Kids, Energy Drinks and Heart Health: What’s the Hype?

Kristin Lombardi, MD

The sheer quantity of energy drinks on grocery store shelves is overwhelming. There are currently over 100 different brands, in every size and flavor, all of which promise to improve both mental and athletic performance. 

It is all too inviting, particularly for adolescents in search of that extra performance boost. However, the truth is that most of these drinks contain chemicals and additives which can have serious adverse effects on teenagers’ hearts.

The caffeine

Almost all energy drinks contain excessive amounts of caffeine.  While there are strict regulations on the maximum amount of caffeine allowed in over-the-counter products, there are no limits for the amount allowed in energy drinks. 

Furthermore, it can be hard to determine exactly how much caffeine is in a particular energy drink. Some brands currently on the market have about 500 milligrams in one can –the equivalent of 14 cans of soda!

The adverse effects

With their small body size and being relatively “caffeine naïve,” children and adolescents are at a particularly high risk of adverse effects: 

  • Caffeine has clearly been shown to disrupt sleep patterns and worsen symptoms of anxiety.
  • Most energy drinks also contain other additives such as taurine, ginseng, I-carnitine, and yohimbine, some of which have been associated with palpitations, arrhythmias, seizures, and gastrointestinal upset.
  • Energy drink consumption appears to increase production of a natural chemical in the body called norepinephrine, which in turn increases heart rate and blood pressure. This is potentially hazardous in children with underlying congenital heart disease.
  • Additionally, several studies have looked at caffeine’s impact on an electrical measurement of the heart known as the QT interval. These studies have shown a significant increase in the corrected QT in otherwise healthy subjects one to two hours after consuming these drinks.

It can be especially dangerous to gulp energy drinks quickly, to drink multiple cans over a short period of time, or to combine the drinks with alcohol or stimulant medications (such as Adderall).  Some heart conditions have been reported in patients who had multiple energy drinks, including atrial fibrillation and lethal ventricular arrhythmias.

The recommendations

There is currently no clear data that these drinks boost performance, either on the athletic field or in the classroom, and much of the available literature is industry-sponsored.  Not surprisingly, however, these drinks are heavily marketed and advertised on television channels, websites, and social media sites that are attractive to children and teenagers.  

In February 2018, the American College of Sports Medicine (ACSM) released an official statement regarding energy drinks, in which they provide helpful guidance and warnings regarding these beverages.  Their primary recommendations are that energy drinks should not be:

  • consumed by children or adolescents
  • consumed by caffeine naïve or sensitive individuals or individuals with cardiovascular or medical conditions
  • used for sports hydration OR before/during/after strenuous exercise
  • mixed with alcohol or other medications (such as stimulants)

If you are drinking these beverages, please talk with your health care provider about the risks, as well as the possible complications with any medications you are taking or conditions you may have.

For more information on children’s heart health, please visit the Pediatric Heart Center website or talk with your child's pediatrician.