Study of medical students' knowledge about the effect of energy drink and nutritional supplement consumption on pulse and blood pressure, a comparative study between males and females.

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Falak Mouhamad Almshhad, Rouaa alkhoja, Taghreed Hammoud This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5383582/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Energy drink consumption has increased dramatically in the past two decades, especially among young adolescents. Energy drinks are heavily marketed with the claim that these products provide a boost of energy to improve physical and cognitive performance, however, studies supporting these claims are limited. Dietary supplements (minerals/vitamins) also play a pivotal role in regulating blood pressure because they help in the function of macronutrients and also improve the functions of some blood pressure-lowering factors. Our aim was to study the knowledge of medical students about the effect of consuming energy drinks and dietary supplements on pulse and blood pressure. Methods A cross-sectional descriptive study was conducted at the Syrian Private University (Daraa Governorate) during the period 23/9/2024 to 4/10/2024. The responses of participating medical students were studied through a questionnaire distributed in paper and electronic form on the university campus. Results Our study included 300 students, with a percentage of males (51%) and females (49%). The largest percentage of participants were fourth-year students (43.7%). The most participating age group was “22 − 18” (79.7%). More than half of the students (60.7%) were aware of the common ingredients found in energy drinks. The majority of students (97.7%) responded that excessive consumption of energy drinks has a clear effect on pulse and blood pressure. The frequency of their consumption of energy drinks was as follows: never (40%), rarely (less than once a month) (29%), daily 16 (5.3%). Conclusion Energy drinks and nutritional supplements may have positive beneficial effects on academic performance or exercise and in various other activities, however, potential harmful health problems have been documented, especially among young people and adolescents. We found that the participating students had an acceptable level of awareness about the consumption of energy drinks and nutritional supplements and their potential effect on pulse and blood pressure. We also found that a small percentage of them had consumed these drinks and experienced some of their effects. Nutrition & Dietetics Endocrinology & Metabolism Energy drinks nutritional supplements blood pressure pulse knowledge and awareness Background The widespread consumption of energy drinks and supplements across populations has raised concerns about their physiological effects, particularly on cardiovascular health. As individuals increasingly seek an immediate boost in energy and performance, understanding the effects of these substances on heart rate and blood pressure is of paramount importance. Several studies, including recent findings published in PubMed, suggest that these products often contain high levels of caffeine and other stimulants, which can lead to acute circulatory changes. High heart rates and blood pressure fluctuations may pose significant risks, particularly for young, healthy consumers who mistakenly believe that these beverages are harmless. The increasing consumption of energy drinks and supplements has become increasingly apparent, particularly among younger populations and athletes. These products are marketed as solutions to enhance physical and mental performance, appealing to individuals seeking a quick burst of energy or improved nutritional support, and their wide availability and increased marketing strategies have contributed to their popularity, attracting a variety of groups, including college students, professionals, and fitness enthusiasts. Demographic studies indicate that males aged 18–34 years represent a significant proportion of energy drink consumers, often driven by a desire to increase alertness during strenuous academic or professional tasks. Conversely, dietary supplements appeal to a broader audience, with individuals of all ages seeking to improve their health, fitness, and overall well-being. Variables such as an individual’s tolerance to caffeine and other stimulants, along with pre-existing health conditions, can significantly influence physiological responses. The current literature provides mixed results, with some studies reporting increased blood pressure and pulse rates after consumption, while others report little effect [10]. Ultimately, informed choices based on empirical evidence and awareness of personal health status are crucial in mitigating potential adverse effects. As additional research emerges, it will be imperative for both consumers and healthcare providers to remain vigilant in assessing the risks and benefits associated with these widely consumed products. By investigating these effects, this research aims to shed light on the knowledge and awareness of medical students at the Syrian Private University about the effects of consuming these beverages on the cardiovascular system, ultimately contributing to a more informed approach to the consumption of energy drinks and nutritional supplements in contemporary society. Aim of the study: Study of medical students' knowledge about the effect of energy drink and nutritional supplement consumption on pulse and blood pressure. Methods A cross-sectional descriptive study was conducted at the Syrian Private University (Daraa Governorate) during the period from 9/23/2024 to 10/4/2024. The answers of the participating medical students, numbering 300 male and female students, were studied through a questionnaire designed with the assistance of the research supervisor, containing a set of questions that serve the research objective (energy drinks axis and nutritional supplements axis). The approval of the Syrian Private University was obtained to publish the questionnaire in paper and electronic form within the university campus. Statistical analysis : Patients' data were tabulated and entered into the computer, and then the Statistical Package for the Social Sciences (SPSS) program, version (26), was used to analyze this data. The following statistical methods were used in the analysis: Descriptive analysis: This involves finding the relative frequency distributions of the categorical study variables (gender, place of residence, financial status, etc.). Results Table 1 shows the demographic information of the students. The most participating age group was 18-22 with 239 (79.7%), followed by 23-27 with 58 (19.3%). Male students accounted for 153 (51%) and female students 147 (49%). The largest percentage of participants were fourth-year students with 131 (43.7%), followed by third-year students with 51 (17%). Table 2 shows that a small percentage of the participating students had undergone a training course related to nutrition and cardiovascular health, and their percentage was 64 (21.3%). Energy drinks: We asked the participating students a set of questions related to general information about energy drinks.Table 3 shows that more than half of the students 182 (60.7%) reported that they were aware of the common ingredients found in energy drinks. Table 4 shows their answers about these ingredients, which were as follows: caffeine 261 (87%), sugar 247 (82.3%), herbal extracts 53 (17.6%), taurine 39 (13%), and vitamin B 38 (12.6%). When asked about the recommended daily limit for caffeine intake for adults, more than half of them, 165 (55%), answered no, while 119 (39.7%) answered yes Table 5. In detail, their answers about the recommended daily limit were as follows: 400 mg 136 (45.3%), 200 mg 82 (27.3%), 600 mg 44 (14.7%) Table 6. Table 7 shows the students’ answers about the effect of excessive consumption of energy drinks on pulse and blood pressure, the majority of the students, 293 (97.7%), answered yes, it has a clear effect. Table 8, the students’ choices regarding the effects that energy drinks can have on the cardiovascular system are clear, and they were as follows: increased heart rate 267 (89%), high blood pressure 238 (79.3%), irregular heartbeat 173 (57.6%). They were asked about the frequency of their consumption of energy drinks, and they answered as follows: the largest percentage does not consume them 120 (40%), rarely (less than once a month) 87 (29%), sometimes (one to three times a month) 55 (18.3%), daily 16 (5.3%) Table 9. Table 10 shows that a small percentage 81 (27%) of students had experienced cardiovascular symptoms (such as palpitations and increased heart rate) after consuming energy drinks. Nutritional supplements: Table 11 shows the students' answers about nutritional supplements and whether they have an effect on pulse and blood pressure, where more than half of the students answered yes 189 (63%), compared to 93 (31%) who answered no. When asked about the effect of these supplements on the cardiovascular system, their answers were as follows: increased heart rate 79 (26.3%), high blood pressure 74 (24.6%), irregular heartbeat 59 (19.6%) Table 12. Table 13 shows the students’ answers about the types of nutritional supplements that can affect cardiovascular health, which were as follows: protein supplements 120 (27.3%), vitamin and mineral supplements 97 (22.1), herbal supplements 55 (12.5). Table 14 shows that a small percentage of students 44 (14.7%) had received formal education or training about the effects of nutritional supplements and energy drinks, compared to 256 (85.3%) who answered no. When asked if they would like to attend a seminar or workshop on the effects of nutritional supplements and energy drinks, more than half of them, 202 (67.3%), answered yes Table 15. Discussion The use of energy drinks and supplements is associated with the desire to increase academic performance and sports activities such as football and others. These activities are attractive to university students in general, especially males, and this could also explain why more male students were interested in filling out this questionnaire compared to female students. Similar behavior was observed in studies conducted in different countries, including Zambia, Taiwan, Poland, Saudi Arabia, the United Arab Emirates, and Lebanon, where males were observed to be more daring and willing to try new things compared to females. [ 1 ] Regarding the knowledge of participating students about energy drinks, more than half of the participants knew that these drinks contain caffeine and sugars and may also contain amino acids and herbal extracts. However, many were not aware that these drinks may also contain L-carnitine, vitamins, and minerals, indicating that students may not generally check the ingredients of the products they consume. About two-thirds of the participants reported that energy drinks may increase heart rate and blood pressure. Many of the side effects of energy drinks are due to the fact that they contain a large amount of caffeine. An eight-ounce serving of energy drinks typically contains 80–141 mg of caffeine. [ 2 ] The biological mechanism of caffeine is not yet fully understood; it positively affects performance by reducing fatigue and enhancing physical endurance. [ 10 ] Although caffeine has some positive effects on mood and cognition at low doses (12⋅5–100 mg), [11] it also has some negative health effects, including increased diuresis, [12] decreased insulin sensitivity, [13] disrupted sleep patterns, [ 3 ] increased mean arterial blood pressure, and chronic daily headaches. [14] Studies conducted in Zambia and the United Arab Emirates among university students found a statistically significant association between energy drink consumption and poor sleep quality. [ 9 , 8 ] In a 2020 study in Jordan, more than 60% of participating students were found to have poor knowledge regarding energy drinks. In this study, participants had acceptable knowledge, which could be attributed to the fact that consumption of these drinks increased further in 2021 and 2022, which may have influenced them to seek more information about these drinks. We found moderate knowledge of energy drink ingredients and adverse health effects in a similar study conducted in Saudi Arabia. [ 3 ] On the other hand, in a study conducted in Poland, students had high knowledge of energy drinks and their side effects, however, their knowledge was not reflected in their consumption of these drinks. A better understanding of energy drink ingredients and side effects was also observed among medical students in a study conducted in Turkey. [15] Regarding the prevalence of energy drink consumption among participating students, we found that 60% of participants consumed these drinks. This percentage is higher than that found in a previous similar study conducted in 2020 in Jordan, where 40⋅1% of participating students reported consuming energy drinks. [ 4 ] This finding of high prevalence of energy drink consumption among students in Jordan is consistent with similar studies conducted worldwide, where the prevalence of energy drink consumption was reported to be around 50% among students in Australia, [ 7 ] Italy, [16] the United States, [ 2 ] and Canada [17] (48, 56⋅2, and 63%, respectively). Similar research conducted in the Middle East and North Africa region showed that energy drinks were consumed by 42.7% of Iraqis, especially young people, [18] 52.6% of medical students in Saudi Arabia, and 63.6% of Lebanese students. [ 5 ] A higher percentage was reported in the United Arab Emirates, where more than 90% of students reported using energy drinks. [ 6 ] In our study, females had a superior knowledge than males. In a study conducted to investigate gender differences in information about both energy drinks and nutritional supplements, it was found that men were often unwilling and unmotivated to interact with health-related information. [21] This could explain why women are often more knowledgeable about health-related information than men, as shown in other studies assessing general knowledge of various health information. [21,20] With the increasing competition between different brands and manufacturers of energy drinks, which is reflected through different means of advertising these products targeting mainly young people, there is a need for awareness campaigns to counter peer pressure and the influence of advertising on young people to reduce their consumption of energy drinks. These drinks are therefore known for their high caffeine and sugar content, especially with the increasing number of cases of caffeine poisoning associated with energy drink consumption. [22] One limitation of the current study is that it was based on an online self-administered questionnaire, which could lead to errors in answering or misunderstandings that could affect the results to some extent. Another limitation is the representativeness of the sample, as most of the participants were from one university, but this provides an opportunity to conduct similar studies in the future at other universities, to see if university students there have similar or different behaviors and perceptions towards energy drinks. Conclusion Energy drinks and nutritional supplements may have positive effects on academic performance, exercise, and other activities, but potential adverse health effects have been documented, particularly among young people and adolescents. We found that the participating students had a reasonable level of awareness about the consumption of energy drinks and nutritional supplements and their potential effects on heart rate and blood pressure. We also found that a small percentage of them had consumed these drinks and experienced some of their effects. Declarations Ethical statement: The ethical consent was obtained from Syrian private university ethical committee Competing Interest: the authors declare no competing of interests. Availability of data and materials: All data are available from the corresponding author on reasonable request. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. References GMOKEONE RONESLIA (2024) Alpilean Reviews (Critical Client Update!) Counterfeit Pills Publicity or Genuine. Snowcapped Weight Reduction Pills? [Stunning Grievances Uncovered!] Katarzyna, Majchrzak et al (2013) Annual Reports of Education, Health and Sport 9781329900523 Puravive BP (2024) My Honest Reviews and Experience GMOKEONE RONESLIA (2024) Alpilean Reviews (Critical Client Update!) Counterfeit Pills Publicity or Genuine. Snowcapped Weight Reduction Pills? [Stunning Grievances Uncovered!] Alexandra Lichvar A, Pabla N, Nguyen P, McDonnell (2024) Caffeinated Energy Drinks and Supplements: A Wake-Up Call for Consumers and Healthcare Providers, p. 116073 Sara Chaudhry S, Iqbal MA, Kareem A, Amanat J, Fatima (2022) Effect of Energy Drinks Consumption on Physical Performance Beneficial and Adverse Impact on Health. South Asian Research Publication, pp 22–27 Bavika KP, Sheelam DPK, Dr Archana D, Nazre (2023) A Review on Efficacy of Dietary Approaches in The Management of Hypertension. Int J Multidisciplinary Res, pp. 1–5 Lydia J, Jilantikiri C, Ezenwaka SA, Yahaya TM, Ajibola KA, Akande A, Toye (2022) An Unblinded Study of the Physiological Effects of Moringa Tea and Coffee on Pulse in Young Adult Nigerians. TARABA JOURNAL OF ENGINEERING AND TECHNOLOGY, pp 10–15 Applied Research Press A Survey of Energy Drink Consumption Patterns Among College Students, Createspace Independent Publishing Platform, 2015-07-22 Leslie A, Pray Iof, Medicine AL, Yaktine, Board on Health Sciences Policy (2014) Food and Nutrition Board, Diana E. Pankevich, Planning Committee for a Workshop on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements, Caffeine in Food and Dietary Supplements Tables Tables 1 to 15 are available in the Supplementary Files section. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5383582","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":373516007,"identity":"0ec119fa-5b9b-45b9-b21b-908ea48891c4","order_by":0,"name":"Falak Mouhamad Almshhad","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYHACNmYGBmZ+BnYGZoYPIC47kVokG5gZmBlnQLnEa2HmAfEJadFtP/7scUGNtQR/M/NjY5tf2+T5mBkYP3zMwa3F7EyOufGMY+kSEofZjJNz+24btgGtk5y5DY+WAzls0jxsh+sYDjMYH87tuc0I1MLGzItPy/nnz6R5/h2WkD/M/vmwZc9te8JabiSYSfO2HZYwOMxjnMzw43YiEVreALX0pUsYHuYpNuxtuJ3cxszYjN8v59OBDvtmLSF3vH2zxI8/t23ntzcf/PARjxZUwNgGJhuIVQ8Cf0hRPApGwSgYBSMFAADFtEtoRjmRqgAAAABJRU5ErkJggg==","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Falak","middleName":"Mouhamad","lastName":"Almshhad","suffix":""},{"id":373516008,"identity":"e5af5f59-177e-4cb3-8908-570a244afd67","order_by":1,"name":"Rouaa alkhoja","email":"","orcid":"","institution":"Syrian Private University","correspondingAuthor":false,"prefix":"","firstName":"Rouaa","middleName":"","lastName":"alkhoja","suffix":""},{"id":373516009,"identity":"d3ce8411-a855-447f-be95-d8763ef51b38","order_by":2,"name":"Taghreed Hammoud","email":"","orcid":"","institution":"Syrian Private University","correspondingAuthor":false,"prefix":"","firstName":"Taghreed","middleName":"","lastName":"Hammoud","suffix":""}],"badges":[],"createdAt":"2024-11-03 20:42:27","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5383582/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5383582/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":68249704,"identity":"13adad18-3c8b-41b2-a445-e29ebede001e","added_by":"auto","created_at":"2024-11-05 09:50:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":270445,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5383582/v1/f6b5a245-716c-46c8-9fb6-342c098e9774.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eStudy of medical students' knowledge about the effect of energy drink and nutritional supplement consumption on pulse and blood pressure, a comparative study between males and females.\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eThe widespread consumption of energy drinks and supplements across populations has raised concerns about their physiological effects, particularly on cardiovascular health. As individuals increasingly seek an immediate boost in energy and performance, understanding the effects of these substances on heart rate and blood pressure is of paramount importance.\u003c/p\u003e \u003cp\u003eSeveral studies, including recent findings published in PubMed, suggest that these products often contain high levels of caffeine and other stimulants, which can lead to acute circulatory changes.\u003c/p\u003e \u003cp\u003eHigh heart rates and blood pressure fluctuations may pose significant risks, particularly for young, healthy consumers who mistakenly believe that these beverages are harmless.\u003c/p\u003e \u003cp\u003eThe increasing consumption of energy drinks and supplements has become increasingly apparent, particularly among younger populations and athletes. These products are marketed as solutions to enhance physical and mental performance, appealing to individuals seeking a quick burst of energy or improved nutritional support, and their wide availability and increased marketing strategies have contributed to their popularity, attracting a variety of groups, including college students, professionals, and fitness enthusiasts.\u003c/p\u003e \u003cp\u003eDemographic studies indicate that males aged 18\u0026ndash;34 years represent a significant proportion of energy drink consumers, often driven by a desire to increase alertness during strenuous academic or professional tasks.\u003c/p\u003e \u003cp\u003eConversely, dietary supplements appeal to a broader audience, with individuals of all ages seeking to improve their health, fitness, and overall well-being.\u003c/p\u003e \u003cp\u003eVariables such as an individual\u0026rsquo;s tolerance to caffeine and other stimulants, along with pre-existing health conditions, can significantly influence physiological responses. The current literature provides mixed results, with some studies reporting increased blood pressure and pulse rates after consumption, while others report little effect [10].\u003c/p\u003e \u003cp\u003eUltimately, informed choices based on empirical evidence and awareness of personal health status are crucial in mitigating potential adverse effects. As additional research emerges, it will be imperative for both consumers and healthcare providers to remain vigilant in assessing the risks and benefits associated with these widely consumed products. By investigating these effects, this research aims to shed light on the knowledge and awareness of medical students at the Syrian Private University about the effects of consuming these beverages on the cardiovascular system, ultimately contributing to a more informed approach to the consumption of energy drinks and nutritional supplements in contemporary society.\u003c/p\u003e\n\u003ch3\u003eAim of the study:\u003c/h3\u003e\n\u003cp\u003eStudy of medical students' knowledge about the effect of energy drink and nutritional supplement consumption on pulse and blood pressure.\u003c/p\u003e "},{"header":"Methods","content":"\u003cp\u003eA cross-sectional descriptive study was conducted at the Syrian Private University (Daraa Governorate) during the period from 9/23/2024 to 10/4/2024.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eThe answers of the participating medical students, numbering 300 male and female students, were studied through a questionnaire designed with the assistance of the research supervisor, containing a set of questions that serve the research objective (energy drinks axis and nutritional supplements axis).\u003c/p\u003e \u003cp\u003eThe approval of the Syrian Private University was obtained to publish the questionnaire in paper and electronic form within the university campus.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStatistical analysis\u003c/b\u003e: Patients' data were tabulated and entered into the computer, and then the Statistical Package for the Social Sciences (SPSS) program, version (26), was used to analyze this data. The following statistical methods were used in the analysis: Descriptive analysis: This involves finding the relative frequency distributions of the categorical study variables (gender, place of residence, financial status, etc.).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable 1 shows the demographic information of the students. The most participating age group was 18-22 with 239 (79.7%), followed by 23-27 with 58 (19.3%). Male students accounted for 153 (51%) and female students 147 (49%). The largest percentage of participants were fourth-year students with 131 (43.7%), followed by third-year students with 51 (17%).\u003c/p\u003e\n\u003cp\u003eTable 2 shows that a small percentage of the participating students had undergone a training course related to nutrition and cardiovascular health, and their percentage was 64 (21.3%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEnergy drinks:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe asked the participating students a set of questions related to general information about energy drinks.Table 3 shows that more than half of the students 182 (60.7%) reported that they were aware of the common ingredients found in energy drinks.\u003c/p\u003e\n\u003cp\u003eTable 4 shows their answers about these ingredients, which were as follows: caffeine 261 (87%), sugar 247 (82.3%), herbal extracts 53 (17.6%), taurine 39 (13%), and vitamin B 38 (12.6%).\u003c/p\u003e\n\u003cp\u003eWhen asked about the recommended daily limit for caffeine intake for adults, more than half of them, 165 (55%), answered no, while 119 (39.7%) answered yes Table 5.\u003c/p\u003e\n\u003cp\u003eIn detail, their answers about the recommended daily limit were as follows: 400 mg 136 (45.3%), 200 mg 82 (27.3%), 600 mg 44 (14.7%) Table 6.\u003c/p\u003e\n\u003cp\u003eTable 7 shows the students\u0026rsquo; answers about the effect of excessive consumption of energy drinks on pulse and blood pressure, the majority of the students, 293 (97.7%), answered yes, it has a clear effect.\u003c/p\u003e\n\u003cp\u003eTable 8, the students\u0026rsquo; choices regarding the effects that energy drinks can have on the cardiovascular system are clear, and they were as follows: increased heart rate 267 (89%), high blood pressure 238 (79.3%), irregular heartbeat 173 (57.6%).\u003c/p\u003e\n\u003cp\u003eThey were asked about the frequency of their consumption of energy drinks, and they answered as follows: the largest percentage does not consume them 120 (40%), rarely (less than once a month) 87 (29%), sometimes (one to three times a month) 55 (18.3%), daily 16 (5.3%) Table 9.\u003c/p\u003e\n\u003cp\u003eTable 10 shows that a small percentage 81 (27%) of students had experienced cardiovascular symptoms (such as palpitations and increased heart rate) after consuming energy drinks.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNutritional supplements:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 11 shows the students\u0026apos; answers about nutritional supplements and whether they have an effect on pulse and blood pressure, where more than half of the students answered yes 189 (63%), compared to 93 (31%) who answered no.\u003c/p\u003e\n\u003cp\u003eWhen asked about the effect of these supplements on the cardiovascular system, their answers were as follows: increased heart rate 79 (26.3%), high blood pressure 74 (24.6%), irregular heartbeat 59 (19.6%) Table 12.\u003c/p\u003e\n\u003cp\u003eTable 13 shows the students\u0026rsquo; answers about the types of nutritional supplements that can affect cardiovascular health, which were as follows: protein supplements 120 (27.3%), vitamin and mineral supplements 97 (22.1), herbal supplements 55 (12.5).\u003c/p\u003e\n\u003cp\u003eTable 14 shows that a small percentage of students 44 (14.7%) had received formal education or training about the effects of nutritional supplements and energy drinks, compared to 256 (85.3%) who answered no. When asked if they would like to attend a seminar or workshop on the effects of nutritional supplements and energy drinks, more than half of them, 202 (67.3%), answered yes Table 15.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe use of energy drinks and supplements is associated with the desire to increase academic performance and sports activities such as football and others. These activities are attractive to university students in general, especially males, and this could also explain why more male students were interested in filling out this questionnaire compared to female students. Similar behavior was observed in studies conducted in different countries, including Zambia, Taiwan, Poland, Saudi Arabia, the United Arab Emirates, and Lebanon, where males were observed to be more daring and willing to try new things compared to females. \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eRegarding the knowledge of participating students about energy drinks, more than half of the participants knew that these drinks contain caffeine and sugars and may also contain amino acids and herbal extracts. However, many were not aware that these drinks may also contain L-carnitine, vitamins, and minerals, indicating that students may not generally check the ingredients of the products they consume.\u003c/p\u003e \u003cp\u003eAbout two-thirds of the participants reported that energy drinks may increase heart rate and blood pressure. Many of the side effects of energy drinks are due to the fact that they contain a large amount of caffeine. An eight-ounce serving of energy drinks typically contains 80\u0026ndash;141 mg of caffeine.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e The biological mechanism of caffeine is not yet fully understood; it positively affects performance by reducing fatigue and enhancing physical endurance.\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAlthough caffeine has some positive effects on mood and cognition at low doses (12\u0026sdot;5\u0026ndash;100 mg),\u003csup\u003e[11]\u003c/sup\u003e it also has some negative health effects, including increased diuresis,\u003csup\u003e[12]\u003c/sup\u003e decreased insulin sensitivity,\u003csup\u003e[13]\u003c/sup\u003e disrupted sleep patterns,\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e increased mean arterial blood pressure, and chronic daily headaches.\u003csup\u003e[14]\u003c/sup\u003e Studies conducted in Zambia and the United Arab Emirates among university students found a statistically significant association between energy drink consumption and poor sleep quality.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e In a 2020 study in Jordan, more than 60% of participating students were found to have poor knowledge regarding energy drinks. In this study, participants had acceptable knowledge, which could be attributed to the fact that consumption of these drinks increased further in 2021 and 2022, which may have influenced them to seek more information about these drinks.\u003c/p\u003e \u003cp\u003eWe found moderate knowledge of energy drink ingredients and adverse health effects in a similar study conducted in Saudi Arabia.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e On the other hand, in a study conducted in Poland, students had high knowledge of energy drinks and their side effects, however, their knowledge was not reflected in their consumption of these drinks. A better understanding of energy drink ingredients and side effects was also observed among medical students in a study conducted in Turkey.\u003csup\u003e[15]\u003c/sup\u003e Regarding the prevalence of energy drink consumption among participating students, we found that 60% of participants consumed these drinks. This percentage is higher than that found in a previous similar study conducted in 2020 in Jordan, where 40\u0026sdot;1% of participating students reported consuming energy drinks. \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e This finding of high prevalence of energy drink consumption among students in Jordan is consistent with similar studies conducted worldwide, where the prevalence of energy drink consumption was reported to be around 50% among students in Australia,\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e Italy,\u003csup\u003e[16]\u003c/sup\u003e the United States,\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e and Canada \u003csup\u003e[17]\u003c/sup\u003e (48, 56\u0026sdot;2, and 63%, respectively). Similar research conducted in the Middle East and North Africa region showed that energy drinks were consumed by 42.7% of Iraqis, especially young people,\u003csup\u003e[18]\u003c/sup\u003e 52.6% of medical students in Saudi Arabia, and 63.6% of Lebanese students.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e A higher percentage was reported in the United Arab Emirates, where more than 90% of students reported using energy drinks.\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn our study, females had a superior knowledge than males. In a study conducted to investigate gender differences in information about both energy drinks and nutritional supplements, it was found that men were often unwilling and unmotivated to interact with health-related information. \u003csup\u003e[21]\u003c/sup\u003e This could explain why women are often more knowledgeable about health-related information than men, as shown in other studies assessing general knowledge of various health information. \u003csup\u003e[21,20]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eWith the increasing competition between different brands and manufacturers of energy drinks, which is reflected through different means of advertising these products targeting mainly young people, there is a need for awareness campaigns to counter peer pressure and the influence of advertising on young people to reduce their consumption of energy drinks. These drinks are therefore known for their high caffeine and sugar content, especially with the increasing number of cases of caffeine poisoning associated with energy drink consumption. \u003csup\u003e[22]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOne limitation of the current study is that it was based on an online self-administered questionnaire, which could lead to errors in answering or misunderstandings that could affect the results to some extent.\u003c/p\u003e \u003cp\u003eAnother limitation is the representativeness of the sample, as most of the participants were from one university, but this provides an opportunity to conduct similar studies in the future at other universities, to see if university students there have similar or different behaviors and perceptions towards energy drinks.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eEnergy drinks and nutritional supplements may have positive effects on academic performance, exercise, and other activities, but potential adverse health effects have been documented, particularly among young people and adolescents. We found that the participating students had a reasonable level of awareness about the consumption of energy drinks and nutritional supplements and their potential effects on heart rate and blood pressure. We also found that a small percentage of them had consumed these drinks and experienced some of their effects.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical statement:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe ethical consent was obtained from Syrian private university ethical committee Competing Interest: the authors declare no competing of interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGMOKEONE RONESLIA (2024) Alpilean Reviews (Critical Client Update!) Counterfeit Pills Publicity or Genuine. Snowcapped Weight Reduction Pills? [Stunning Grievances Uncovered!]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKatarzyna, Majchrzak et al (2013) Annual Reports of Education, Health and Sport 9781329900523\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePuravive BP (2024) My Honest Reviews and Experience\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGMOKEONE RONESLIA (2024) Alpilean Reviews (Critical Client Update!) Counterfeit Pills Publicity or Genuine. Snowcapped Weight Reduction Pills? [Stunning Grievances Uncovered!]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlexandra Lichvar A, Pabla N, Nguyen P, McDonnell (2024) Caffeinated Energy Drinks and Supplements: A Wake-Up Call for Consumers and Healthcare Providers, p. 116073\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSara Chaudhry S, Iqbal MA, Kareem A, Amanat J, Fatima (2022) Effect of Energy Drinks Consumption on Physical Performance Beneficial and Adverse Impact on Health. South Asian Research Publication, pp 22\u0026ndash;27\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBavika KP, Sheelam DPK, Dr Archana D, Nazre (2023) A Review on Efficacy of Dietary Approaches in The Management of Hypertension. Int J Multidisciplinary Res, pp. 1\u0026ndash;5\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLydia J, Jilantikiri C, Ezenwaka SA, Yahaya TM, Ajibola KA, Akande A, Toye (2022) An Unblinded Study of the Physiological Effects of Moringa Tea and Coffee on Pulse in Young Adult Nigerians. TARABA JOURNAL OF ENGINEERING AND TECHNOLOGY, pp 10\u0026ndash;15\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eApplied Research Press A Survey of Energy Drink Consumption Patterns Among College Students, Createspace Independent Publishing Platform, 2015-07-22\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLeslie A, Pray Iof, Medicine AL, Yaktine, Board on Health Sciences Policy (2014) Food and Nutrition Board, Diana E. Pankevich, Planning Committee for a Workshop on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements, Caffeine in Food and Dietary Supplements\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 15 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Syrian Private University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Energy drinks, nutritional supplements, blood pressure, pulse, knowledge and awareness","lastPublishedDoi":"10.21203/rs.3.rs-5383582/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5383582/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEnergy drink consumption has increased dramatically in the past two decades, especially among young adolescents. Energy drinks are heavily marketed with the claim that these products provide a boost of energy to improve physical and cognitive performance, however, studies supporting these claims are limited. Dietary supplements (minerals/vitamins) also play a pivotal role in regulating blood pressure because they help in the function of macronutrients and also improve the functions of some blood pressure-lowering factors. Our aim was to study the knowledge of medical students about the effect of consuming energy drinks and dietary supplements on pulse and blood pressure.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional descriptive study was conducted at the Syrian Private University (Daraa Governorate) during the period 23/9/2024 to 4/10/2024. The responses of participating medical students were studied through a questionnaire distributed in paper and electronic form on the university campus.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOur study included 300 students, with a percentage of males (51%) and females (49%). The largest percentage of participants were fourth-year students (43.7%). The most participating age group was \u0026ldquo;22\u0026thinsp;\u0026minus;\u0026thinsp;18\u0026rdquo; (79.7%). More than half of the students (60.7%) were aware of the common ingredients found in energy drinks. The majority of students (97.7%) responded that excessive consumption of energy drinks has a clear effect on pulse and blood pressure. The frequency of their consumption of energy drinks was as follows: never (40%), rarely (less than once a month) (29%), daily 16 (5.3%).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eEnergy drinks and nutritional supplements may have positive beneficial effects on academic performance or exercise and in various other activities, however, potential harmful health problems have been documented, especially among young people and adolescents. We found that the participating students had an acceptable level of awareness about the consumption of energy drinks and nutritional supplements and their potential effect on pulse and blood pressure. We also found that a small percentage of them had consumed these drinks and experienced some of their effects.\u003c/p\u003e","manuscriptTitle":"Study of medical students' knowledge about the effect of energy drink and nutritional supplement consumption on pulse and blood pressure, a comparative study between males and females.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-05 09:42:16","doi":"10.21203/rs.3.rs-5383582/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fe395354-3938-4cd0-94ba-71cb139366de","owner":[],"postedDate":"November 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":39752035,"name":"Nutrition \u0026 Dietetics"},{"id":39752036,"name":"Endocrinology \u0026 Metabolism"}],"tags":[],"updatedAt":"2024-11-05T09:42:16+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-05 09:42:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5383582","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5383582","identity":"rs-5383582","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}