“Red Bull’s effects are appreciated throughout the world by top athletes, busy professionals, active students and drivers on long journeys.” From www.redbull.ca
Energy drinks first appeared on the market in 1987 (Red Bull); now there are more than 500 different varieties available worldwide. There has been an astronomical increase in sales (and one assumes consumption) of these products. One study reports a 17% increase in sales from 2005 to 2006 worldwide. This is a hugely profitable area with over 600 million dollars in sales in the US alone in 2006 (1). We have no doubt that many adults choose to consume energy drinks on a regular basis for a variety of reasons. Although we do not endorse these products as a healthy choice, we can appreciate that adults have the wherewithal to make informed decisions about their use.
What we find alarming is the use of energy drinks in children and young adolescents. A report from the Washington Post cites 31% of teenagers use energy drinks. Unpublished data from a study we are currently conducting finds that 14% of athletes between the ages of 11 and 25 years admit to using energy drinks. Use is definitely highest in the older age groups, but even younger athletes are consuming these drinks. At present there isn’t a lot of published data to indicate what percentage of children and adolescents are consuming energy drinks but you only have to spend a couple of minutes at the local 7/11 to know it’s a problem!
Before we can decide if energy drinks are appropriate for children and youth, let’s take a look at the formulation of an energy drink and the logic (or lack thereof) behind the ingredient list. Each brand has a slightly different formulation but there are common themes throughout.
In general, they will contain taurine, some form of caffeine, B-vitamins, water, and sugar (or other sweeteners). After this it’s a hodge-podge of herbal extracts, colours and flavours (artificial or natural).
Rockstar Energy Drinks: http://www.rockstar69.com/productIngredients.php?pdt=1
Taurine – An amino acid (proteins are made up of amino acids). It gets its name from the Latin word taurus (bull or ox) because it was first extracted from ox bile. Yum!! The logic for adding taurine to energy drinks, according to the manufactures, is that in times of high stress (mental or physical) your body excretes more taurine and can’t make enough to replace it.
The reality is that most North Americans already consume excessive amounts of protein, even for an athlete’s needs, and should have plenty of taurine from food sources like meat and seafood. Really the only people who should be at all concerned are strict vegans. With respect to performance, a review by Clauson et al. found that the amount of taurine in energy drinks is not enough to elicit positive or negative health effects, as levels are far below those predicted to have therapeutic effects (2).
Caffeine – An effective stimulant and has actually been shown to improve exercise performance in endurance athletes (3). Don’t get too excited though: there are still concerns with caffeine intake and physical performance. It can increase anxiety, act as a diuretic in people who aren’t habitual consumers, cause gastrointestinal problems, lead to insomnia and dangerously increase heart rate.
With respect to energy drinks, the amount of caffeine varies but generally ranges from 80-114 mg per 250mL, with the low end being similar to that of a cup of coffee (4). Studies looking at the benefits of caffeine on physical performance have used up to 4 times this dose (5); an amount that approaches Health Canada’s 400 mg/d upper limit not to be exceeded by adults (6). Make sure you also watch out for other sources of caffeine such as: yerba mate, guarana, cocoa, coffee, and tea. Remember it all adds up!
B-vitamins – Many of the B group vitamins are involved in the chemical reactions required to metabolize carbohydrates, proteins and fats. The theory is that they will facilitate fat-burning; providing you with more energy. Sounds great! Unfortunately, unless you are deficient you’ll just pee out the excess amounts of these water soluble vitamins.
Water – Not much needs to be said here. Caffeine is often thought of as a diuretic, however, research suggests that as you become habituated to caffeine, it loses its diuretic effect. The water in energy drinks does likely contribute to fluid intakes BUT there are much healthier sources, like plain water or a sports drink.
Sugar – Yes, it provides energy. Yes, it’s needed during long-duration, intense exercise. No, it’s not necessary to get through recess!!
So…back to the original question: are energy drinks appropriate for children and adolescents? Let’s start with the caffeine. For children under the age of 12 the upper limit for caffeine is 2.5 mg/kg body weight and this should also apply to adolescents (6). If you figure an average 11 year old weighs 80 lbs that works out to 89 mg/caffeine per day MAXIMUM (35.6 kg x 2.5 mg/kg = 89 mg)!!! Many energy drinks provide more than this per serving. Data from a single US poison center found 35 cases (average age 20 years) of caffeine intoxication after ingestion of a caffeine enhanced beverage between 2002 and 2004 (7). To reiterate, this is only reported cases from one site. The true percentage of individuals who experience symptoms is likely much greater. Keep in mind that although caffeine consumption is common, it is still a drug and dependence and addiction can occur – AND children and adolescents are more vulnerable than adults (8).
Another concern is the sugar content. Several studies show that sugar-sweetened beverages are contributing to the childhood obesity epidemic (9). The ~ 110 calories in a small 8 oz energy drink are, for all intents and purposes, empty calories and not beneficial to children. It seems like a small amount of calories but they add up, especially if you are drinking 2 or 3 a day, every day! There are sugar-free brands but again artificial sweeteners are also associated with obesity.
Another very real concern is combining energy drinks with alcohol. A study looking at 697 college students found that 24% admitted to consuming energy drinks in combination with alcohol in the last month (10). I think it would be naive to assume that adolescents are not following suit and it certainly sets them up for these activities later in life.
Can we blame the manufactures for the consumption of energy drinks in children and youth? Well, that’s complicated. If you read the label above, in no small letters, it states “Not recommended for children, pregnant or nursing women, or those sensitive to caffeine” HOWEVER, their advertising is a different story. A report on advertising by Yale Rudd Center for Food Policy & Obesity reports that “in 2010 teens saw 18% more tv ads and 46% more radio ads for energy drinks than adults did.” You can also check out Marion Nestle’s post on advertising of energy drinks to children.
No Baloney’s Advice…Overall, there isn’t an apparent need for children and adolescents to consume energy drinks. The effects on physical performance are still questionable and certainly the consequences of caffeine overdose far outweigh the benefits (of which we can report none) from a health perspective. If improved mental alertness is the goal, take away the cell phone to stop the 2 am texting and let your children have a good night’s sleep! Wake them up in time to have a healthy breakfast and send them to school with a healthy lunch, not money for a doughnut and energy drink (true story…..sigh).
Don’t take our word for all of this though, Health Canada and the America Academy of Pediatrics also say no to energy drinks in children. Check out these great resources:
- Health Canada: Information for Parents on Caffeine in Energy Drinks
- Pediatrics: Clinical Report – Sports drinks and energy drinks for children and adolescents: are they appropriate?
- Mayo Clinic Proceedings: Energy beverages: content and safety
(1) Reissig CJ, Strain EC, Griffiths RR. Caffeinated energy drinks–a growing problem. Drug Alcohol Depend 2009; 99:1-10.
(2) Clauson KA, Shields KM, McQueen CE, Persad N. Safety issues associated with commercially available energy drinks. J Am Pharm Assoc 2008; 48:e55-63.
(3) Doherty M, Smith PM. Effects of caffeine ingestion on exercise testing: a meta-analysis. Int J Sport Nutr Exerc Metab 2004; 14:626-646.
(4) Bigard, AX. Danger des boissons energisantes chez le jeunes. Archives di pediatrie 2010; 17: 1625-1631.
(5) Wiles JD, Coleman D, Tegerdine, M et al. The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial. J Sports Sci 2006; 24:165-71.
(6) Health Canada. Information for parents on caffeine in energy drinks; 2011. Available here.
(7) McCarthy DM, Mycyk MB, DesLauriers CA. Hospitalization for caffeine abuse is associated with abuse of other pharmaceutical products. Am J Emerg Med 2008; 26:799-802.
(8) Walsh M, Marquardt K, Albertson T. Adverse effects from ingestion of Redline energy drinks. Clin Toxical 2006; 44:624.
(9) Lasater G, Piernas C, Popkin BM. Beverage patterns and trends among school-aged children in the US, 1989-2008. Nutr J 2011; 10:103.
(10) O’Brien MC et al. Caffeinated cocktails: energy drink consumption, high-risk drinking, and alcohol-related consequences among college students. Acad Emerg Med 2008; 15:453-460.