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Pediatricians urged to ask patients about energy drink use
Seifert SM. Pediatrics. 2011; doi:10.1542/peds.2009-3592
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Pediatricians need to be aware of the possible adverse effects associated with young people consuming energy drinks, and should ask patients about use, according to a study published online this week.
“The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy-drink use,” wrote researchers from the Department of Pediatrics and the Pediatric Integrative Medicine Program at the University of Miami.
The researchers searched Pubmed and Google using various key words, including “sports drink,” “energy drink,” “insulin,” “adolescents,” and “poison control center” to identify various published surveys and articles related to energy drink use.
The researchers found some surveys that indicated about 30% to 50% of adolescents and young adults drink energy drinks, many of which contain high amounts of caffeine. They noted about 5,500 caffeine overdoses in 2007, half of which occurred in people younger than 19 years. The researchers noted that many energy drinks contain three times the amount of caffeine as soda products. The two products are regulated differently, the researchers said, because soda products are considered “food,” whereas energy drinks, are regulated as “supplements.”
The researchers urge screening in some patients, particularly “athletes, children with high-risk behaviors, certain health conditions (ie, seizures, diabetes, hypertension, cardiac abnormalities), and children with behavioral changes, such as anxiety, poor nutrition or sleep disturbances.”
Many legislators have debated restricting the sale of these high caffeine products, according to the researchers. In addition, several studies have shown that youth who consume caffeinated drinks are more likely to abuse alcohol.
Late last year, the FDA told the manufacturers of several caffeinated alcoholic beverage companies that their drinks were a “health concern,” and demanded they reconfigure their formulations, including the makers of Four Loko, a drink that garnered the nickname “blackout in a can,” by some users.
The researchers urged long-term research into the effects of these drinks on “at-risk populations.” And, they added, “toxicity surveillance should be improved, and regulations of energy-drink sales and consumption should be based on appropriate research.”
Disclosures: The researchers reported no relevant financial disclosures.
What else can the soft drink industry foist upon our kids? In school, there is too much juice (bad for obesity and nutrition), too much acid in soft drinks (bad for teeth), too much chocolate in our milk (just plain bad), and now, too much caffeine? We in pediatrics were already aware of the seemingly “innocent” adverse effects of soft drink caffeine upon sleep and anxiety and palpitations in our youngsters.
Recently, these companies have found a way to bolus them with caffeine and probably simultaneously engender further dependence upon caffeinated drinks. Fortunately, consumer bird dogs have already exposed the serious hazards of adding high-dose caffeine to fruity alcoholic mixtures, which were intended to counteract the somnolence effects of the alcohol in our youngsters. Can we just legislate a reduction in the amount of caffeine per ounce to reasonable levels, and employ public health reminders to parents (supported by a soft drink tax)? Why does the burden always fall upon the pediatrician?
The authors have tried to add another screening point to my adolescent counseling. There are so many issues competing for time during an adolescent visit — screening for mood, grades, home life, sexuality, health concerns, acne, dysmenorrhea, alcohol and drug use, etc. Add to that, performing a thorough exam, along with counseling them on a multitude of points. Do I really have the extra hour needed to spend with patients for screening for caffeine use, too?
— Stan L. Block, MD
Infectious Diseases in Children Editorial Board
Disclosure: Dr. Block reports no relevant financial disclosures.
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