displace healthier dietary choices and contribute to unfavorable nutritional behaviors during a critical period of growth and development. Yet, evidence on how ED consumption relates to overall nutrition-related health indicators in youth remains limited. Purpose This study aims to investigate the association between ED use and key nutrition-related outcomes in healthy pupils to better understand its potential implications for pediatric health. Methods This cross-sectional assessment was conducted using data from an ongoing prospective study, which includes comprehensive information on demographic, lifestyle, and nutrition-related variables. The influence of ED consumption (yes/no) on a wide range of nutrition outcomes, including overall dietary quality, food label awareness, school-day lunch sources (canteen, home-prepared, fast food, supermarket, kiosk, and other options), dietary patterns (diet type, intake of sugary drinks, fast food, convenience foods, fresh foods, fruits, vegetables, legumes, nuts, sweets/snacks, whole grains, and dairy products), family meal habits (breakfast, lunch, and dinner), meal preparation practices at home, use of convenience meals, plant-based food intake, olive oil use, and breakfast skipping, was examined. Categorical outcomes were analyzed using chi-square tests while continuous variables were evaluated with t-tests using R v4.5.0. Results Of 1,445 included pupils, 57.4% had consumed ED at least once. ED consumers were older (mean 14.1 vs. 11.9 years, p < 0.001) and more likely to be male (55.7% vs. 48.3%, p = 0.007) compared to non-consumers. We found several differences in multiple aspects of diet between ED consumers vs non-consumers: ED consumers were more likely to have lower dietary scores (36.7% vs. 23.8%, p < 0.001), consume more sugary drinks (83.6% vs. 64.4%, p < 0.001) and fast-food weekly (60.8% vs. 45.5%, p < 0.001), and were more likely to skip breakfast regularly (45.7% vs. 25.4%, p < 0.001). They also reported lower intake of fruits (51.3% vs. 66.8%, p < 0.001), vegetables (69.0% vs. 75.0%, p = 0.016), nuts (12.5% vs. 21.1%, p < 0.001), and whole grain foods (72.5% vs. 66.5%, p = 0.016). Furthermore, ED consumers were less likely to have family meals, use olive oil, or consume food prepared at home. Conclusion Overall, these findings suggest that pupils who consume ED exhibit patterns of unhealthy nutrition, characterized by higher intake of sugary and fast foods, lower consumption of nutrient-dense foods, and less structured meal habits. Enhancing understanding of balanced nutrition can empower youth to make informed decisions and reduce preventable chronic diseases.