Energy drink consumption among undergraduate students: Prevalence, regional variations, associated factors, and adverse effects - A systematic review and meta-analysis.

Abstract

BackgroundEnergy drink (ED) consumption is common among undergraduate students and has been linked with adverse health outcomes, including sleep disturbances, cardiovascular effects, and risk-related behaviours.AimThis study aimed to estimate the prevalence of ED consumption among undergraduate students and examine regional variations, associated factors, and reported adverse effects.MethodsA systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Scopus, CINAHL, and Web of Science were searched from database inception to August 2025, with additional screening of Google Scholar and grey literature. Cross-sectional studies reporting ED consumption among undergraduate students were included. Three reviewers independently screened studies, extracted data, and assessed risk of bias using the Joanna Briggs Institute checklist. A random-effects meta-analysis was used to estimate the pooled prevalence.SummaryFifty-eight studies were included. The pooled prevalence of ED consumption among undergraduate students was 49.6% (95% CI: 39.8%-59.5%), although substantial heterogeneity was observed (I² = 99.6%). Subgroup analyses showed the highest prevalence in Africa (61%), followed by Asia (50%), North America (47%), and Europe (37%). Common motivations for consumption included staying awake, enhancing academic performance, and improving energy levels, while peer influence, marketing, affordability, and availability were identified as important contributing factors. Reported adverse effects primarily involved cardiovascular, neurological, and psychological symptoms. Overall, ED consumption appears to be common among undergraduate students and is associated with behavioural and environmental factors and a range of self-reported adverse effects. As the evidence is derived from cross-sectional studies, causal inferences cannot be made, highlighting the need for longitudinal research to better understand long-term health outcomes and inform targeted interventions.