Energy Drinks Pose Serious Health Risks for Young People

For those who consume Energy drinks, who’s kids do or might do it in future.I am very glad that we started looking at it seriously.     MY

News Author: Emma Hitt, PhD

February 16, 2011 — A lack of research and regulation associated with energy drinks, combined with reports of toxicity and high consumption, may result in potentially dangerous health consequences in children, adolescents, and young adults, according to a review of scientific literature and Internet sources.

Sara M. Seifert, BS, and colleagues from the Department of Pediatrics and the Pediatric Integrative Medicine Program at the University of Miami, Leonard M. Miller School of Medicine in Florida, reported their findings in a report published online February 14 and in the March print issue of Pediatrics.

According to the review, self-report surveys indicate that energy drinks are regularly consumed by 30% to 50% of children, adolescents, and young adults. The current trial questions the use of energy drinks in these young populations, as they provide no therapeutic benefit and are associated with risks for serious adverse health effects.

The authors note that because energy drinks are categorized as nutritional supplements, they avoid the limit of 71 mg caffeine per 12 fluid ounces that the US Food and Drug Administration has set for soda, as well as the safety testing and labeling that is required of pharmaceuticals. As a consequence, energy drinks can contain as much as 75 to 400 mg caffeine per container, with additional caffeine not included in the listed total often coming from additives such as guarana, kola nut, yerba mate, and cocoa.

“Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years,” the authors note.

The recommended maximum caffeine intake of 2.5 mg/kg per day for children and 100 mg/day for adolescents, although safe levels of consumption of other energy drink ingredients have not been established.

Although US poison centers have only recently begun tracking toxicity of energy drinks, Germany, Australia, and New Zealand have reported numerous adverse outcomes associated with energy drink consumption. These include liver damage, kidney failure, respiratory disorders, agitation, confusion, seizures, psychotic conditions, nausea, vomiting, abdominal pain, rhabdomyolysis, tachycardia, cardiac dysrhythmias, hypertension, myocardial infarction, heart failure, and death.

The researchers also note that the caffeine in energy drinks may interfere with bone mineralization during a critical period of skeletal development.

“The marketing of energy beverages is targeting towards males in the preadolescent, adolescent, and young adult ages,” Dr. Higgins told Medscape Medical News. “The fact that a child can walk into a grocery store or supermarket and buy these and consume [them] is frightening.”

Clinical Context

Caffeine has wide and far-reaching effects on human physiology. It causes coronary and cerebral vessel vasoconstriction, reduces insulin sensitivity, and stimulates skeletal muscle. It is also a ventilatory stimulant with bronchoprotective effects. Regular consumption of low to moderate amounts of caffeine among adults can improve exercise tolerance and cognition as well as reduce the risks for Parkinson’s disease and age-related cognitive decline.

However, caffeine can also have many unhealthy effects, particularly at high doses. Children are at greater risk for harm related to caffeine, yet the popularity of energy drinks that combine caffeine with other activating substances is soaring. The current review examines the use of energy drinks and the health consequences of this trend among children and adolescents.

Study Highlights

  • Energy drinks are consumed by 30% to 50% of adolescents and young adults. A study of college students found that more than half of them mixed energy drinks with alcohol, a practice that might promote risky behaviors such as drinking and driving.
  • Energy drinks contain 70 to 80 mg of caffeine per 8-ounce serving, which is approximately 3 times the amount of caffeine as cola drinks. The caffeine content of “energy shots” may be up to 5 times that encountered in 8 ounces of cola drinks.
  • Energy drinks combine caffeine with substances such as guarana, which itself contains 40 to 80 mg of caffeine per gram. Moreover, guarana may have a longer half-life than caffeine.
  • Caffeine consumption should not exceed 100 mg/day or 2.5 mg/kg/day among children and adolescents. In a study, consumption of 1 retail unit of energy drinks was associated with caffeine exposure that was considered excessive among 70% of children and 40% of teenagers.
  • Consumption of 4 to 12 mg/kg of caffeine can promote anxiety and jitteriness. Headache and fatigue are common withdrawal symptoms after short-term, high-dose use of caffeine.
  • Some countries have tracked cases of caffeine intoxication, but most reports are sporadic, and the prevalence of caffeine overdose is poorly understood. Caffeine intoxication is characterized by tremor, tachycardia, and insomnia. Other symptoms may include vomiting, abdominal pain, hypokalemia, hallucinations, seizures, arrhythmias, and death.
  • Children and adolescents who may be at particularly high risk for complications related to the use of caffeine include those receiving stimulants for attention-deficit/hyperactivity disorder, children with known heart defects and arrhythmias, and those with eating disorders. Energy drinks can also add to total caloric intake and may reduce peak bone mineral density.
  • The authors of the current recommendations conclude that energy drinks have no therapeutic benefit but may promote serious adverse events. They call for greater regulation of these drinks, which have thus far escaped existing regulations for soft drinks because producers have labeled them as “natural dietary supplements.”

Toxicity surveillance of energy drinks should be improved. Clinicians should screen for the use of energy drinks, particularly among athletes, and advise their young patients and parents regarding the potential negative health consequences associated with energy drinks.

Clinical Implications

  • Caffeine causes coronary and cerebral vessel vasoconstriction, reduces insulin sensitivity, and stimulates skeletal muscle. It is also a ventilatory stimulant with bronchoprotective effects.
  • Caffeine consumption should not exceed 100 mg/day or 2.5 mg/kg/day among children and adolescents, meaning that consumption of 2 energy drinks per day is inappropriate.
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