The effects of energy drink consumption in children and adolescents: a cross-sectional study and the recommendations of the Italian Pediatric Society.

Abstract

Background: Energy drinks are widely marketed to enhance alertness and performance and are increasingly consumed by children and adolescents, despite warnings from pediatric and public health organizations regarding potential health risks. This study aimed to investigate energy drink consumption, age of initiation, motivations, risk perception, and awareness of health guidelines among Italian adolescents, with comparisons across distinct clinical and non-clinical subgroups.

Methods: A cross-sectional survey was conducted between May and December 2025 using an anonymous questionnaire administered to adolescents aged 9-17 years. Participants were recruited from four settings: inpatients with eating disorders, other hospitalized patients, competitive athletes, and healthy controls. The questionnaire assessed demographics, familiarity and frequency of energy drink consumption, age of first use, motivations, perceived health risks, knowledge of official guidelines, and attitudes toward sales regulations. Data were analysed descriptively and using chi-square tests, with statistical significance set at p < 0.05.

Results: In the study period, 430 participants were recruited. Overall, 96.5% of participants were familiar with energy drinks, and 65.1% reported at least occasional consumption. Early initiation was common, with 39.2% of consumers starting before age 12. Frequent consumption was relatively low (10.2%) but more prevalent among older adolescents and healthy controls. Only 52.3% perceived energy drinks as harmful, and awareness of official health guidelines was limited (40.4%). Consumption patterns, risk perception, and knowledge differed significantly across subgroups, with athletes showing greater awareness and eating disorder patients exhibiting higher uncertainty.

Conclusions: Although frequent energy drink use was uncommon, early exposure and substantial knowledge gaps were identified. These findings highlight the need for routine screening, targeted education, and preventive strategies to reduce energy drink consumption and protect vulnerable pediatric populations.