Energy drinks and rise in addictive substance use: interim results from “Hand aufs Herz” study

Abstract Background About 50% of school children consume energy drinks (EDs), raising concerns due to high sugar and caffeine content. Their consumption alongside other addictive substances remains unclear. Methods The “Hand aufs Herz” study is an ongoing project in schools across Greater Munich, Bavaria, Germany. Data on lifestyle, diet, and health risks are collected via questionnaires, along with anthropometric measurements (height, weight, body circumferences). Clinical assessments include ECG, echocardiography, body fat analysis, blood pressure, oxygen saturation, and fitness tests (stair climbing test, exhalation flow, handgrip strength). Voluntary biomarker tests include fasting glucose, HbA1c, blood lipids, and vitamin D levels. This analysis uses pilot phase data from 922 children, excluding those ≤6 or ≥ 19 years to examine associations between ED consumption and alcohol, smoking, vaping, shisha, cannabis, and illicit drug use in all children and in sub-groups of children (≤12 and ≥13 years) using Chi-square tests and binomial logistic regressions in R v4.4.2. Results Data from 892 children (mean age 13±2.4; 483 boys, 409 girls) were analyzed. About 60% of pupils (n = 521) consumed ED (17.7% once/week, 9.2% multiple times/week). Consumption increased to almost 100% by age 18 years. ED consumers (vs 370 non-consumers) had a higher rate of alcohol (56.2% vs 10.5%), vaping (34.9% vs 1.9%), smoking (19% vs 0.5%), shisha (14.6% vs 0.8%), cannabis (9.2% vs 0%), and illicit drug use (1.5% vs 0%) and a 5.3-fold (95% CI: 3.9-7.3) higher risk of alcohol intake. After age-adjustment, the risk was 2.8 (95% CI: 2.1-3.9). Subgroup analysis showed stronger associations in children ≤12 years (RR: 5.3; 95% CI: 2.5-11.1) than in those ≥13 years (RR: 2.5; 95% CI: 1.8-3.4). Conclusions Strong relation between ED use alcohol and other addictive substances highlights the need for prevention policies and education to limit ED access and raise youth awareness. Key messages • About 60% of school children consumed EDs. Among older age group, ED consumption rose to nearly 100%. • ED use was linked to a 180–430% higher alcohol intake risk (RR: 2.8–5.3).