PAMF Health Blog

Be Well, Be Well Informed

The Risks of Energy Drinks

Posted on Jul 15, 2014 | 4 comments

Ads for energy drinks are plastered on the walls of sporting events and on the jerseys of leading athletes. The beverage makers sponsor models, music events and videos games. Red Bull, the market’s leading drink, even has its own TV series and printed magazine. They claim to boost your immune system, enhance your performance, and help you stay up longer.

No wonder 30 to 50 percent of adolescents and young adults say they buy energy drinks. But are they safe for young people to drink?

“No,” says Stephanie Nguyen Lai, M.D., a pediatrician at the Palo Alto Medical Foundation. Energy drinks are loaded with caffeine – often twice as much as coffee and eight times as much as a soda. They’re especially dangerous when mixed with alcohol.

“As a parent, it is important to talk with your adolescent, and explain the risks of these products,” Dr. Lai says. “Their health could be at stake.”

Hidden Caffeine in Energy Drinks

The caffeine content in popular energy drinks varies greatly. It’s not regulated by the Food and Drug Administration (FDA). Ironically, some drinks do not even list the caffeine content on their label. Instead, it’s part of their secret “proprietary blend.”

Why does the FDA regulate soft drinks, but not energy drinks? The beverage makers claim that energy drinks are “natural dietary supplements,” thus not subject to the regulations that apply to food.

So your teen may not know how much caffeine he or she is drinking, and likely it’s a lot more than they realize. A typical 16 ounce energy drink contains between 150-280 milligrams of caffeine; larger cans have up to 500 milligrams of caffeine. By comparison, a 12-ounce can of soda can contains 35 milligrams of caffeine. See this list of caffeine content in popular drinks from the Center for Science in the Public Interest.

Many energy drinks also contain guarana, which is a South American plant with a more potent form of caffeine. One gram of guaranine (a derivative of guarana) is equivalent to 40 milligrams of caffeine. In reality, these drinks can contain much more caffeine than stated on the packaging.

The Side Effects of Too Much Caffeine

The side effects of too much caffeine are well known. They include:

  • increased heart rate
  • high blood pressure
  • palpitations
  • insomnia
  • dehydration

Caffeine withdrawal is associated with headache, marked fatigue, anxiety, tremors and irritability.

Energy drinks also contain other substances touted to improve energy, such as taurine, ginseng, Vitamin B, carnitine and bitter orange.

“Unfortunately, the safety and effects of daily consumption of these additives are not well known,” Dr. Lai says.

When Energy Drinks Are Mixed With Alcohol

Dr. Lai says she is most concerned with new products that mix energy drinks with alcohol. Many of these have packaging that’s similar to non-alcoholic energy drinks. Although you must be over 21 to buy the drinks, teens can often get them through friends or with fake IDs. It’s also becoming more common for teens to create their own cocktails by mixing energy drinks with hard liquor.

Combining high-caffeine energy drinks with alcohol may give a teen the perception that he or she isn’t as drunk as she really is. And when teens feel fewer effects from alcohol, they tend to drink more. This problem became apparent as early as 2010, where teens have been hospitalized – and nearly died – due to consumption of the alcoholic energy drinks.

The Bottom Line on Energy Drinks

In 2011, a clinical report published by the American Academy of Pediatrics (AAP) stated that, “rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents.”

Take time to talk this over with your child. If you have further questions, call your child’s pediatrician.

Nguyen-Stephanie-2013-web Stephanie Nguyen Lai, M.D., is a pediatrician at the Palo Alto Medical Foundation‘s Palo Alto Center.


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  1. Is this “Energy” drink including “Gatorade”?


    • Hi John,

      Great question. Sport drinks and energy drinks are very different. Many people, including teenagers, often confuse energy drinks and sport drinks.

      Sport drinks, such as Gatorade, are beverages that contain water, carbohydrates, electrolytes, minerals, and other flavoring, meant to replenish fluids and electrolytes lost through exercise. While sport drinks can be use by athletes that are participating in prolonged (> 1 hour) and vigorous physical activity, they should not be used for general fluid consumption because they contain a lot of extra sugar and unneeded calories. This can lead to dental cavities and obesity.

      Under no circumstances are energy drinks ever recommended. In general, my favorite beverages for adolescents are water and milk for calcium.

      – Dr. Nguyen

  2. Isn’t sugar also dehydrating and inflammatory? My understanding is that despite health claims so-called sports drinks, loaded with sugar, work against health & hydration. Throw caffeine into the mix and it’s a real problem.

    • Hi Maya,

      To my knowledge, moderate amounts of sugar does not cause dehydration or inflammation. Sugar comes in many different forms. There are naturally occurring sugars, such as the sugar that makes fruit taste sweet, and artificial sugars, such as corn syrup, that are not as healthy. However, you are correct that excess sugar is not healthy. Sports drinks do contain a lot of sugar. So as a general rule, water the best drink for rehydration instead of sports drinks.

      On the other hand, energy drinks are different than sports drinks in that they contain caffeine. Caffeine is a diuretic, meaning that it causes you to urinate more which could contribute to dehydration. I definitely do not recommend energy drinks for rehydration.

      – Dr. Nguyen-Lai

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