Cardiologists put forward energy drink limits for adolescents, following heart health fears

Energy drinks are ‘fashionable’ and are now consumed by 30%-50% of adolescents (10-19 years-old) and young adults. But the drinks have been linked to heart problems and high blood pressure in various studies, as well as an increase in anxiety and depression.   

Researchers' recommendations include limiting consumption of energy drinks to a single 250ml can a day, and educating parents on the potential adverse effects.

Caffeine and young people​

Energy drinks have a high caffeine content and are marketed as a way to relieve fatigue and improve physical and cognitive performance.

A 250 ml energy drink serving contains around 70-80 mg of caffeine (a similar quantity of tea contains about 30mg and percolated coffee contains around 90 mg).

But 46% of the 5,448 caffeine overdoses reported in the US in 2007 occurred in adolescents younger than 19 years old, wrote one of the authors, Fabian Sanchis-Gomar, in the study.

“Even if caffeine is widely used and generally recognized as safe, serious adverse effects have been reported when consumed in larger doses, especially in children, adolescents, and young adults with anxiety, seizures, agitation, migraines, sleeplessness, dehydration, gastrointestinal problems, arrhythmias, and other cardiac events,” ​he said.  ​

“Importantly, it has been recently demonstrated that energy drinks also induce a cumulative cardiovascular load and reduce cerebral blood flow even under mental stress. Moreover, caffeine has been implicated in some cases of rhabdomyolysis [muscle cell break down] complicated by subsequent acute kidney injury.”​

Heart health​

The researchers (who are based at universities and academic hospitals in Italy, Spain, and the US) say the rapid rise in energy drinks’ popularity has ‘serious implications’ for cardiac health in adolescents.

They say energy drinks can trigger sudden cardiac deaths both in young people with underlying heart conditions, and those that are apparently healthy.

They draw on a range of previous research, such as the case of a 13 year old boy who experienced acute atrial fibrillation [irregular heartbeat] during soccer training after ingesting energy drinks.

Additional studies also show caffeinated energy shots increase blood pressure, heart rate, and cardiac output, they add.

“Cardiac manifestations such as atrial or ventricular arrhythmias [abnormal heart rhythms], QT prolongation, or ST-segment elevation, have been reported after high ingestion of energy drinks,” ​said Sanchis-Gomar.

“Consumption of energy drinks has been also associated with other detrimental cardiac effects such as SADS [sudden arrhythmic death syndrome] and, more recently, myocardial infarction [heart attack]. ​

“This evidence is supported by a reliable biological basis; it has been observed that energy drink intake acutely increases platelet aggregation and decreases endothelial function in healthy young adults. ​

“Accordingly, these adverse cardiac effects could be linked to energy drink consumption during the adolescence period.”​

Studies also show an association between the consumption of a daily 250ml can of energy drink, and an increase in anxiety and depression in young adults in certain circumstances, added Sanchis-Gomar.

How much is too much?​

The researchers have put forward the following recommendations:

• Do not consume more than 1 energy drink can (250 ml) a day
• Avoid energy drink consumption before or during sports practice
• Individuals with diagnosed cardiovascular anomalies should consult cardiologists before drinking energy drinks
• Do not combine energy drinks and alcohol or other drugs
• Parents should be taught potential adverse effects related to energy drink consumption
• Provide continual advice against overconsumption/abuse of energy drinks

The researchers want physicians, parents and children to be better educated about the risk of cardiac arrhythmias and the potential development of anxiety and phobias that could accompany excessive energy drink consumption.

“Although the same or higher amounts of caffeine can be obtained through consumption of coffee alone, prudent health care should take into account that energy drinks are currently fashionable among children and adolescents, and additional fortifying ingredients may exacerbate the risk,” ​said Sanchis-Gomar.

“This challenge is evidenced by the number of individuals, specifically teenagers, receiving emergency treatment because of ED overconsumption over the past few years.”​

Source​​: Canadian Journal of Cardiology, published online March 27, 2015. doi:10.1016/j.cjca.2014.12.019.

Title​​: ‘​Energy Drink Overconsumption in Adolescents: Implications for Arrhythmias and Other Cardiovascular Events’​

F. Sanchis-Gomar; H. Pareja-Galeano; G. Cervellin; G. Lippi; C.P. Earnest.