In a written response, Maureen Storey, senior vice president of science policy at the American Beverage Association, an industry group, said the report "does nothing more than perpetuate misinformation" about energy drinks.
She wrote that many of the drinks contain much less caffeine than coffee from popular coffeehouses, and caffeine amounts are listed on many of the products.
The response from Red Bull added that because "an 8.4-ounce can of Red Bull contains about the same amount of caffeine as a cup of coffee (80mg), it should be treated accordingly."
Still, the report found that high caffeine content has been associated with serious adverse effects especially in youngsters who have underlying health condition. "The labels on these products sometimes list a general caffeine content instead of giving you exact milligrams," warned Dr. Marcie Schneider, one of the pediatricians on the nutrition review board of the American Academy of Pediatricians, the group that published the paper. "They often don't account for the caffeine in some of the other chemicals which can be fairly significant."
Although the FDA limits caffeine content in soft drinks, which are categorized as food, there is no such regulation of energy drinks which are categorized as dietary supplements.
"Because kids are smaller, the recommended dose of caffeine that's safe is lower," noted Tara Harwood, pediatric nutritionist at the Cleveland Clinic. "So for the average adult, what is recommended is less than 400 mg of caffeine per day. But in kids, they recommend less than 100 mg of caffeine per day. And the average energy drink, for 8 ounces has about 80 mg of caffeine. So for one 8-ounce can that's putting you close to that limit. Energy drinks do have about three times the caffeine of a regular soda."
Harwood added, "We don't really have studies on the effects of caffeine on a developing brain or all the developing organs in a kid and how that can actually affect them. Especially in some of the mood disorders, such as ADHD, we don't really know its effects yet. So it's not really regulated and it's really understudied."
And caffeine is just one of the many issues many experts have with these beverages. For example, one common ingredient, the herb guarana, contains three times the caffeine as coffee, and has been known to cause difficulty urinating, vomiting, and abdominal cramps, spasms and most seriously, heart arrhythmias. Yohimbine, another typical ingredient, can cause rapid heart rate and high blood pressure in usual doses and even death in susceptible individuals. Theobromine, a compound similar in its effects to caffeine, speeds up heart rate and frequently leads to sleeplessness, tremors, restlessness and anxiety. Until several overdose deaths were reported, the diet drug ephedra was also a common additive.
"These ingredients in and of themselves may have undesired side effects," Schneider cautioned. "We also don't know how each of these chemicals may potentiate the others."
The authors argue that because energy drinks have no therapeutic benefit in children and may actually put some children at risk for adverse health events, these products need to be better studied and more tightly regulated particularly for certain populations. They also recommend better education and awareness.