Manufacturers of energy drinks are coming under pressure from governments and regulatory bodies following concerns about the health impacts of their products on teenagers and other at-risk groups.
Typically, drinks such as Red Bull, Monster, Mother and Cocaine contain a cocktail of caffeine, taurine, glucuronolactone and sugar. And they are heavily promoted to shift workers, students and long-haul drivers.
An estimated $15 million was spent in 2009 alone on marketing by the energy drinks industry in Australia. It’s obviously money well spent; energy drink sales account for one in five beverages sold by convenience stores.
The caffeine content of a can of Red Bull - 80 milligrams for a 250 millilitre can – is roughly the same as a standard cup of coffee. But such potent energy drinks have recently caused concern in the health profession.
In Australia and New Zealand, energy drink manufacturers are required to print a health warning on all cans stating: “This food contains caffeine and is not recommended for children, pregnant or lactating women and individuals sensitive to caffeine”. They are also expected to advise consumers to limit intake to a maximum of two cans in one day.
There’s growing international concern about the likely negative health effects of energy drinks. A growing body of research evidence directly links energy drink consumption to cardiovascular risk and other adverse health outcomes.
Available since 1987, Red Bull was the first energy drink on the market and sales reached 4.6 billion cans worldwide in 2011.
Its original formula was banned in France in 1996 on the basis of the unknown health consequences of taurine, and only a modified version was allowed. But the ban was lifted by the European Commission following a 2008 French Food Safety investigation that was unable to prove the existence of health risks.
European regulations require positive proof of harm and a growing body of research evidence may soon be able to assist.
A 2007 study of students found they were using energy drinks to cope with their lack of sleep and for mixing with alcohol. Researchers found they consumed energy drinks between one and four days in a month. The study also showed young adults had three or more such drinks with alcohol when partying.
The “Jagerbomb”, for instance, is a popular way to combine alcohol and energy drinks. It comprises of a measure of the alcohol Jagermeister dropped into a glass of Red Bull, which is then consumed as a shot. The drink delivers an alcohol, sugar and caffeine fix and can be consumed with high frequency.
Research from 2010 suggests that adding alcohol to energy drinks leads to an increased rate of absorption through the carbonation and dilution of the alcohol. This allows the drinker to stay awake for longer and consume an even greater amount of alcohol through binge drinking. It also lessens the appearance of drunkenness but not its effects.
Two city councils in New South Wales – Manly and Newcastle – have banned pubs and clubs from selling Jagerbombs on the basis that they encourage irresponsible and binge drinking. Some “schoolies week” events have also adopted this safety initiative or taken some other approach to limit their sale.
Research from 2011 involving a group of fourth-year university students found weekly or daily energy drink consumption was strongly associated with alcohol dependence. Although this study had a small sample, it makes a good case for targeting alcohol dependence prevention education at this group.
Consuming energy drinks has also been associated with a number of other health complications including irritability, headache, nervousness, insomnia, hallucinations, seizure, irregular or rapid heartbeat, heart attacks and death.
But it’s not all doom and gloom. Energy drinks have a positive impact on physical performance in sport and increased cognitive function, including choice reaction time, concentration and memory. A study that was financially supported by Red Bull found all this may be particularly helpful when driving prolonged distances or cramming for exams.
A public heath issue
Mass consumption of energy drinks is fast becoming a public health issue. Research looking at the number of calls to the Australian Poisons Information Centre recorded a 400% increase in annually reported incidents between 2004 and 2010. It found a total of 297 reports about energy drinks recorded over the seven years, noting the number only included cases the centre was alerted to.
Governments should consider measures to curb the potential harm of energy drinks. These could include clearer labelling similar to those on over-the-counter caffeine tablets; restricting the sale of energy drinks based on age; and re-classing such beverages as non-prescription medications.
Coupled with targeted community education, such action may help keep people of all age groups, but especially teenagers, safe from the hazards of binging on energy drinks.