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Sales of energy drinks surge, along with controversy over health effects
Caffeine » More adolescents are chugging them, but doctor says water is the way to go.
First Published Aug 05 2013 07:28 am • Last Updated Feb 14 2014 11:31 pm

While many Americans still reach for a cup of coffee for a boost, more consumers — particularly the younger set — have developed a taste for energy drinks.

Justin Alvey, a pediatrician and associate professor at the University of Utah School of Medicine, estimates 20 to 30 percent of the adolescents in his practice admit to consuming energy drinks regularly. Some say they drink the beverages to augment their athletic performance, but most say they chug just to get through the day. Either way, it’s a concern.

At a glance

Comparing caffeine content

Here‘s how some top-selling energy drinks stack up with other caffeinated favorites. Unless otherwise noted, numbers are for 16 ounces. According to the Mayo Clinic, adults who consume more than 500 milligrams a day can experience negative side effects.

Red Bull Energy Drink » 154 milligrams

Rockstar Energy Drink » 160 milligrams

Monster Energy » 160 milligrams

Amp Energy » 142 milligrams

5-Hour Energy Extra Strength (1.9 ounces) » 215 milligrams

Starbucks Caffe Latte » 150 milligrams

Folgers Classic Roast Instant Coffee (12 ounces) » 148 milligrams

McDonald’s Coffee » 133 milligrams

NoDoz (1 caplet) » 200 milligrams

Sources » Consumer Reports, Center for Science in the Public Interest, nodoz.com

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"A safe amount has not been established, but we would recommend not ever using energy drinks," Alvey said. "For everything kids are doing, water is the way to go."

He said the biggest worry with energy drinks is they have been linked to heart problems in those with a predisposition, although such cases are rare. More common, he said, are weight gain, dental issues caused by the caffeine and sugar in the drinks, stomach aches, anxiety, shakiness and sleep problems.

"There’s a lot of this stuff that’s marketed to kids, but really there is no substitute for good old-fashioned healthy food and lots of water," Alvey said. "Energy drinks really have no place for kids."

What’s in an energy drink? » Read the labels on popular energy drinks and the ingredients vary: There’s likely taurine (an amino acid) or ginseng, B-vitamins or sucrose and glucose (sugars). But the common denominator is a sizable dose of caffeine.

A stimulant, the effects of caffeine on the body vary from person to person, but consuming too much can cause harm. According to the Mayo Clinic, adults who consume 500 to 600 milligrams a day could experience rapid heartbeat, muscle tremors and insomnia. And caffeine can have side effects with other medications such as antibiotics, said Barbara Crouch, clinical professor and director of the Utah Poison Control Center.

She said the center’s hot line has received some calls from parents worried about the caffeine-overdose of a child and adults experiencing increased heart rate after drinking an energy drink.

Her primary concern is that the total amount of caffeine and other stimulants in energy drinks remains unknown. She adds that while adults can handle 400 milligrams a day, most adolescents and children can’t.

"The real issue is knowing how much caffeine is in there," she said. "Parents need to understand that and make decisions about what’s appropriate for their kid."

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Some have called for oversight of energy drinks by the Food and Drug Administration, but Crouch said she would "stop short" of regulation because that could lead to increased standards for a host of other beverages such as coffee and colas. Still, more information about caffeine content in energy drinks is needed.

"You see kids drinking [energy drinks], you see parents buying them for young children," Crouch said. "That may not be the intended market, but the reality is, they are being used by adolescents."

Targeting children? » Health concerns surrounding energy drinks spurred a call from the American Medical Association last month to ban marketing energy drinks to consumers younger than 18. That rattled the industry.

This week, members of three leading energy drink companies defended their products before a congressional committee, saying the products have the same amount of caffeine as a cup of coffee. And they vigorously denied marketing to youth.

"To be clear, [Red Bull] has never targeted our marketing to children and we will not do so in the future," Amy Taylor, vice president and general manager of Red Bull North America (RBNA), told the U.S. Senate Committee on Commerce, Science and Transportation on Wednesday. "RBNA believes that the underlying science and historical product use support the conclusion that Red Bull products may be safely consumed by teenagers in the same way as coffee, tea, or caffeinated soft drinks. However, because teenagers younger than 18 do not represent our target demographic, we do not focus our marketing activities on them."

Those assertions are "laughable," said Cara Wilking, senior staff attorney at The Public Health Advocacy Institute at Northeastern University’s School of Law, which released the report "Energy Drink Self-Regulation" this week. "If you look at the self-regulatory guidelines set forth by the American Beverage Association [about energy drinks] and then you look at the way these products are marketed, there are major gaps."

In 2011, the American Beverage Association (ABA) set some voluntary guidelines, which the association asserts major energy drink manufacturers have pledged to follow. These include not marketing energy drinks to children younger than18 or selling or sampling the products in schools. In addition to the marketing pledge, ABA materials also note that "these companies voluntarily display an advisory statement on energy drink packaging, stating that the product is not intended (or recommended) for children, pregnant or nursing women and persons sensitive to caffeine."

During his congressional testimony, Monster Beverage Co. president and chief executive Roland Sacks said Monster follows ABA labeling guidelines and noted its primary consumer demographic remains young adult males.

"The company does not focus its brand initiatives on young teenagers," he testified. "To do so would undermine the credibility of the brand image in the eyes of young adults."

But Wilking argues that point, noting the intense presence of energy drink companies on social media as well as a marketing strategy built around young athletes and extreme sports is naturally attractive to youth.

"When children and adolescents see their sports heroes plastered in energy-drink marketing, the logical conclusion is, in order to excel at these sports, you should consume these products," she said.

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