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Doctors urge ban on children buying caffeinated energy drinks

We already have sufficient evidence to act to protect children, argues RCPCH president

Louise Prime

Friday, 21 September 2018

Children should be legally banned from buying caffeinated energy drinks in order to protect them from the drinks’ potential harms to their physical and mental health, according to the president of the Royal College of Paediatrics and Child Health (RCPCH). In his BMJ editorial*, Professor Russell Viner insisted that marketing should not be allowed “to drive consumption of products likely to worsen obesity and the wellbeing of our children”.

He said little evidence exists that so-called energy drinks provide needed energy – children and young people in high-income countries are unlikely to need extra energy as they already consume more sugar and calories than they require.

Viner said most such drinks contain a combination of caffeine and sugar, but some have non-sugar sweeteners and/or amino acids. He argued that the high sugar content in many energy drinks (up to 108g/l, with servings often as much as 500ml), “undoubtedly contributes to the overall calorie excess and resultant obesity epidemic among our children” – but even the no-added-sugar caffeinated energy drinks are reported to be used by young people with eating disorders, for their stimulant effects.

He said it was surprising that so little is known about the safety profile of caffeine, which is “probably the most commonly used psychoactive drug across the world; it increases activity and heightens attention and awareness”. The European Food Safety Authority said data suggest there are important safety concerns at caffeine doses of >3mg/kg body weight – which would mean one 250ml can of providing 80mg caffeine would not give rise to safety concerns in children weighing >30 kg.

Yet Viner cited evidence supporting real concerns about the effects of caffeine in children and young people, even at the small doses deemed “safe” for the cardiovascular system: associations with anxiety, depression, sensation seeking, poorer executive function, and increased hyperactivity and inattention; increased psychological distress, poor behaviour, risky behaviours (such as substance use), and poorer academic attainment in maths and English; and a clear inverse association between consumption of caffeinated energy drinks and sleep duration.

He argued: “So-called energy drinks have no clear benefits in terms of energy, and evidence is growing of important effects on behaviour and mental wellbeing for children and young people. For our young people, in the middle of an apparent epidemic of mental health problems and low energy, energy drinks can appear to be a cheap and quick fix for fatigue and worries in life. Yet high caffeine intake leads to fatigue and increased anxiety.”

He acknowledged that we still need more evidence regarding these concerns, but insisted that we already have sufficient evidence to act to protect children. He noted that people get energy from a good diet, refreshing sleep, exercise, and interactions with other people, and said: “When the twin epidemics of obesity and mental health problems stalk the land, we cannot afford to allow marketing to drive consumption of new products likely to worsen obesity and the wellbeing of our children.”

He concluded: “Many UK supermarkets have now banned the sale of caffeinated energy drinks to under 16s, and several countries have bans in place. At the Royal College of Paediatrics and Child Health we support restriction of the sale of energy drinks to under 16s alongside an evaluation of the effect that these policies have on young people’s purchasing habits, and their health.”

*Viner R. Editorial: Ban on sale of energy drinks to children. BMJ 2018; 362: k3856. doi: https://doi.org/10.1136/bmj.k3856 (Published 19 September 2018)

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