Manchester Julianne, Eshel Inbal, Marion Donald W
General Dynamics Health Solutions, The Defense and Veterans Brain Injury Center, 1335 East West Highway, 4th Floor, Silver Spring, MD 20910.
Mil Med. 2017 Jul;182(7):e1726-e1733. doi: 10.7205/MILMED-D-16-00339.
Energy drinks (EDs) have become an integral part of the young adult, athletic, and military culture. Many athletes are convinced that EDs enhance performance, and service members as well as college students frequently use EDs as stimulants to counter sleep deprivation, or to improve academic performance. However, concerns have been raised by some military leaders about potential adverse effects of EDs.
A needs assessment survey of a convenience sample of military health care providers was conducted and identified EDs as a top knowledge need for those providers working in the area of traumatic brain injury (TBI). The instrument demonstrated high interitem consistency (Cronbach's α > .80). To further explore the state of knowledge on EDs, and to prompt further discussion of ED use and how it may related to military treatment protocols and supporting educational products, we conducted a literature review of English language publications listed in the National Library of Medicine using the search term "energy drinks" and published during the last 5 years to determine what is known about EDs in terms of their potential benefits and health risks.
The active ingredients in most EDs are caffeine, and to a lesser extent taurine and sugars. Several reports suggest that the combination of these ingredients is more active than the caffeine alone. Despite the positive attributes of EDs, there are increasing reports of serious and potentially life-threatening side effects. Most recently there also has been a dramatic increase in the use of ED/alcohol combination drinks, and there are preliminary studies that suggest important adverse effects with this combination. A 2013 National Institutes of Health expert workshop concluded that more clinical studies are needed to clearly define the health risks associated with ED use.
The needs assessment points to a desire for more ED knowledge of health providers working with TBI patients. A few key themes emerged from the exploratory literature review that can be taken into consideration when educating health providers and delivering knowledge-based resources. Adverse effects of EDs are most closely associated with the dose of caffeine consumed. In general, the combination of ED with alcohol should be avoided because the ED can mask the level of intoxication, and the combination may be associated with increased risk-taking behavior. Overall, the risks and benefits of EDs remain controversial and good-quality long-term clinical trials are needed to inform policymaking, regulation, and the development of prevention and treatment resources.
能量饮料已成为年轻人、运动员和军事文化中不可或缺的一部分。许多运动员坚信能量饮料能提高运动表现,军人和大学生也经常将能量饮料用作兴奋剂,以对抗睡眠不足或提高学业成绩。然而,一些军事领导人对能量饮料的潜在不良影响表示担忧。
对军事医疗服务提供者的便利样本进行了需求评估调查,结果表明能量饮料是在创伤性脑损伤(TBI)领域工作的医疗服务提供者最需要了解的知识之一。该调查工具显示出较高的项目间一致性(Cronbach's α>.80)。为了进一步探索关于能量饮料的知识状况,并促使人们进一步讨论能量饮料的使用及其与军事治疗方案和辅助教育产品的关系,我们对美国国立医学图书馆列出的英文出版物进行了文献综述,使用搜索词“能量饮料”,并检索了过去5年发表的文献,以确定关于能量饮料的潜在益处和健康风险的已知信息。
大多数能量饮料的活性成分是咖啡因,其次是牛磺酸和糖。一些报告表明,这些成分的组合比单独的咖啡因更具活性。尽管能量饮料有积极的特性,但关于严重且可能危及生命的副作用的报告越来越多。最近,能量饮料与酒精混合饮料的使用也急剧增加,初步研究表明这种组合有重要的不良影响。2013年美国国立卫生研究院的专家研讨会得出结论,需要更多的临床研究来明确与能量饮料使用相关的健康风险。
需求评估表明,治疗TBI患者的医疗服务提供者渴望获得更多关于能量饮料的知识。探索性文献综述中出现了几个关键主题,在对医疗服务提供者进行教育和提供基于知识的资源时可以考虑这些主题。能量饮料的不良影响与摄入的咖啡因剂量密切相关。一般来说,应避免将能量饮料与酒精混合,因为能量饮料会掩盖醉酒程度,而且这种组合可能与冒险行为增加有关。总体而言,能量饮料的风险和益处仍存在争议,需要高质量的长期临床试验为政策制定、监管以及预防和治疗资源的开发提供信息。