title: Association between energy drink intake, sleep, stress, and suicidality in Korean adolescents: energy drink use in isolation or in combination with junk food consumption.
abstract: A considerable amount of research suggests that the frequent use of caffeinated energy drinks may be associated with undesirable effects, particularly so in children and adolescents. This study aimed to investigate the associations between energy drink intake and mental health problems, in isolation or in combination with junk food consumption, in a nationally representative sample of Korean adolescents.
  
  
  
  Data from the 2015 Korean Youth Risk Behavior Web-Based Survey, collected from 68,043 adolescents aged 12-18 years (mean age 15.09 ± 1.72 years), were analyzed. Questionnaires were administered to collect information related to dietary behavior including energy drink intake and junk food consumption. Single item measures of sleep dissatisfaction, stress, depression, suicidal ideation, suicide plan, and suicide attempt were also administered. Associations between energy drink intake and sleep dissatisfaction, perceived severe stress, persistent depressive mood, and suicidality were investigated, and a multivariate approach was taken so that additional variance from demographic and lifestyle factors could be controlled for statistically.
  
  
  
  Energy drink intake was significantly associated with sleep dissatisfaction (adjusted odd ratios [AORs] = 1.64 and 1.25), severe stress (AORs = 2.23 and 1.38), depressive mood (AOR = 2.59 and 1.51), suicidal ideation (AORs = 3.14 and 1.43), suicide plan (AORs = 4.65 and 1.78), and suicide attempt (AORs = 6.79 and 1.91), with a higher risk for more frequent use of energy drinks (≥5 times/wk) than for less frequent use (1-4 times/wk). The detrimental effect of energy drinks on mental health was particularly prominent in frequent junk food consumers.
  
  
  
  Our data suggest that energy drink intake had detrimental effects related to stress, sleep dissatisfaction, mood, and suicidality, in isolation or in combination with junk food consumption, in Korean adolescents. However, the cross-sectional study design prevents our ability to assess causal relationships.
authors.affiliation: Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, South Korea.
authors.forename: Subin
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of psychology, Korea University, Seoul, South Korea.
authors.forename: Yeeun
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, National Center for Mental Health, 127, Yongmasan-ro, Gwangjin-gu, Seoul, 04933, South Korea. leejunghyun1@gmail.com.
authors.forename: Junghyun H
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D044466:Asian People / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D004032:Diet; D061215:Energy Drinks / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008603:Mental Health; D056910:Republic of Korea / Q000453:epidemiology; D012890:Sleep / Q000502:physiology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D013405:Suicide / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Adolescents; Energy drinks; Junk food; Mood; Suicide