Refreshing the Data
The American College of Sports Medicine (ACSM) has released a new official statement regarding energy drinks, published in the college’s clinical review journal, Current Sports Medicine Reports. “Energy Drinks: A Contemporary Issues Paper” provides guidance and warnings regarding these beverages because of the dangers they present to at-risk populations, primarily children who are the most vulnerable and the target of marketing efforts.
“Energy drinks are extremely popular, and concerns about their consumption are coming from every sector of society, which is why we’ve published these recommendations,” said Dr. John Higgins. “Our review of the available science showed that excessive levels of caffeine found in energy drinks can have adverse effects on cardiovascular, neurological, gastrointestinal, renal, and endocrine systems, as well as psychiatric symptoms. More needs to be done to protect children and adolescents, as well as adults with cardiovascular or other medical conditions.”
Energy drinks are highly caffeinated beverages that often contain myriad vitamins, minerals, amino acids, and herbal mixtures. As a global authority for sports medicine, exercise science, and the promotion of participant safety, the ACSM is focused on facilitating high performance while protecting those who compete in athletics or engage in other forms of physical activity. By publishing the new recommendations, the ACSM is helping consumers to understand the risks associated with rapid and excessive consumption of energy drinks.
“When used safely and with moderation, energy drinks may have some short-term, performance-enhancing effects. However, users are generally unaware of the many potential adverse reactions that could have long-term effects, some of which are quite serious,” said Higgins. We highly encourage consumers, parents, physicians, athletic trainers, personal trainers, and coaches to follow these recommendations.”
Children and adolescents appear to be at particularly high risk of complications from energy drinks due to their small body size, being relatively caffeine-naive, and potentially heavy and frequent consumption patterns, as well as the amounts of caffeine. The message that these beverages are not intended for children needs to be reinforced and widely disseminated, Higgins said.
At the same time, he added, marketing should not appeal to vulnerable populations. Currently, manufacturers of energy drinks advertise on websites, social media, and television channels that are highly appealing to both children and adolescents. Target marketing to sporting and other events involving children and adolescents should not be permitted.
Regardless of health and fitness level, and until such time that proper safety and efficacy data are available, the ACSM recommends that energy drinks should be avoided before, during, or after strenuous activities. Some of the deaths allegedly due to energy drinks have occurred when a person consumed them before and/or after performing strenuous activities.
Clearly, Higgins notes, investment in awareness and educational resources highlighting the potential adverse effects and safe use of energy drinks is required. Significant efforts should be made to educate consumers regarding the clear and present differences between soda, coffee, sports drinks, and energy drinks. Energy-drink education also should be a priority in school-based curricula related to nutrition, health, and wellness.
The ACSM is calling for a research agenda to prioritize key questions about the acute and chronic effects of energy-drink use. At a minimum, standard safety and efficacy studies should be performed and submitted to the FDA by manufacturers. Well-designed and controlled research is required to examine the increasing frequency of adverse events being reported by emergency departments.
In addition, the organization notes, healthcare providers must talk to their patients about energy-drink use and report adverse events to watchdog agencies like poison-control centers, the Consumer Product Safety Commission, and the FDA. A national registry should be set up to specifically track energy-drink side effects with mandated reporting requirements.
Among other specific recommendations, the ACSM argues that energy drinks should not be consumed by children or adolescents; should not be consumed by other vulnerable populations, including pregnant or breastfeeding women, caffeine-naive or sensitive individuals, or individuals with cardiovascular or medical conditions; should not be used for sports hydration; should not be mixed with alcohol; and should bear a label such as “high source of caffeine” or “do not mix with alcohol.”