Energy drink consumption and mental health problems in university students: A cross-sectional study

Abstract Background Energy drinks (EDs) represent the fastest-growing non-alcohol beverage sector worldwide. Their caffeine content has raised concerns regarding potential adverse health effects. This study aimed to analyse the association between ED consumption and mental health problems among young adults, and to explore whether sleep duration mediates this relationship. Methods The study population included full-time students participating in the Norwegian national cross-sectional survey of health and wellbeing among students (SHOT2022). A total of 31,316 participants aged 18-24 years provided information on ED consumption frequency and mental health problems, measured using the Hopkins Symptom Checklist-25 (HSCL-25). Analyses were adjusted for sociodemographic and lifestyle covariates. Results Overall, 57.6% of participants reported any ED use, and 37.4% consumed EDs at least weekly. ED consumption frequency was positively associated with symptoms of anxiety and depression in a dose-response manner for both sexes. Compared to seldom/never consumers, daily ED use was associated with a significantly higher likelihood of poor mental health (HSCL ≥ 2.0) in females (adjusted OR 2.33) and males (adjusted OR 1.77). The mediation analysis indicated that shorter sleep duration partly explained the association between ED consumption and mental health problems. Conclusions Although a causal effect cannot be established, the findings suggest that regular ED consumption among young adults may constitute a risk behaviour associated with adverse mental health outcomes, partly mediated by reduced sleep duration. Health professionals could routinely assess ED and caffeine consumption in students presenting poor sleep or mental health problems. Public health efforts, including initiatives by student welfare associations and educational institutions, may also be warranted to reduce regular ED use and support better sleep and mental health in this vulnerable group. Key messages • Regular ED consumption among university students may constitute a risk behaviour associated with adverse mental health outcomes. • Shorter sleep duration may be a potential mediating factor for the association between ED consumption and mental health problems.