Energy drinks: what's the evidence?

Abstract

The UK, in common with many other countries, has seen a rapid rise in the per capita consumption of energy drinks in the last few years. Energy drinks (soft drinks containing more than 150mg of caffeine per litre) are made up of water, caffeine, sugars and a range of additives and flavourings. Sales of energy drinks in the UK increased by 155% between 2006 and 2014, from 235 to 600 million litres, an average per capita consumption of 9.4 litres in 2014. While the market for soda is declining, the $50 billion global energy drinks market is projected to grow at an annual rate of 3.5% between 2015 and 2020. This paper aims to present the latest available evidence on whether this trend is cause for concern, and if so, what could be done about it. Robust evidence demonstrates that children and teenagers who drink energy drinks are also more likely to consume alcohol, smoke or use drugs. There is also some evidence that youth energy drink consumers are more likely to have unhealthy diets, and experience hyperactivity and a range of other health effects. For example, emergency department visits linked to youth energy drink consumption in the USA doubled between 2007 and 2011, with the most frequently indicated symptoms being vomiting, nausea, feeling jittery or on edge, trouble sleeping, palpitations, dizziness, fainting, abdominal pain and headache. There is still a lot we do not know about the health impacts of energy drinks, particularly in relation to heavy and long-term consumption by young people. Evidence is also lacking in terms of the effects on younger children and those with existing cardiovascular problems. However, in light of high levels of consumption among young people, a few countries and localities have taken action in an attempt to reduce levels of intake, including banning sales to under-18s, permitting sales only from pharmacies, as well as voluntary measures to reduce consumption. Energy drinks are also captured under many of the soda taxes in place in a range of countries. Owing to concerns about sugar, some energy drink manufacturers have developed low or no sugar varieties. However, there has been no action on the high caffeine content of energy drinks. There are a range of actions that, however, could be taken to reduce consumption in light of the health concerns, including labelling and limits on marketing and sales. While there are significant gaps in the evidence base around the health impacts of energy drinks, the evidence that has emerged so far indicates some effects worrying enough for policy makers and civil society to sit up and take note.