Background There is a high rate of mental health conditions among the youth athlete population; however, there is limited information about the impact mental health disorders can have on their overall health and athletic performance. Methods Data was collected by Simon’s Heart, a nonprofit organization that coordinates pre-participation examinations (PPE) for adolescents. Multivariable logistic regression adjusting for age, gender, race, BMI, asthma, anemia, and participation in sports was performed to assess the relationship between mental health disorders and each outcome. Results The HeartBytes dataset is composed of screening data from 7425 patients ranging from 12 to 20 years old. We identified 565 patients (7.6%) diagnosed with ADHD and 370 patients (5.0%) diagnosed with anxiety/depression. Screened participants without a diagnosis of ADHD, anxiety, or depression were significantly more likely to play sports compared to those with these conditions (75.4% vs 59.4%, P < 0.001 for ADHD; 89.4% vs 72.4%, P < 0.001 for anxiety/depression). Those with anxiety/depression not on an antidepressant (OR: 2.09, CI: 1.31–3.19, P < 0.01), but not those on an antidepressant (OR: 1.87, CI: 0.96–3.33, P = 0.05), were more likely to report chest pain or dyspnea with exercise. Those with ADHD not on a stimulant (aOR 1.91, CI 1.22–2.89, p < 0.01), but not those on a stimulant (aOR 1.40, CI 0.82–2.24, p = 0.19) were more likely to report palpitations. ECG abnormalities were not more prevalent regardless of anxiety/depression, ADHD, or medical therapy with an antidepressant or a stimulant. Conclusion Young athletes with anxiety/depression were less likely to participate in sports than healthy individuals. This may be due to deterrence as a result of the symptoms, such as dyspnea or chest pain, they experience during exercise. However, those taking antidepressants had fewer symptoms during exercise. Given that exercise has been shown to improve depression/anxiety, increasing the rate of antidepressant use may lead to less symptoms, more exercise, and an overall improvement in the mental health conditions in this population.
Background: Caffeine consumption causes diverse physiologic effects that can affect athletes both positively and negatively. There is a lack of research investigating the long-term effects of caffeine intake on exercise and on overall cardiovascular health in young athletes. Hypothesis: Certain characteristics such as age, body mass index (BMI), race, and medical diagnoses are associated with increased caffeine use, and there is a relationship between caffeine consumption and symptoms during exercise and cardiovascular abnormalities in young athletes. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: This study utilized the HeartBytes National Youth Cardiac Registry to collect data related to demographics, caffeine use, and physical examination and electrocardiogram (ECG) findings of 7425 12- to 20-year-olds (60.6% male, 39.4% female) who attended a Simon’s Heart cardiac screening event between 2014 and 2021. Univariable and multivariable logistic regression models were used for analysis. Results: Persons who consumed caffeine were more likely to have attention deficit hyperactivity disorder (ADHD) (adjusted odds ratio [aOR], 1.43; CI, 1.15-1.76]; P < 0.01) and more likely to have a BMI ≥30 kg/m2 (aOR, 1.69; CI, 1.27-2.25]; P < 0.01) compared with nondrinkers. After controlling for age, gender, race, and BMI, there were no significant differences in symptoms during exercise (aOR, 1.27; CI, 0.97-1.66; P = 0.08) or abnormal ECG findings (OR, 0.93; CI, 0.66-1.31; P = 0.70) between those who consume caffeine and those who do not. Conclusion: Caffeine consumption was associated with increased BMI and increased likelihood of having ADHD; however, caffeine use overall was not associated with increased risk of symptoms during exercise or ECG abnormalities. Clinical Relevance: Whereas caffeine consumption overall did not increase risk of exercise-related symptoms, soda drinkers were at higher risk for symptoms during exercise, and coffee drinkers were at higher risk of syncope with exercise. Prospective studies with longitudinal follow-up and more specific outcomes data is the next step in qualifying the impact of caffeine on young athletes.
Introduction: Studies on adult athletes have found that caffeine consumption has both positive and negative effects on physical performance and cardiovascular physiology. While roughly 3 in 4 children older than 5 years old consume caffeinated beverages, the effects of caffeine on children and adolescent athletes are less studied. Methods: The HeartBytes National Youth Database produced by Simon’s Heart, a nonprofit organization that organizes pre-participation examinations (PPEs) of adolescents, was utilized for this study. This database contains demographic, exercise-related symptom (chest pain or dyspnea), and electrocardiogram data obtained during Simon’s Heart PPEs. Logistic regression models were adjusted for age, BMI, race, and gender except for the model assessing BMI as an outcome, which adjusted only for age, race, and gender. Results: Of the 7425 patients in the HeartBytes database, the majority were male (60.6%) and White (83.9%). The median age was 15.0 years old (interquartile range 13.5 - 16.5). Those who consumed caffeine were more likely to have a history of ADHD (adjusted odds ratio [aOR] 1.43 [CI: 1.15 - 1.76]; p = 0.001) and a BMI ≥ 30 (aOR 1.69 [CI: 1.27 - 2.25]; p < 0.001) when compared to non-caffeine drinkers. Caffeine drinkers overall were at no higher risk for exercise-related symptoms. However, when type of beverage was assessed, soda drinkers were more likely to have symptoms during exercise (aOR 1.33 [CI: 1.02 - 1.73]; p = 0.032) and coffee drinkers were more likely to have syncope with exercise (aOR 2.13 [CI: 1.20 - 3.60]; p = 0.006) compared to those who do not consume caffeinated beverages. No association was present between caffeine consumption or beverage type and ECG changes. Conclusions: In this dataset from a national registry of PPEs, caffeine consumption was independently associated with obesity and ADHD. While caffeine consumption itself did not increase risk of exercise-related symptoms, soda drinkers were at higher risk for symptoms during exercise, and coffee drinkers were at higher risk of syncope with exercise. The study shows that caffeine consumption may have significant impact on youth health. Future studies are needed to further confirm our findings.
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