Generally, the current study indicated that energy drink consumption is a popular practice among athletes in the universities in Ghana. Most of the participants (62.2%) reported consuming at least one can of energy drink in a week similar to the finding of Ballistreri and Corradi-Webster [13
] that 64.9% of the study participants consumed energy drinks. However, the percentage in the present study is slightly lower than in previous studies where higher proportions, 73% [17
] and 86.7% [18
] were reported. A lower prevalence value of 51% among surveyed college students in general was reported in a study by Malinauskas et al. [1
]. Malinauskas et al. [1
] further indicated that student-athletes in particular consumed energy drinks at a higher rate, seeing that many marketing advertisements linked energy drinks to sports.
A common reason given by most (64.1%) respondents regarding why they drank energy drinks was to help replenish lost energy after training sessions and competitions. Such a response is not surprising, for as asserted by Bonci (2002) [19
], most people believe that drinking energy drinks is a fast means of obtaining 'extra energy' to undertake the activities of a day and speed up recovery from exercise. The findings of the present study corroborate those of Malinauskas et al., [1
], in which 65% of college students indicated that they drank energy drinks because they needed energy. Similarly, Oteri et al. [20
] reported that energy drink usage has become widespread among college students, particularly student-athletes who have to meet both cognitive and physical performance demands. Duchan et al. [16
] also pointed out that young athletes are increasingly using energy drinks because of the ergogenic effects of caffeine and the other ingredients in these beverages which manufacturers claim as energy boosters.
Approximately 25.9% of the respondents also indicated that they consumed energy drinks because they provided energy and fluids to the body. However, it has been pointed out that there are serious consequences of substituting energy drinks for water when engaging in strenuous physical activities. This is because the caffeine in most energy drinks can have a dehydrating effect on the body. Caffeine acts as a diuretic agent and as such causes the kidneys to remove extra fluid from the body [6
]. Consequently, if a person consumes energy drinks while sweating, it will result in severe dehydration. Therefore, energy drinks used during exercise or other strenuous activities compound the problem of dehydration, and do nothing to provide the body with any fluids. High consumers are at an even higher risk of sweating more and burning out all the extra energy supposed to have been obtained from the energy drinks. One can infer from the responses of the study participants that they are confused between the role of sports drinks and that of energy drinks. Unlike energy drinks, the purpose of sports drinks is to replenish lost body fluids, essential minerals and nutrients during and after an exercise.
Only 9.8% of the athletes indicated that they consumed energy drinks because they improved their performance. Literature available presents contradictory evidence regarding the capacity of energy drinks to enhance performance in sports. As indicated by Paddock [3
], many of the marketing campaigns explicitly state that energy drinks help to improve the functioning and performance of an individual, suggesting that their consumption will boost athletic performance. A study indicated that the main ingredients in energy drinks support manufacturers' claims of an increased performance, endurance, concentration and an enhanced mood during physical activities [21
]. Similarly, Janzen [22
] pointed out that caffeine, a stimulant, increases alertness and enhances performance of certain tasks when consumed in small doses. In addition, Desbrow and Leveritt [23
] reported that most elite athletes consume energy drinks in order to improve their physical performance and concentration during an activity. Other experimental studies revealed that, energy drinks increased long-term exercise endurance and improved speed and work output compared to a placebo drink [24
]. Alford et al. [24
] showed that consumption of energy drinks delayed the time of exhaustion in a study where the effect of energy drink on endurance performance was compared with carbonated water. Similarly, Mucignat-Carette [26
] reported that a faster reaction time was observed in study participants who consumed energy drinks compared to participants who drank a placebo drink under similar controlled experimental conditions. Geiss et al. [27
] also observed an improvement in the performance of athletes who consumed 500 ml of energy drink compared to the control group.
A comparison between energy drink consumption practices of males and females, shows that a higher proportion (81.2%) of the respondents who indicated that they drank energy drinks were males compared with 18.8% females. However, it is important to note the wide gender disparity (148 males to 32 females) in the study sample. In addition, whereas none of the females drank more than 2 cans of energy drink a week, all the respondents who drank more than 2 cans a week were males and represented 25.3% of the male population of energy drink consumers. The findings of this present study corroborate those of similar studies in which it was found out that male athletes consumed more servings of energy drinks than females [11
]. Similarly, in another study, male-athletes indicated deliberately using energy drinks as stimulants and ergogenic aids [29
]. A reason that can be given for the higher intake of energy drinks among males compared with females is perhaps, as asserted by Miller [11
], advertisements of energy drinks which usually target primarily young adult males. Miller [11
] further reported on the basis of a survey of undergraduate students that males (who reported that they employed measures to enable them appear more masculine in appearance) were more likely to increase their frequency of energy drink consumption. Furthermore, McClelland et al. [30
] asserted that there are personality factors that determine the competitiveness of an individual, and that the need to achieve and the tendency to achieve success are more predominant in males than females. Most men are competitive, accept challenges, tend to be stimulated by situations involving task or role accomplishment and assume risks compared with females. These reasons could explain the high tendency for male athletes to consume energy drinks more often and in higher quantities than female athletes.
The health implications of an excessive intake of energy drinks, particularly brands that contain high quantities of caffeine, are numerous. High intakes of caffeinated drinks can result in irregular heartbeats, nausea, restlessness, headache, and dehydration [31
]. One of the negative effects of energy drinks which contain high percentages of carbohydrates is that they often slow down the rate at which nutrients are absorbed into the bloodstream. Consequently, one's energy level is not likely to be boosted very much. In addition, a high quantity of carbohydrates slows down the rate of fluid absorption or rehydration during an exercise. Ingesting high levels of sugar can also lead to a high sugar crash. This occurs when sugar enters the blood stream and provides a "blast" of energy enabling the athlete to feel good and perform well. Once that energy is burned up, usually in about 30 to 45 minutes, there is a sugar crash. The athlete's reflexes slow down, causing dizziness and resulting in a decrease in muscle power and a subsequent drop in performance [32
]. Other health implications include reported cases of seizures and cardiac arrest (following energy drink consumption) and dental enamel erosion resulting from the acidity of energy drinks [16
In each of the sporting disciplines, except team events, a higher proportion of the study participants took energy drinks. In addition, a higher proportion of long distance and middle distance runners, compared with short distance runners, indicated that they consumed energy drinks. The findings also suggest that a higher proportion of middle distance runners, long distance runners and athletes who actively participate in both track and field events are more likely to consume energy drinks than athletes who participate in only team events and short distance disciplines. Most athletes in the team events group (with the exception of athletes who run as a team in track events) did not drink energy drinks, perhaps because these team events, by their nature, require explosive reactions, coupled with maximum strength, power and techniques rather than sustained energy levels. Therefore consuming energy drinks can offer little or no assistance to athletes who participate in these team events with respect to athletic performance. Also, the duration and intensity of team events can influence the decisions of athletes not to consume energy drinks frequently and in great quantities. It is known that middle and long distance events require sustained energy levels throughout the events (running at times between moderate to high intensity levels that could last for 40 minutes, an hour or beyond, with minimal or no rest intervals) compared with team events in which sustained energy periods for athletes are of short durations (with intermittent rest intervals), which may necessarily not require the consumption of energy drinks.