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Feature Energy Drinks

Energy drinks: cause for concern or scaremongering?

BMJ 2013; 347 doi: (Published 24 October 2013) Cite this as: BMJ 2013;347:f6343
  1. Bob Roehr, journalist
  1. 1Washington, DC, USA
  1. BobRoehr{at}

Bob Roehr looks at the evidence and debate over whether the FDA should be reining in the energy drink industry

Caffeine is a stimulant that has been ubiquitously consumed across cultures from time immemorial. But new forms of caffeinated products—including energy drinks, chewing gum, and maple syrup—have the US Food and Drug Administration (FDA) wondering whether the compound should continue to be categorised as “generally regarded as safe” and regulated with minimal restrictions.

Proponents of regulation point to basic science suggesting the potential for cardiovascular risk and that children might be a particularly vulnerable population that needs protection, even if the risk is slight.

Opponents say that theory flies in the face of extensive experience with caffeine products and the consumption of tens of billions of cans of energy drinks; there is no evidence of a problem on a population basis or in the emergency room—it is scaremongering by a few people out to make a name and a buck for themselves.

Sales of energy drinks such as Red Bull and Monster have rocketed to $12.5bn (£7.7bn; €9bn) in 2012 in the US and are projected to reach $21.5bn by 2017. Most of these drinks go down the gullets of teens and 20-somethings, who are a generational divide from regulators, and this perhaps as much as anything explains their elders’ unease with these new formulations of traditional ingredients.

Round one

Four Loko was the poster child for the first round of restrictions on these products. It was first marketed in 2005 as an energy drink containing alcohol, caffeine, taurine, and guarana in a variety of sweet flavors. But concern that the stimulants might mask the depressant effects of the alcohol led some universities and state regulators to issue a blanket ban on Four Loko and similar products.

The final blow came in …

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