Guido Mandilaras, Pengzhu Li, Robert Dalla-Pozza, André Jakob, Nikolaus Alexander Haas, Felix Sebastian Oberhoffer
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HRV was monitored via a 24-h Holter ECG, with analysis centered on time-domain measures, such as the standard deviation of normal RR intervals (SDNN) and root-mean square of successive differences (RMSSD), along with frequency-domain metrics. Statistical analysis included a two-way repeated-measures ANOVA to examine the effects of \"beverage\" and \"time.\" The study revealed a significant increase in the SDNN in the ED group within the first hour post-consumption, with a mean difference of 17.692 ms compared with that in the placebo group (SDNN: ED = 133.346 ± 50.217 ms vs. placebo = 115.654 ± 47.583 ms, p = 0.023). However, no significant differences in the SDNN were observed in the subsequent time intervals (60-240 min). In addition, frequency-domain parameters, such as total power, RMSSD, LF, HF, and the LF/HF ratio, showed no significant changes across the four-hour observation period, indicating that sympathetic activation was transient. The findings suggest that ED consumption in children and adolescents leads to a temporary increase in autonomic activity, marked by elevated SDNN, without lasting dysregulation. While the cardiovascular effects are brief, acute sympathetic activation underscores the need for regulated ED intake among minors. Further studies are recommended to explore the long-term effects of regular ED consumption on cardiovascular health in youth.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of Acute Energy Drink Consumption on Heart Rate Variability in Children and Adolescents. A Randomized Trial.\",\"authors\":\"Guido Mandilaras, Pengzhu Li, Robert Dalla-Pozza, André Jakob, Nikolaus Alexander Haas, Felix Sebastian Oberhoffer\",\"doi\":\"10.1007/s00246-025-03770-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The EDUCATE study investigated the acute impact of energy drink (ED) consumption on heart rate variability (HRV) in children and adolescents, with a focus on how these stimulant-rich beverages influence cardiac autonomic function. Given the popularity of EDs among young people, this study assessed the immediate cardiovascular response to ED intake. This randomized, double-blind, placebo-controlled crossover trial involved 26 healthy participants aged 10-18 years. Each participant consumed a weight-adjusted ED or placebo in two separate test sessions. HRV was monitored via a 24-h Holter ECG, with analysis centered on time-domain measures, such as the standard deviation of normal RR intervals (SDNN) and root-mean square of successive differences (RMSSD), along with frequency-domain metrics. Statistical analysis included a two-way repeated-measures ANOVA to examine the effects of \\\"beverage\\\" and \\\"time.\\\" The study revealed a significant increase in the SDNN in the ED group within the first hour post-consumption, with a mean difference of 17.692 ms compared with that in the placebo group (SDNN: ED = 133.346 ± 50.217 ms vs. placebo = 115.654 ± 47.583 ms, p = 0.023). However, no significant differences in the SDNN were observed in the subsequent time intervals (60-240 min). In addition, frequency-domain parameters, such as total power, RMSSD, LF, HF, and the LF/HF ratio, showed no significant changes across the four-hour observation period, indicating that sympathetic activation was transient. The findings suggest that ED consumption in children and adolescents leads to a temporary increase in autonomic activity, marked by elevated SDNN, without lasting dysregulation. While the cardiovascular effects are brief, acute sympathetic activation underscores the need for regulated ED intake among minors. 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引用次数: 0
摘要
教育研究调查了儿童和青少年能量饮料(ED)消费对心率变异性(HRV)的急性影响,重点是这些富含兴奋剂的饮料如何影响心脏自主功能。鉴于ED在年轻人中很受欢迎,本研究评估了ED摄入后的即时心血管反应。这项随机、双盲、安慰剂对照的交叉试验涉及26名10-18岁的健康参与者。每个参与者在两个单独的测试阶段服用体重调整ED或安慰剂。通过24小时动态心电图监测HRV,分析集中于时域测量,如正常RR区间的标准偏差(SDNN)和连续差的均方根(RMSSD),以及频域指标。统计分析包括双向重复测量方差分析,以检验“饮料”和“时间”的影响。研究显示,ED组在服药后1小时内SDNN显著增加,与安慰剂组相比平均差异为17.692 ms (SDNN: ED = 133.346±50.217 ms vs安慰剂= 115.654±47.583 ms, p = 0.023)。然而,在随后的时间间隔(60-240分钟)中,未观察到SDNN的显著差异。此外,总功率、RMSSD、LF、HF、LF/HF比值等频域参数在4小时内均无显著变化,说明交感神经激活是短暂的。研究结果表明,儿童和青少年服用ED会导致自主神经活动暂时增加,以SDNN升高为标志,但不会出现持续的失调。虽然对心血管的影响是短暂的,但急性交感神经激活强调了未成年人摄入ED的必要性。建议进一步的研究来探索经常摄入ED对青少年心血管健康的长期影响。
Impact of Acute Energy Drink Consumption on Heart Rate Variability in Children and Adolescents. A Randomized Trial.
The EDUCATE study investigated the acute impact of energy drink (ED) consumption on heart rate variability (HRV) in children and adolescents, with a focus on how these stimulant-rich beverages influence cardiac autonomic function. Given the popularity of EDs among young people, this study assessed the immediate cardiovascular response to ED intake. This randomized, double-blind, placebo-controlled crossover trial involved 26 healthy participants aged 10-18 years. Each participant consumed a weight-adjusted ED or placebo in two separate test sessions. HRV was monitored via a 24-h Holter ECG, with analysis centered on time-domain measures, such as the standard deviation of normal RR intervals (SDNN) and root-mean square of successive differences (RMSSD), along with frequency-domain metrics. Statistical analysis included a two-way repeated-measures ANOVA to examine the effects of "beverage" and "time." The study revealed a significant increase in the SDNN in the ED group within the first hour post-consumption, with a mean difference of 17.692 ms compared with that in the placebo group (SDNN: ED = 133.346 ± 50.217 ms vs. placebo = 115.654 ± 47.583 ms, p = 0.023). However, no significant differences in the SDNN were observed in the subsequent time intervals (60-240 min). In addition, frequency-domain parameters, such as total power, RMSSD, LF, HF, and the LF/HF ratio, showed no significant changes across the four-hour observation period, indicating that sympathetic activation was transient. The findings suggest that ED consumption in children and adolescents leads to a temporary increase in autonomic activity, marked by elevated SDNN, without lasting dysregulation. While the cardiovascular effects are brief, acute sympathetic activation underscores the need for regulated ED intake among minors. Further studies are recommended to explore the long-term effects of regular ED consumption on cardiovascular health in youth.
期刊介绍:
The editor of Pediatric Cardiology welcomes original manuscripts concerning all aspects of heart disease in infants, children, and adolescents, including embryology and anatomy, physiology and pharmacology, biochemistry, pathology, genetics, radiology, clinical aspects, investigative cardiology, electrophysiology and echocardiography, and cardiac surgery. Articles which may include original articles, review articles, letters to the editor etc., must be written in English and must be submitted solely to Pediatric Cardiology.