PREVALENCE, PATTERNS AND HEALTH-RISK AWARENESS OF ENERGY DRINK AND DIETARY STIMULANT CONSUMPTION AMONG FEMALE MEDICAL STUDENTS IN SIALKOT, PAKISTAN

Background: Energy drinks are widely available and inexpensive in Pakistan, where they are consumed alongside a longstanding habit of daily tea drinking that is largely absent from the Western populations in which most energy drink research has been conducted. Pakistani studies have rarely described energy drink use together with background tea intake symptoms and care-seeking in the same population.

Objective: To describe the prevalence and patterns of energy drink and dietary stimulant consumption and to characterise health-risk awareness and care-seeking behaviour among female medical students in Sialkot, Pakistan.

Methods: This cross-sectional study enrolled 274 female medical students from three medical colleges in Sialkot, selected by stratified sampling proportional to institutional enrolment. A structured pilot-tested, interviewer-administered questionnaire recorded energy drink brand, frequency, serving size, timing, and reason for use; background tea and coffee intake; self-reported cardiac autonomic and stimulant-related symptoms in the past 30 days and awareness of caffeine content and cardiac risk, symptom attribution, and care-seeking. Data are presented as frequencies and percentages.

Results: In total, 171 participants (62.4%) had used energy drinks in the past 3 months, and 36 (13.1%) consumed five or more cans weekly. Among the 171 consumers, Sting was the most used brand (42.7%), night-time use after 9 pm was the most common timing (50.9%), and studying was the most frequently cited reason for use (62.6%). Two to three cups of tea per day was the modal background intake (45.3%), and 19.0% of participants self-estimated a total daily caffeine intake of 300 mg or more. Most participants already knew that energy drinks contain high amounts of caffeine (91.2%), and 64.2% were aware that caffeine can affect heart rhythm. Of the 154 participants reporting at least one cardiac symptom in the past 30 days, 64 (41.6%) attributed their symptoms to energy drinks, while only 22 participants (8.0% of the sample) had ever sought medical care for them. Just over half of the full sample, which included non-consumers, said they would definitely reduce their energy drink intake if advised by a doctor (53.6%).

Conclusion: Energy drink use is common in this population and is layered onto habitual tea drinking; nearly a fifth of participants estimated a combined daily caffeine intake of 300 mg or more, approaching the 400 mg/day level that the European Food Safety Authority regards as not raising safety concerns in healthy adults. Awareness of stimulant-related cardiac risk was high, whereas care-seeking for symptoms was rare, a gap that general risk information may not close by itself.