Relationships Among Soda and Energy Drink Consumption, Substance Use, Mental Health and Risk-Taking Behavior in Adolescents.

: Energy drink (ED) use is increasing among children and adolescents, but little is known about the impacts on health, including substance use and mental health. The purpose of this study was to examine the relationship between soda and ED consumption and substance use, mental health, and risk taking in a nationally representative sample of high school students. We used data from the 2019 Youth Risk Behavior Surveillance System (YRBS) from New Jersey, Montana, and Florida to assess these relationships using binary and multinomial regression analyses to determine odds ratios, comparing non-consumers with daily consumers. The sample was 10,548 adolescents (51.6% female) between the ages of 13-19 years. : Daily soda and ED consumption were associated with greater odds of substance use (OR(95% CI): 5.8 (3.7, 6.9)/10.2 (6.4, 16.3)), poorer mental health (OR(95% CI): 2.6 (1.3, 4.8)/1.8 (1.2, 2.8), and higher odds of eating fast food (OR(95% CI): 17.2 (8.9, 33)/10.6 (5.6, 19.9). These effects were moderated by sex. : These findings suggest that soda and ED use are associated with greater risk taking among adolescents and that these relationships are moderated by sex. Future studies should determine the directionality of these relationships and examine the impact of reduced soda and ED consumption on health behaviors in children and adolescents.