Energy drinks consumption among football players in Lagos, Nigeria
Objectives: This study assessed the prevalence, frequency and reasons for the consumption of energy drinks among members of registered football clubs in Lagos, Nigeria. A descriptive cross-sectional study design was employed and the study setting was Onikan Stadium Lagos, Lagos State, Nigeria. A simple random sampling technique was employed to select 350 members of the football clubs.
Method: A pretested self-administered questionnaire was used to assess the prevalence, frequency and reasons for consumption of energy drinks. Epi Info® software (version 6.04) was used for data analysis.
Results: Most of the respondents (76.3%) were energy-drink consumers but none of them was a daily user. Most of those who took it (71.9%) drank at least two cans a week. Power Horse™ was the most preferred choice (58.4%) and more than one-third (37.1%) mixed it with alcohol. The commonest reasons for using energy drinks were leisure (42%), performance enhancement (25.1%) and drinking with friends (25.1%). Single students between ages 21 and 30 years consumed energy drinks more than married, younger or older workers (p < 0.05).
Conclusions: The majority of the football players were weekly energy-drink users and the commonest reason for consumption was leisure. Although it can be expected that football players consume energy drinks to enhance their sporting performance, it was of concern to find that one-third of the football players mixed energy drinks with alcohol. Education regarding the effects of energy-drink consumption and alcohol is needed among the football players in Lagos.
Global energy-drink consumption increased by 14% (i.e. 1.5 billion litres higher) between 2007 and 2011 and had grown by a mean of 10% yearly from 2007 to 2011. More than half of young adults consume a minimum of one can of energy drink monthly and about 6% use energy drinks daily.1,2Zenith International. Global Energy Drinks Report. Global Energy Drinks Report; 2012 [cited 2013 Mar 21]; 878. Available from:http://www.zenithinternational.com/reports_data/146/
Schmidt RM, McIntire LK, Caldwell JA, et al. Prevalence of energy drink and supplement usage in a sample of Air Force personnel: interim report. Wright-Patterson Air Force Base, OH: Air Force Research Laboratory; 2008 [cited 2013 Mar 27]. Available from:http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA514723 Most energy drinks contain natural products such as guarana, ginseng and/or taurine, but also as much as 50 to 505 mg of caffeine and 35 grams of processed sugar per 8-oz serving. The amounts of guarana, taurine and ginseng found in popular energy drinks are far below the amounts expected to deliver either therapeutic benefits or adverse events. However, the other ingredients with potential interactions such as between taurine and other amino acids and between caffeine and some herbal extracts can create ‘synergistic effects especially side effects’. On the other hand, caffeine and sugar are present in amounts known to cause a variety of adverse health effects.3–5Ballistreri MC, Corradi-Webster CM. Consumption of energy drinks among physical education students. Rev Latino-Am Enfermagem. 2008;16(Special): 558–64. doi:10.1590/S0104-11692008000700009.
Clauson KA, Shields KM, McQueen CE, et al. Safety issues associated with commercially available energy drinks. J Am Pharm Assoc. 2008;48(3): e55–63.10.1331/JAPhA.2008.07055
Weise E. Petition calls for FDA to regulate energy drinks. USA Today. 2008 Oct 22 [cited 2010 Sept 3]. Available from:http://www.usatoday.com/news/health/2008-10-21-energy-drinks_N.htm
Caffeine from plant extracts that contain polyphenol has been associated with positive vascular health and improved blood flow as a result of its antioxidant, anti-inflammatory and anti-cancer qualities. Taurine has also been identified to enhance endurance performance and to aid in the reduction of lactic acid build-up after exercise.6Matsuzaki Y, Miyazaki T, Miyakawa S, et al. Decreased taurine concentration in skeletal muscles after exercise for various durations. Med Sci Sports Exerc. 2002;34: 793–7.10.1097/00005768-200205000-00011[Crossref], [Google Scholar] Several studies confirm that caffeine consumption can increase energy utilisation, enhance mood and alertness and improve exercise performance.7Smit HJ, Rogers PJ. Effects of energy drinks on mood and mental performance: critical methodology. Food Qual Pref. 2002;13: 317–26.10.1016/S0950-3293(02)00044-7[Crossref], [Web of Science ®], [Google Scholar] Caffeine and other substances in energy drinks increase pain tolerance, allowing athletes to work out harder and longer thereby leading to enhanced performance.8Forbes SC, Candow DG, Little JP, et al. Effect of red bull energy drink on repeated wingate cycle performance and bench-press muscle endurance. Int J Sport Nutr Exe. 2007;17: 433–444.10.1123/ijsnem.17.5.433[Crossref], [Web of Science ®], [Google Scholar] However, if consumed in excess amounts, energy drinks could have adverse effects on health. The adverse reactions and toxicity from high energy-drink consumption stem predominantly from their caffeine content, though the combination of caffeine with the other ingredients has synergistic effects that increase the side effects of energy drinks.9,10Higgins JP, Tuttle TD, Higgins CL. Energy beverages: content and safety. Mayo Clin Proc. 2010;85:1033–41.10.4065/mcp.2010.0381
Reissig CJ, Strain EC, Griffiths RR. Caffeinated energy drinks—A growing problem. Drug Alcohol Depend 2009;99(1–3):1–10.10.1016/j.drugalcdep.2008.08.001
Different brands of energy drinks contain caffeine ranging from 50 mg to 550 mg per can or bottle.10 Caffeine has a long history of safe use and scientific evidence maintains that when consumed in moderation (300–400 mg/day/adult) no adverse effects should occur. However, energy drinks are usually consumed rapidly, unlike coffee or tea. This can quickly increase the concentrations of caffeine and other ingredients in the blood, thereby increasing the risk of side effects. Toxicity from excess caffeine can result in nausea, dehydration, irregular headache, nervousness, irritability, increased respiration, insomnia, hallucinations, poor academic performance, aggressive behaviour, tachycardia and cardiac dysrhythmias, hypokalaemia, paralysis, cerebral oedema, rhabdomyolysis, sudden cardiac death, and psychosis.11,12Cappelletti S, Daria P, Sani G, et al. Caffeine: cognitive and physical performance enhancer or psychoactive drug? Curr Neuropharmacol. 2015[cited 2014 Mar2];13(1):71–88. doi:10.2174/1570159X13666141210215655.
Hedges DW, Woon FL, Hoopes SP. Caffeine-induced psychosis. CNS Spectr. 2009;14(03):127–31.10.1017/S1092852900020101 The increasing reports of caffeine intoxication from energy drinks indicate that caffeine dependence and withdrawal could also increase after short-term, high-dose use.1,13Zenith International. Global Energy Drinks Report. Global Energy Drinks Report; 2012 [cited 2013 Mar 21]; 878. Available from:http://www.zenithinternational.com/reports_data/146/
Smit HJ, Cotton JR, Hughes SC, et al. Mood and cognitive performance effects of ‘energy’ drink constituents: caffeine, glucose and carbonation. Nutr Neurosci. 2008;7:127–139. Taking an excess dose of energy drinks before or during exercise might also be linked to an increased risk of myocardial ischaemia while the elevated sugar quantity in energy drinks contributes to obesity.14,15Thomson B, Schiess S. Risk profile: caffeine in Energy drinks and energy shots. [cited 2013 Mar 21]. Available from:www.nzfsa.govt.nz/science/risk-profiles/fw10002-caffeine-inbeverages-risk-profile.pdf
Riddell L, Keast RS. Is caffeine in soft drinks really necessary? Med J. 2007;187:655.
Some brands of energy drinks are labelled as conventional foods while others are labelled as dietary supplements. Substances that are generally recognised as safe by qualified experts can be added to conventional foods without pre-approval from the FDA; therefore, energy drinks are not properly regulated.16U.S. Department of Health and Human Services. Energy ‘drinks’ and supplements: investigations of adverse event reports. 2012 [cited 2017 Feb 21]. Available from:https://www.fda.gov/default.htm [Google Scholar] This lack of regulation has allowed aggressive promotion of energy drinks in many countries including Nigeria and these promotions are usually targeted towards 18- to 35-year-old highly active and risk-taking consumers and athletes. Athletes are increasingly using energy drinks because of the ergogenic effects.17Duchan E, Patel ND, Feucht C. Energy drinks: a review of use and safety for athletes. Phys Sportsmed. 2010;38(2):171–9. doi:10.3810/psm.2010.06.1796.[Taylor & Francis Online], [Google Scholar]Adolescents and young adults are particularly attracted to energy drinks not just because of effective product marketing but due to peer influence and lack of knowledge of the potentially harmful effects.18Attila S, Çakir B. Energy-drink consumption in college students and associated factors. Nutrition 2011;27:316–22.10.1016/j.nut.2010.02.008[Crossref], [Web of Science ®], [Google Scholar] The urge to improve performance causes athletes to take energy drinks before contests because the drinks have been promoted as boosting performance and endurance.15Riddell L, Keast RS. Is caffeine in soft drinks really necessary? Med J. 2007;187:655. [Google Scholar] In spite of the well-documented consequences of frequent and high consumption of energy drinks,19Badaam KM, Masroor SS. A study of energy drinks consumption practices among football players in India. IOSR-JDMS. 2013;4(5):24–27.10.9790/0853[Crossref], [Google Scholar] little is known about the consumption frequency of energy drinks among football players in Lagos, Nigeria. This study, therefore, determined the prevalence, brand and reasons for consumption of energy drinks among registered football players in Lagos State, Nigeria. This will offer useful information for football players, dietitians, sports professionals, the Nigerian regulatory authority and the media on the use of energy drinks among football players in Lagos State.
Materials and methods
Study setting and population
This was a descriptive cross-sectional study and was conducted at Onikan Stadium, which is the headquarters of the Lagos State Football Association (LSFA). Inclusion criteria were football players who are members of the clubs registered with the LSFA.
Sixty amateur football clubs, consisting of 55 men’s clubs and five women’s clubs, were registered with the LSFA in 2016. Each club had an average of 30 football players, giving a total of about 1 800 football players in the football clubs registered with the LSFA in 2016. The minimum sample size calculated was 301. A simple random sampling technique was used to select 15 clubs and all the members of each club were interviewed to give a total of 350 football players.
Instrument and pre-testing of instrument
A self-administered questionnaire was used for data collection. The questionnaire was developed from past literature on consumption of energy drinks, especially among football players.2,3,18–23,29Schmidt RM, McIntire LK, Caldwell JA, et al. Prevalence of energy drink and supplement usage in a sample of Air Force personnel: interim report. Wright-Patterson Air Force Base, OH: Air Force Research Laboratory; 2008 [cited 2013 Mar 27]. Available from:http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA514723
Ballistreri MC, Corradi-Webster CM. Consumption of energy drinks among physical education students. Rev Latino-Am Enfermagem. 2008;16(Special): 558–64. doi:10.1590/S0104-11692008000700009.
Attila S, Çakir B. Energy-drink consumption in college students and associated factors. Nutrition 2011;27:316–22.10.1016/j.nut.2010.02.008
Badaam KM, Masroor SS. A study of energy drinks consumption practices among football players in India. IOSR-JDMS. 2013;4(5):24–27.10.9790/0853
Miller KE. Energy drinks, race, and problem behavior among college students. J Adolesc Health. 2008;43:490–7.10.1016/j.jadohealth.2008.03.003
Arpaci N, Tosun S, Ersoy G. Sports and energy drink consumption of physical education and sports students and their knowledge about them. OUA. 2010;10(2):732–6. Available from:http://analefefs.ro
Buxton C, Hagan JE. A survey of Energy drinks consumption practices among student-athletes in Ghana: lessons for developing health education intervention programs. J Int Soc Sports Nutr. 2012;9(1):9.10.1186/1550-2783-9-9
Sabbah H, Qamhia N, Younis M. Consumption Patterns and Side Effects of Energy Drinks among University Students in Palestine: Cross-Sectional Study. MOJ Public Health. 2015;2(2):00015. Doi: 10.15406/mojph.2015.02.00015
Oteri A, Salvo F, Caputi A, et al. Intake of energy drinks in association with alcoholic beverages in a cohort of students of the school of medicine of the University of Messina. Alcohol ClinExp Res. 2007;31(10):1677–80.10.1111/acer.2007.31.issue-10 It consisted of questions on frequency, reasons for use and brands preferred. The questionnaire was pre-tested among 20 football players in one of the clubs that were not selected for the study (based at another stadium) to detect ambiguity, and necessary adjustments were made before the study.
FOR FURTHER INFORMATION AND DATA FOR ENERGY DRINKS IN NIGERIA: