Earlier this year, half a dozen students from City Hill Middle School in Naugatuck, Connecticut, accompanied their science teacher Katrina Spina to the state capital to testify in favor of the University of Ottawa. a bill banning the sale of energy drinks to children under 16 years of age. After spending three months in a chemistry unit studying the ingredients and potential health impacts of mainstream energy drinks (known as brands such as Red Bull, Monster Energy, and Rockstar), students came to a conclusion that Reflects: "Energy drinks can be fatal to everyone, but especially teens," said Luke Deitelbaum, Grade 7. "While this is true, most energy drink companies continue to market them specifically for teens."
A 2018 report found that more than 40% of American teens surveyed had consumed an energy drink in the last three months. Another survey found that 28% of teenagers in the European Union had consumed this type of drink in the past three days.
This popularity contrasts sharply with recommendations from groups such as the American Academy of Pediatrics and the American College of Sports Medicine, which claim that young people should give up these products altogether. These recommendations are based on concerns about health issues that, although rare, may occur after consumption, including seizures, delirium, rapid heart rate, stroke, and even sudden death. A US government report found that between 2007 and 2011, the number of emergency service visits involving energy drinks more than doubled to nearly 21,000.
Of these, about 1,500 were children aged 12 to 17, although the number of visits in this age group increased only slightly over the four years.
For their part, the manufacturers of energy drinks say that they are unjustly targeted. During the hearing in Connecticut, Red Bull North America's public relations chief, Joseph Luppino, asserted that there was no scientific justification for regulating energy drinks differently from other beverages caffeinated drinks, such as sodas, coffee and tea, especially when some coffees serve coffee with a higher caffeine content than a can of Red Bull. "The determination of age is an incredibly powerful tool," said Luppino, and should be reserved for "inherently dangerous products" like nicotine.
The Connecticut clash, which pitted City Hill students against a growing global industry of $ 55 billion a year, was the latest in an ongoing debate on the safety and regulation of energy drinks. . In recent years, countries such as the United Kingdom and Norway have been considering banning sales to young people, while Lithuania and Latvia have enforced prohibition measures. In the United States, with Connecticut, lawmakers from the states of Maryland, Illinois, and Indiana have introduced bills but none has been signed. A South Carolina bill to ban sales to children under the age of 18 – and to fine those who get caught selling them to minors – was passed by the legislature in April and is presently before the Committee of the Whole of Medical Affairs of that State. He is supported by the parents of a 16-year-old child who died from a caffeine-induced cardiac event after consuming a coffee, a soda and an energy drink after two hours.
While the regulatory status of energy drinks continues to be debated, a growing number of consumers and public health advocates are wondering why and how a product loaded with caffeine and other stimulants has become so popular among young people. The reasons are a mixture of lax regulation, the use of caffeine as an enhancer of athletic performance in adults and some scientific uncertainty.
According to sports cardiologist John Higgins, a professor at UTHealth's McGovern Medical School in Houston, there is another factor: "a very, very smart ad."
Historically, government agencies such as the US Food and Drug Administration have struggled to regulate caffeinated beverages. Although it offers some guidance, the FDA allows liquid product manufacturers to decide themselves to market their products as dietary supplements, or as conventional foods and beverages, which are subject to different regulatory requirements. Most of their products are now regulated as food rather than as food supplements, which has not always been the case.
Researchers at the Johns Hopkins School of Medicine, in a review published in the journal Drug and Alcohol Dependence, note that the lack of consistency is partly due to our long history of love with drinks in which caffeine is naturally present, including coffee and tea. In 1980, citing health concerns, the FDA proposed eliminating caffeine from soft drinks, which are regulated as foods. However, manufacturers have stated that caffeine is a flavor enhancer. The FDA has approved caffeine, but has limited the maximum level of non-alcoholic cola drinks to 0.02%, or about 71 milligrams per 12 ounce serving.
"If caffeine had not been accepted as a flavor enhancer, but as a psychoactive ingredient," Johns Hopkins researchers write, "non-alcoholic drinks may have been regulated by the FDA as drugs." , which is subject to additional regulations.
When energy drinks first appeared on the US market in the late 1990s and early 2000s, some manufacturers claimed that these products were neither drugs nor conventional foods, but dietary supplements. . Drugs containing caffeine require warning labels, but not dietary supplements. "It's a stark contradiction that in the United States, a [over-the-counter] stimulant drug containing 100 mg of caffeine per tablet (eg, NoDoz) should include [a series of] The warnings, "write Johns Hopkins researchers," while an energy drink at 500 mg can be marketed without these warnings and no information on the amount of caffeine dose contained in the product. "
Since 2009, sports and medical organizations have started to publish statements of principle discouraging the consumption of energy drinks by young people. In 2011, the American Academy of Pediatrics concluded that energy drinks "are not appropriate for children and adolescents and should never be consumed". In addition, the group warned that teens could mistakenly use energy drinks, rather than sports drinks like Gatorade, for rehydration. during physical activity. "Advertisements for young people contribute to confusion," wrote the authors.
Two years later, in 2013, questions about security and marketing arose in the Congress halls. Three Democratic senators have opened an investigation into the business practices of energy drink companies. They found that teenagers aged 13 to 17 are frequent targets for the marketing of energy drinks and said in a written report that "this population is also vulnerable to the harmful effects of energy drink consumption". claims not evaluated or justified by the FDA. For example, AMP Energy manufacturers marketed beverages as helping to "energize and hydrate the body," while Red Bull ads promised "increased concentration and speed of response."
(In fact, a few months before the Senate hearing, Monster Beverage Corporation and Rockstar Inc. announced their intention to follow in Red Bull's footsteps by stating that their products were food rather than dietary supplements.)
Jennifer L. Harris, a researcher at the Rudd Center for Food Policy and Obesity, currently housed at the University of Connecticut, also testified at a committee hearing. She and her team had already conducted a study on the marketing of sugary drinks to children. "What we learned about energy drinks amazed us," she told the audience.
Energy drink companies have been the pioneers in using social media to market their products, Harris said. At the time of its study, Red Bull and Monster Energy were the fifth and twelfth most popular brands on Facebook, a platform particularly popular at the time by students and teens. In addition, Harris said, "energy drink brands often promote teenage athletes and musicians and sponsor local events, where they provide free samples, including to minors". Marketing is effective, she noted. Sales of most other beverage categories declined, but energy drink sales increased 19% the previous year to $ 8 billion in 2012.
The energy drinks industry has defended its products and marketing practices vigorously. In his statement to Congress, Rodney Sacks, CEO of Monster Beverage Corporation, noted that a 16-ounce can of Monster Energy contains 160mg of caffeine. In contrast, the equivalent amount of Starbucks coffee contains 330 mg, more than double. In addition, Monster cans include a label recommending consumption by children. (According to the guidelines of the American Beverage Association, a professional group, energy drinks should not be marketed to children under 12, and other major brands such as Red Bull and Rockstar wear similar tags recommend not to consume them.)
In addition, Sacks and representatives of Rockstar, Inc. and Red Bull North America have denied that their companies advertise young teenagers. According to Mr. Sacks, this would undermine the credibility of the brand image in the eyes of young adults "- nominally their target demographic.
It's not everyone who buys that. A study published in 2017 in the journal Public Health Nutrition, for example, aimed to determine whether young consumers perceived the advertising of energy drinks as targeting people their age and under. Researchers at the University of Waterloo randomly assigned more than 2,000 Canadians aged 12 to 24 to one of Red Bull's four online ads. Among the youngest subjects – those aged 12 to 14 – almost 72% of participants who watched an advertisement highlighting the company's sponsorship of the X Games, an extreme sports event, perceived that advertising was intended to people of their age and under.
Researchers at the University of Waterloo compare energy beverage marketing practices with those of twentieth-century cigarette manufacturers. "While tobacco advertising was apparently aimed at adults only," she wrote, "she has nevertheless achieved a very high level of attraction and seduction among young people."
What's more, and perhaps not surprisingly, in all age groups, 71% of those who were shown a Red Bull advertising with a sports theme – the X Games, for example, or an image of a snowboarder in flight accompanied by the following text: "RED BULL GIVES YOU WIIINGS" – thought that the advertising that they were viewing promoted the use of energy drinks during sports.
This is a problem, said Matt Fedoruk, Chief Scientific Officer of the US Anti-Doping Agency (USADA). Although her organization is best known for its role in controlling banned substances by Olympic athletes, it also promotes a positive sport culture for youth. Fedoruk says they're asking questions about energy drinks from athletes of all ages.
"Caffeine is the most studied ergogenic aid on the planet," says Fedoruk. Its use is widespread among top athletes. The research even produced recommendations for ingestion before exercise. But these guidelines have been developed for adults. Young people who try to follow them could quickly surpass the recommendations of the American Academy of Pediatrics for adolescents: no more than 100 mg of caffeine a day, or roughly the amount in a typical cup of coffee. Also, because energy drinks are made in adult serving sizes, Fedoruk says, it's easy for a child to have too much. "Depending on the product you choose, you could certainly give your young child or young athlete doses far beyond what can be safe for their weight and height."
With regard to young athletes, "our experts recommend both water-based drinks and sports drinks as the best option to hydrate," writes Danielle Eurich, spokeswoman for the 39; USADA. Athletes who exercise less than an hour probably do not even need sports drinks, she adds. "The water would be the best."
Last year, sports cardiologist John Higgins conducted a small study in which healthy medical students consumed a 24-ounce can of Monster Energy. Ninety minutes later, the students' arteries were measured for their ability to bounce or expand after being squeezed by a blood pressure cuff. The dilation helps to control blood flow, increasing circulation if necessary, including during exercise. In this study, the blood flow of medical students was "significantly and negatively affected," says Higgins.
Higgins suspects that the combination of ingredients – caffeine and other stimulants such as guarana, taurine, L-carnitine, as well as added vitamins and minerals – interferes with the endothelium, a thin layer of cells controlling the dilatation. But he can not say for sure because there is not enough research. Higgins' own study was preliminary and did not have a control group. In addition, a recent study by a group of Harvard researchers revealed considerable limitations to the existing literature on energy drinks. The authors found that most of the studies used small samples or used a cross-sectional design that did not identify the causal link. Large longitudinal studies require time and money.
Higgins explains that the main reason why there is no evidence of safety is that energy drinks are not classified as drugs by most countries. "They are classified as supplements, additives, etc." Until more data is available, Higgins' opinion is that energy drinks should be avoided before, during and after exercise. Anyone under 18 should avoid them completely, he says. This recommendation has been approved by the American College of Sports Medicine.
However, during the hearing in Connecticut, Red Bull's Joseph Luppino insisted that there was plenty of evidence of security. He referred to the European Food Safety Authority, which carries out risk assessments of the food chain for the European Union: "They concluded unequivocally that it was not there. has no synergistic effect between the various ingredients contained in energy drinks. "
When asked to comment, the European Agency referred to its 2015 report and a spokesperson explained the findings: In general, the combination of substances that we usually find in the Energy drinks "would not affect the safety of single doses of caffeine up to 200 mg. "People likely to drink a 16-ounce can of Rockstar or a 24-ounce can of Monster containing 240 mg of caffeine and other stimulants have not been accounted for by the analysis. The spokesman for the European agency also warned that there was not enough data to determine whether other common energy drink ingredients such as guarana and taurine had an influence on acute effects. caffeine on blood pressure.
Monster and Rockstar have not responded to repeated requests for comments. Asked about the gap between the characterization of the European report by Luppino and that of its conclusions, the agency, Erin Mand, spokesman for Red Bull, pointed out particular passages of the report suggesting the safety of combinations of Special ingredients up to 200 mg. caffeine. She further noted that "her individual portion products fall below 200 mg of caffeine".
The American Beverage Association also did not respond to interview questions but said: "Energy drinks have been consumed by millions of people worldwide for over 30 years and are recognized as being safe for consumption. . The amount of caffeine contained in energy drinks is usually half the amount found in a coffee and does not differ from the caffeine contained in other foods and beverages. In addition, major US energy drink companies have taken voluntary measures to ensure that their products are not marketed to children. "
In the spring of 2017, Gary Watts, the coroner of Richland County, South Carolina, released autopsy results from Davis Cripe, the teenager whose death prompted the Carolina bill to ban the sale of energy drinks to minors. The cause of death: a caffeine-induced cardiac event that causes a probable arrhythmia. "In general, autopsies do not cause arrhythmia because the heart is not really damaged," said Watts.
After the Cripe collapse at school, a staff member who previously worked as a nurse in a cardiology unit diagnosed a cardiac arrhythmia.
"Who can say that has not happened yet?" Said Watts, whose services performed autopsies on other young adults who died. "That's probably the case, it's just that we could not document [the cause] at that time, with someone on the scene who says, "Okay, it's an arrhythmia." Watts thinks there are too many uncertainties about energy drinks to be able to say that they are safe for teens. "I'm not trying to get rid of energy drinks," he said. "I know a lot of people use them. But I think that age is a concern on which everyone has to be really serious. "
As for the Connecticut bill, he did not leave the committee, but in mid-May, City Hill Middle School students and their teacher returned to the capital to lobby lawmakers. They shared student-generated information leaflets, as well as informal results from a survey of students and parents, indicating widespread support for their bill among them. In the meantime, the students say, their brothers and sisters and their comrades continue to consume energy drinks – on football pitches, in canoes, in front of video game consoles.
"It's so interesting," City Hill student Emily Fine said about energy drink manufacturers and their products, and how they are still putting them on the market.
This article was originally published on Undark. Read the original article.