Pediatricians Sound Alarm About

Kids Consuming Sports, Energy Drinks

By John Voket

One only has to look in the dugouts, along the sidelines, or in the trash left behind after youth sports teams play or practice to see that local athletes as young as elementary school age drink plenty of Gatorade and other types of sports drinks. And as those young athletes graduate into the middle and high school age range, there are plenty of cans of energy drinks like Red Bull and Monster being tossed down as well.

These popular and tasty sports and energy drinks are heavily marketed to children and adolescents, but in most cases kids don’t need them according to Newtown resident and pediatrician Jack Fong. Dr Fong, a Danbury Hospital former head of pediatrics and a medical advisor to the Danbury and New Fairfield school districts, agrees with his peers who report that some if not most of these products contain substances that could be harmful to children.

In a new clinical report, the American Academy of Pediatrics (AAP) outlines how these products are being misused, discusses their ingredients, and provides guidance to decrease or eliminate consumption by children and adolescents.

The report, “Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate?” is published in the June 2011 issue of Pediatrics (published online May 30).

“There is a lot of confusion about sports drinks and energy drinks, and adolescents are often unaware of the differences in these products,” said Marcie Beth Schneider, MD, FAAP, a member of the AAP Committee on Nutrition and co-author of the report. “Some kids are drinking energy drinks — containing large amounts of caffeine — when their goal is simply to rehydrate after exercise. This means they are ingesting large amounts of caffeine and other stimulants, which can be dangerous.”

Sports drinks and energy drinks are different products, said Holly J. Benjamin, MD, FAAP, a member of the executive committee of the AAP Council on Sports Medicine and Fitness, and a co-author of the report. Sports drinks, which contain carbohydrates, minerals, electrolytes, and flavoring, are intended to replace water and electrolytes lost through sweating during exercise.

Sports drinks can be helpful for young athletes engaged in prolonged, vigorous physical activities, but in most cases they are unnecessary on the sports field or the school lunchroom.

“For most children engaging in routine physical activity, plain water is best,” Dr Benjamin said. “Sports drinks contain extra calories that children don’t need, and could contribute to obesity and tooth decay. It’s better for children to drink water during and after exercise, and to have the recommended intake of juice and low-fat milk with meals. Sports drinks are not recommended as beverages to have with meals.”

Dr Fong said even with sugar-free sports drinks, the artificial sweeteners or salt used to flavor the beverages act as an appetite stimulant.

“Take away the word ‘energy’ and you still typically have sugar, even in the good old fruit juice, which should be limited to one 8-ounce serving daily,” Dr Fong said. “But I know when a young person gets through with a sports event or practice, they may be consuming one or two bottles at a time, every day. That’s inappropriate, but not unusual.”

Energy drinks contain substances not found in sports drinks that act as stimulants, such as caffeine, guarana, and taurine. Caffeine — by far the most popular stimulant — has been linked to a number of harmful health effects in children, including effects on the developing neurological and cardiovascular systems.

Energy drinks are never appropriate for children or adolescents, said Dr Fong. In general, caffeine-containing beverages, including soda, should be avoided.

“These drinks provide a jacked up amount of ingredients in quantities many times more than even an active child needs,” he said. “When it comes to sports drinks, more is not better.”

The AAP report contains tables listing specific products available today and their contents.

“In many cases, it’s hard to tell how much caffeine is in a product by looking at the label,” Dr Schneider said. “Some cans or bottles of energy drinks can have more than 500 mg of caffeine, which is the equivalent of 14 cans of soda.”

Dr Fong said the human body has a highly efficient regulatory system, and while a 17- or 18-year-old who just finished running a marathon might need some mineral or electrolyte replacement, a 7- or 8-year-old who just finished a soccer game does not.

“In the case of young children, even in a competitive game, there is not enough loss of electrolytes to require replacement. In these cases, water is the best and most health alternative for them.”

AAP recommendations include:

*Pediatricians should highlight the difference between sports drinks and energy drinks with patients and their parents, and talk about the potential health risks.

*Energy drinks pose potential health risks because of the stimulants they contain, and should never be consumed by children or adolescents.

*Routine ingestion of carbohydrate-containing sports drinks by children and adolescents should be avoided or restricted, because they can increase the risk of overweight and obesity, as well as dental erosion.

*Sports drinks have a limited function for pediatric athletes; they should be ingested when there is a need for rapid replenishment of carbohydrates and/or electrolytes in combination with water during prolonged, vigorous physical activity.

*Water, not sports drinks, should be the principal source of hydration for children and adolescents.