It's time to bring in laws to ban the sale of caffeinated energy drinks to children and young people in England to tackle the twin epidemics of obesity and mental health problems, argues Professor Russell Viner, President of the Royal College of Paediatrics and Child Health in The BMJ today.
Children and young people in high income countries consume more sugar and calories than required and are therefore unlikely to need additional energy. This combined with regular caffeine consumption is concerning, explains Viner, as there is little evidence of the effect caffeine could potentially have on the developing body.
In a 2014 survey of over 5000 children in England 14% of 11-15 year olds reported consuming energy drinks at least two to four times a week, and 5% of all young people reported drinking energy drinks daily. The high sugar content in many of these drinks (as much as 27g of sugar per 250ml serving) "undoubtedly contributes to the overall calorie excess and resultant obesity epidemic among our children," he writes.
Caffeine is probably the most commonly used psychoactive drug across the world as it increases activity and heightens attention and awareness. But caffeine also increases anxiety, reduces sleep and is linked with behavioural problems in children, adds Viner. Recent studies also show that it may have concerning effects on the developing brain.
Yet surprisingly little is known about the safety profile of caffeine. Energy drinks can contain at least 320 mg/L of caffeine and evidence is emerging that consumption of energy drinks among children and young people is associated with anxiety, depression, sensation seeking, and increased hyperactivity and inattention.
This is alarming, says Viner, because psychological distress can lead to risky behaviours like drug use, and poorer academic attainment.
But perhaps most concerning are the effects on sleep, he says - a clear inverse association has been established between consumption of caffeinated energy drinks and sleep duration. Humans get energy naturally from a "good diet, refreshing sleep, exercise and, most importantly, interaction with other people", he writes.
He points out that many UK supermarkets have now banned the sale of caffeinated energy drinks to under 16s, and several countries have bans in place. The Royal College of Paediatrics and Child Health support these restrictions, alongside an evaluation of the effect that these policies have on young people's purchasing habits, and their health.
Viner believes the government's consultation must drive a search for improved evidence, but concludes "there is now sufficient evidence to act to protect children."
Externally peer-reviewed? No
Type of evidence: Opinion