Amelia Arria from the University of Maryland School of Public Health and Mary Claire O’Brien from Wake Forest University School of Medicine write that current limitations for caffeine levels in cola-like drinks do not apply to energy drinks, perhaps due to the presence of herbal ingredients and vitamins.
This has led to products on the market containing between 50- 505 mg caffeine/serving, compared with FDA limits for cola-like drinks, which is 71 mg per 12-oz serving.
As such, these products are a “just as great a threat to individual and public health and safety” as the ‘premixed’ alcoholic energy drinks recently deemed unsafe by the FDA.
“Although more research is necessary, so are proactive steps to protect public health,” write Arria and O’Brien. “To promote informed consumer choices, regulatory agencies should require specific labeling regarding caffeine content, with warnings about the risks associated with caffeine consumption in adolescents and in pregnant women as well as with explicit information about the potential risks associated with mixing energy drinks with alcohol.”
“The collective priority of health professionals should be to educate the public about known risks, and industry officials and servers should caution consumers about the risks of mixing alcohol with energy drinks,” they added.
According to a recent report from market analyst Canadean, energy drinks have managed to maintain their popularity during the economic downturn, despite their higher price per litre and negative publicity.
Canadean’s latest report “Emerging Trends & Growth Opportunities in Energy Drinks: Shots, Flavour Trends & Forecasts to 2015” claimed that whilst the rate of growth for performance enhancing products has slowed since 2008, many consumers are still prepared to pay the price premium for functional benefits.
In North America, Canada is expected to return to growth on the back of increasing competition between the multinationals and strong innovation. Progress in the US is predicted to be driven by a pick up in convenience store sales, said Canadean. Indeed, some estimates put the US market at a eye-opening $5.4 billion in 2006.
In terms of ingredients, Canadean said exotic herbs and substances such as ginkgo biloba, ginseng and milk thistle are commonly present in energy drinks, and that the fat-burning compound L-carnitine is increasingly appearing in formulations.
The new commentary in JAMA may serve as a warning shot across the bow of the energy drink sector.
“More research that can guide actions of regulatory agencies is needed,” write Arria and O’Brien. “Until results from such research are available, the following should be seriously considered: health care professionals should inform their patients of the risks associated with the use of highly caffeinated energy drinks; the public should educate themselves about the risks of energy drink use, in particular the danger associated with mixing energy drinks and alcohol; and the alcohol and energy drink industries should voluntarily and actively caution consumers against mixing energy drinks with alcohol, both on their product labels and in their advertising materials.”
Published online ahead of print, doi:10.1001/jama.2011.109
“The "High" Risk of Energy Drinks”
Authors: A.M. Arria, M.C. O’Brien