The effects of energy drink consumption in children and adolescents: a cross-sectional study and the recommendations of the Italian Pediatric Society

Abstract

Background

Energy drinks are widely marketed to enhance alertness and performance and are increasingly consumed by children and adolescents, despite warnings from pediatric and public health organizations regarding potential health risks. This study aimed to investigate energy drink consumption, age of initiation, motivations, risk perception, and awareness of health guidelines among Italian adolescents, with comparisons across distinct clinical and non-clinical subgroups.

Methods

A cross-sectional survey was conducted between May and December 2025 using an anonymous questionnaire administered to adolescents aged 9–17 years. Participants were recruited from four settings: inpatients with eating disorders, other hospitalized patients, competitive athletes, and healthy controls. The questionnaire assessed demographics, familiarity and frequency of energy drink consumption, age of first use, motivations, perceived health risks, knowledge of official guidelines, and attitudes toward sales regulations. Data were analysed descriptively and using chi-square tests, with statistical significance set at p < 0.05.

Results

In the study period, 430 participants were recruited. Overall, 96.5% of participants were familiar with energy drinks, and 65.1% reported at least occasional consumption. Early initiation was common, with 39.2% of consumers starting before age 12. Frequent consumption was relatively low (10.2%) but more prevalent among older adolescents and healthy controls. Only 52.3% perceived energy drinks as harmful, and awareness of official health guidelines was limited (40.4%). Consumption patterns, risk perception, and knowledge differed significantly across subgroups, with athletes showing greater awareness and eating disorder patients exhibiting higher uncertainty.

Conclusions

Although frequent energy drink use was uncommon, early exposure and substantial knowledge gaps were identified. These findings highlight the need for routine screening, targeted education, and preventive strategies to reduce energy drink consumption and protect vulnerable pediatric populations.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s13052-026-02305-7.

Background

Energy drinks (EDs) are marketed as beverages that enhance alertness, concentration, and physical performance. Since their introduction into the global market, they have gained popularity among adolescents and, increasingly, even among younger children [1]. Unlike traditional caffeinated beverages such as coffee or tea, energy drinks often contain multiple psychoactive ingredients and are marketed aggressively toward youth through sports, gaming, and social media platforms [2]. Caffeine is the primary active ingredient in most energy drinks. Typical energy drinks contain 80–300 mg of caffeine per serving, with some products exceeding 500 mg per container. This amount may surpass the recommended maximum caffeine intake for adolescents (≤ 100 mg/day) and far exceeds any suggested limit for children under 12 years [3]. Children have lower body mass, immature hepatic metabolism, and heightened neurodevelopmental vulnerability, making them more susceptible to caffeine’s adverse effects [4]. Energy drinks often contain taurine, guarana (a concentrated caffeine source), ginseng, L-carnitine, B-vitamins in supraphysiologic doses. The synergistic effects of these compounds are poorly studied in children, and safety data are limited. Another concern is the amount of sugar and non-nutritive sweeteners. Many energy drinks contain 20–60 g of sugar per serving, contributing to caloric excess, insulin resistance, and dental erosion. Sugar-free formulations still pose risks due to caffeine and other stimulants [2, 5, 6].

Pediatric organizations, including the American Academy of Pediatrics (AAP) and the European Academy of Paediatrics, have warned against energy drink consumption in minors. Despite these warnings, prevalence remains high [7, 8]. Recent scientific literature has expanded understanding of the pathophysiological effects, clinical presentations, and long-term risks associated with energy drink intake in pediatric populations. The main concern is on cardiovascular effects. Multiple randomized crossover trials in adolescents have shown that energy drink consumption may be linked to acute hemodynamic changes, including increased systolic and diastolic blood pressure, elevated heart rate, reduced endothelial function. A controlled trial showed a mean systolic blood pressure increase of 5–7 mmHg after a single energy drink in healthy adolescents [9]. Literature is also consistent with arrhythmias and cardiac events, such as supraventricular tachycardia, atrial fibrillation, ventricular arrhythmias and sudden cardiac arrest in predisposed youth [10]. Children with underlying channelopathies or cardiomyopathies appear particularly vulnerable [11]. As for neurological and neurodevelopmental effects, the consumption of energy drink has been associated to sleep disruption, including reduced total sleep time, delayed sleep onset, poor sleep quality. A 2021 cohort study found that adolescents consuming energy drinks ≥ 3 times/week slept one hour less per night than non-consumers [12]. Caffeine may interfere with synaptic pruning, dopaminergic signaling, prefrontal cortex maturation. Although direct causal human data are limited, pediatric neurologists caution against exposure during critical developmental windows [13, 14]. Psychiatric and behavioural effects include anxiety and mood disorders, panic attacks, irritability and depressive symptoms. Literature is consistent with a dose-dependent relationship between energy drink intake and depression and anxiety disorders in adolescents [15, 16]. Energy drink consumption is associated with behavioural dysregulation, worsening hyperactivity, emotional dysregulation, sleep-related behavioural deterioration [2, 17, 18]. Because of their high sugar content, energy drink consumption has been associated with metabolic and endocrine alterations, including increased body max index and risk of obesity and cardiovascular disease [6]. Frequent consumption of sugar-sweetened energy drinks has been linked to impaired glucose tolerance, though long-term pediatric data remain limited [18, 19]. Furthermore, energy drinks have low ph and a high erosive potential, so to be related to dental erosion and caries. Pediatric dental studies demonstrate significantly higher enamel erosion in adolescents consuming energy drinks weekly [20, 21].

The aim of this study was to investigate energy drink consumption patterns, risk perception, and awareness of health guidelines among Italian adolescents, with a specific focus on distinct clinical and non-clinical subgroups.

Materials and methods

Study design and participants

A cross-sectional study was conducted between May 1 and December 1, 2025, among adolescents aged 9–17 years. The study was designed to assess the prevalence and patterns of energy drink consumption and related perceptions among adolescents with different clinical and lifestyle characteristics.

Participants were recruited from three distinct clinical settings: pediatric hospital wards; a cardiology outpatient clinic providing eligibility certification for competitive sports participation; general pediatricians’ outpatient offices. These settings were selected to ensure heterogeneity in health status and lifestyle profiles, allowing comparison across clinically distinct groups. An informed consent was required to participants to enter the study.

Eligible participants were adolescents aged 9–17 years who attended the participating facilities during the study period and were able to complete a self-administered questionnaire. Written informed consent was obtained from parents or legal guardians, and assent was obtained from participants, according to age and local regulations. Adolescents with cognitive or medical conditions preventing questionnaire completion and those who declined participation were excluded.

Participants were classified a priori into four groups based on recruitment setting and clinical characteristics:

1. Inpatients with Eating Disorders (ED): adolescents hospitalized with a clinical diagnosis of an eating disorder.

2. Other Inpatients: adolescents hospitalized for medical conditions other than eating disorders.

3. Athletes: adolescents attending the cardiology clinic for competitive sports eligibility certification.

4. Healthy controls: adolescents attending general pediatricians’ offices for routine care without known chronic medical conditions.

The sampling strategy was consecutive and facility-based. All eligible adolescents attending the participating centers during the study period were invited to participate. As recruitment was not population-based, the sample may not be fully representative of the general adolescent population; however, inclusion of diverse clinical settings was intended to improve variability and comparability across subgroups.

Biological sex (male/female) was self-reported in the questionnaire. Race and ethnicity were not collected because these variables are not routinely recorded in the participating clinical settings and were not directly related to the primary study objectives.

The study protocol was approved by the Ethics Committee of Ospedale Pediatrico Bambino Gesù (Protocol No. 3334_OPBG_2024). The study was conducted in accordance with the Declaration of Helsinki. No external organizations were contracted for data collection, management, or analysis. No artificial intelligence tools were used in the design, conduct, or statistical analysis of the study.

Data collection techniques and tools

Data were collected using a structured, paper-based, self-administered questionnaire developed by the research team following a review of the relevant literature and discussion among investigators. An English language version of the questionnaire has been uploaded as supplementary material. The questionnaire was designed to capture information related to the study objectives.

Before study implementation, the questionnaire underwent a validation process. Content validity was assessed by a multidisciplinary team including pediatricians and experts in adolescent health. In addition, pilot testing was conducted among 15 adolescents representative of the target population to evaluate item clarity, comprehensibility, and acceptability. All items were judged comprehensible by participants. Based on participant feedback, minor wording modifications were introduced to improve readability and understanding. The questionnaire was designed to capture information related to the study objectives and included closed-ended and multiple-choice items covering:

demographic characteristics (age and biological sex);

awareness of energy drinks;

frequency of consumption;

age at first use;

reasons for initial consumption;

perceived health risks;

knowledge of health recommendations;

opinions regarding sales regulations for minors.

The questionnaire was administered in paper format and completed independently by participants. No identifying information was collected. To minimize social desirability bias and ensure confidentiality, completed questionnaires were deposited in a sealed collection box placed outside the medical offices.

No biological samples, pharmacological interventions, laboratory tests, or medical devices were involved in the study.

Study objectives and outcomes

The primary outcome was the prevalence and frequency of energy drink consumption.

Secondary outcomes included:

• Age at first consumption of energy drinks.

• Motivations for initiating consumption (e.g., advertising exposure, peer influence, product availability in supermarkets).

• Perceived health risks associated with energy drink consumption.

• Awareness of official health recommendations, including those issued by the World Health Organization.

• Attitudes toward potential regulatory measures restricting the sale of energy drinks to minors.

Data management and analysis

Completed questionnaires were reviewed for completeness and internal consistency prior to data entry. Data were coded and entered into a dedicated database and subsequently exported for statistical analysis. Descriptive statistics were used to summarize participant characteristics and study variables. Categorical variables are presented as absolute frequencies and percentages. Where appropriate, 95% confidence intervals (CIs) were calculated to provide estimates of precision.

Group comparisons were performed using the chi-square (χ²) test for independence. When expected cell counts were fewer than five, Monte Carlo simulation was applied to obtain more accurate p-values. All statistical tests were two-sided, and a p value < 0.05 was considered statistically significant. Effect sizes and confidence intervals were interpreted alongside p values to avoid overreliance on statistical significance alone.

All analyses were conducted using IBM SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). Only analyses prespecified in the study protocol were performed; no additional exploratory subgroup analyses were conducted. Given the exploratory nature of the study, no formal correction for multiple comparisons was applied. Therefore, the results of subgroup analyses should be interpreted as exploratory and hypothesis-generating.

Results

Participant characteristics

A total of 430 adolescents aged 9–17 years were enrolled in the study. Participants were classified into four groups: adolescents hospitalized for eating disorders (ED; n = 46), adolescents hospitalized for other medical conditions (n = 27), athletes undergoing competitive sports eligibility assessment (n = 68), and healthy controls recruited through pediatric outpatient clinics (n = 289). Overall, 232 participants (54.2%) were female. Regarding age distribution, 30 participants (7.0%) were aged 9–11 years, 131 (30.4%) were aged 12–14 years, and 269 (62.5%) were aged 15–17 years.

Awareness and consumption patterns

Overall, 415 participants (96.5%) reported being familiar with energy drinks.

Regarding consumption, 150 participants (34.9%) had never consumed energy drinks, 149 (34.6%) reported rare consumption (1–2 times/month), 87 (20.2%) occasional consumption (1–2 times/week), and 44 (10.2%) frequent or regular consumption.

Among consumers, the most frequently reported effects were increased energy (n = 151), anxiety (n = 16), and improved concentration (n = 7).

The most commonly reported reasons for first use were product availability in supermarkets (n = 133), friends’ recommendations (n = 79), and advertising through television or the internet (n = 30).

In 177 cases (41.2%), at least one family member also consumed energy drinks. Sixty-three participants reported having attempted to reduce or discontinue energy drink consumption.

Age of initiation

Among the 280 consumers, 110 (39.2%) reported initiating energy drink consumption before the age of 12 years, including 19 participants who reported first use before the age of 9 years.

One hundred thirty-eight participants (49.3%) reported first consumption between 12 and 14 years of age, whereas 45 initiated consumption after the age of 15 years.

A statistically significant association was observed between age group and frequency of energy drink consumption (p < 0.001), with higher consumption frequencies reported among adolescents aged 15–17 years (Table 1).

Table 1.

Frequency of energy drink consumption by age groups

Frequency	9–11 years	12–14 years	15–17 years
Never	21 (70.0)	58 (44.3)	71 (26.5)
Rarely / Occasionally	7 (23.3)	63 (48.1)	166 (61.6)
Often / Very often	2 (6.7)	10 (7.6)	32 (11.9)

Risk perception and awareness of recommendations

Overall, 225 participants (52.3%) considered energy drinks potentially harmful to health.

The most frequently identified adverse effects were sleep disturbances (45.6%), anxiety (31.8%), cardiac problems (20.6%), and headache (2.0%).

Awareness of official health recommendations was limited, with only 174 participants (40.4%) reporting familiarity with existing recommendations.

Regarding safety during adolescence, 241 participants (56.0%) considered energy drinks unsafe, whereas 104 (24.2%) considered them safe and 85 (19.7%) were uncertain.

Concerning regulatory measures, 151 participants (35.1%) supported restrictions on the sale of energy drinks to minors, whereas 140 (32.6%) opposed such restrictions.

As for advertising on energy drinks, 75 judged it in a negative way, 71 in a positive, and 264 neutral.

Family environment and energy drink consumption

Participants reporting at least one family member who consumed energy drinks showed significantly higher frequencies of consumption (p < 0.001), earlier initiation of use (p < 0.001), lower perception of risk (p = 0.004), and fewer attempts to discontinue consumption (p = 0.024).

Comparisons across study groups

Group analysis revealed a significant difference in gender distribution (p < 0.001). In particular, the hospitalized ED group was composed almost exclusively of females (93.5%). The group of patients hospitalized for conditions other than ED showed a female prevalence of 63.0%, as did the group of healthy patients (52.2% females). In contrast, the athletes group had a male prevalence (67.6% males). Nominal familiarity with the term “energy drink” is high across all groups, although statistically significant differences emerge (p = 0.008) Almost all athletes (98.5%) and healthy young people (97.9%) have already heard of energy drinks. A slightly lower percentage is found among those hospitalized for reasons other than ED (92.6%), while the lowest rate is recorded among patients with ED (89.1%). Although respondents are familiar with them, the majority report not consuming them. However, frequency of consumption shows disparities (p < 0.001). The group with the highest percentage of abstention (“Never”) is that of hospitalized with ED (71.7%) and with other pathologies (70.4%), followed by the athletes (54.4%). The lowest percentage was found in the control group (21.0%). Regular consumption (“Often/Always”) remained low in all groups, ranging from 0% in those hospitalized for reasons other than ED to 13.5% of healthy controls. A statistically significant association emerged between cohort and frequency of energy drink consumption (p < 0.001), as shown in Fig. 1.

Fig. 1.

Frequency of energy drinks consumption

Males and females do not differ in age at which they drink (p 0.451). The various cohorts do not differ in age at which they drink (p 0.645).

Different motivations for first use were reported across age groups.The youngest children (9–11 years) appear to be more influenced by television advertising, whereas older children choose them independently at the supermarket (39.7% of the 12–14 age group and 48.2% of the 15–17 age group) or are influenced by peers (34.8% of the 12–14 age group and 22.8% of the 15–17 age group).

As for the home environment differences were found between cohorts (p 0.009). Among the control group the presence of at least one family member (parent or sibling) who consumed EDs was more common (43.8%) than in the other groups (25-29.6%). When asked “Have you ever tried to quit?“, responses varied based on consumption habits (p 0.016). A significant proportion of ED patients and non-ED patients hospitalized (46.7% and 50.0% respectively) reported having considered or attempted to limit their use, a higher percentage than that of athletes (20.0%) and healthy adults (19.9%). Those with close family members who consume energy drinks have the same age distribution as the others (p 0.458) and gender (p 0.162) but have a significantly higher frequency of use (p < 0.001) and started using them earlier (p < 0.001). Participants reporting family consumption of energy drinks were less likely to report attempts to discontinue consumption (p 0.024) and reported lower risk perception (p 0.004).

ED patients showed high uncertainty regarding the safety of energy drink consumption in adolescence (60%) and a lower perception of the risks (53.3%). Awareness of official guidelines on the maximum amount of caffeine and stimulants was uniformly low: over 55% of subjects declared they were unaware of them. However, when asked about the amount they considered acceptable, differences emerged (p < 0.001). Athletes (33.8%) and healthy controls (39.0%) tended to indicate “1–2 cans” as the limit, while 52.2% of ED patients answered “I don’t know” or believed there was no recommended amount. Attitudes towards the introduction of stricter rules on sales to adolescents are predominantly positive across the sample (p 0.002: the healthy control group had significantly higher proportions of patients who considered restrictions not necessary (39.3%) compared with the other groups (13.0–20.0%).

Discussion

The consume of energy drink among children and adolescents represents a significant public health challenge and a matter of concern. Energy drinks are distinct from traditional caffeinated beverages due to their high concentrations of caffeine, sugar, and a variety of additional stimulants such as taurine, guarana, and ginseng, which are often present in supraphysiologic doses [1, 2]. Evidence from the last five years strongly indicates that energy drink consumption in children and adolescents is associated with significant short- and long-term health risks across multiple organ systems. There is no established safe dose for minors. Current evidence supports the recommendation that energy drinks should be avoided entirely in individuals under 18 years of age. Many countries adopt regulatory policies, including restriction of energy drink sales to minors or to pharmacies or providing health risk warnings; however, enforcement varies widely [2, 7, 22]. In Italy, energy drinks can be found in supermarket, without any restriction of marketing.

A major strength of the present study is the inclusion of distinct adolescent populations, including patients with eating disorders, hospitalized adolescents with other medical conditions, athletes, and healthy controls. This design allowed the identification of differences in consumption patterns, risk perception, and awareness of recommendations across clinically and socially distinct groups.

In our sample, although frequent consumption is relatively low (10.2%), 65.1% of participants reported at least some exposure, and 25.6% initiated consumption before the age of 12, highlighting a critical window of vulnerability. This is in line with the prevalence rates worldwide of 57.7% [23]. Nevertheless, there is a great variability in data. For instance, data from the United States suggest approximately 64% occasional use among adolescents, while the United Kingdom reports lifetime or recent use of 7% [24, 25]. Of concern, data suggest that up to 74% of adolescents consume energy drinks [2, 26, 27]. Furthermore, an American study revealed that roughly 30% of secondary school students are regular consumers of energy drinks or “shots,” illustrating a pervasive cultural normalization of these stimulants [28]. Regional variations also include the Middle East and North Africa, with Egypt and Israel reporting a 38.5% and 39% respectively adolescents as regular users, often driven by academic pressure and fatigue [29, 30]. In Saudi Arabia, reports indicate even higher engagement, with studies showing 82% of students consume at least one energy drink once to twice a week and revealing a positive correlation between social media use and consumption of energy drinks [31].

Of note, a critical “early onset” data has been found out: 25.6% of the consumers started before age 12, a finding that aligns with observations in other regions, where early adolescence is identified as the peak period for initiating consumption [22, 32].

A unique contribution of the manuscript is the comparative analysis of four distinct groups that allows to make deeper considerations: athletes, ED patients, other hospitalized patients, and healthy controls. While the frequent/very frequent general consumption is 10.2%, the ED sub-group shows a less concerning profile compared to controls, with a 6.5% prevalence of regular consumption and a starting before the age of 12. A possible explanation lies in the fact that the beverages often contain sugar and calories, which individuals with ED may avoid if they believe it interferes with weight control. The higher proportion of ED patients reporting attempts to reduce or discontinue energy drink consumption may reflect greater attention to substances perceived as potentially affecting health or weight-control behaviours. As for the control group, 13.4% of healthy subjects use energy drinks in a frequent/very frequent way, with an onset before 12 years of age in approximately one third of cases. A great concern is represented by the fact that 15 adolescents declared they drank their first energy drink before the age of 9. As for the athletes, 44.1% admitted using EDs occasionally/rarely and just 1 participant frequently. In this group a matter of concern is represented by the fact that 16.2% of the sample size started consuming energy drinks very early, before the age of 12 years. One possible explanation is that some athletes may consume energy drinks because they perceive them as improving alertness or reducing fatigue. Despite this data the group of athletes appears to be the one with the greatest awareness regarding side effects, including cardiovascular and sleep-related consequences. This finding may reflect increased exposure to health information through sports medicine evaluations and competitive sports environments. Many adolescents report positive immediate effects of energy drinks—feeling more alert, focused, or energized—which reinforce consumption despite knowing health warnings. Moreover, risk and benefit perceptions are processed differently: even with awareness of harm, strong perceived benefits can reduce the impact of risk information.

Despite most of participants perceive health risks, the majority is unaware of official health guidelines, and only a minority correctly identified recommended limits, confirming a substantial information gap. This discrepancy may partly explain why 35.1% supported stricter regulation, despite limited personal consumption. The lack of knowledge on energy drink by the Italian adolescents is in line with previous studies. Giran’s survey revealed that almost one-third of Hungarian pupils consumed energy drinks regularly, even if they considered the consumption unhealthy [33]. Adolescence is a period of ongoing brain development. The parts of the brain that evaluate risk and control impulses (mainly the prefrontal cortex) are still maturing, while reward-seeking and emotion-driven systems develop earlier. Because of this imbalance, teens may know a behaviour is unhealthy but still do it because the “reward” (e.g., energy boost, peer approval) feels more salient than future harm [34]. Adolescents engage in behaviours that help them fit in and avoid social rejection – even if they know it’s unhealthy. Previous literature suggests that behaviours are shaped by friends and social groups; if peers drink energy drinks and see it as normal, individuals are more likely to copy them [35].

A final reflection should involve the environment. Participants exposed to family consumption of energy drinks reported higher consumption frequencies, earlier initiation, and lower risk perception, suggesting that the family environment may influence attitudes and behaviours related to energy drink use.

Pediatricians must recognize that the transition into middle school often coincides with increased autonomy and exposure to aggressive marketing through social media and gaming platforms, which target youth specifically.

Pediatricians play a central role in prevention, early identification, and education on energy drink use and co-use with alcohol or stimulants. The counselling is important in providing information to families that energy drinks are not safe for children or adolescents and that sports drinks and energy drinks are not interchangeable. Sleep, hydration, and nutrition are healthier alternatives. School-based education and parental guidance are effective preventive strategies as well that should be implemented by scientific societes.

Based on these findings, pediatricians should adopt the following strategies:

• Routine Screening: Pediatricians must move beyond general questions about “diet” and specifically ask about the frequency of energy drink use, particularly during sports physicals and psychiatric evaluations.

• Targeted Counseling: Families should be educated that energy drinks are not interchangeable with sports drinks; the former are stimulants, while the latter are intended for electrolyte replacement.

• Emphasis on Development: Counseling should focus on the impact of caffeine on the developing brain and its interference with sleep, which is critical for academic and emotional regulation.

• Identify “At-Risk” Profiles: Be particularly vigilant with patients who have eating disorders, or known underlying conditions, such as cardiac problems.

• Promotion of Alternatives: Shift the focus toward healthy alternatives like adequate hydration, balanced nutrition, and consistent sleep hygiene as the only safe ways to “enhance” energy and performance.

Limitations

Several limitations should be acknowledged

First, although the questionnaire underwent content validation and pilot testing among 15 adolescents, a formal psychometric validation was not performed. Second, no a priori sample size calculation was conducted because the study was designed as an exploratory survey aimed at providing preliminary data regarding energy drink consumption in different pediatric populations. Despite subgroup imbalance, the overall sample size of 430 participants provided sufficient precision for descriptive analyses and exploratory comparisons. Because no previous studies using a comparable design and subgroup structure were available, an a priori power calculation was not performed. Given the exploratory nature of the study, analyses were primarily descriptive and hypothesis-generating. Multiple statistical comparisons were performed without formal correction for multiplicity, subgroup sizes were unequal, particularly for hospitalized patients without eating disorders, which may have reduced statistical precision and limited the generalizability of subgroup comparisons. Then, the cross-sectional design precludes causal inference and only allows the identification of associations between variables. Longitudinal studies are needed to clarify the directionality and temporal nature of these relationships.

Conclusion

Energy drink consumption was common among Italian adolescents, with a substantial proportion reporting initiation before the age of 12 years. Although frequent consumption was relatively uncommon, important gaps in knowledge regarding potential health risks and existing recommendations were identified.

Differences in consumption patterns, risk perception, and awareness emerged across clinical and non-clinical subgroups, highlighting the need for targeted preventive interventions.

These findings suggest that routine screening, educational initiatives, and public health interventions may be useful to improve awareness and reduce energy drink consumption among vulnerable pediatric populations.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

AAP

American Academy of Pediatrics

BMI

Body Mass Index

CI

Confidence Interval

ED

Eating Disorder

EDs

Energy Drink

IRCCS

Scientific Institute for Research, Hospitalization and Healthcare

OPBG

Ospedale Pediatrico Bambino Gesù

WHO

World Health Organization

χ²

Chi-square

Author Contributions

Conceptualization, E.B.; Methodology, F.C. and V.C; Formal Analysis, L.A. and G.DL.; Investigation, M.M., G.C., A.C., C.M., L.R.; Data Curation, C.M., M.I. and G.S.; Writing – Original Draft Preparation, E.B. and G.S.; Supervision, R.A. and C.C.

Funding

This work was supported also by the Italian Ministry of Health with “Current Research Funds”.

Data Availability

Data supporting reported results are available by contacting the corresponding author.

Declarations

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Bambino Gesù Children Hospital (3334_OPBG_2024 approved on January 2025). Informed consent to participate was obtained from all of the participants in the study.

Consent for publication

Not applicable.

Competing interests

E.B. is a Senior Editor of the Italian Journal of Pediatrics.