Energy drinks mixed with alcohol: misconceptions, myths, and facts

Joris C Verster1, Christoph Aufricht2, Chris Alford31Utrecht University, Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacology, Utrecht, The Netherlands; 2Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Währinger Gürtel, Wien, Austria; 3University of the West of England, Psychology Department, Faculty of Health and Life Sciences, Frenchay Campus, Coldharbour Lane, Bristol, UKBackground: Whilst energy drinks improve performance and feelings of alertness, recent articles suggest that energy drink consumption combined with alcohol may reduce perception of alcohol intoxication, or lead to increased alcohol or drug use. This review discusses the available scientific evidence on the effects of mixing energy drinks with alcohol.Methods: A literature search was performed using the keywords “energy drink and Red Bull®” and consulting Medline/Pubmed, PsycINFO, and Embase.Results: There is little evidence that energy drinks antagonize the behavioral effects of alcohol, and there is no consistent evidence that energy drinks alter the perceived level of intoxication of people who mix energy drinks with alcohol. No clinically relevant cardiovascular or other adverse effects have been reported for healthy subjects combining energy drinks with alcohol, although there are no long-term investigations currently available. Finally, whilst several surveys have shown associations, there is no direct evidence that coadministration of energy drinks increases alcohol consumption, or initiates drug and alcohol dependence or abuse.Conclusion: Although some reports suggest that energy drinks lead to reduced awareness of intoxication and increased alcohol consumption, a review of the available literature shows that these views are not supported by direct or reliable scientific evidence. A personality with higher levels of risk-taking behavior may be the primary reason for increased alcohol and drug abuse per se. The coconsumption of energy drinks being one of the many expressions of that type of lifestyle and personality.Keywords: energy drink and Red Bull®, Red Bull®, alcohol, intoxication, caffeine, maskin

Alcohol Hangover and Multitasking: Effects on Mood, Cognitive Performance, Stress Reactivity, and Perceived Effort

The aim of this study was to examine the effects of hangover on mood, multitasking ability, and psychological stress reactivity to cognitive demand. Using a crossover design and semi-naturalistic methodology, 25 participants attended the laboratory in the morning following a night of (i) alcohol abstinence and (ii) alcohol self-administration during a typical night out (with order counterbalanced across participants). They completed a four-module multitasking framework (MTF, a widely used laboratory stressor) and a battery of questionnaires assessing mood, hangover symptom severity, and previous night’s sleep. The effects of the MTF on mood and perceived workload were also assessed. Participants in the hangover condition reported significantly lower alertness and contentment coupled with a higher mental fatigue and anxiety. Multitasking ability was also significantly impaired in the hangover condition. Completion of the cognitive stressor increased reported levels of mental demand, effort, and frustration, and decreased perceived level of performance. MTF completion did not differentially affect mood. Lastly, participants rated their sleep as significantly worse during the night prior to the hangover compared with the control condition. These findings confirm the negative cognitive and mood effects of hangover on mood. They also demonstrate that hangover is associated with greater perceived effort during task performance

The effects of alcohol hangover on mood and performance assessed at home

The current study evaluated the next day consequences of a social night of drinking compared to a no alcohol night, with standardised mood and portable screen-based performance measures assessed in the morning at participants’ homes, and a breathalyser screen for zero alcohol. A mixed sex group (n = 20) took part in the study. Participants reported consuming on average 16.9 units (135 g) alcohol, resulting in a hangover rating of 60 (out of 100) compared to 0.3 following the no alcohol night. Statistical significance comparisons contrasting the hangover with the no alcohol condition revealed an increase in negative mood and irritability during hangover and an (unexpected) increase in risk and thrill seeking. Performance scores showed an overall slowing of responses across measures, but with less impact on errors. The results support the description of hangover as a general state of cognitive impairment, reflected in slower responses and reduced accuracy across a variety of measures of cognitive function. This suggests a general level of impairment due to hangover, as well as increased negative mood. The use of a naturalistic design enabled the impact of more typical levels of alcohol associated with real life social consumption to be assessed, revealing wide ranging neurocognitive impairment with these higher doses. This study has successfully demonstrated the sensitivity of home-based assessment of the impact of alcohol hangover on a range of subjective and objective measures. The observed impairments, which may significantly impair daily activities such as driving a car or job performance, should be further investigated and taken into account by policy makers

A comparison between ecological momentary assessment and the adapted-quick drinking screen: Alcohol mixed with energy drinks

Aims: To compare alcohol consumption and risk-taking behaviours on alcohol mixed with energy drink (AMED) and alcohol-only (AO) drinking occasions collected via ecological momentary assessment (EMA) versus retrospective survey methods (adapted-Quick Drinking Screen: a-QDS). Methods: Completing participants were 52 university students who reported AMED consumption during the 30-day data collection period. Alcohol consumption and risk-taking behaviours were captured for recreational AMED and AO consumption occasions using a smartphone-based app across 30 days. Data were aggregated for comparison with the a-QDS conducted at the end of data collection. Results: Irrespective of data collection method, alcohol was consumed more frequently and at higher quantities on the heaviest drinking occasions when consumed alone compared with when it was mixed with energy drinks. Consistent with this finding, more risk-taking behaviours were experienced on AO occasions compared with AMED occasions. Compared with the a-QDS, the quantity of alcohol consumed on the average and heaviest drinking occasion was significantly higher when reported via EMA. This was consistent across both AO and AMED drinking occasions. Conclusion: EMA provides a more valid measure of consumption quantity compared with retrospective recall, which was susceptible to under-reporting, although this was not differentially affected across consumption occasions. In line with previous research, this study demonstrated that mixing alcohol with energy drinks does not increase alcohol consumption or risk-taking behaviours

Self-Reported Impaired Wound Healing in Young Adults and Their Susceptibility to Experiencing Immune-Related Complaints

The current study examined to what extent individuals with wound infection (WI group), slow healing wounds (SHW group), or both (COMBI group) report poorer immune fitness and whether they experience immune-related complaints more often as compared to healthy participants (control group). Survey data from 3613 Dutch students was re-analyzed. Compared to the control group, perceived immune fitness was significantly lower by the SHW group (p < 0.001) and the COMBI group (p < 0.001), but no difference was found for the WI group (p = 0.059). Also, perceived immune fitness of the COMBI group was significantly worse compared to the WI group (p = 0.040). Compared to the control group, reduced immune fitness was reported to be significantly more frequently by the SHW group (p < 0.001) and the COMBI group (p < 0.001). Reduced immune fitness was significantly more common for the COMBI group compared to the SHW group (p = 0.011) and WI group (p = 0.001). Immune-related complaints such as headache, runny nose, coughing, sore throat, diarrhea, flu, and fever were significantly more frequently reported by individuals with impaired wound healing. The effects were most pronounced in the COMBI group, followed by the SHW group and a lesser extent the WI group. A highly significant correlation was found between perceived immune fitness and the percentage of individuals that reported impaired wound healing. In conclusion, the findings confirm that poorer immune functioning is characteristic for individuals with impaired wound healing. In follow-up studies, immune biomarkers analyses are needed to support patient-reported outcome measures

The association of irritable bowel complaints and perceived immune fitness among individuals that report impaired wound healing: Supportive evidence for the gut-brain-skin axis

The gut–brain–skin axis is important in wound healing. The aim of this study was to investigate the association between experiencing irritable bowel syndrome (IBS) symptoms, perceived immune fitness, and impaired wound healing. N = 1942 Dutch students (mean (SD) age 21.3 (2.1), 83.6% women) completed an online survey. They were allocated to one of four groups: (1) control group (N = 1544), (2) wound infection (WI) group (N = 65), (3) slow healing wounds (SHW) group (N = 236), or (4) a combination group (COMBI), which experienced both WI and SHW (N = 87). Participants rated their perceived immune fitness on a scale ranging from very poor (0) to excellent (10), and the severity of IBS symptoms (constipation, diarrhea, and pain) was assessed with the Birmingham IBS Symptom Questionnaire. Compared to the control group, perceived immune fitness was significantly poorer for the SHW group (p < 0.001) and COMBI group (p < 0.001), but not for the WI group. Compared to the control group, constipation was reported significantly more frequently by the SHW group (p < 0.001) and the WI group (p = 0.012), diarrhea was reported significantly more frequent by the SHW group (p = 0.038) and the COMBI group (p = 0.004), and pain was reported significantly more frequent by the SHW group (p = 0.020) and COMBI group (p = 0.001). Correlations between IBS complaints and perceived immune fitness were statistically significant (p < 0.001), and also a highly significant and negative association was found between the percentage of participants that reported impaired wound healing and perceived immune fitness (r = −0.97, p < 0.001). In conclusion, among participants with self-reported impaired wound healing, IBS complaints were significantly more severe, and accompanied by a significantly reduced perceived immune fitness