Highly caffeinated beverages were in the spotlight again this week with the publication of a paper in the journal Pediatrics Monday that reviewed studies in the scientific literature, as well as government and media reports, about the contents and effects of so-called energy drinks.
The latest paper, “Health Effects of Energy Drinks on Children, Adolescents, and Young Adults,” like one published in November in The Mayo Clinic Proceedings and a recent Journal of the American Medical Association (JAMA) commentary, raises questions about the long-term health effects for children and young people who may over-consume drinks like Red Bull, Full Throttle, Rockstar and Monster.
“Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated,” concluded the peer-reviewed study, which was carried out by researchers from the University of Miami and funded by the U.S. National Institutes of Health.
The authors caution pediatricians to be aware of the safety issues surrounding energy drinks, particularly for children and teenagers with heart problems, diabetes and attention-deficit hyperactivity disorder (ADHD), and recommend discussing the risks of routine consumption with patients and their parents.
The potential problems, from too much caffeine or other ingredients that act as stimulants, include heart palpitations, seizures, strokes and even sudden death, the authors write.
Because the drinks are sold in the U.S. as “dietary supplements,” their manufacturers don’t have to follow federal regulations for sodas and juices. An average energy drink contains 70 to 80 milligrams of caffeine per eight-ounce serving, which is about three times the concentration of cola drinks, along with vitamins, herbal supplements, sugar or sweeteners.
Some of the ingredients found in energy drinks include taurine, glucuronolactone, B, vitamins, ginseng, ginkgo biloba, milk thistle and stimulants such as kola nut, cocoa and guarana.
The UK’s Committee on Toxicity has analyzed Red Bull and determined it to be safe for the general public, but said children younger than 16 years old or people sensitive to caffeine should avoid drinks with high caffeine content. The European Food Safety Authority has also examined energy drinks, and said key ingredients, like taurine and glucuronolactone, are generally recognized as safe.
In Canada, energy drinks are marketed as natural health products. They’ve been banned in France, Denmark, Turkey and Uruguay, although some of those bans have been lifted, and Norway prohibits sales to children under 15. Germany, Ireland and New Zealand have tracked energy-drink related incidents and have found evidence of adverse effects, including liver damage, kidney failure, respiratory disorders, hypertension, heart problems and a handful of fatalities, according to the study.
After adding a code specific to energy drink overdoses and related problems, U.S. Poison Control Centers began tracking such incidents last year, receiving 677 case reports from October through December, 2010, and another 331 so far this year. A quarter of the energy drink overdoses in 2011 have involved children younger than 6.
Firing back against the Pediatrics paper was the American Beverage Association, the trade group that represents the estimated $9 billion energy drink industry, the fastest growing sector of the U.S. beverage market.
In a news release, the beverage association said this newest study does nothing more than spread misinformation about energy drinks, and that an average drink contains similar amounts of caffeine to a cup of coffee. Although the group said the drinks aren’t recommended for children, it also said the caffeine consumed from energy drinks for those under 18 is less than what they get from soft drinks, coffee and teas.
Energy drinks are marketed to young people, through advertising campaigns and sponsorship of events like extreme-sport competitions aimed at 16- to 29-year-olds. Some manufacturers host college campus promotions that endorse mixing alcohol with the beverages.