Energy Drinks Cause Serious Illness in Young Children

More than 40% of calls placed to US poison control centers concerning energy drinks involve children under age 6, some of whom suffer serious cardiac and neurological symptoms, according to a study presented at the American Heart Association’s Scientific Sessions 2014, held November 15-19, 2014, in Chicago.

Researchers from Wayne State University and the Children’s Hospital of Michigan in Detroit analyzed records collected in the American Association of Poison Control Centers’ National Poison Data System. The database contains information from calls related to energy drinks exposures from the public and health care providers to 55 poison control centers across the United States. According to the researchers, “exposures” are defined as actual or suspected contact with any substance that has been ingested, inhaled, absorbed, applied to, or injected into the body, regardless of toxicity or clinical manifestation.

Energy drinks can contain pharmaceutical-grade or natural caffeine, both of which can cause the heart to race and blood pressure to increase. Energy drinks with multiple caffeine sources are linked to a higher rate of side effects, which generally involved the nervous, digestive, or cardiovascular systems.

While there is generally 100 to 150 mg of caffeine in a single cup of coffee, some energy drinks contain up to 400 mg per can or bottle. To put that into perspective, the researchers noted that caffeine poisoning can occur at levels greater than 400 mg/day in adults, above 100 mg/day in adolescents, and at 2.5 mg/kg of body weight in children aged less than 12 years. Furthermore, many ingredients listed in energy drinks have never been tested for safety in children.

The researchers identified 5156 cases of energy drink exposure reported to poison control centers between October 2010 and September 2013. Of those cases, 40% were unintentional, unforeseen, or unplanned exposures by young children.

According to the researchers, 42% of the cases involved energy drinks that had been mixed with alcohol and resulted in moderate to major adverse outcomes. Even though the FDA banned pre-packaged energy drinks that contain alcohol in 2010, some individuals may still mix their own, the researchers noted. Since the ban, however, calls to poison control centers about those beverages have fallen sharply.

Across all age groups, the researchers found cardiovascular events such as abnormal heart rhythm and conduction abnormalities in 57% of energy drink exposure cases, while neurological events such as seizures and status epilepticus were identified in 55% of cases.

“Energy drinks have no place in pediatric diets,” said senior study author Steven Lipshultz, MD, in a press release. “And anyone with underlying cardiac, neurologic, or other significant medical conditions should check with their health care provider to make sure it’s safe to consume energy drinks.”

Dr. Lipshultz further explained that reports to poison control centers are likely underestimated because many people do not call hotlines. He also said emergency room visits were not included in the data.

“The reported data probably represent the tip of the iceberg,” Dr. Lipshultz concluded.

The researchers argued that energy drink labels should be improved to reflect caffeine content and potential health risks. The team also called for a continued effort to reduce children’s exposure to energy drinks.