Marketing and brands

Whether it’s playing video games, jamming with friends, having a drink, playing your favourite sport or powering through the night for due coursework, your perfect companion is often a caffeine load packed in a small ‘energy drink’ can.

Between 2004 and 2009, the market for energy drinks has grown by a staggering 240%. In 2014, the estimated global energy drink market was worth $50 billion, growing at a yearly rate of 3.5% since then. Red Bull is one of many energy drinks sold globally that has been enjoying this increased fame.  Most energy drinks are aggressively marketed to associate with action sports, motor sports and gaming or ‘eSports’. Thus, they appeal most strongly to hormonal, adrenaline-pumped young males. The market is nevertheless growing and as a result manufacturers are now targeting as many  18-34 year-olds as they can: girls, boys, adventurous, musicians, athletes, geeks, hipsters, etc. To reach larger segment of the population, energy drinks associate with countless celebrity endorsers, music artists, performers, actors, models, athletes and even other personalities such as student ambassadors to appeal to a much wider segment of the young population. Some products are even named after illicit or recreational drugs such as NOS (nitrous oxide) and cocaine to increase their popularity by appealing to ‘drug-like’ effects.

To make matters worse, there are products called energy shots. A mere 60ml shot can provide as much caffeine as would a can of regular energy drink (200 mg). It doesn’t stop here, the cherry on top is the extra-strength energy shots providing 230mg caffeine per shot. If you’re curious enough to visit the web pages of energy shots, you will notice caution labels and warnings like the ones below:

An excerpt from a popular energy shot webpage reads:

When such warnings or claims are placed on the product or webpage, can you help but question the safety? And how can such products be so unregulated?

Statistics and regulation

Because the FDA only allows a certain limit of caffeine in conventional beverages, energy drink manufacturers can choose to label their products as dietary supplements, which also contain any such ingredients as vitamins, minerals, herbs, amino acids, and enzymes. Classification under ‘dietary supplements’ allows manufacturers to slip past the more-controlled FDA regulation of conventional beverages while escaping the caffeine ceiling (talk about two massive birds with one stone). Thus, all products today are marketed either as conventional foods or as dietary supplements, despite all of them being known as energy drinks. The FDA can only ban the sales of a ‘dietary supplement’ if its labelling is misleading or if evidence exists of the product’s unsafety (good luck finding such ‘compelling’ evidence, let alone finding someone willing to look for such evidence). The story is not very different for the UK Food Standards Agency. Thanks to those arbitrary and rather lax regulations, the market has been growing profoundly. Since 2014, the UK’s energy drink market has grown by 8% and is now worth over £2 billion. Those that are classified as dietary supplements can freely advertise unsubstantiated health claims on their website and products in order to expand their target market and boost sales.

Physical health effects

 The British Soft Drink Association (BSDA) states that energy drinks ‘provide functional benefits by boosting energy and alertness. The functionality is obtained from ingredients such as glucose, caffeine or taurine.’ A large cross-sectional study across European countries found that 68% of adolescents and 18% of children reported consumption of energy drinks. In the UK, energy drink consumption is a growing problem for the youth as the study found that the UK youth regularly consumed more energy drinks than their European counterparts. Immediate health effects of energy drink consumption range from headaches, nausea and vomiting, dizziness, abdominal pain, palpitations and fainting. More adverse outcomes include tachycardia, cardiac arrest, liver damage, psychotic conditions, kidney failure and seizures, not to mention the contribution of high amounts of sugar found in most energy drinks to long-term development of dental caries, insulin-resistance, obesity and diabetes. Longitudinal studies assessing the long-term health effects of habitual consumption are very limited. In addition, energy drinks that are classified under dietary supplements commonly contain many herbal extracts and other ingredients (taurine, ginseng, glucuronolactone, yerba mate, etc.) whose safety for consumption whether as isolated ingredients or in combination lacks scientific evidence. So how safe are they? And at what cost are they ‘boosting energy and alertness’? The answer is: Although some studies looked into this and identified some of the short-term effects listed above, we still don’t know the whole picture about potential long-term health consequences.

Behavioural health effects

 Behavioural problems among energy drink consumers are an equally important yet less discussed concern. Adolescents who regularly consume energy drinks commonly exhibit a cluster of risky behaviours including smoking, alcohol consumption and illicit drug use. It has also been suggested that energy drink consumption is a gateway to other forms of drug use and later alcohol use. Regular consumption of energy drinks have also been associated with higher risk-taking on dares, failure to put on seatbelts, physical aggressiveness and fighting, violent behaviours and delinquency and risky sexual behaviours such as unprotected sex or sexual assault. Other behavioural consequences that were associated with regular energy drink consumption include symptoms of attention deficit hyperactivity disorders (ADHD) such as inattention or hyperactivity, insomnia, anxiety, mood fluctuations, stress and even suicidality. All that aside, perhaps the most concerning risky behaviour associated energy drink consumption is driving while under the influence of alcohol, Many adolescents and young adults regularly mix energy drinks with alcohol. Mixing both substances may mask alcohol intoxication levels due to the stimulant effect of caffeine and other constituents in energy drink thereby leading people to incorrectly believe that they are sober enough to drive. Another misconception is the assumption that caffeine from energy drinks actually reverses the alcohol effects, enabling better driving. This finding is particularly alarming since the leading cause of death among adolescents globally is road traffic accidents.

Conclusion and recommendations

So far, research on energy drinks is winning in the battle against nutritionists. There is still insufficient data about their safety or physical health effects for regulatory bodies in most countries to prohibit their sales or at least restrict them. However, it is still very important for families, schools, clinics, health clubs and all other members of the community, particularly healthcare providers, nutritionists and dietitians to educate patients and communities about the physical and behavioural consequences of energy drink consumption. We need to spread the idea that just because energy drinks are widely available in markets does not mean they are actually safe for consumption. Although causality is not yet known regarding the behavioural consequences of energy drink consumption – that is, whether energy drink consumption leads to other behavioural problems or that behavioural problems encourage energy drink consumption, or even that both behaviours are part of a bigger problem – it is essential that we stop and think about how the abundance in availability and ease of access of energy drinks to children, adolescents and young adults is creating a public health problem that will soon go out of control.

Laura Jabri, MSc 

Laura has a masters in Clinical and Public Health Nutrition from University College London and a bachelors degree from the American University of Beirut. Her interests include nutrition education, obesity prevention, maternal and child nutrition, undernutrition in developing countries and food sustainability solutions.  Tweet her @laurajabri

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