Energy drinks are a staple among college students and club kids, and they’re even becoming ubiquitous in many American households. But a new report, published Monday by the journal Pediatrics, suggests that energy drinks may be dangerous to children’s health.
According to the report — a review of studies on drinks marketed to boost energy, endurance and performance — the health hazards may be especially worrisome for children with conditions such as ADHD, diabetes or heart conditions.
Dr. Steven Lipshultz, chairman of the department of pediatrics at the University of Miami, and his colleagues collected all the existing studies on the health effects of energy drinks and found that not only do 30% to 50% of children use them, but that the drinks may do harm while not improving performance or energy levels substantially.
Sales of products such as Red Bull, Full Throttle, Monster Energy and Rockstar are expected to reach about $9 billion in the U.S. this year, with children and young adults under 25 providing most of the revenue. Energy drinks, Lipshultz points out, are different from sports drinks, which are designed to replace electrolytes and nutrients that a body pushed to physical extremes may need.
What worries pediatricians like Lipshultz is the fact that energy drinks, which are classified as dietary supplements, are not regulated by the Food and Drug Administration (FDA). That means they don’t have to follow the same strict limits that the FDA places on potentially harmful ingredients such as caffeine (a primary component of energy drinks) that soda makers must follow. Lipshultz became personally interested in the issue when children began coming to the hospital after getting sick from energy drinks.
“As I started looking into it, I was very surprised by what I found,” he says.
For one, many pediatricians and families are not aware of the differences between energy and sports drinks, and confuse the nutritional claims made for sports drinks with the primarily stimulant-based effects of energy beverages.
Also, before 2010, U.S. poison control centers were not tracking adverse events related to energy drinks specifically; they monitored only problems arising from caffeine overdoses. When consumed in high enough amounts over a long enough period of time, caffeine can cause changes in blood flow and reduce insulin sensitivity, which affects the body’s ability to regulate sugars from food.
Lipshultz was also surprised to find that energy drinks receive less scrutiny than sodas and over-the-counter medications, which allows energy drink manufacturers to include potentially concerning levels of ingredients in their products. Based on the labels on their cans, for example, some energy drinks contain as much as twice the caffeine as the stimulant NoDoz; most contain three times the caffeine found in caffeinated sodas.
In Germany, where health officials have been tracking health effects of energy drinks since 2002, adverse events have included liver damage, seizures, racing heart rate, respiratory disorders and even death.
Energy drinks typically contain other compounds that are also high in caffeine, such as guarana, yerba mate and cocoa. In general, says Lipshultz, caffeine can disturb children’s sleep, which can actually compound energy problems since sleep deprivation can make children even more listless and tired.
While these health consequences of too much caffeine aren’t new, Lipshultz is hoping to alert pediatricians and parents to the growing popularity of the drinks, and the negative consequences of mixing them with, for example, medications to treat ADHD. Those treatments primarily act as stimulants, and adding additional stimulants in the form of energy drinks to those drugs “may not produce the desired effect in improving concentration,” he says.
Children with diabetes should also be careful about drinking too many energy shots, since some of the beverages contain sugars and other ingredients that could cause imbalances in their sugar and insulin levels.
Other countries are already tracking the health effects of these beverages, presumably as a way to figure out how much is too much. And the U.S. is following suit as well — since 2010, poison control centers now document reported adverse events related specifically to energy drinks. “Hopefully,” says Lipshultz, “as we gather more data, we will be able to make more appropriate recommendations about energy drinks in the future.”