The study comes only months after a U.S. crackdown on alcoholic caffeinated beverages such as Phusion Projects' Four Loko (click here for previous CSP Daily News coverage).
A beverage industry association spokesperson, meanwhile, said that the report "does nothing more than perpetuate misinformation" about energy drinks. And an energy drink maker said that the study ignores other scientific research.
The potential harms, caused mostly by too much caffeine or similar ingredients, include heart palpitations, seizures, strokes and even sudden death, the authors said. Children with diabetes, seizures, cardiac abnormalities or mood and behavior disorders, may be especially at risk.
The authors reviewed data from the government and interest groups, scientific literature, case reports and articles in popular and trade media. They want pediatricians to routinely ask patients and their parents about energy drink use and to advise against drinking them.
"We would discourage the routine use" by children and teens, said Dr. Steven Lipshultz, pediatrics chairman at the University of Miami's medical school and senior author of the study.
The report said energy drinks often contain ingredients that can enhance the jittery effects of caffeine or that can have other side effects including nausea and diarrhea. It said that they should be regulated as stringently as tobacco, alcohol and prescription medicines.
In a review of the current literature, the authors determined that energy drinks have no therapeutic benefit to children, and both the known and unknown properties of the ingredients, combined with reports of toxicity, may put some children at risk for adverse health events.
Youth account for half of the energy drink market, and according to surveys, 30% to 50% of adolescents report consuming energy drinks. Typically, energy drinks contain high levels of stimulants such as caffeine, taurine and guarana, and safe consumption levels have not been established for most adolescents.
The authors advised that because energy drinks are frequently marketed to athletes and at-risk young adults, it is important for pediatric health care providers to screen for heavy use both alone and with alcohol, and to educate families and children at risk for energy drink overdose, which can result in seizures, stroke and even sudden death.
"Until further research establishes their safety, routine energy drinks usage by children and teen-agers should be discouraged," said Lipshultz. "We wanted to raise awareness about the risks. Our systematic review suggests that these drinks have no benefit and should not be a part of the diet of children and teens. We need long-term research to define maximum safe doses of these beverages and the effects of chronic use, especially in at-risk populations."
"For most children, adolescents, and young adults, safe levels of consumption have not been established," the report said.
The study focuses on nonalcoholic drinks, but emphasizes that drinking them along with alcohol is dangerous.
The American Association of Poison Control Centers adopted codes late last year to start tracking energy drink overdoses and side effects nationwide, said AP; 677 cases occurred from October through December; so far, 331 have been reported this year. Most 2011 cases involved children and teens. Of the more than 300 energy drink poisonings this year, a quarter of them involved kids younger than 6, according to a data chart from the poison control group. That is a tiny fraction of the more than 2 million poisonings from other substances reported to the group each year, AP added. The study does not quantify drink-related complications or deaths. It cites other reports on a few deaths in Europe of teens or young adults who mixed the drinks with alcohol, or who had conditions like epilepsy that may have increased the risks.
Maureen Storey, senior vice-president of science policy at the American Beverage Association, told AP that the report "does nothing more than perpetuate misinformation" about energy drinks.
Many of the drinks contain much less caffeine than coffee from popular coffeehouses, and caffeine amounts are listed on many of the products, she said. Caffeine is safe, but those who are sensitive to it can check the labels, she said.
A clinical report on energy drinks is expected soon from the American Academy of Pediatrics that may include guidelines for doctors, said AP.
U.S. sales of nonalcoholic energy drinks are expected to hit $9 billion this year, with children and young adults accounting for half the market, said a report by Reuters Health.
Because the beverages are classified as nutritional supplements, they have received much less scrutiny and are under fewer restrictions than both foods and drugs. Manufacturers claim their products will enhance both mental and physical performance. Red Bull's website, for instance, says energy drink will increase concentration and reaction speed, and improve vigilance and emotional status.
"Red Bull's effects are appreciated throughout the world by top athletes, busy professionals, active students and drivers on long journeys," the website claims.
According to the study, the industry's claims of benefit are questionable. "We couldn't find any evidence at all of any therapeutic effects," Lipshultz told Reuters.
"This article just draws together material from the Internet and largely ignores in its conclusions the genuine, scientifically rigorous examination of energy drinks by reputable national authorities," Red Bull told the news agency.
"The effects of caffeine are well-known and as an 8.4 oz can of Red Bull contains about the same amount of caffeine as a cup of coffee (80 mg), it should be treated accordingly."
Lipshultz countered that he found caffeine contents ranging anywhere from 75 to 400 milligrams (mg) per container, including the small "energy shots."
Mild side effects begin to appear when people drink around 3 mg of caffeine per kilo body weight (1.4 mg per pound) in addition to normal dietary intake. That means an energy shot would push a typical 12-year-old three times over the limit.
And there is another difference between coffee and energy drinks, which are often marketed toward athletes. "If you're a 16-year-old who just came out of football practice, you're not going to have three cups of hot coffee. But you might have three energy drinks," Lipshultz said.
Members help make our journalism possible. Become a CSP member today and unlock exclusive benefits, including unlimited access to all of our content. Sign up here.