Energy drinks ‘threat to public health’: JAMA commentary

By Stephen Daniells

- Last updated on GMT

Scientists and health professions should not wait for FDA action and should be educating consumers of the dangers of consuming energy drinks, says a new commentary in the Journal of the American Medical Association (JAMA).

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.

Booming market

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.

New comment

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.”

Source: JAMA
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

Related topics: R&D

Related news


Show more

consumer response

Posted by Pam,

As a consumer I do read labels! I also want the labels to be accurate. These energy drinks do one any good and I do not buy them. the beverage industry and food industry need to be 110% more honest and accurate with the garbage their putting in the food. As a consumer I buy only fresh food. Excellant article. We need more people to be honest.

Report abuse

ABA response to commentary on EDrinks

Posted by Jessica Badger,

It’s important to remember that this is an opinion piece, not a peer-reviewed, scientific study. In fact, the findings of a prior study by one of the same authors did not show that energy drinks cause the misuse of alcohol in any way.

When it comes to energy drinks, it is important to keep a few things in perspective. ABA member companies manufacture non-alcoholic beverages, including energy drinks, but do not manufacture or distribute alcoholic beverages.

There is nothing unique about the caffeine in energy drinks. In fact, most mainstream energy drinks actually contain about half the caffeine of a similar size cup of coffeehouse coffee. That means that college students enjoying a coffee at the corner coffeehouse are getting about twice as much caffeine as they would from an energy drink. Even so, consumers should be aware that, consistent with federal regulations, beverage companies list caffeine on product labels when it is added as an ingredient. And for years, ABA member companies have voluntarily provided caffeine content information through their Web sites and consumer hotlines. In addition, some of our member companies voluntarily list the amount of caffeine directly on a product’s label. Regardless, caffeine is one of the most thoroughly tested ingredients in the food supply today and has been deemed safe by the U.S. Food and Drug Administration, as well as more than 140 countries around the world.

For more information on energy drinks, visit

- Maureen Storey, Ph.D, Senior Vice President, Science Policy, American Beverage Association

Report abuse

Accurate Labeling - Yes

Posted by A. De Rubeis,

Thank you for the clarification Doctor. Your assertion regarding a mandate toward accurate labeling is spot on. However, as stated, my issues with the commentary begin with the rather sensational title and end with, as of yet unsubstantiated conjecture. Further, since not all energy drinks derive their purported “energy” from caffeine alone and, given your subsequent acknowledgment that “more research is needed,” a more appropriate heading would have been interrogative rather than a declaration. Your implied conclusion that caffeine alone is as dangerous as caffeine and alcohol is incomprehensible as the latter is easily measured physiologically and by the application of common sense. In the age of wild claims from the food and supplement industry, it is equally inappropriate to publish self-acknowledged preliminary opinions as it serves only to increase the growing level of consumer confusion.

Report abuse

Follow us

Featured Events

View more


View more