Energy drinks again linked to health risks for children and adolescents

British researchers conducted a systematic review of scientific papers and once again concluded that the use of energy drinks in childhood and adolescence is associated with a variety of behavioral disorders and health problems. A publication about this appeared in the journal Public Health.

Energy drinks contain large amounts of caffeine (150 milligrams per liter or more) and sugar, as well as various additives: taurine, ginseng, guarana and others. One serving of such a drink can contain from 50 to 505 milligrams of caffeine, compared to 90 in 250 milliliters of coffee, 50 in the same volume of tea and 34 in half a liter of cola. Systematic consumption of such high doses can lead to intoxication and, in severe cases, addiction, which is why some countries have banned the sale of energy drinks to children and adolescents.

In 2016, Amelia Lake, then at Durham University, and colleagues conducted a systematic review of 46 studies involving European and North American adolescents aged 11-18 years. They found a strong positive association between energy drink consumption and the risk of risky health behaviors, as well as headaches, abdominal pain, hyperactivity and insomnia.

Now Lake, who has moved to Teeside University, has released a review with colleagues that complements and expands on previous work. It included 57 studies that appeared in the ASSIA, CINAHL, Cochrane Library, DARE, Embase, ERIC, MEDLINE, PsycINFO and Web of Science databases between January 2016 and July 2022. 16 were conducted in North America, 24 in Europe and Central Asia, seven in East Asia and the Pacific, eight in the Middle East and North Africa; two covered multiple countries from different regions. The total number of participants was nearly 1.3 million people under the age of 21.

The findings of the previous review were generally confirmed and were also supplemented by new data. In particular, regular consumption of energy drinks was positively correlated with the intake of alcohol (including in excessive amounts) and other psychoactive substances, smoking and vaping, as well as the intention to start these activities. Mixing these drinks with alcohol was also associated with poor academic performance, discipline violations, dangerous driving, and appearing drunk in public.

In addition, energy drink use was associated with behavioral traits such as seeking new (unsafe) sensations, disruptions to established norms (e.g., truancy), irregular and unhealthy eating, unprotected sex, and less healthy lifestyles in general. Addiction to these drinks was also correlated with a range of physical symptoms, including excess body weight, increased blood pressure, palpitations, frequent urination, allergies, sleep disturbances, and a variety of mental health problems such as anxiety, suicidal tendencies, and others. There were heterogeneous findings regarding physical activity and attitudes towards sports.

Boys and older adolescents were the most likely to consume energy drinks, as in the previous survey. Motivation for consumption was most often motivated by the desire to cheer up, peer example, curiosity, affordability, branding and marketing.

The authors of the paper note that because three-quarters of the studies included in the review were cross-sectional, it is difficult to judge the causal nature of the correlations found. However, given the evidence of dose-dependence of some of the effects, they supported measures to limit children's and adolescents' access to energy drinks.