Energy drinks pose public health risk

Researchers from the World Health Organisation Regional Office for Europe have warned that increased consumption of energy drinks may pose danger to public health, especially among young people.

In a paper published in the journal Frontiers in Public Health, João Breda, from the WHO Regional Office for Europe, and colleagues reviewed the literature on the health risks, consequences and policies related to energy drink consumption.

Energy drinks are non-alcoholic beverages that contain caffeine, vitamins and other ingredients, for example, taurine, ginseng and guarana. They are typically marketed as boosting energy and increasing physical and mental performance.

Energy drinks first hit European markets in 1987 and the industry has since boomed worldwide. The European Food Safety Authority (EFSA) estimates that 30% of adults, 68% of adolescents and 18% of children below 10 years consume energy drinks.

“From a review of the literature, it would appear that concerns in the scientific community and among the public regarding the potential adverse health effects of the increased consumption of energy drinks are broadly valid,” write the authors.

Part of the risks of energy drinks are due to their high levels of caffeine. An EFSA study found that the estimated contribution of energy drinks to total caffeine exposure was 43% in children, 13% in teenagers and 8% in adults.

Studies included in the review suggest that caffeine intoxication can lead to heart palpitations, hypertension, nausea and vomiting, convulsions, psychosis and, in rare cases, death. In the USA, Sweden and Australia, several cases have been reported where people have died of heart failure or were hospitalised with seizures from excess consumption of energy drinks.

Research has shown that adolescents who often take energy drinks are also more likely to engage in risky behaviours such as sensation seeking, substance abuse and binge drinking.

Another EFSA study found that over 70% of young adults who drink energy drinks mix them with alcohol. Numerous studies have shown that this practice is more risky than drinking alcohol only, possibly because these drinks make it harder for people to notice when they are becoming intoxicated.

“As energy drink sales are rarely regulated by age, unlike alcohol and tobacco, and there is a proven potential negative effect on children, there is the potential for a significant public health problem in the future,” the authors conclude.

They make the following suggestions to minimise the potential for harm from energy drinks:

• Establishing an upper limit for the amount of caffeine allowed in a single serving of any drink in line with available scientific evidence.
• Regulations to enforce restriction of labelling and sales of energy drinks to children and adolescents.
• Enforcing standards for responsible marketing to young people by the energy drink industry.
• Training healthcare practitioners to be aware of the risks and symptoms of energy drinks consumption.
• Patients with a history of diet problems and substance abuse, both alone and combined with alcohol, should be screened for the heavy consumption of energy drinks.
• Educating the public about the risks of mixing alcohol with energy drinks consumption.
• Further research on the potential adverse effects of energy drinks, particularly on young people.