Action on Sugar has been putting significant pressure on the UK government and industry to reduce national sugar intakes over the past few years with its campaigns largely focused on soft drinks.
But this latest report shows it turning its attention to sugar and caffeine content of energy drinks.
It warned that “robust evidence” had demonstrated children and teenagers who drink energy drinks are also more likely to consume alcohol, smoke or use drugs and there was some evidence that young energy drink consumers were more likely to have unhealthy diets and experience hyperactivity.
It also pointed to a rise in emergency department visits linked to youth energy drink consumption in the US, which doubled between 2007 and 2011 and mostly concerned symptoms like vomiting, nausea, feeling on-edge, trouble sleeping, palpitations, dizziness, fainting, abdominal pain and headaches.
The report, written by lecturer in public policy and health at Durham University Dr Shelina Visram and Action on Sugar researcher Kawther Hashem, outlined several policy options to be considered by industry and government “in light of the growing evidence base on the potentially harmful effects of energy drink consumption and increasing calls for action from teachers, parents and others”.
One such option would be a ban on the sale of energy drinks to under 16s, “similar to that which is already in place for tobacco and alcohol”.
This could come nationally or from local UK authorities, which have existing powers in licensing, trading standards and planning.
“For example, many councils offer training courses to licensees in breach of the alcohol license. These courses could encourage each licensee to adopt a voluntary code which would restrict sales of energy drinks to those under 16 years of age,” they wrote.
A ban on the sale of energy drinks to under 18s has already been seen in Lithuania and Latvia.
“Strict limits” on the caffeine and sugar content of energy drinks and in-school interventions were also among the policy suggestions.
Industry: ‘No scientific justification to treat energy drinks differently’
Gavin Partington, British Soft Drinks Association (BSDA) director general, pointed to the European Food Safety Authority’s (EFSA) review, which said 400 mg of caffeine a day and 200 mg within two hours does not pose a health risk for healthy adults.
“The latest review by the European Food Safety Authority (EFSA) in 2015 confirms that energy drinks are safe confirms that energy drinks are safe and make up a very small part of the caffeine intake of adolescents and a negligible amount amongst children,” he said in a statement to press.
“With a 250 ml can of energy drink typically containing about the same amount of caffeine as a cup of coffee there is no scientific justification to treat energy drinks differently than the main contributors to daily caffeine intake in all age groups including tea, coffee and chocolate.”
He added that energy drinks producers provided caffeine content on all labelling, as required by the EU Food Information for Consumers (FIC) regulation, and “market their products responsibly by recommending consumption in moderation and not promoting these drinks to children”.
This has been the stance repeated by industry groups like Energy Drinks Europe (EDE), not least of late as a debate on caffeine health claims came to a head in the European Parliament.
Evidence gaps
The paper acknowledged there were “significant gaps in the evidence base” around the health effects of energy drinks, including the impact of high consumption by children and adolescents.
It said currently the majority of published studies involve cross-sectional study designs and rely on self-report data often gathered in North American high schools.
This self-reported evidence was cast aside in EFSA’s risk assessment last year as unreliable, nor did it look at very high caffeine doses and caffeine in conjunction with binge drinking.
This week's report called for longitudinal and cross sectional studies with younger children as well as research with parents and teachers.
“However, the evidence that has emerged so far indicates some effects worrying enough for policy makers and civil society in the UK to take notice and to develop a plan for action.”
Rapid rise
The report said the UK and other countries have seen a rapid rise in the per capita consumption of energy drinks in the last few years.
Sales of energy drinks in the UK increased by 155% between 2006 and 2014, from 235 to 600 million litres.
This equated to an average per capita consumption of 9.4 litres in 2014.
Globally, it said the $50 billion energy drinks market is projected to grow at an annual rate of 3.5% between 2015 and 2020 – outpacing the soda market.
It also pointed to EFSA’s 2011 calculations of consumption in Europe, which showed 30% of adults, 68% of adolescents (10-18 years) and 18% of children (3-10 years) reported consuming energy drinks.
This prevalence for adolescents ranged from 48% in Greece to 82% in the Czech Republic, while for children this ranged from 6% in Hungary to 40% in the Czech Republic.
The report was published by the Food Research Collaboration, an initiative of the Centre for Food Policy at City University London.