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Energy drinks: Why a ban may not be the answer.

The potential energy drink ban has dominated news and discussion in the UK this week. The proposed ban would mean that selling energy drinks to teenagers would become illegal- this would affect either those under 18 or just those under 16.

Why is a ban being considered? Energy drinks contain caffeine and large amounts of sugar, which effects young people's sleep and can cause hyperactivity, headaches, tiredness and irritation. Of course, the other reason mentioned is obesity- essentially making the debate almost identical to that over the sugar tax.

The evidence on energy drinks and children/adolescents:

Visram et al. 2016

This review of the literature compiled results from 46 studies.

The main findings were:

  • Higher energy drink consumption among teenagers was positively associated with being obese or underweight, receiving free school meals, having special educational meals and having more spending money.

  • Lower consumption was found among those with a higher academic average, higher levels of parental monitoring and more educated parents.

  • Consumption of energy drinks was linked to alcohol consumption and binge-drinking, as well as smoking and use of other substances. Consumption was also linked to sensation-seeking, self-destructive behaviour and problems with behavioural regulation.

  • Young people seemed to be unaware of, or ignored, possible risks of energy drink use. Their main reasons for consumption were taste, getting energy and the packaging (younger and female more susceptible to this).

Busuttil and Willoughby 2015

This research assessed patients presenting to A&E with palpitations (n=60).

Those who were considered high consumers of energy drinks were more likely to have significantly increased palpitation frequency. Consumption of alcohol with an energy drink appeared to exacerbate the effect on palpitation risk.

Troxel et al. 2016

18% of adolescents consumed energy drinks (n=2,485). Use was significantly associated with later weekend bedtime, shorted total weekend sleep and more trouble sleeping.

Sampasa-Kanyinga et al. 2017

Of 9,473 adolescents (Canada), 81.4% consumed sugar-sweetened beverages (SSBs) and 12% consumed energy drinks. Energy drink consumption was associated with shorter sleep duration. Males were more likely than females to consume.

Schwartz et al. 2015

Beverage consumption of middle school students in the USA was assessed (n=1,649). One in seven reported energy drink consumption. Boys were significantly more likely to consume energy drinks, sports drinks and flavoured milks compared to girls.

15% of students were reported to be "at risk" of hyperactivity/inattention. Energy drinks were the only beverage that was independently associated with risk of hyperactivity/inattention.

Bryant-Luddent and Wolfson 2010

Girls reported using energy drinks as an appetite suppressant (more than boys).

O'Dea 2003

Adolescents mentioned short-term health benefits they believed applied to energy drinks, including preventing illness, improved immunity and desire to rectify a poor diet.

Bunting et al. 2013

The youngest participants (16-21) believed that energy drinks were safe, claiming they wouldn't be on sale if their caffeine content was too high.

Older age groups highlighted more concerns, mentioning in particular sugar content and the need for moderation.

The research clearly highlights a number of issues related to a high intake of energy drinks, however the ban may not be the answer. Here's why I think a ban on the sale of energy drinks to teens may not help:

Making the beverages illegal to those underage may make it more desirable- we always seem to want what we can't have.And let's face it, if teenagers can get alcohol and cigarettes when underage, I'm sure they won't have much trouble getting a can of Monster or Redbull (other brands are available ;) ).

Most energy drinks contain the same amount of caffeine as is found in a cup of coffee- however no ban seems on the horizon for coffee. This ban won't prevent caffeine consumption. The concern should, perhaps, lie with the number of energy drinks consumed, rather than whether any are consumed.

The ban won't prevent sugar consumption. (Sugar seems to be constantly blamed these days doesn't it?). We have already introduced the sugar tax, and that affects energy drinks. It would be advisable to assess the effects of the sugar tax on consumption and learn from it, before jumping to ban and restrict something else.

Marketing and packaging appear to have a huge impact on consumption among young people. The associations drawn by manufacturers between their products and sports people, for example, appears to increase consumption among young athletes. Perhaps policy should look at stricter marketing of these products or consider plain packaging (as has been done recently with cigarette packaging).

Education is needed. Many studies highlight a lack of knowledge among young people about the ingredients of these drinks, or the effects of high levels of caffeine. Education will not prevent consumption, but it may reduce high level consumption (where real risk lies).

These studies indicate many concerns that a ban will not fix- the fact that teens are using these drinks as appetite suppressants and as stimulants to stay up all night, the fact that consumption of these drinks is associated with sensation-seeking and self-destructive behaviour, the fact that most vulnerable youths have the highest consumption. These things will not be truly addressed by a ban on energy drinks.

Childhood obesity will not be impacted by this ban either.

Free sugars, mainly from SSBs (33%), contribute to 14% of total energy from the diet among teenagers in the UK. Given that energy drinks make up less than 5% of the UK SSB market, it appears that energy drinks play a very small role in energy provision.

AKA- this ban will have very little affect on energy intakes of children and young people.

Take home message:

We should be concerned about high levels of energy drink consumption, because it is associated with potential ill-health and serious side-effects. But an age limit will likely have a limited impact on the health of teenagers and children.

Lots of love,

Little O x

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