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New energy drinks pose risks for children, pregnant women

Prime energy drinks, now on South African shelves and heavily promoted around the globe, have generated frenzied sales and even bans in some schools. But the drinks may pose problems to under-18 and pregnant or breastfeeding mothers, writes Dr Evangeline Mantzioris in The Conversation.

The drink, offered in two forms – one a “hydration” drink, the other an “energy” drink – is so popular stock has reportedly run out in the UK and the US, and now in SA, but what’s in it?

Caffeine in Prime Energy

Prime Energy contains 200mg of caffeine per can, equivalent to about two to three instant coffees. This caffeine content is roughly double what is legally allowed for products sold in Australia.

Despite its name, Prime Energy drink contains only about 40 kilojoules from carbohydrates, which is one of our body’s key sources of energy. The “energy” in Prime Energy refers to the caffeine, which makes you feel more alert and lessens the perceived effort involved in any work you do.

Caffeine does provide performance benefits for athletes aged over 18. However, given the high quantities in the drinks, there may be better ways to get caffeine in more appropriate doses.

A concern in pregnancy

Health guidelines recommend limiting caffeine intake during pregnancy and while breastfeeding to below 200mg a day.

Theoretically, this drink alone, with 200mg of caffeine per can, should be fine. But practically, diets include many other sources of caffeine including coffee, tea, chocolate and cola drinks. Consumption of these alongside the energy drinks would increase the intake for pregnant women above this safety threshold.

A problem for foetuses and babies

Caffeine can cross the placenta into the growing foetus’ bloodstream. Foetuses can’t break down the caffeine, so it remains in their circulation.

As the pregnancy proceeds, the mother becomes slower at clearing caffeine from her metabolism. This potentially exposes the foetus to caffeine for longer.

Studies have shown a high intake of caffeine is associated with growth restriction, reduced birth weight, preterm birth and stillbirth. Some experts argue there is no safe limit of caffeine intake during pregnancy.

With breastfeeding, caffeine passes into the breast milk. It remains in the baby’s circulation, as they’re unable to metabolise it. Evidence shows that caffeine may make babies more colicky, irritable and less likely to sleep.

What about in children?

Children also have a limited ability to break down caffeine. Combined with their lighter body mass, a caffeine-based drink will have a more pronounced effect.

As such, safe caffeine levels are determined on a weight basis: 3mg per kg of body weight per day. For example, children aged nine to 13 years, who weigh no more than 40kg, should have no more than 120mg of caffeine per day. Those aged between 14 to 17 years who weigh less than 60kg should have no more than 180mg per day.

Studies have shown higher intakes increase the risk of heart problems, such as heart palpitations, chest pain, shortness of breath and fainting. This may reflect underlying heart rhythm problems, which have in some case ended up with children and teenagers presenting to hospital emergency departments.

What about Prime Hydrate, which doesn’t contain caffeine?

This drink contains branch chain amino acids, or BCAA, which the supplements industry promotes as helping gain muscle bulk. There are three BCAA: valine, leucine and isoleucine.

However, there is no evidence they provide any benefit. As such, the Australian Institute of Sport has concluded they are not an effective supplement for athletes.

Supplements in general are not recommended in children or pregnant women as they have not been tested in these groups.

There is also concern about the impact of BCAA and how they may impact the growth of the foetus. A scientific animal study has shown altered patterns of growth with foetal mice.

No human studies have examined BCAA and foetal growth, so that research needs to be done before recommendations can be given to pregnant women. They should avoid these ingredients in the absence of evidence.

Similarly, there has been no testing of these supplements in children under 18, so there is no guarantee of their safety.

Performance-enhancing sport supplements are not recommended for children and adolescents, as they are still developing physically as well as refining and improving their sporting skills.

What does the science say about BCAA?

Scientists have been investigating how BCAA affect adults. Circulating BCAA can affect carbohydrate metabolism in the muscle and therefore can change insulin sensitivity. BCAA are elevated in adults with diet-induced obesity and are associated with increased future risk of type 2 diabetes, even when scientists account for other baseline risk factors.

Adults with obesity and insulin resistance have been found to have higher levels of BCAA. Emerging evidence suggests children and adolescents with obesity also have higher levels of BCAA, which may predict future insulin resistance, a risk factor for diabetes.

However, we don’t yet know if these elevated levels of BCAA in the blood are because people are overweight or obese, or if it plays a role in them becoming overweight or obese.

The bottom line is we have clear evidence that caffeine is problematic for children and women who are pregnant and lactating. And there is emerging evidence BCAA may be also problematic.

Dr Evangeline Mantzioris is programme director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia.


The Conversation article – Prime drinks aren’t suitable for children and pregnant women. Here’s why (Creative Commons Licence)


See more from MedicalBrief archives:


Energy drinks may increase risk of electrical disturbances in the heart


Energy drinks notably diminish blood vessel function in young adults


UK set to ban sale of energy drinks to children


Serious health risks to energy drinks — Harvard study






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