Energy drink consumption has been linked to an increased risk of mental health issues, including depression and ADHD, among children and young people, a scientific review has revealed.
The study, which is said to be the most comprehensive of its kind to date, was published in the Public Health journal on Monday.
The research found that excessive consumption of energy drinks is associated with negatively impacted physical and mental health, potentially leading to antisocial or risky behaviours including substance use, violence, unsafe driving and unprotected sex.
Energy drinks, which are marketed as providing mental and physical stimulation, are typically highly caffeinated and may also contain sugar or artificial sweeteners, as well as numerous other ingredients such as taurine, guarana, inositol or creatine. According to research published in 2015, a standard energy drink will typically contain 80–150mg of caffeine per 8 ounces (about 240ml) - one cup of brewed coffee contains about 95mg on average.
For example, the popular but controversial beverage Prime Energy - which was launched by social media influencers Logan Paul and Olajide 'KSI' Olatunji - has 200mg of caffeine in a 12-ounce (355ml) can, about six times the amount of caffeine in a comparable can of Coke.
It's also been documented approximately two thirds of energy drink consumers are aged 13 to 35, with boys comprising the majority of the market - findings that were backed up by the review.
In the latest research, teams from Newcastle University and Fuse, the Centre for Translational Research in Public Health at Teesside University, analysed data from 57 studies of over 1.2 million children and young people from 16 countries to probe the effects the drinks can have. The researchers did not reveal what brands of energy drinks were included in the review.
Poor sleep, high blood pressure, higher than average BMI (body mass index), poor diet, heart palpitations and dental problems, as well as depressive symptoms, anxiety, severe stress, ADHD, eating disorders and an increased risk of suicidal thoughts were among the negative health outcomes found to be linked to energy drink consumption.
Some of the studies included in the review also found young people who consumed the beverages were at a greater risk of unhealthy lifestyle habits, such as smoking, drinking alcohol, binge-drinking, vaping and substance use.
However, the researchers noted the review was observational, meaning it could not conclusively pinpoint that energy drinks were to blame for the poor health outcomes linked to their consumption; alternatively, the drinks could be more popular among groups which already had higher risks of mental and physical health issues.
Commenting on the data, Dr Shelina Visram, a public health expert from the University of Newcastle and the study's co-author, said the researchers are "deeply concerned" about the findings that energy drinks "can lead to psychological distress and issues with mental health".
"These are important public health concerns that need to be addressed," she said, as reported by the Daily Mail. "There has been policy inaction on this area despite government concern and public consultations. It is time that we have action on the fastest growing sector of the soft drink market."
"We have raised concerns about the health impacts of these drinks for the best part of a decade after finding that they were being sold to children as young as 10-years-old for as little as 25p. That is cheaper than bottled water," Professor Amelia Lake of Public Health Nutrition at Fuse, the Centre for Translational Research in Public Health at Teesside University, added.
"The evidence is clear that energy drinks are harmful to the mental and physical health of children and young people as well as their behaviour and education."
Concluding the findings, the review stated: "This review adds to the growing evidence that ED (energy drinks) consumption by children and young people is associated with numerous adverse physical and mental health outcomes.
"Where feasible and ethical, additional longitudinal studies are required to ascertain causality. The precautionary principle should be considered in regulatory policy and restriction of ED sales to this population."
In the UK, the sale of energy drinks to children under 16 was banned by most major supermarkets in 2018.
The unveiling of the new findings comes as over 40 healthcare bodies signed a letter to the UK government demanding it to "finally implement the national sales restriction on these harmful drinks to under 16 year-olds", ITV reported.
"The effects of these drinks are more significant and broader than previously understood - in particular negative outcomes for children's mental health in addition to physical health. How much more evidence is needed before the government take action?" the letter said.
Signatories include the Royal College of Paediatrics and Child Health, the British Diabetic Association and the British Dental Association.
According to Food Standards Australia and New Zealand (FSANZ), the Food Standards Code restricts how much caffeine can be added to soft drinks and energy drinks. Foods containing added caffeine must also have a statement on the label that the product contains caffeine; foods containing guarana (a South American plant with high levels of natural caffeine) must also be labelled as containing caffeine.
In soft drinks, the total caffeine content must not exceed 145mg/kg in the drink as consumed. Energy drinks, which are regulated under Standard 2.6.4 of the Code, can only contain a maximum of 320mg of caffeine per litre. This Standard includes additional labelling requirements advising the products are not suitable for young children, pregnant or lactating women and individuals who are sensitive to caffeine.
The popular Prime Energy drink, which contains almost double the legal limit, has been banned in New Zealand, but can still be purchased for exorbitant amounts via online marketplaces or some dairies. The sports drink Prime Hydration is available to purchase freely as it is said not to contain added sugar or caffeine.
This article was amended on January 25, 2024 to reflect that the research did not conclusively link energy drinks to these health issues, but instead found consumption can be associated with these conditions.
