# Consumption of Energy Drinks among University Students in Eastern Croatia
## 4 Discussion
[61] was the only one reporting more prevalent AmED consumption among females supporting their results with those obtained in-vivo, the increased use of alcohol among the female population in the last few years, and marketing that targets women. [PERSON] et al. [32] found no correlation between alcohol and EDs consumption with reasonable explanation due to the Muslim study population and the fact that drinking alcohol is generally forbidden. Our study shows that only 24.8% of participants who consume EDs at the University of Osijek do not mix these drinks with alcohol, which is very disturbing because AmED consumers are more likely to engage in binge drinking. Further, the consumption of AmED may lead to alcohol addiction, liver diseases, and obesity or diabetes related to the high-caloric content of these drinks. The caffeine content of EDs increases the need for more alcohol consumption, leading frequently to alcohol intoxication, not to mention all other previously mentioned caffeine adverse effects [6; 59]. A cross-sectional study from the 2019 European School Survey Project on Alcohol and other drugs reported that 33.9% of 16-year-old students in Europe consumed AmED with the global prevalence greater among males. They stated significantly higher odds of AmED users with risk behaviors which also has been proven in this study [62]. The present study also showed that mixing EDs with alcohol is more frequent among smokers which were shown in the study by [PERSON] et al. which confirmed that besides smoking, alcohol use, as well as drug use, and depression symptoms were also positively associated with AmED use [63]. We also found that those who play sports or are engaged in regular physical activity were more likely to consume EDs. This finding is consistent with some other research [39], while some studies did not confirm this association [64]. However, when analyzing sports engagement in correlation to the monthly frequency of EDs consumption this study did not confirm the existence of a such connection. [PERSON] et al. [65] revealed that a large proportion of extreme sports enthusiasts consume EDs regularly, younger adults above all. [PERSON] et al. [25] stated how being a man and living in an urban environment were independent predictors for the consumption of EDs in association with sports or physical activity among university students in Sarajevo in Bosnia and Herzegovina. A review by [PERSON] et al. [66] concluded that caffeinated drinks effectively increase several aspects of sports performance. The authors highlighted how the ergogenic role is connected to at least 3 mg of caffeine per kg of body mass. [PERSON] et al. [48] found that 37.3% of high school athletes in the U.S. consume EDs. The alarming fact is also that they start this consumption very early, around 11-12 years of age, or even younger, mostly to gain energy. The market is full of caffeinated beverages such as EDs that are widely used today by professional and recreational athletes to improve their performance. This could be a very significant problem because of the possible occurrence of serious cardiovascular events [66]. Students who smoke were found to consume more EDs than non-smokers. A Similar was found by some other authors [16; 38; 67]. However, some studies did not find a connection between the consumption of EDs and smoking habit [28; 68], although according to gender differences among EDs users, male smokers were found to consume EDs more frequently than females [28]. Our study showed no statistical differences in EDs consumption according to coffee drinking habits which is consistent with the results of another similar study [39]. However, some studies found a connection between those two consumptions [25; 28]. Finally, this research showed that there were more of those who prefer sweetened energy drinks (56.3%), which is in line with some other research [33]. Additionally, females were more prone to sugar-free versions [33]. According to research, the male population is a risk population group regarding the consumption of EDs.