Potential health risks of energy drinks are cause for alarm

By Mike Wade
New River Valley Community Services

Produced in a variety of flavors, the high quantity of caffeine and 12% alcohol volume in “Four Loko” is contained in cans featuring bright colors and flashy graphics. The potential health risks of the product, as well as the marketing strategies used to sell it, have already gotten the attention of several state attorneys general. An official with Philadelphia’s Chester Youth Collaborative recently referred to it as “legalized liquid cocaine.”

Rene Cox and Lee Spiegel, both Prevention Specialists with New River Valley Community Services (NRVCS), agree that beverages like “Four Loko” or “Joose” pose an even greater potential threat to young people.

“The alcoholic energy drinks and those energy drinks made without alcohol look so much alike that it’s very hard to tell which is which – and some of the same brands have both a non-alcoholic and alcoholic version,” explained Cox. “These companies may be producing adult beverages, but they seem to market themselves – directly or indirectly – to underage youth…It’s along the same lines of the old Joe Camel cigarette ads if you ask me.”

The U.S. energy drink market is currently worth nearly $10 billion in annual sales and beverage giants from Coca-Cola to Anheuser-Busch are vying for their share. Who is buying all of those drinks? According to a 2007 report published by the Marin Institute, an alcohol industry watchdog, 31% of 12- to 17-year-olds and 34% of 18- to 24-year-olds report regular consumption of energy drinks. Consumption declines steadily with age based on the report’s findings.

“When you pick up a Coke and a Pepsi and put them side by side, it’s pretty easy to distinguish between the two,” noted Spiegel. “They’ve been around for years and even if we can’t be sure of the difference in taste, the packaging on each bottle or can lets you know right away which one of those soft drinks you’re holding in your hand.”

“That’s not the case with energy drinks,” Spiegel continued. “They purposely emulate one another and the market has just been inundated with dozens and dozens of different brands. It’s really hard for anyone to keep straight – whether its kids, parents, retailers or even law enforcement.”

Aside from the issues that come with brand confusion, the Marin Institute report also points to the marketing messages and imagery used to sell energy drinks as key factors in the high levels of youth consumption. With names like Rockstar, Amp, Full Throttle, Spark, Wired, DareDevil and even Cocaine, energy drink brands have also become major sponsors of sporting events and other activities that appeal to today’s teens and young adults.

Energy drinks have also developed a substantial presence online, with interactive websites designed for youth and a high volume of promotion using social networking sites like Facebook and MySpace.

The evolution of energy drinks
Jolt Cola, first introduced in 1985, was the first drink to boast a high octane dose of caffeine and sugar. Ten years later, PepsiCo was the first major U.S. beverage company to enter the market with Josta, a product that was eventually discontinued in 1999.

Red Bull, a drink first developed in Austria and introduced to America in 1997, is credited with igniting the energy drink phenomenon and today owns 42.7% of the market share.

Over the past decade, literally dozens of new energy drinks have been introduced and there is a growing trend to sell these products in larger cans and bottles so companies can comply with government regulations regarding the level of caffeine allowed in energy drinks.

Gatorade, first introduced in the 1960s, was the first drink marketed as a performance enhancer for athletes. Fast forward forty years, and the company is apparently not interested in being left behind - expanding its product line to include a four-ounce “primer” that is designed to be consumed 15 minutes prior to exercise in order to maximize performance. To its credit, however, the new “G4” series of Gatorade does not include caffeine, alcohol or other stimulants to its mix of ingredients.

Health implications
Although many energy drinks are sold based on the idea of enhanced performance or alertness, those claims have been seriously challenged by health experts. Some researchers claim that any measurable improvements in performance are less about the boost one gets from caffeine and more likely the reversal of effects that may lessen performance caused by caffeine withdrawl.

Instead, critics say dangerously high levels of caffeine are doing more damage than good – especially in young people. A poison center in Chicago conducted a three-year study and saw more than 250 cases of caffeine overdose, several requiring hospitalization and intensive care. The average age of those patients was 21.

The deaths of young people around the world who have consumed energy drinks shortly before their death have led officials in France and Denmark to ban the sale of energy drinks. Norway has limited sales of energy drinks to drug stores.

Closer to home, the Sports Medicine Committee of the Virginia High School League (VHSL) recently recommended that energy drink possession and consumption be prohibited by athletes during participation in VHSL practices and competitions because of serious health concerns.

According to the committee, a primary issue is that many young athletes are using energy drinks for post-exercise fluid replacement instead of water or sports drinks like Gatorade. They noted that caffeine acts as a diuretic when the body is at rest and therefore only increases the potential for dehydration. Committee members also warn that high levels of caffeine can elevate blood pressure and heart rates, putting athletes at extreme risk.

Accessible and affordable
Energy drinks and alcoholic energy drinks are readily available at nearly any store in the U.S. Generally priced between $1.50 - $2.50 per unit the cost of energy drinks is comparable to that of regular soft drinks or sports drinks.

Surprisingly, the Marin Institute discovered in several convenience stores in California that some energy drinks containing alcohol were actually cheaper than those without alcohol.

How is that possible? The classification of alcoholic energy drinks as malt beverages means companies pay significantly less in state and federal taxes and allows those drinks to be sold in retail outlets – including many convenience stores – that can sell beer but not spirits. Government regulations allow a product to be classified as a malt beverage if its alcohol content is less than six percent and no more than 49% of their alcohol content comes from distilled spirits flavoring.

Another concern about alcoholic energy drinks is the lack of labeling requirements. Non-alcoholic energy drinks are regulated by the Food and Drug Administration (FDA), while the U.S. Tax and Trade Bureau (TTB) regulates alcoholic energy drinks. The TTB currently does not impose labeling requirements, as the FDA does for virtually all mass produced food and beverages. There is also no federal requirement to disclose the amount of caffeine in alcoholic energy drinks.

Alcohol and caffeine: A dangerous mix
Red Bull’s dominance of the energy drink market can – at least in part – be attributed to its use as a key ingredient in popular mixed drinks.

A 2007 study conducted by Wake Forest University determined that students who consumed alcohol mixed with energy drinks were more likely to experience alcohol-related consequences than those who consumed only alcohol. These consequences included injury, medical treatment, riding in a vehicle where the driver was under the influence and taking advantage of someone or being taken advantage of sexually.

An uphill battle
Cox admits that grassroots efforts to educate communities and families about the dangers of energy drinks – those with and without alcohol – is a significant challenge because of the millions of dollars that are spent annually to advertise such beverages.

“It’s a huge problem and until we have better government regulation, it will continue to grow,” Cox declared. “So, we have to do what we can to get good information in the hands of parents, store owners, police officers and our kids. These energy drinks can have a serious impact on our young people and we need to view them the same way we look at traditional forms of alcohol and any other drug.”

“I would dare say that most people know very little about energy drinks and those that do probably see them as a positive thing – sort of a ‘pick-me-up’ to get them through the day or whatever,” Spiegel added. “But they present a real danger, not only to our physical health but to our ability to make good decisions.”

“Children and teens these days are already faced with enough challenges and we have to be diligent in educating not only them but ourselves about the potential dangers that are out there,” concluded Spiegel. “Pleading ignorance simply is not acceptable.”

For more information on prevention services offered through New River Valley Community Services, visit www.nrvcs.org/prevention.