Pound et al. (1) should be commended for their excellent position statement on ‘Energy and sports drink in children and adolescents’. Caffeine Energy Drinks (CEDs) are a relatively new class of beverage—a legal stimulant that can increase alertness, attention, energy, as well as increase blood pressure, heart rate and breathing (2,3). The authors are clear to address the potential health risks of CEDs. However, they do not appear to emphasize the emerging public health hazard of increasing consumption in Canada and globally (4–6)—meanwhile community concern grows about the sale of CEDs (7). More importantly, youth and adolescents are a particularly vulnerable population because of high caffeine levels, added sugars and mixing with alcohol, as well as youth-orientated marketing (8). Further, later adult risk of habitual intake increases (9).
Since 2012, Health Canada regulates the conditions under which CEDs may be sold and marketed using a Temporary Market Authorization process. Enforcement is complaint-driven by the Canadian Food Inspection Agency (10). Among the Health Canada provisions are that CEDs have a caffeine concentration between 200 to 400 ppm (mg/L); and that CED product labels must contain CED-specific messages, such as ‘Not recommended for children’, ‘Do not mix with alcohol’ and ‘Not recommended for individuals sensitive to caffeine’. However, conditions most relevant to children are prohibition of marketing CEDs to children (12 years old and under), prohibition against providing CED samples to children and prohibition against presenting CEDs for hydration and/or electrolyte replacement before, during or after physical activity.
What can we do? We can take an advocacy role through environmental changes and food regulation by broadening legislation to include individuals under the age of majority and supporting compliance regarding the marketing and distribution of CEDs. Certainly, we can join wellness committees that consider supportive policies. For example, healthy vending machines, sponsorship and restriction of sale of CEDs in locally-owned and operated places or promotion of education and awareness-raising.
When it comes to the impact on our youth and adolescents’ health, there is no excuse for inaction. Paediatricians are well-positioned to play an integral role in health promotion. And an even louder voice in advocacy.
References
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