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Published on: 18 January 2024

Energy drinks are associated with an increased risk of mental health issues among children and young people, including anxiety, stress, depression, and suicidal thoughts, a new study has found.

In a study, published in the Public Health journal, researchers found energy drink consumption was more common among boys than girls, and was also associated with increased risky behaviours such as substance use, violence, and unsafe sex.

It also links consumption of the drinks with an increased risk of poor academic performance, sleep problems, and unhealthy dietary habits.

'Deeply concerned'

Researchers from Fuse, the Centre for Translational Research in Public Health, at Newcastle University and Teesside University, looked at data from 57 studies of more than 1.2 million children and young people from over 21 countries.

Experts say it highlights the need for regulatory action to restrict the sale and marketing of energy drinks to children and young people.

Co-author Dr Shelina Visram, Senior Lecturer in Public Health from Fuse, the Centre for Translational Research in Public Health at Newcastle University, said: "We 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.

"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."

This is an update to a review in 2016. In 2017, the same researchers from Fuse, the Centre for Translational Research in Public Health, were the first to publish research exploring in-depth the views of children, as young as 10-years-old, on energy drinks.

The academics called on the UK government to take action on the sale of energy drinks to under 16s after finding that they were being sold to young people cheaper than bottled water.

The research revealed that energy drinks were easily available in local shops; sold for as little as 25p ('four for £1' promotions); targeted at children through online adverts, computer games, television and sports sponsorship; and linked to extreme sports, gaming, sexuality, gender, and use of sexualised imagery.

Previous research had also found that up to a third of children in the UK consume caffeinated energy drinks on a weekly basis and that young people in the UK were the biggest consumers of energy drinks in Europe for their age group.

Professor Amelia Lake was involved in a national campaign, fronted by celebrity chef Jamie Oliver, to restrict the sale of energy drinks to teenagers, and gave evidence to the House of Commons Science and Technology Committee on the effects of energy drinks on young people's mental and physical health.

Many large UK supermarkets subsequently agreed to ban the sale of energy drinks to children.

Lead author Professor Lake, Professor of Public Health Nutrition from Fuse, the Centre for Translational Research in Public Health at Teesside University, said: "Energy drinks are marketed to children and young people as a way to improve energy and performance, but our findings suggest that they are actually doing more harm than good.

"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.

"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. We need to take action now to protect them from these risks."

Regulating energy drinks

A number of countries have attempted to regulate energy drinks, including bans on sales to under 18s in Lithuania and Latvia. The UK government ran a consultation on ending the sale of energy drinks to children in England and also proposed this in their 2019 green paper 'Advancing our health: prevention in the 2020s'.

While 93% of respondents to the consultation supported restricting sales to under 16s, there has been no further action. In 2022, the devolved government in Wales launched its own consultation to ban the sales of energy drinks to under 16s.

The UK Food Standards Agency says that energy drinks are generally drinks with high levels of caffeine. They are usually marketed as giving a mental and physical 'boost' by providing more 'energy' than regular soft drinks. They are different to 'sports drinks' which might be used to replace electrolytes lost during exercise.

Caffeine levels in a can of energy drink can vary between 80mg (equivalent to two cans of cola or a mug of instant coffee) and 200mg (equivalent to five cans of cola).

William Roberts, Chief Executive of the Royal Society for Public Health, said: "This important review adds to the growing evidence that energy drinks can be harmful to children and young people's physical and mental health, both in the short and long-term.

"That's why we need the UK Government to step up and deliver on its 2019 commitment to ban sales of energy drinks to under 16s.

"In doing so it would not only be following the evidence, but also following the example of countries that have already restricted sales to children, a move supported by the majority of the public."

More than 40 health related organisations have joined the researchers in calling on government to finally restrict the sale and marketing of energy drinks to children and young people.

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Evidence shows risks associated with energy drinks in children

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Energy drinks are associated with an increased risk of mental health issues among children and young people, including anxiety, stress, depression, and suicidal thoughts, a new study has found.

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Energy drink alternatives.

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Whether it's before a long day at the office, a hard workout, or an all-night study session, many of us turn to energy drinks when we need a little boost. Energy drinks are a multi-billion dollar industry. If their popularity is any indication of their effectiveness, they appear to be working. But are these drinks doing us more harm than good?

Despite how popular energy drinks are, the term "healthy energy drink" is still an oxymoron. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more than 20,000 emergency room visits in the United States in 2011 involved energy drinks. More than half of those visits were due to energy drinks alone. The other cases involved people mixing alcohol or other stimulants with energy drinks. According to the Center for Science in Public Interest, energy drinks have been linked to 34 deaths since 2004. Most of these were from people taking 5-Hour Energy.

Most energy drinks pack a serious caffeine punch. Caffeine is a central nervous system stimulant. It gives you energy and makes you more alert. The average 8-ounce cup of coffee contains about 95-200 milligrams of caffeine, according to the Mayo Clinic. In comparison, a 2-ounce 5-Hour Energy shot contains about the same amount of caffeine (200-207 mg).

Caffeine is relatively safe in small doses, such as in a cup of coffee or tea. But it can be dangerous in large doses (over 400 mg), according to an info sheet published by the University of California, Davis. An overdose of caffeine can cause symptoms such as:

irregular or rapid heartbeat

trouble breathing

diarrhea

fever

convulsions

Excessive caffeine consumption can cause health issues for:

people unaware of a sensitivity to caffeine

people who have issues with blood pressure or heart rate regulation

pregnant women

Energy drinks can be appealing to children and teens because they are available at local stores and are legal for all ages. According to the Centers for Disease Control and Prevention, 50 percent of teens say they consume energy drinks, and 75 percent of school districts don't have a policy regulating their sale on campus. In general, regulation of energy drinks in the United States is lax. However, there is a movement calling for stricter regulation and content labeling, as well as the addition of health warnings.

Children and teens are particularly vulnerable to energy drinks as their bodies generally aren't used to caffeine. One study found that caffeine intoxication, or drinking too much caffeine, leads to caffeine addiction and potential withdrawal. The study concludes that energy drinks may be a gateway to other forms of drug dependence.

Usually there are other stimulants besides caffeine in energy drinks. Additives such as guarana and ginseng are common. These can amplify the drink's energy boost and also the adverse effects of caffeine.

Energy drinks often contain large amounts of sugar to aid their energy-boosting effects. A single serving of an energy drink can have more than 30 grams of sugar, according to scientists at UC Davis. Sugary drinks have been linked to obesity, high blood pressure, and high cholesterol, according to the American Heart Association. This study also shows that added sugar consumption increases your risk of developing cardiovascular disease.

The UC Davis info sheet lists several ingredients that may not be familiar to you. Many of these ingredients are new to commercial products, so not much research has been done on them. Despite claims made by producers, their effects are unknown. Currently, there isn't enough data to establish the safety of these ingredients:

Alcohol

In 2010, the Food and Drug Administration banned the sale of energy drinks that contain alcohol. It declared them to be unsafe. This study shows how mixing alcohol and energy drinks can lead to drinking too much alcohol. Energy drinks keep people awake longer. This can increase the amount of alcohol people drink. High alcohol consumption is linked to sexual assault, driving under the influence, and other risky behaviors.

It's safe to have caffeine in moderation. But if a cup of joe a day doesn't give you a big enough boost, try some of these alternatives:

Drink water: Staying hydrated helps keep your body running, according to this study. Drink a glass of water when you wake up, with meals, and before, during, and after workouts.

Eat protein and carbohydrates: According to the American Heart Association, they are great fuel for a workout. Carbohydrates provide your muscles with energy, while protein helps build them. Try chocolate milk, fruit, and a boiled egg, or a peanut butter and banana smoothie.

Take vitamins: Naturally occurring vitamins and minerals, such as magnesium, help your body produce energy. A vitamin or mineral deficiency may cause fatigue. If you feel like you always need an energy boost, talk to your doctor about having a nutritional assessment or adding a vitamin supplement to your diet. You can also add more vitamin- and mineral-rich foods to your diet, such as fresh fruits, vegetables, nuts, and yogurt.

Be active: When you exercise, your serotonin and endorphin levels increase shortly after, which helps you feel better. Also, those who exercise regularly often have more energy.

While energy drinks may seem like a quick fix for fatigue, the short- and long-term effects of drinking them outweigh the benefits. Energy drinks have been linked to obesity, high blood pressure, and cardiovascular issues. A single energy drink can contain more sugar and caffeine than you should have in a day. Plus, many energy drinks have other ingredients that haven't been tested well enough to know their effects on the body. There are many alternatives to energy drinks that offer a healthy energy boost and won't let you down.

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Is There Such a Thing as Healthy Energy Drinks?

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Whether it's before a long day at the office, a hard workout, or an all-night study session, many of us turn to energy drinks when we need a little boost. Energy drinks are a multi-billion dollar industry. If their popularity is any indication of their effectiveness, they appear to be working.

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Energy drink consumption statistics (uk 2023).

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While energy brands are keen to broaden the appeal of their beverages, research commissioned by The Grocer from Vypr shows the category remains very much a young man's game.

Almost double the number of men drink energy drinks as women, revealed a poll of Vypr's 65,000-strong consumer panel. While 18.6% of men aged 18 to 64 buy energy products once a week, the equivalent figure for women is only 11.6%, showed the research.

And this is skewed towards younger men. Vypr's findings revealed younger people are much more likely to regularly consume energy drinks.

Some 21% of men and 15% of women aged between 18 and 24 buy such drinks at least once a week, versus just 10% of men and 6% of women aged between 55 and 64.

Yet whatever age or sex, people's reasons for avoiding energy drinks are similar. Two-fifths (42%) "say it's due to the perception they're unhealthy and full of artificial ingredients", says Vypr founder Ben Davies.

This finding tallies with a seemingly widespread lack of awareness about 'clean' energy drinks. Again, there is a disparity across both sex and age.

Almost two-thirds (60%) of men aged between 18 and 34 have heard of clean energy drinks, but that number decreases as age increases, Davies says.

Meanwhile, just 48% of women aged 18 to 24 and just 39% women aged 25 to 34 are aware. And men are "much more likely to want to try a clean energy drink", Davies notes.

"While there is a health awareness around the products maybe not being natural, it looks like the energy benefits of these drinks outweighs that consideration," he says.

He suggests energy brands and retailers should focus on new flavours and marketing strategies, rather than trying to create 'clean' versions of energy drinks.

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How does energy drink consumption change across age and sex?

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Almost double the number of men drink energy drinks as women

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A beverage that typically contains large amounts of caffeine, added sugars, other additives, and legal stimulants such as guarana, taurine, and L-carnitine. These legal stimulants can increase alertness, attention, energy, as well as increase blood pressure, heart rate, and breathing.¹⁻⁴

These drinks are often used by students to provide an extra boost in energy. However, the stimulants in these drinks can have a harmful effect on the nervous system.⁵

In 2011, 1,499 adolescents aged 12 to 17 years went to the emergency room for an energy drink related emergency. ⁶

Some of the dangers of energy drinks include ¹:

Dehydration (not enough water in your body).

Heart complications (such as irregular heartbeat and heart failure).

Anxiety (feeling nervous and jittery).

Insomnia (unable to sleep).

The American Academy of Pediatrics states that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents.⁹

Teachers and other school staff can educate students about the danger of consuming too much caffeine, including energy drinks.

Coaches can educate athletes about the difference between energy drinks and sports drinks and potential dangers of consuming highly caffeinated beverages.

School nutrition staff can provide only healthy beverages such as fat-free/low-fat milk, water, and 100% juice if extra items (i.e., a la carte items) are sold in the cafeteria.

Parents, school staff, and community members can join the school or district wellness committee that sets the policies for health and wellness and establish or revise nutrition standards to address the sale and marketing of energy drinks in school settings.

Everyone can model good behavior by not consuming energy drinks in front of kids.

The American Academy of Pediatrics recommends that adolescents do not consume energy drinks, yet between 30-50% reported consuming energy drinks.1,3

The National Federation of State High School Associations recommends that young athletes should not use energy drinks for hydration, and information about the potential risk should be widely distributed to young athletes.¹⁰

As many as 11.6% of secondary schools in some districts sell energy drinks in vending machines, school stores, and snack bars.⁷

Nationwide, 75% of school districts do not have a policy in place regarding these types of beverages that contain high levels of caffeine for sale in high school vending machines, schools stores, or a la carte in the cafeteria.⁸

1. Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. Health effects of energy drinks on children, adolescents, and young adults. Pediatrics. 2011:127(3), 511-528.

2. Brown University Health Promotion. Energy Drinks. Retrieved from https://www.brown.edu/campus-life/health/services/promotion/alcohol-other-drugs-other-drugs/energy-drinks.

3. Schneider MB, Benjamin HJ. Clinical Report-Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Pediatrics. 2011;127(6):1182-1189.

4. Pomeranz JL, Munsell CR, Harris JL. Energy drinks: an emerging public health hazard for youth. Journal of Public Health Policy. 2013;34(2):254-271.

5. Ishak WW, Ugochukwu C, Bagot K, Khalili D, Zaky C. Energy drinks: psychological effects and impact on well-being and quality of Life-a literature review. Innovations in Clincial Neuroscience. 2012;9(1):25-34.

6. Center for Behavioral Health Statistics and Quality. The DAWN Report: Update on Emergency Department Visits Involving Energy Drinks: A Continuing Public Health Concern. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013.

7. Demissie Z, Brener N, McManus T, Shanklin SL, Hawkins J, Kann L. School Health Profiles 2014: Characteristics of Health Programs Among Secondary Schools. In: Centers for Disease Control and Prevention, ed2014.

8. Chriqui J, Resnick E, Schneider L, et al. School District Wellness Policies: Evaluating Progress and Potential for Improving Children's Health Five Years after the Federal Mandate. School Years 2006-07 through 2010-11. Chicago, IL: Bridging the Gap Program, Health Policy Center, Instriture for Health Research and Policy, University of Illinois at Chicago; 2013.

9. Heckman MA, Weil J, Gonzalez De Mejia E. Caffeine (1, 3, 7-trimethylxanthine) in Foods: A comprehensive review on consumption, functionality, safety, and regulatory matters. Journal of Food Science. 2010;75(3):R77-87.

10. National Federation of State High School Associations. Position Statement and Recommendations for the Use of Energy Drinks by Young Athletes; Indianapolis, IN: National Federation of State High School Associations, Sports Medicine Advisory Committee; 2014.

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In 2007, 1,145 adolescents aged 12 to 17 went to the emergency room for an energy drink related emergency, in 2011 that number climbed to 1,499.

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