When Kelly Morrow sees patients who complain of fatigue, they often mention relying on caffeine, whether in the form of coffee, tea, soda or energy drinks.
Morrow, who teaches at Bastyr University and has a clinical practice at the Bastyr Center for Natural Health, describes caffeine as a credit card.
“It’s like using a credit card for energy: It’s false energy,” she says. “What goes up must come down.”
One form of caffeine has become increasingly popular among (and, some say, dangerous to) young people: energy drinks. These cans of sweetened, caffeinated, often fruit-or coffee-flavored beverages with brand names such as Red Bull, Rockstar and Monster are seemingly everywhere. Usually placed next to the sodas and bottled teas at grocery and convenience stores, the drinks saturate online and TV advertising, their brands are attached to a variety of products and events. Their ingredients and marketing also have been the subject of Congressional and medical studies, involvement from the Food and Drug Administration (FDA), and warnings from health and youth advocates.
On the rise
In March, the University of Connecticut’s Rudd Center for Food Policy and Obesity released a national study of the sales and consumption of energy drinks, especially among young people under age 18. The study found that sales jumped 53 percent between 2007 and 2012, and that the number of emergency room visits by young people linked to energy drinks increased by about 350 during that same period. Calls to poison-control centers grew from 672 in 2010 to more than 3,000 in 2013; more than half of those calls concerned children and teens ages 18 and younger.
In Washington, calls to the Poison Center regarding energy drinks and youth ages 18 and younger have remained relatively steady since 2011— anywhere between 62 and 70 a year, up from 18 calls in 2010.
The American Academy of Pediatrics and the American Medical Association advise against young people consuming energy drinks, essentially because of their ingredients, and the tendency for young people to indulge in them. Common ingredients include sugar, caffeine, taurine (an amino acid) and guarana, a South American plant that contains a caffeine compound. The amount of caffeine in energy drinks varies, and drink manufacturers argue that caffeine amounts are similar to a cup of coffee. But health experts say a typical drink can contain significantly more than that.
Of course, many young people consume caffeinated sodas (and sometimes, coffee and tea), which doctors also discourage because of the threat to healthy sleep patterns, mood, blood pressure and heart conditions. Caffeine is addictive, as anyone with a coffee habit knows, and that adds to the safety concerns associated with energy drinks.
“If you drink them enough, you will want to continue to drink them, and you will feel a withdrawal when you don’t,” says Dr. Leslie Walker, chief of adolescent medicine at Seattle Children’s Hospital. “Kids are more likely to become dependent on something, and it hits that reward center [in the brain], and a dependency is developed.”
High dosages of caffeine disrupt sleep, and during childhood and adolescence, neurological connections form during sleep, Walker says. Disrupt sleep, and you disrupt child development.
Energy drink manufacturers dispute some statements about the levels of caffeine in their products and children’s consumption of them. In response to a 2014 U.S. Senate report on the marketing of drinks to young people, the American Beverage Association issued a statement: “Energy drinks have been enjoyed safely by millions of people around the world for more than 25 years, and in the U.S. for more than 15 years.” The association maintained that its members have voluntarily promised not to market energy drinks to children under age 12 or in K–12 schools.
The FDA classifies energy drinks as either dietary supplements or “conventional foods.” Manufacturers are not required to report amounts of caffeine (in any product) on labels, because caffeine is not a nutrient. Investigations and analysis by Consumer Reports and the Center for Science in the Public Interest list the amounts of caffeine in drinks of various sizes: An 8-ounce cup of coffee has roughly 100 milligrams, depending on the type of brew; black tea can have up to 80 milligrams, and a 12-ounce bottle of regular cola, 35 milligrams. An 8-ounce portion of an energy drink can range from 80 milligrams to more than 200. Some energy drinks come in 2-ounce sizes, with as much or more caffeine, according to a 2012 Consumer Reports study.
Some school districts have adopted policies or offered parents specific guidance regarding energy drinks. Nurses in the Kent School District, for example, make available information for school newsletters that defines energy drinks and urges caution in consuming them, due to individual differences in responses to caffeine. The tips warn against using them during exercise, because of the potential for dehydration.
Some parents have rules about caffeine, while others have discussed energy drinks, specifically.
Jennie Duncan discussed the dangers of energy drinks when her daughter was in sixth grade.
“It was definitely about the caffeine,” says Duncan, whose daughter is now 19. “I’d heard horror stories about kids who didn’t know they had a heart problem ending up in the hospital or worse, and by the time she was in sixth grade, she’d heard those stories, too.”
Now 19, Duncan’s daughter grew up with only the occasional pop at the movie theater and hasn’t developed a taste for caffeinated beverages, let alone a habit.
Becky Riley, a Lake Forest Park mother of four, said she won’t expose her kids to energy drinks; pop is a rarity, as it is.
“I just don’t think they need these types of beverages,” she says. “I feel energy drinks are not healthy at all, and the dangers are all too real.”
Health experts say there are, of course, alternatives.
“Water is highly underrated,” Dr. Walker says. “When kids are tired, they should sleep. When they’re thirsty, they should drink water.”
In other words, Walker says, parents and children maintain healthy, common-sense habits. Start talking with kids around age 10, when they might be taking on more activities and busier schedules. “At very early ages, kids can have access to these drinks, and they don’t think there’s anything wrong with them,” Walker says. “Help them have balance, water, and sleep. Bodies can work perfectly well without an energy drink.”
Consider why your child, or his or her friends, are choosing energy drinks, Morrow advises parents. If it’s because of the “coolness factor,” she says, then discuss with your child the advertising messages and images, and their purpose. If it’s about genuine fatigue, then examine the causes of low energy and try to address them through diet, sleep, and exercise.
If you want to guide young people to healthy choices, or even to moderation of unhealthy habits, Morrow added, find out their interests first. If a teen wants to do well in school or in sports, for instance, and is consuming energy drinks to stay alert for homework and activities, then target your tips for healthy living on those goals.
“Appeal to what’s important to them, then they’ll listen,” she says.