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Energy Drink Consumption 

Practices of Young People in 

Bahrain 

Maryam M. Nassaif, Ghufran J. J. 

Alobed, Noor A. A. Alaam, Abdulla 

N. Alderrazi, Muyssar S. Awdhalla, 

Asokan G. Vaithinathan 

 

College of Health Sciences, University of Bahrain, 

Bahrain 

 

Vol. 4, No. 2 (2015)   |   ISSN 2166-7403 (online)  

DOI 10.5195/cajgh.2015.216 |   http://cajgh.pitt.edu 

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Volume 4, No. 2 (2015) |  ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2015.216|http://cajgh.pitt.edu 

 

 

Abstract 

Background: Energy drink (ED) consumption is becoming increasingly popular among young Bahrainis, who may be unaware of 

the health risks associated with ED consumption. To date, there have been few publications on the consumption of ED in Bahrain, 

particularly among adolescents. This study seeks to fill a gap in the literature on energy drink consumption practices of Bahraini 

adolescents.  

Methods: Data were collected using a previously established European Food Safety Authority questionnaire. Cross-sectional 

analyses were conducted on a convenience sample of 262 Bahraini students aged 10 to 18 years.  

Results: Most participants consumed energy drinks 2 to 3 times per week and consumed two or more cans at a time. Eighty percent 

of partcipants preferred energy drinks with sugar. Participants in the older age group and higher educational level consumed more 

ED. The majority (57%) consumed ED at home with friends as part of socialization. Notably, 60% of the parents of the respondents 

have not consumed energy drinks. Prominent reasons for consumption of energy drinks included: taste (40%), energy (30%), stay 

awake (13%), augment concentration (4%), and enhance sports performance (6%).  

Conclusion: Energy drink consumption is a popular socialization activity among adolescents of Bahrain. The potential health risks 

necessitates the need for novel health promotion strategies and advocacy efforts for healthy hydration practices. 

Keywords: energy drinks, health effects, young people, health promotion 

 

Energy Drink Consumption Practices 

of Young People in Bahrain 

Maryam M. Nassaif, Ghufran J. J. 

Alobed, Noor A. A. Alaam, Abdulla N. 

Alderrazi, Muyssar S. Awdhalla, 

Asokan G. Vaithinathan 

 

College of Health Sciences, University of Bahrain, Bahrain 

Research 

Energy drink(s) (ED) refers to beverages that 

contain caffeine in combination with other ingredients 

such as taurine, guarana, and B vitamins, with claims to 

provide its consumers with extra energy.1 Over 140 

countries report ED consumption, with children, 

adolescents, and young adults representing half of the 

consumers of ED.2 The prevalence of ED consumption 

varies by age group and size. Regionally, ED are largely 

consumed in the Middle East and in the Western World. 

For instance, 55% of male and 26% of female students in 

the University of Dammam consumed ED,3  and Saudi 

Arabia was ranked among the top ten ED consuming 

countries.4 In 2013, the Central Information Organization 

of Bahrain reported that the consumption of ED in 

Bahrain was 174 per 1,000 persons.5 In the USA, about 1 

in 9 youths received counseling discouraging ED 

consumption from a health care professional.6 The 

prevalence of ED consumption in Europe was 68%, 

varying from 48% in Greece to 82% in the Czech 

Republic, and mostly observed in the age group of 15-18 

years (73%).7  On average, adolescents consume 2.1 L of 

ED per month in Europe.7 An Australian report revealed 

that 48% of young adults consumed ED at least once a 

month with an average intake of 1-2 cans per day.8 

EDs act as non-nutritive stimulants with 

purported ergogenic or performance-enhancing effects. 

Caffeine, taurine, D-glucorono-y-lactone, and sugar are 

the main ingredients. Other products found in ED are 

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vitamins, L-carnitine, and extracts such as guarana (1 gm 

of guarana equates 40 to 80 mg of caffeine), ginkgo 

biloba, bitter orange, and ginseng.2 The intended effects 

of ED are to provide sustenance, endurance, 

concentration, and enhanced performance. 

Manufacturers of ED target their sales to students, 

athletes, and people in professions that warrant sustained 

alertness.9 Popularity of ED among teenagers is 

associated with risk taking.10 

Studies have shown that moderate caffeine 

consumption (<400mg/ day) is not associated with the 

adverse effects of caffeine such as general toxicity, 

cardiovascular effects, effects on bone status, and 

calcium balance;11 however, the amounts of caffeine in 

ED far exceed that of safety limits.11 According to the 

World Health Organization (WHO) 2015 sugar intake for 

adults and children guidelines,12 the suggested limit of 

sugar consumption for adults of normal BMI is 25g/day 

(6 teaspoons). In general, sugar content in ED ranges 

from 21 g to 34 g per 8 oz. Daily consumers of two or 

three cans of ED could be ingesting 4 to 6 times the 

maximum recommended daily intake of sugar, which 

poses a risk for obesity and dental problems. 13 

Common adverse effects of ED that have been 

documented are dizziness, inability to focus, 

nervousness, gastrointestinal upset, and insomnia.14 In 

rare situations, anxiety, seizure, increased heart rate, 

dehydration, acute mania, stroke, and behavioral 

problems like fighting and addiction have been 

observed.14 Potential problems associated with ED 

consumption in children and adolescents include 

cardiovascular effects and eating disorders. A systematic 

review suggests using caution in consuming ED, even 

though long term studies with health effects follow up 

were lacking.14 The prevalence of non-communicable 

diseases is similar to other developed economies 

according to the National Non-Communicable Diseases 

(NNCD) risk factor survey carried out in Bahrain,15 thus 

nutritional factors are important to investigate.  

As of 2016, no reports have been published on 

the consumption practices of ED in Bahrain. Therefore, 

this study was undertaken to explore energy drink 

consumption practices of Bahraini adolescents.  

 

Methods 

Data collection for this cross-sectional study 

was carried out by study investigators using a 

convenience sampling approach from public places that 

students frequently visit (i.e. parks and malls of Bahrain 

during the weekends). Our study sample included 

Bahraini adolescent students aged 10 to 18 years of both 

genders.  

To be 95% confident that the true value of the 

estimate will be within 5 percentage points of the 

prevalence of 17%,5 the required sample size was 

calculated to be 217 in order to achieve the desired level 

of accuracy. The final number of participants recruited 

was 262. In the initial phase of data collection, 

participants were asked whether they had ever consumed 

ED. Those that answered yes were given a structured, 

self-report questionnaire. The questionnaire was 

modified from a previously established questionnaire for 

gathering consumption data on specific consumer groups 

of energy drinks by the European Food Safety Authority 

(EFSA).16 The modifications introduced were designed 

to make the questionnaire more suitable and compatible 

with the Bahraini society regarding demographic, 

economic, and socio-cultural aspects. Broadly, the 

questionnaire had two sections: 1) demographic data (i.e., 

age, gender, and current education level); 2) energy drink 

consumption data (i.e., consumption frequency, 

consumption amount, place of consumption, reasons for 

consumption, choice of sugar or sugar free, preferred 

brand, and parental consumption). For affirming face and 

content validity, the questionnaire was scrutinized by a 

panel of experts from the College of Health Sciences and 

Nutrition in Bahrain. The questionnaire was translated 

into Arabic and back translated to English to ensure there 

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were no translation errors. Before beginning the study, 

the questionnaire was piloted with 30 participants to 

determine feasibility.  

The study was approved by the institutional 

research committee of the College of Health Sciences, 

Bahrain. After explaining the study purpose, a written 

informed consent was obtained from all of the 

participants. Confidentiality of the participants and 

protection of data gathered was ensured by using study 

codes on data documents and removing all identifiable 

information. 

Data Analysis 

The data from the questionnaires were cleaned, 

coded, and entered in Excel (Microsoft, Redmond, WA, 

USA) and then exported to SPSS version 21 (SPSS Inc, 

Chicago, Illinois, USA) for analysis. Descriptive 

statistics were used to analyze baseline participant 

characteristics. Chi-square tests were used to compare the 

ED consumption patterns and baseline characteristics of 

the participants. 

 

Results 

The median age of the participants was 16 years 

(range: 10-18), which was not normally distributed. The 

majority of participants were enrolled in secondary 

education institutions (grades 10 to 12) and 51% were 

male (Table 1). 

 

Table 1: Qualitative demographic characteristics of 

participants 

 

Analyzing the consumption practices,  habitual 

consumption of ED was significantly higher in those 

aged 16 to 18 compared to those aged 10 to 12 or 13 to 

15 (p<0.01), and a similar significant difference was 

observed in the  group with higher levels of education 

compared to  groups with two other levels of education 

(p<0.03). Sixty one percent of participants had initiated 

ED consumption in the past year. Fifty seven percent 

declared that they consumed ED at home and with friends 

as a part of socialization adjoining sedentary high screen 

media use such as watching TV or playing video games; 

less than 10% consumed ED during physical activities 

and sports or in public places. Frequency of ED 

consumption varied in the sample (Table 2). Among the 

respondents, one third consumed ED two to three days a 

week, and one fifth consumed ED less than once per 

month. Over 80% of respondants preferred a portion size 

of 250 ml more than any other available choice of 

portions. In an average month of the past year, 34% of 

the respondents had 2-4 cans and 23% of the respondents 

had 5-10 cans. In a single session of ED consumption 

over the last year 51% consumed either two or more cans.  

 

Table 2: Frequency and volume of energy drink 

consumption 

 

Table 3 describes respondents’ key reasons for 

consumption of ED. Among them, 40% liked the taste of 

the drink, and 30% thought that ED provides the needed 

energy. Other reasons included: stay awake (13%), 

augment concentration (4%), and enhance sports 

performance (6%). The top three popular brands 

consumed by the participants of this study were Red Bull, 

Boom Boom, and Bison. Over 80% preferred ED with 

sugar over sugar free ED, and no difference in the 

preference between the age groups, gender or educational 

levels was found. Among the parents of the respondents, 

40% have consumed ED. 

 

Table 3: Reasons for energy drink consumption  

 

 

 

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Discussion 

Most participants consumed ED 2 to 3 times per 

week, two or more cans at a time, and primarily preferred 

ED with sugar. Older participants tended to consume 

more ED. Many consumed ED as a part of socialization.  

This study supports the idea that ED marketing 

strategies have reached young people in Bahrain, since 

the majority of the participants consumed two or more 

cans in a single session 2 to 3 times a week, which is 

similar to the frequency of ED consumption reported 

from Italy.17 This study showed that in our sample, higher 

intake of ED was found in the older age group with a 

higher educational level, which may be due to 

independent money spending capacity and the ability to 

buy ED without parental supervision. The majority 

admitted to consuming ED at home and with friends as 

part of socialization. The primary reasons for 

consumption of ED were for the taste of the drink and the 

energy need. These findings corroborate the reasons 

adolescents consume ED given in a report18 from 

neighboring Saudi Arabia Findings of our study 

contradict the belief that the intended effect of ED use is 

endurance and physical activity. Less than 10% of the 

respondents reported that they consumed ED during 

physical activities or sports. 

The majority of the respondents were habitual 

consumers of ED and preferred ED with sugar, indicating 

that this practice may also be associated with higher 

consumption of other sugar-sweetened beverages. High 

consumption of sweetened ED without physical activity, 

along with sedentary high screen media use among young 

people, are risk factors for non-communicable diseases, 

such as cardiovascular disease and obesity. This finding 

can be cautiously corroborated by the NNCD survey in 

Bahrain. Almost two thirds of adults in Bahrain were 

reported to be consumers of high calorie sugar-sweetened 

beverages and less than 3% used artificial sweeteners 

instead of sugar.5 NNCD has also revealed that the 

overall prevalence of overweight was 33%,   obesity was 

36%, diabetes mellitus was 14%, and 

hypercholesterolemia was 41%.15 Considering that over 

60% of parents did not consume ED, and generalizing the 

prevalence of non-communicable diseases by the NNCD 

survey to our study, there is a trend of unhealthy 

consumption practices of ED by the current generation of 

young people in Bahrain, and with the anticipated 

demographic shift of these young people to adults, the 

burden of non-communicable diseases in Bahrain is 

expected to escalate over the reported NNCD survey 

prevalence rates. At the same time, it is possible that ED 

consumption in various situations may serve as a marker 

for other unhealthy behaviors among young people.19 

Adolescents may not be fully capable of 

understanding complex concepts of behavior and health 

consequences, and their behavior patterns are different 

from children and adults. The successful transition period 

from childhood to adulthood of young people depends on 

the support of families, communities, schools, and health 

services. These support systems have the responsibility 

to promote their development and intervene effectively 

when problems arise.20  

Increasing popularity of ED, particularly with 

adolescents, has been observed since their introduction at 

the end of the last century. It has been suggested that 

some young adults consume ED for their perceived 

physiologic benefits, unaware of the ingredients in ED 

and the associated health risks.21 The American Academy 

of Pediatrics22 suggests that ED pose potential health 

risks to children and young adults primarily due to the 

stimulant content. Often, young people do not distinguish 

ED from sports drinks.  Therefore, this exploratory study 

was conducted to investigate the consumption practices 

of ED among adolescents in Bahrain. 

This preliminary study has a limitation. The 

convenience sampling method used in this study of over 

200 individuals may not be representative of the general 

Bahraini population. Regardless of this limitation, our 

study employed an EFSA validated survey tool with 

reliable measures to examine practices of ED 

consumption among young people of Bahrain. We 

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recommend larger cross-sectional and logitudinal studies 

in the future to address this limitation.  

 

Conclusion 

This study has shown that the ED consumption 

is a popular, high frequency socialization tool used 

among young people of Bahrain. The potential health 

risks that high ED consumption may cause necessitates 

the need for novel health promotion strategies. To 

prevent consumption at home, where the majority 

reported consuming ED, parents should be educated 

about the potential consequences associated with ED 

consumption and promote healthy habits of hydration. 

Fundamental to the health promotion campaign is 

instituting nutrition educational programs in educational 

institutions. The encouragement of the consumption of 

beverages with nutritive value, or water, and restricting 

the sale and use of ED on the institutional premises could 

curtail ED consumption. Taking the experience from the 

health promotions of the Saudi government23 and the 

active health promotion campaign in Bahrain, health 

regulatory authorities may consider warning labels on the 

containers of ED, and regulation of advertisements of ED 

similar to alcohol and tobacco.  

 

Conflicts of Interests  

The author declares that they have no competing 

interests. 

 

Acknowledgements 

We gratefully acknowledge all the participants 

in the study and the European Food Safety Authority. We 

thank the following from College of Health Sciences, 

University of Bahrain: Dr. Aneesa Al Sindi, Dean, for the 

encouragement and support, and Mr.Hassan Al Basri for 

statistical analysis. 

 

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8. Trapp GS, Allen KL, O'Sullivan T, Robinson M, Jacoby P, 

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sugar-guideline/en/ Accessed February 11, 2015. 

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14. Burrows T, Pursey K, Neve M, Stanwell P. What are the 

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Volume 4, No. 2 (2015) |  ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2015.216|http://cajgh.pitt.edu 

 

 

15. Ministry of Health, Kingdom of Bahrain. National Non-

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http://www.intranet.health.gov.bh/Docs/Reports%20%20Studies/NCD%20Survey%20Report.pdf
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Table 1: Qualitative demographic characteristics of participants  

Variables N (%) 

Age (in years)  

     10-12 38 (14.5) 

     13-15 90 (34.4) 

     16-18 134 (51.1) 

Gender  

     Male 133 (50.8) 

     Female 129 (49.2) 

Education  

     Primary (Grades 1-6) 31 (11.8) 

     Intermediate (Grades 7-9) 81 (30.9) 

     Secondary (Grades 10-12) 150 (57.3) 

 

  

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Table 2: Frequency and volume of energy drink consumption  

 N(%) 

Frequency of energy drinks consumed per month  

     Rarely 42 (22.8) 

     Once-twice a month 28 (15.2) 

     Once per week 19 (10.3) 

     2-3 days per week 53 (28.8) 

     4-5 days per week 19 (10.3) 

     Everyday 23 (12.5) 

Consumption of energy drinks by volume  

     250 ml can 149 (81.0) 

     355 ml can 28 (15.2) 

     Others   7 (3.8) 

Frequency of energy drinks consumed per month  

     1 or less 40 (21.7) 

     2 to 4 cans 63 (34.2) 

     5 to 10 cans 42 (22.8) 

     11 to 20 cans 24 (13.0) 

     >20 cans 15 (8.2) 

Number of cans of energy drinks consumed in a 

single session 
 

     1 Can 88 (47.8) 

     2 Cans 59 (32.1) 

     3 Cans 20 (10.9) 

     4 Cans   7 (3.8) 

     >4 Cans 10 (5.4) 

 

  

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Table 3: Reasons for energy drink consumption  

 N(%) 

Need energy (in general) 54 (30.0) 

Stay awake 24 (13.3) 

I like their taste 72 (40.0) 

Concentration augmenting  (Studying/Working)   8 (4.4) 

Enhance sport performance 11 (6.1) 

Effect of promotions and advertisements   3 (1.7) 

Stimulate my metabolism   1 (0.6) 

Others   7 (3.9) 

 

 

 

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