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Energy Drinks: Frequently Asked Questions

Should not be used for hydration in sports

 

Energy drinks, such as Red Bull, have become increasingly popular among adolescents and young adults in recent years. In 2006, nearly 500 new brands were introduced to the marketplace, and over 7 million adolescents reported that they had consumed an energy drink.  Energy drinks are particularly popular among young athletes who see the consumption of energy drinks as a quick and easy way to maximize athletic and academic performance.      Cans of energy drinks

In October 2008, the Sports Medicine Advisory Committee (SMAC) of the National Federation of State High School Associations (NFHS), the governing body for high school sports,  approved a position statement strongly recommending against the use of energy drinks by young athletes:

  • Water and appropriate sports drinks, not energy drinks, should be used for rehydration.Information about the absence of benefit and the presence of potential risk associated with energy drinks should be widely shared among all individuals who interact with young athletes.
  • Energy drinks should not be consumed by athletes who are dehydrated
  • Energy drinks should not be consumed by athletes taking over-the-counter or prescription medications without prior medical approval.
  • Energy drinks are not regulated by the FDA - which means that their content and purity cannot be insured - and their use may lead to adverse side-effects, potentially harmful interactions with prescription medications (particularly stimulant medications used to treat ADHD), or positive drug tests.* 

In May 2011, the American Academy of Pediatrics issued a clinical report1 strongly recommending against the consumption of energy drinks because of the potential health risks,2 including harmful effects on the developing neurologic and cardiovascular systems.

"There is no place for energy drinks in school, play, or sport for children or adolescents, and dare I say, adults," echoed MomsTeam sports hydration expert, Dr. Susan Yeargin.

Energy drink FAQs

Question: What is an energy drink?

Answer: An energy drink is a beverage marketed to both athletes and the general public as a quick and easy means of relieving fatigue and improving performance. In addition to water, nearly all energy drinks contain carbohydrates and caffeine as their main ingredients. The carbohydrates provide nutrient energy while the caffeine acts as a stimulant to the central nervous system.

Question: What are the differences between an energy drink and a sports drink?

Answer: Sports drinks are designed to provide re-hydration during or after athletic activity. While contents vary, most sports drinks contain a 6-8% carbohydrate solution and a mixture of electrolytes. The carbohydrate and electrolyte concentrations are formulated to allow maximal absorption of the fluid by the gastrointestinal tract.

Energy drinks contain a higher concentration of carbohydrates (usually 9-10%), and thus a larger number of calories than sports drinks. They also contain high amounts of caffeine and, in some cases, other nutritional supplements. Energy drinks are not designed to re-hydrate athletes during activity and should not be used in such circumstances.  

Question: What ingredients are found in energy drinks?

Answer:

  • Caffeine: Nearly all energy drinks contain some amount of “natural” or synthetic caffeine. The caffeine concentration may range from the equivalent to an 8 ounce cup of coffee (85mg) to more than five times that amount. "In many cases, it's hard to tell how much caffeine is in [an energy drink] by looking at the label," noted Marcie Beth Schneider, MD, FAAP, a member of the American Academy of Pediatrics Committee on Nutrition and a co-author of the AAP's 2011 clinical report.  "Some cans or bottles of energy drinks can have more than 500 mg. of caffeine, which is the equivalent of 14 cans of soda."  The AAP report notes that such levels are "clearly high enough to result in caffeine toxicity," adding that a "lethal does of caffeine is considered to be 200 to 400 mg. per kilogram of body weight.
  • Herbs: Many energy drinks include herbal forms of caffeine such as guarana seeds, kola nuts, and Yerba mate leaves, in addition to synthetic caffeine. The “performance enhancing” effects and health benefits of other herbs like Astragalus, Echinacea, Ginko biloba, ginseng, and countless other herbs have not been well established by scientific studies. 
  • Vitamins: Athletes with even reasonably good diets should be assured that they are not at risk for vitamin deficiency and do not need supplementation. There is no evidence to suggest that vitamin supplementation improves athletic performance. Female athletes may benefit from iron and calcium supplementation, but these are more easily and inexpensively obtained in pill form rather than energy drinks.
  • Protein and amino acids: Only a small amount of protein is used as fuel for exercise. Carbohydrates are utilized as the primary fuel source. No scientific evidence exists to support claims that amino acids enhance athletic performance.  Protein, and the amino acids which compose it, are available less expensively in food.  
  • Other ingredients: With the hundreds of energy drink brands available, the potential ingredients they may contain are virtually unlimited.  Possible additions include pyruvate, creatine, carnitine, medium-chain triglycerides, and even oxygen.

Question: What are the possible effects of using energy drinks?

Answer:

  • Central nervous system stimulant: Caffeine often has the effect of making a person feel “energized.” Studies have shown some performance-enhancing benefits from caffeine at high doses (6mg/kg of body weight). Such high doses of caffeine may produce light headedness, tremor, impaired sleep and difficulty with fine motor control, and may exceed drug testing caffeine thresholds.
  • Gastrointestinal system: The high concentrations of carbohydrates found in energy drinks may delay gastric emptying, resulting in a feeling of being bloated. Abdominal cramping may also occur. Both carbohydrates and caffeine in the high concentrations found in most energy drinks can cause diarrhea.
  • Dehydration: Energy drinks should not be used for the purposes of hydration or re-hydration. The high carbohydrate concentration results in slow absorption from the gastrointestinal tract and may cause diarrhea.
  • Positive drug tests: Like all nutritional supplements, there is little or no regulatory oversight of energy drinks. The purity of the products cannot be assured and it is possible that they may contain banned substances.

Source: National Federation of State High School Associations, American Academy of Pediatrics

Notes:

1. Scheider M, Benjamin H, Clinical Report - Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Pediatrics 2011; 127(6): 1182-1189.

2. Seifer S, Schaechter J, Hershorin E, Lipshultz S. Health Effects of Energy Drinks on Children, Adolescents, and Young Adults. Pediatrics 2011;127(3):511-528. Revised June 7, 2011

* On September 22, 2010, Virginia became the first state in the nation to ban the use of energy drinks during high school football games and practices.

Revised December 20, 2011

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