Energy drinks” are beverages that contain caffeine, taurine, vitamins, herbal supplements, and sugar or sweeteners and are marketed to improve energy, weight loss, stamina, athletic performance, and concentration. 1–3Energy drinks are available in 140 countries and are the fastest growing US beverage market; in 2011, sales are expected to top $9 billion. 4–10 Half of the energy-drink market consists of children (12 years old), adolescents(12–18 years old), and young adults (19 –25 years old).
Although healthy people can tolerate caffeine in moderation, heavy caffeine consumption, such as drinking energy drinks, has been associated with even more serious consequences such asseizures, mania, stroke, and sudden death. 6– 8,12–14 Numerous reports exist in the popular media, and there are a handful of case reports in the literature that associate such adverse events with energy-drink consumption; it is prudent to investigate the validity of such claims (Appendix).
Children, especially those with cardiovascular, renal, or liver disease, seizures, diabetes, mood and behavioral disorders, or hyperthyroidism or those who take certain medications, may be at higher risk for adverse events from energy-drink consumption. 6–8,14–24 Although the US Food and Drug Administration (FDA) limits caffeine content in soft drinks, which are categorized as food, there is no such regulation of energy drinks, which are classified as dietary supplements. 1–3 Despite the large, unregulated market for energy drinks and reports in the literature and popular media of serious adverse events associated with their consumption, research into their use and effects has been sparse. However, schools, states, and countries increasingly are exploring contentand sales regulations of these drinks. 1,8,13,26–35
Given the rapidly growing market and popularity among youth, we reviewed the literature to determine what energy drinks are, compile consumption data of energy drinks by children, adolescents, and young adults, compile caffeine and energy-drink overdose data, examine the physiologic effects of the ingredients in energy drinks, identify potential problems of energy drinks among children and adolescents, assess the marketing of energy drinks, report current regulation of energy drinks, and propose educational, research, and regulatory recommendations.