High-Energy Drinks and Students: An Unhealthy and Risky Brew

High-energy drink (HED) consumption has been on the rise in the past few years and continues to rise as its popularity increases. It has been well documented that Americans drink “more sweetened beverages and eat more energy-dense, poor nutrient foods such as candy and chips” (Whitney, 2011, p. 24). As a result, energy intake has risen and so has the incidence of overweight and obesity. As a sweetened beverage in the alternative beverage industry, HED has been linked to obesity and a variety of other health effects. This paper seeks to add a contribution by investigating five important topics surrounding HED consumption. These topics include (1) What energy drinks are from a nutritional standpoint; (2) What the effects are and consequences of HED consumption; (3) An analysis of the profitability of the HED market; (4) An analysis of the rules, regulations, and legality of the HED market; and (4) The role health care providers and parents can play in providing awareness. The proposed thesis of this paper will survey the HED market and its consumption by underaged and college-aged students from a nutritional science perspective while incorporating scientific literature to provide a potential clinical benefit to combat the rise of HED consumption in these two age groups.

In the U.S., there are a combination of natural sugars in food products and added sugars where each account for half of the sugar intake. Natural sugars include those in milk, fruit, vegetables, and grains, while the other is concentrated sugar that is added to food. In the past several decades, the use of added sugars has increased with soft drinks and sweetened fruit drinks mainly account for the increase. The added sugars are usually found on the label and include “sucrose, invert sugar, corn sugar, corn syrups, solids, high-fructose corn syrup and honey” (Whitney, 2011, p. 109). In small amounts, sugars are pleasurable to a meal and won’t affect the health, but in excess they are harmful. The average American diet consumes sugars in excess placing them at risk of chronic diseases including high blood pressure, diabetes and many others (Whitney, 2011, p. 109). Major sources of added sugars in beverages include “energy drinks, sports drinks, sodas and fruit drinks” (Whitney, 2011, p. 109). Added sugars are particularly harmful because they deliver calories with no or few nutrients which are considered “discretionary calories” (Whitney, 2011, p. 109). These calories since they are not used by the body readily should be limited in consumption. Reducing the intake of HEDs can “lower the calorie content of a diet without compromising the nutrient component” (Whitney, 2011, p. 12). Therefore, the removal of HEDs can benefit students seeking healthy lifestyles tremendously.

There has been a variety of research conducted that survey the effects and consequences of HED consumption among children, adolescents and young adults. Energy drinks are heavily caffeinated and have been proven to be associated with the “onset of seizures, mania, stroke and sudden death” (Seifert et al., 2011, p. 512). Children who are already diagnosed with “cardiovascular, renal, or liver disease, seizures, diabetes, mood, and behavioral disorders, or hypothyroidism or taking certain medications” for other illnesses are significantly at risk to having an adverse effect from HED consumption (Seifert et al., 2011, p. 512). Seifert et al. (2011) compiled an aggregate of research published on HED consumption from June 2010 to January 2011. One of the studies noted that in the United States alone adolescent caffeine intake “can average 60 to 70 mg/day and can range up to 800 mg/day” (Seifert et al., 2011, p. 512). Another study found of those who reported regularly consuming energy drinks, “28% of them were 12 to 14-year-olds, 31% of them were 12 to 17-year-olds, and 34% of them 18 to 24-year-olds” (Seifert et al., 2011, p. 514). The reasons for consuming HEDs despite their adverse effects range, but most respondents said they “wanted to increase their energy (65%)” (Seifert et al., 2011, p. 515). The research on HED consumption has been scarce in the U.S. compared to other countries, like Germany, who have tracked energy drinking-related incidents since 2002 (Seifert et al., 2011, p. 517). In the U.S. it is hard to determine which deaths or serious incidents are due to HED consumption or other caffeinated products. In Germany, the reported outcomes of HED consumption have been linked to “liver damage, kidney failure, respiratory disorders, agitation, seizures, psychotic episodes, tachycardia, cardiac dysrhythmias, hypertension, heart failure,” and in some most serious cases, death (Seifert et al., 2011, p. 518). Ireland has also tracked the HED consumption related adverse effects to include “17 reported events including confusion, tachycardia and seizures,” as well as 2 deaths between 1999 and 2005 (Seifert et al., 2011, p. 518).

For children, caffeine in HEDs can improve memory and attention but also increase the likelihood of “high blood pressure and sleep disturbances” (Seifert et al. 2011, p. 519). Furthermore, those children that are habitual caffeine consumers are susceptible to “attention decrease and reaction time increase”, which significantly increases developmental delay in future classrooms (Seifert et al. 2011, p. 519). Additionally, HED consumption is linked to the changing of food and drink preferences on a child’s brain as it impacts “the reward and addiction center of the brain” (Seifert et al., 2011, p. 519).

As students get older there is more pressure to perform and focus well. Velazquez et al. (2012) studied the connection between HED consumption and heavy alcohol use among 585 college-aged participants. The authors measured HED and alcohol consumption while controlling gender, age, and race/ethnicity. They found strong interactions, particularly among college-aged males of a link between HED consumption and alcohol use. Among those surveyed, “nearly 40% reported consuming energy drinks in the past month and 17.5% reported consuming energy drinks in the past week. Also, it was reported that 46.7% of students reported consuming alcohol in the past month, 36.8% reported consuming alcohol in the past two weeks, and 22.4% of students reported an episode of heavy drinking in the last two weeks” (Velazquez et al., 2012, p. 169). The results suggested at the least that undergraduates who consume more energy drinks also consume alcohol at higher rates (Velazquez et al., 2012, p. 171). It demonstrates the popularity of energy drinks being equated with alcohol and for college students, the combination is certainly lethal. In high-stress environments, many college students turn to alcohol for relief, and similarly, students have sought energy drinks for extra energy to combat the stress they come across in college. However, the adverse events associated with HED consumption make it imperative that children and undergraduates be well informed as to the negative consequences of HED consumption in the short and long term.

Packaged Facts (2013) published a tremendous amount of data surrounding the HED marketplace. Despite its steep price of $3, 150 this paper has taken advantage of the abstract attached to the report. While HED is representative of only a small percentage of the nonalcoholic beverage industry its market has grown 60% from 2008 to 2012. In 2012, it was reported that “The sale of energy drinks and shot were totaled at more than $12.5 billion” (Packaged Facts, 2013, p. 1). Packaged Facts (2013) has projected that sales of energy drinks and shots to grow to “almost $21.5 billion by 2017” because of the current economic recovery period, “expansion in retail distribution and strong product development opportunity” (p. 1).

The profitability of the market has caused increased competition among the few companies that dominate the industry. They have sought to market to their consumers the “healthy and functional” aspects of their beverages despite the negative effects associated with HED consumption (Packaged Facts, 2013, p. 1). Additionally, energy drink companies are also in competition with sports drinks providers, coffee, and tee beverages that promise energy-boosting like it does. As a result, there is an increasing drive to create new products to tap into the market that has traditionally used other methods of energy-boosting. Energy drinks have also been popular because of the access associated with its retail distribution strategies. Energy drink and shot products are accessible at almost “any retail outlet, major grocery store, dollar store, sporting goods” and other easily accessible outlets (Packaged Facts, 2013, p. 1). In some instances, energy drinks can be found at 24/7 gas stations where clients may be looking for a way to boost their energy while pumping their gas. The convenience of obtaining HEDs has contributed immensely to its popularity and profitability. It is reported that convenience stores hold the largest share of market sales at 59% for energy drinks (Packaged Facts, 2013, p. 1).

A discussion of the profitability and market strategies of the HED market has prompted another discussion of how the industry is regulated, if, at all. As discussed earlier, HEDs contain a high amount of caffeine which is considered dangerous if taken in excess. The U.S. Food and Drug Administration (FDA) has limited caffeine content in soft drinks, which are categorized as food. However, there is no such regulation of caffeine in energy drinks. HEDs can contain equal, if not more caffeine than the average soft drink, but since it is classified as a dietary supplement it is not subject to caffeine regulation by the FDA (Seifert et al., 2011, p. 512). The FDA lists caffeine as safe in sodas if it “remains at a level of 0.02% caffeine, which is equivalent to 71 mg for a 12 oz soft drink” (Seifert et al., 2011, p. 512). However, HEDs are increasingly entering the market unregulated containing an “average of 10 mg/oz of caffeine” (Seifert et al., 2011, p. 512). The actual amount of caffeine in a beverage is not required to be listed on the label which leaves the consumer uninformed of the amount they are consuming. Compared to the United States, many other countries have taken steps to address this concern by developing regulatory guidelines for energy drink manufacturers to follow. These countries are raising awareness of the importance of the FDA to do the same so it can regulate the energy drink market (Heckman et al., 2010, p. 314-315).

Lastly, pediatric health care providers must be aware of HED consumption by children, adolescents and young adults to educate them on dangerous consequences of “inappropriate and habitual use” (Seifert et al., 2011, p. 522). Doctors should take priority in screening their patients particularly those that are athletes, “Children with high-risk behavior and other health conditions related to HED consumption (including seizures, diabetes, hypertension, and cardiac abnormalities)” to investigate the role HED consumption may play (Seifert et al., 2011, p. 522). Also, health care providers should inform parents on the role they can play in being aware of their child, adolescent or young adults’ HED consumption to inform them of the negative consequences (Seifert et al., 2011, p. 522). If health care providers and parents are involved in the awareness of HED related illnesses and consumption facts children, adolescents and young adults will be better informed in consuming HEDs. The greater awareness of the health effects of HEDs will likely reduce the consumption rate altogether. Health care providers are important in educating families and children at risk for the potential effects of energy drinks, particularly those with illnesses related to HED consumption (Seifert et al., 2011, p. 522).

References

Heckman, M. A., Sherry, K., & Mejia, E. G. (2010). Energy drinks: An assessment of their market size, consumer demographics, ingredient profile, functionality, and regulations in the United States. Comprehensive Reviews in Food Science and Food Safety, 9(3), 303-317. doi:10.1111/j.1541-4337.2010.00111.

Packaged Facts (2013). Energy drinks and shots: U.S. market trends. Market Research Group, LLC website. Retrieved from http://www.packagedfacts.com/Energy-Drinks-Shots-7124908

Seifert, S. M., Schaechter, J. L., Hershorin, E. R., & Lipshultz, S. E. (2011). Health effects of energy drinks on children, adolescents, and young adults. Pediatrics, 127(3), 511-528. doi:10.1542/peds.2009-3592.

Velazquez, C. E., Poulos, N. S., Latimer, L. A., & Pasch, K. E. (2012). Associations between energy drink consumption and alcohol use behaviors among college students. Drug and Alcohol Dependence, 123(1-3), 167-172. Retrieved from http://dx.doi.org/10.1016/j.drugalcdep.2011.11.006.

Whiney, E. A. (2011). Understanding nutrition (13 ed.). Belmont, California, USA: Wadsworth.