The use of energy drinks among physical education students
RESUMEThis cross-sectional descriptive study aimed to characterize the pattern of consumption of energy drinks in a sample of physical education students through a self-applied questionnaire (socio-demographic data and characterization of consumption). Variables associated with consumption (p <0.05): sex, marital status, going to the gym, swimming for competition and studying in the morning. Consumption pattern (n = 137): 2.2% once in a lifetime, 9.5% at least once in the last 12 months; 38% at least once in the last month; 39.4% six times or more in the last month; 10.9% twenty times or more in the last month. Reasons for using energy drinks: 54% improve the taste of alcohol, 27.7% have fun all night, 13.9% improve sports performance, 9.5% stimulate, 8.8% like the taste; 6.6% out of curiosity and 4.4% to study. Among those who consumed energy drinks, 87.6% mixed it with alcohol and 25.9% of students said they consume more alcohol when they mix it with energy drinks.
CONCLUSION: the consumption of energy drinks seems to be associated with sport and also with alcohol.
INTRODUCTIONFor some years the market has been invaded by drinks called energy drinks by their producers, who according to them were created to increase physical resistance, provide faster reactions and greater concentration, increase mental alertness, avoid sleep, provide a feeling of well being. being, stimulating the metabolism and helping to eliminate harmful substances to the body.
Young people have free access to these drinks in the places where they gather to dance, in clubs, bars, gyms, sports centers, and music concerts (1) where they are sold separately or together with alcoholic drinks.
This consumption, even more when mixed with alcoholic beverages, is becoming a custom among young people, becoming a new cocktail and dangerous to health. The Secretariat of Programming for the Prevention of Drug Addiction and the Fight Against Drug Trafficking in Argentina (SEDRONAR) is committed to spreading a warning about this consumption. Another issue that arises is that, with the use of energy drinks, the pattern of use of alcoholic beverages, especially distilled ones, would be changing, since, with the mixture and the improvement in flavor, greater amounts of alcohol would be being consumed ( 1) .
The risk associated with high levels of caffeine seems to be the most common problem of these drinks, in comparison to other substances that compose it. The main ingredients of most of these drinks are: taurine, caffeine, guarana, ginseng, glucuronolactone and vitamins. Some have minerals, inositol and carnitine, among other substances. Many of these components are of plant origin. Some ingredients are classified as adaptogens, as they help to normalize functions of body systems altered by tension.
Caffeine is the most widely ingested psychoactive substance in the world. For some time, it has been considered an "ergogenic" substance in sports performance, but only a decade ago controlled studies appeared showing its effectiveness in relation to resistance exercises.
Within sports medicine, an "ergogenic agent" is any mechanism, physiological, nutritional or pharmacological effect that is capable of improving the performance of both physical and occupational activities. There are three types of ergogenic agents: physiological, nutritional and pharmacological. Nutritional ergogenic agents are characterized by the application of strategies and the consumption of nutrients with an extremely variable degree of efficiency. Many athletes use various nutritional supplements, most of which have not yet been scientifically confirmed as being ergogenic (2) .
According to the National Administration of Food and Medical Technology (ANMAT), for energy drinks to be considered food supplements in Argentina, they must modify the maximum values of their components: the current percentage of caffeine from 35mg for every 100ml must drop to 20 mg / ml, which represents a total decrease of 143%.
The potential risk of consuming energy drinks would be increased by concomitant use with other substances, such as alcohol. This could trigger a series of disorders such as seizures, arrhythmias and sudden death. On the other hand, energy drinks seem to delay the depressant effects of alcohol, leading to the consumption of more alcoholic drinks (3) .
However, the greatest danger of using ergogenic agents is that they devalue and minimize the effects of physical training. As athletes resort to the use of these agents, the common person seems to be led to believe that exercise only has an effect when associated with an ergogenic agent, and that the effectiveness of the activity associated with a balanced diet seems to be increasingly questioned by the population.
There are few studies in the literature on the use of energy drinks among young people, either as an ergogenic agent in sports, or for recreational use, mixed or not with alcoholic beverages. This study aimed to characterize the pattern of energy use among physical education students at a school in the city of Rosario, Argentina. It is hoped that the results obtained may serve as a basis for future health education programs aimed at the youth population, and especially at young people who will be teachers or masters in physical education tomorrow.
METHODOLOGYThis is a quantitative, descriptive and cross-sectional study. The participants were students enrolled in the fourth year of the Physical Education Teacher at a school in the city of Rosario, Argentina.
This Institution of Higher Education of Physical Education is of provincial dependency, located in the central zone of the city of Rosario. In this institution there are three schools - one of them is the Physical Education Teachers' School (EPEF), which develops the Initial, First, Second and Third Cycle of Basic General Education and Polimodal Education, in Physical Education. The diploma awarded by such an institution is that of a Physical Education Teacher, and the aspirant must have the complete Secondary School diploma as a prerequisite for admission. In the year the survey was conducted, this faculty had 1541 (845 men and 696 women) students enrolled in conditions to regularly attend any of the four years that the career lasts.
A non-probabilistic sample for convenience was performed. Inclusion criteria were: students over 21 years old, attending the fourth year of regular physical education teaching, who were present at the time of the questionnaire application and who gave and signed the free and informed consent form to participate in the study. search. Students who did not meet the criteria described above were excluded. The fourth-year student population was 364 people, but the total sample was confirmed with 211 students.
For data collection, a self-applicable questionnaire was used based on the author's professional experience and the Questionnaire on the pattern of use of energy drinks used in a survey conducted by the Department of Psychobiology, Federal University of São Paulo (UNIFESP) (1) .
To elaborate questions number 16 regarding: what do you look for when you drink these drinks? and number18 on: if you have tried energy drinks but never drank them again, can you tell us what was the reason for not doing it again? A meeting was held with students from a nursing school and the categories that include such questions were formed from brainstorming .
The final instrument was composed of two parts, one referring to sociodemographic data and sports practices of the individuals surveyed, with eleven (11) structured questions, dichotomous and multiple choice answers, and a second part referring to the consumption pattern of the drinks, with 12 structured questions (dichotomous and multiple choice answers).
Data collection was carried out on six non-consecutive days between October 31 and November 10, 2005, and the questionnaire was successfully applied in all divisions (8) of the fourth year of teaching. The application of the questionnaire began after the permission of the authorities of the School of Teachers in Physical Education, the Board of Directors of the Institution and the Research Department. The modality of data collection was agreed as follows: the conductor of each shift was in charge of presenting the author to the teachers in charge of the time at the beginning of classes in the morning and afternoon shifts, getting them interested in the project and getting their authorization for data collection, which should not consume more than 10 minutes of class. Once with the students, the researcher explained the purpose of the questionnaire that heads each instrument. It was mentioned that this research would aim to understand the mode of consumption of energy drinks, a little studied situation in the city, and that the information could support future health education programs for young people. The students were informed of the anonymous nature of the data, and that its purpose was exclusively scientific. They were also informed that they were not required to participate, and that those who wished to do so voluntarily should first fill out a form called "free and informed consent form". Once the completion of the instruments was completed, the form was placed in an envelope to later receive its classification.
For the analysis, the data were organized in an Excel spreadsheet and then processed in the statistical program EPI INFO version 3.3.2 for Windows. For the descriptive analysis of the data, frequencies, percentages and averages were used. Pearson's chi-square test was used for analytical analysis, considering a 95% confidence interval.
An evaluation of the project was requested by the Bioethics Commission of the Faculty of Medical Sciences of the National University of Rosario, and when it was considered ethically correct, fieldwork began.
RESULTSSociodemographic characteristicsAs for sex, the sample was made up mostly of men, 114 (54%). The mean age of students was 22 years and 6 months (min = 21 years; max = 38 years, ds = 2.25). Regarding marital status, 191 (90.5%) declared themselves single / separated and only 9 (4.3%) declared having children.
When asked about their place of origin, 135 (64%) said they were from Rosario. Regarding the people with whom they live, 165 (78.2%) mentioned their families of origin.
As for work, 163 (77.3%) students said they work regularly or sporadically. With regard to attending a gym in addition to participating in school sports, 113 (53.6%) students said that they do it regularly or sporadically.
Regarding the practice of sports for competition, a wide range of responses was marked. The sports with the highest frequency were: swimming (n = 42, 19.9%); football (n = 41; 19.4%); weight lifting (n = 18; 8.5%); volleyball (n = 15; 7.1%) and basketball (n = 13; 6.2%).
Among those who train for competitions (n = 143), the average number of days per week that trained the sport practiced was 3.66 days (min. = 1; max. = 7 days, ds = 1.46).
As for the shift they study at the institution, most do it in just one shift, with 99 (46.9%) students in the morning and 106 (50.2%) in the afternoon.
Consumption of energy drinksRegarding the consumption of energy drinks, 137 (64.9%) of the individuals said they had already consumed and 74 (35.1%) said they had not.
Table 1 shows how the numerical and percentage distribution of the sociodemographic variables of the total sample occurred according to the use of energy drinks.
Since 137 students said they had already consumed energy drinks, Table 2 helps to characterize how this consumption occurred, showing the distribution of individuals according to the consumption pattern, the occasions when the energy drinks were consumed, what people seek when they ingest these drinks and the intake of energy drinks mixed with alcohol.
Consumption of energy drinks associated with sports practicesThe study found a statistically significant association between the use of energy drinks and individuals who attend a gym. Among students who attend a gym, 82 (72.6%) consume energy drinks, and among those who do not, 55 (56.1%) consume such drinks ( χ 2 = 6.232; p = 0.012). Regarding the competitive sport practiced and the use of energy drinks, a statistically significant association was found between the practice of swimming for competition and the use of energy drinks ( χ 2 = 3.62; p = 0.044).
Energy consumption associated with alcoholic beveragesAmong students who have already consumed energy drinks (n = 137), 120 (87.6%) said they did it by mixing it with alcoholic beverages, and 17 (12.4%) said they did not use this mixture.
DISCUSSIONThe results found show that the use of energy drinks is frequent (from one to six occurrences in the last month) among young people who chose physical activity as the activity that will be their way of life in the future. Athletes in general, and especially those who play highly competitive sports, are always interested in innovative products that promise to improve performance or increase their recovery. In this way, energy drinks, categorized as dietary supplements in Argentina, are a strong temptation for these sportsmen. The energy sales message announces that they vitalize the mind and body, and are made for times when physical and mental stress increases. The manufacturer of one of these drinks recommends them for sports that require high levels of energy and an immediate recovery (such as adventure courses, mountaineering, skiing) and states that its use is indicated during and after exercise (4) . In this study, when questioning the sports practiced by physical education students, it was found that swimming is associated with the consumption of energy drinks, in order to improve individual performance. Sports performance cannot be conceived if the quality of strength is not improved. Both strength and endurance are the qualities that can best be developed through proper training, regardless of the external and structural aspect. The training with weight loads has the particularity of bringing favorable results to improve the quality of strength in a short period (5) . One of the cardinal principles of muscle development during sports training is that muscles worked without load, even if exercised for hours, experience little increase in strength. However, muscles that contract at maximum, or near maximum, develop muscle strength very quickly, even if the contractions are performed only a few times a day. Through this principle, it has been demonstrated, with muscle development experiments, that the execution of six maximum or almost maximum muscle contractions, in three separate sets for three days a week, produces a practically optimal increase in muscle strength without producing chronic muscle fatigue. (6) .
Through the sample, it was identified that the practice of attending a gym to train on a regular or sporadic basis, outside of school hours, is also associated with the consumption of energy drinks. This increased use of beverages during training can be an answer to the impact of the media and advertisements for energy drinks that promise an increase in performance and an improvement in sports performance through ingestion during or after intense exercise. However, in a survey conducted among individuals who attend gyms to perform some physical activity, it was found that most were unaware of the purpose of energy drinks and their nutritional benefits. They said they knew that the drink did not contain alcohol, did not eliminate the toxins produced during the activity, and that they believed that it could bring cardiovascular disorders (7) .
With regard to other sociodemographic characteristics of the students in this study, significant associations were identified between the consumption of energy drinks and the fact that the individuals belong to the male sex and are single or separated. Perhaps this can be explained from the literature, which shows that men drink more than women and singles or separate more than married people. As for the association found between higher energy consumption and the fact that they study during the morning shift, it can be inferred that students who chose the afternoon shift may have other activities, such as working in the morning, and necessarily see their time limited to studies and night out, which is where the consumption of these drinks takes place. But this is just a hypothesis, and it should continue to be studied.
Since energy drinks have invaded the market since the beginning of this decade under English-language brands that exalt energy, vigor and strength, today thousands of young people, far from consuming them for sports activities, usually enjoy them in other occasions, seeking an ergogenic effect that allows them to reconcile the daily responsibilities of studying, working and the demands of their personal life with fun. The possibility of over-the-counter sales and consumption on occasions other than sports are supported by advertisements from different companies that, based on research, demonstrate positive effects of energy drinks on physical performance, increasing aerobic and anaerobic resistance and psychomotor performance ( reaction in time, concentration and memory) (8-9) .
The young students in the sample revealed that the occasions when they most consume these drinks are in nightclubs, bars and parties, all of which are fun situations, very far from physical training and sport, and when using them, they try to have resistance to take advantage of all night, in addition to improving the taste of alcoholic beverages. These data match those available in a Brazilian study (1) .
As for the experimental use of energy drinks, it may be more of an effect of the result of the pressure of market marketing strategies on young people, who, in order to feel included in groups, in nightclubs and usual youth meeting places, have to do so drinking alcohol or other drinks.
The consumption of energy drinks with alcohol is more and more frequent among the youth population and this sample of physical education students was no exception.
In the work carried out by the Department of Psychobiology at the Federal University of São Paulo, data were also found in which the use of energy drinks by young people is most often associated with the use of alcohol (1) . In this study, the main purpose of mixing with alcohol on the part of the students was to improve the taste of alcoholic beverages, since it is with vodka, a distilled drink of high alcohol content and very bitter taste, that most mix energy drinks. It seems that the young person does not want to miss the opportunity to ingest this drink with a high alcohol content, which allows him to feel the "pleasant" effects of alcohol, while avoiding its unpleasant taste. That is why it seeks to mix it, not with juices or cola drinks, but with energy drinks, seeking a double effect. Although studies on the interaction between energy drinks and alcohol are scarce, there is some evidence that this mixture would increase the exciting properties of alcohol or decrease its depressant effects (1) . This would allow them to reach their goal, which is to be able to have fun all night drinking alcohol, but without having the depressing effects of it: sleep, tiredness, drunkenness. Although the advertising of beverages announces that they prevent fatigue and improve performance, scientific findings suggest that energy drinks do not increase performance or reduce changes induced by an acute alcohol intake (10) . In the sample, 25.9% said they consume more alcoholic drinks when mixing them with energy drinks. This behavior could be based on the fact that the mixture improves the taste of the drink and allows a greater intake of alcohol.
Considering that students are future educators in physical activity, and how it favors healthy life and health, both sportspeople and educators in sports and physical activities must be informed about these products, their benefits and risks, and look for other foods or liquids that do not represent a potential damage to health (11) .
The message to be spread by both, to the community in general, is that, since sports practices are an important part of the culture of the people, there are no other substitutes to be able to carry them out besides training and good nutrition.
FINAL CONSIDERATIONSThis sample being composed of physical education students, at the beginning of the study, the researchers expected to find the use of energy drinks strongly associated with sports practice. Although this association exists, its frequency is less than the association that appears with alcoholic beverages in clubs, bars and parties.
The students expressed their desire to improve the taste of the alcoholic beverage and in a considerable number also said they consume more alcohol when they make this mixture.
Although energy drinks are sold freely, being advertised by their manufacturers as an indispensable element for sportsmen in search of replenishing nutrients and energy, in practice they are consumed in bars and clubs, and their use seems to contribute to the risky behavior of the use of alcohol by young people.
In addition, it is necessary to recognize that the risk of energy consumption is based not only on its combination with alcohol or other psychoactive substances, but on the "toxicity" of the lifestyle that it imposes on young people, since it causes them to accelerate, lose control and abnormal yields.
With this, it is perceived the importance of other studies to be carried out in order to clarify how the association of energy drinks with alcoholic beverages occurs, whether their mixed consumption increases alcohol intake and how the interaction between the two occurs. This situation presents itself more and more frequently among young people and more data is needed to clarify whether it is harmful to health or not.
Young people need to be guided to recognize that, as future physical activity educators, they must incorporate and be able to share with others that, in order to achieve a good level in sport, good hydration is necessary, a sufficient energy contribution achieved through adequate intake of food without the need for other supplements.
In view of these results, the importance and the need for interventions for the prevention of energy consumption are perceived, with simple guidelines for these young people in order to reduce their use, reinforce the importance of hydration and adequate food to achieve a good performance in sport, and also to prevent the risks they take when drinking energy drinks with alcohol.
Monster Energy Drink, Green, Original, 16 Ounce (Pack of 24)
