Cardiology News
Energy Drinks Pose Worrisome Risks to
Adolescents’ Cardiovascular Health
Tracy Hampton, PhD
A
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lthough studies by numerous
investigators and reports from
major medical societies have
raised health-related concerns about
the consumption of energy drinks by
youth, manufacturers of the products
continue to market them to children
younger than the age of 18 years.
Many parents, teens, and healthcare
professionals are often left wondering
how serious the risks of such a readily
available beverage might be, and what
additional studies are needed.
“The research on energy drinks is
in its very early stages, so there is a
lot we don’t know about their effects,”
said Jennifer Harris, PhD, MBA, Director of Marketing Initiatives at the University of Connecticut Rudd Center for
Food Policy and Obesity. “But what we
do know is disturbing, especially when
they are consumed by youth.”
Energy drinks contain high
amounts of caffeine, sugar, and
other stimulants, and ingredients
such as taurine, guarana, ginseng,
l-carnitine, inositol, B vitamins, and
glucuronolactone. In contrast, energy
shots do not contain sugar, but caffeine and other stimulants are highly
concentrated. Research funded by
energy drink manufacturers indicate
that these products are safe when
consumed as intended by teenagers
and adults; however, independent research studies have linked them with
severe short-term events including
emergency department visits, poison
control calls, and even death. “These
consequences typically occur when
the drinks are consumed with alcohol,
as well as when they are consumed
1052 October 4, 2016
by young people who have not developed caffeine tolerance, especially
when they consume more than one in
a short-term time period and/or when
they have an underlying undiagnosed
heart condition,” said Harris.
High consumption, meaning ≥2
cans, of energy drinks has been associated with elevated blood pressure and increased frequency of
palpitations and arrhythmias (rising
with coingestion of alcohol or other
illicit drugs), even in healthy individuals without cardiovascular risk factors. “Moreover, previous investigations have demonstrated that energy
drink consumption enhances platelet
aggregation, alters electrolytes, triggers endothelial dysfunction, and
promotes atherosclerosis,” said Fabian Sanchis-Gomar, MD, PhD, an
investigator at the Research Institute
Hospital 12 de Octubre (‘i+12’) in Madrid. “In addition, it induces a positive
inotropic effect on cardiac function,
meaning that it increases heart rate,
stroke volume, cardiac output, and
contractility, and it also increases
blood glucose concentration and reduces cerebral blood flow velocity.”
Research also suggests the potential for dependence and withdrawal following regular consumption of energy
drinks, in addition to anxiety, aggressiveness, and sleep disturbances.
Physicians who care for adolescents
should make a point to inquire about
energy drink consumption, especially
when these symptoms are present.
The long-term effects of consumption are less clear; however, the effects of these drinks on the heart and
their association with conduct disorders, violent behaviors, and consumption of illegal substances points
to the potential for lasting dangers
that warrant further study. Long-term
systematic assessments of energy
drinks and general caffeine intake by
youth should therefore be a priority.
Sanchis-Gomar and his colleagues
would also like to see more research
on the various components found in
energy drinks. “We highlight the importance of knowing the synergy of
the different stimulant substances.
Our viewpoint is that the combination
of compounds contained in these
beverages may produce a much
greater cardiovascular risk, by generating uncertain interactions, than
any component alone,” he said.
Companies advertise that energy
drinks increase energy and enhance
mental alertness, focus, hydration,
physical performance, and health.
Many people consume energy drinks
for improved performance in academics or sports, but there is little
research to support such beneficial
Circulation. 2016;134:1052–1053. DOI: 10.1161/CIRCULATIONAHA.116.025039
Cardiology News
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effects. “In fact, consumption of energy drinks in association with sports
activities increases their risks, and
the NCAA [National Collegiate Athletic
Association] discourages their use by
athletes,” said Harris. The NCCA bans
high levels of caffeine because it considers the effects performance enhancing; however, the organization’s
ban is also linked to a concern about
the uncertainty of energy drinks.
The American Academy of Pediatrics has also stated that energy
drinks should never be consumed
by youth <18 years of age because
of potential adverse consequences
on children’s developing neurological and cardiovascular systems.
The American Medical Association
also supports a ban of the marketing of high-stimulant/caffeine drinks
to children because of the potential
for heart problems and other effects.
“Since the energy drink companies
refuse to take responsible actions,
policy actions are required,” said Harris. “These could include mandated
warning labels, restrictions on sales
of energy drinks to minors and/or restrictions on where they can be placed
in stores, restrictions on the inclusion
and/or concentration of caffeine and
other stimulants in the products, and
legal action against misleading and/
or deceptive marketing practices.”
Some countries, such as Denmark,
Norway, and Iceland, have bans on
the sale of energy drinks to minors,
whereas others have enacted or are
considering measures to regulate the
labeling, distribution, and sale of the
beverages. Such measures can be
difficult to enforce, however; when
France banned the energy drink Red
Bull in 2008, the manufacturers challenged the ban through the European
Commission, which ordered the ban
to be lifted because the caffeine and
taurine concentrations in beverages
had not been proven to be health
risks. The European Food Safety Authority has encouraged international
data pooling to obtain a better assessment of the risks to children,
adolescents, and young adults.
Harris and Sanchis-Gomar also encourage much more education about
the dangers of these products, especially aimed at physicians, parents,
educators, and coaches. “Middle
school-age children are prime targets
for energy drink advertising and their
use among these children is growing rapidly,” said Harris. “There is no
reason that children should consume
these products, and many reasons
why they should not.” n
© 2016 American Heart Association, Inc.
THE PULSE
Circulation. 2016;134:1052–1053. DOI: 10.1161/CIRCULATIONAHA.116.025039
October 4, 2016
1053
Energy Drinks Pose Worrisome Risks to Adolescents' Cardiovascular Health
Tracy Hampton
Circulation. 2016;134:1052-1053
doi: 10.1161/CIRCULATIONAHA.116.025039
Downloaded from http://circ.ahajournals.org/ by guest on June 16, 2017
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