A risk assessment carried out on behalf of the Norwegian Food Safety Authority found caffeine consumption above 1.4 milligrams (mg) per kilogram of body weight per day (kg/bw/day) may pose a risk of sleep disturbance.
If the intake is above 3 mg per kilogram of body weight per day, there is a negative risk of effects on the cardiovascular and central nervous system.
“The highest acute intake of energy drinks containing 32 mg caffeine per dl, consumed within a short time, e.g. during a 24-hour period, may pose a risk of sleep disturbances and other general adverse health effects in 8- to 18-year-olds,” the report concluded.
“A regular intake poses little or no risk in this age group. A high regular intake poses low or no risk for 8- to 12-year-olds, while for 13- to 18-year-olds it may pose a risk of sleep disturbances.”
The effect of energy drinks on adults and especially on children is an ongoing issue throughout Europe, with the drinks’ sugar, caffeine and taurine content of particular concern to authorities.
Current EU legislation requires drinks with over 150 mg of caffeine per litre to be labelled ‘High caffeine content. Not recommended for children or pregnant or breast-feeding women’.
Other countries like Lithuania and Latvia have banned the sale of energy drinks to under-18s. In Sweden, a number of energy drinks are only sold in pharmacies and banned to under-15s.
The UK is currently looking into restricting the sale of energy drinks to children under 16 years of age. If passed, the legislation would mean retailers would be unable to sell drinks with more than 150 mg of caffeine per litre to children.
The government is now evaluating responses to its consultation, which closed 21 November 2018.
High caffeine consumption
While the Norwegian report said occasional energy drink consumption by youngsters in moderation was not linked to negative health effects, there was concern over the addictive nature of the drinks’ high caffeine content.
“Children and adolescents who consume energy drinks tend to have a higher caffeine intake than youths who do not consume energy drinks,” the report said, which was carried out by the Norwegian Scientific Committee for Food and Environment (VKM).
“That is, children and young people who consume energy drinks also seem to consume more of other foods and drinks containing caffeine than do youths who don’t consume energy drinks. This conclusion is based on the average daily caffeine intake for the population studied.”
Additional findings pointed to a little or no risk that regular intake of caffeine from food and drinks, except for from soft drinks posed to 8- to 18-year-olds.
However, a Norwegian Consumer Council investigation said a high regular intake of caffeine from beverages other than from energy drinks may pose a risk for sleep disturbance to 16- to 18-year-olds.
The same observation applied to 13- to 15-year-olds, but only for those who drunk energy drinks. For 10- to 12-year-olds, a high regular intake may pose a risk to both sleep disturbance and other general adverse health effects, but again this applies only to the group that drinks energy drinks.
The study acknowledged that participants in the age group 10-12 are too few to come to any firm conclusions about how high intake of energy drinks may affect them.
EFSA findings
According to the European Food Safety Authority (EFSA) consumption of a single dose of 480 ml energy drink containing caffeine equivalent to a dose of 3.4 mg/kg bw led to an increase in blood pressure.
Single doses of caffeine equivalent to 1 mg/kg bw to 6.2 mg/kg bw increased systolic and diastolic blood pressures with 0.5-9 mm Hg and 1-9 mm Hg, respectively, for the healthy, general population (including children and adolescents 8-17 years).
EFSA noted that habitual consumption in adults, doses up to 400 mg caffeine per day (5.7 mg caffeine/kg bw for a 70 kg adult) do not raise fasting blood pressure significantly after habituation to caffeine takes place.
The Authority further stated that changes in blood pressure induced by repeated intake of caffeine would be of low clinical relevance for healthy individuals.
This applies only if the intakes would not exceed the maximum plasma concentrations that can be achieved with a single dose of 200 mg caffeine (about 3 mg/kg bw for 70 kg person).
EFSA also noted that in children, regular consumption of 3 mg caffeine/kg bw in children would not induce anxiety or behavioural changes.
“Children appear to develop tolerance to the effects on the central nervous system at high habitual intakes of caffeine (over 300 mg per day) and show withdrawal symptoms,” the Authority said.
The Norwegian Food Safety Authority will send its recommendations to the Ministry of Health and Care Services by Feb 15.
