Energy Drinks and Cardiovascular Health: A Critical Review of Recent Evidence

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The authors describe a selection of studies from 2020-2025 on the risk of energy drink consumption.

While the results may be included in the papers, the discussion is not very balanced and limitations are not clearly pointed out.

A major deficit is the exlclusive use of open access publications. This biases the results somehow to lesser journals and excludes a considerable body of research. A rationale for this exclusion must be provided. 

A rationale should also be provided for the cutoff 2020. Was a major review conducted in 2020? Can the previous researches somehow summarized.

Results from this study appear to have been missed: https://link.springer.com/article/10.1007/s10654-025-01292-z

This study shows that confounding factors with energy drink consumption may have a larger influence than the energy drinks themselves.

The discussion on policy responses is a bit weak. For example, education has mostly no effects and is therefore the preferred option by industry. Taxation is already mentioned. Limitation of ingredients such as caffeine limits might be pointed out.

Introduction: it might be mentioned that caffeine intake from other sources is already quite high, specifically in Europe and South Ameria due to coffee, tea, mate etc. Therefore, the safe limits of caffeine intake might be exceeded even with single energy drink portions.

Line 112: the search strategy is very short and could be moved into the main text

The other supplements could be presented in the annex (check journal template)

FIgure 2: the text inside the figure is unreadable. Suggest ot delete the figure as this is not very helpful anyway.

Line 252: this study probably fits better in the next section on mechanism?

Table 3-7: should be English and Grammar edited. E.g. avoid "He" and "It" for papers with several authors including females.

Line 490: provide reference for claims about excitotoxic environment

Line 501: check "cerebral territory". is this a correct term?

Around lines 497-519: mention as limitation that causality is often unclear in this type of studies

Acknowledgements: the approach for AI usage in text generation must be added. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This manuscript presents the literature review on the relationship between energy drink consumption and cardiovascular health risks among young people. The study analyzed 33 studies published from 2020 to 2025. The literature review identifies key themes, including the direct impacts on cardiovascular health, the harmful components of energy drinks, and the habits of young consumers, which reveal that regular intake can lead to serious health issues like increased blood pressure and arrhythmias. The adolescents and young adults are particularly vulnerable due to their physiological responses and lifestyle choices. Concluding lines emphasize the need for longitudinal studies, stricter ingredient regulations, better consumer education, and targeted public health initiatives to address these risks effectively. Overall, the review presents an interesting topic relevant to modern lifestyle, and shows the coordinated efforts to promote safer consumption practices among youth.

 

The review is thoughtfully crafted, with a clear and logical structure and content. Each section is presented clearly.

I feel that a table can be included summarizing the components of energy drinks reported in those 33 studies, what age groups were studied, reported effects on the health or risks associated with it.

Including the discussion on the effects of these drinks on gut health can be useful, as the gut-brain axis can influence cardiovascular health.  

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Dear Authors,

The article presents very important content on the subject of energy drinks and cardiovascular health. This is a current and very important topic in the perspective of today's world, therefore I consider the article to have high potential. The discussion is very well written. However, I have a few comments that could improve the manuscript:

Lines 58-61 – I suggest shortening the sentence because it is unclear.

What distinguishes this work from the available literature on this subject? Please highlight the novelty of the research.

Lines 183-184 – what kind of habits? Please expand on this section.

The authors use enumerations: first, second, third, etc. when describing the research. It would be worth making the text more fluid by adding expressions such as “on the other hand” or “however.” Please consider this. The text is well written, but it lacks dynamism.

Figure 6 – the captions are not visible. Please enlarge the font.

3.1.3. section – in this article, the section on chemical composition is very important, but in my opinion it is written too generally. Please expand the section. The same applies to section 3.1.4.

Section 3.1.5 – the authors have skillfully provided specific examples of research, but I suggest describing them in more detail. They are described in just one sentence, which I think is insufficient. The subject matter of the work is important, and a more in-depth analysis would be desirable.

Section 3.2. – the figures are very well done, but there is no description of them. Please add.

Lines 452-459 – the reference is missing.

I suggest shortening the conclusions – they should be a concise summary of the entire article, and in their current form they are too long.

Line 622 – section 7 – this section should be before the conclusions. Please change.

References – please use abbreviations for journal names, as in the guide for authors.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

The authors responded to all my comments. I have no further comments. I recommend the paper for publication.