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The question: My teenage son says all his friends are drinking "energy drinks" and he wants to try them too. Are there any risks with these products?

The answer: I find the term "energy drink" to be confusing as it means different things to different people. Not long ago, energy drinks were electrolyte containing sports beverages such as Gatorade or Powerade. Although these drinks are of questionable benefit and may contribute to weight gain and obesity, they are generally regarded to be safe for children when used in moderation.

More recently, the term energy drink has been used to describe beverages that contain significant amounts of caffeine. These caffeine infused drinks (think Red Bull, Rockstar, and Full Throttle) are widely available and have become popular with teens. Arguably, the more appropriate term for these drinks (although admittedly not as catchy) is "caffeine containing beverage" or perhaps "stimulant drug containing drink."

I do have concerns about adolescents using these products. Although moderate amounts of caffeine are generally well-tolerated in adults, not much is known about the effects of high doses of caffeine on the developing brain and body of a teenager. Particularly worrisome is the fact that the naturally high levels of hormones found in healthy teens seem to decrease caffeine metabolism, making adolescents particularly susceptible to caffeine side effects and overdose. Classic caffeine side-effects include insomnia, disrupted sleeping patterns, nausea, headache, and heart palpitations. More severe effects can include high blood pressure, heart rhythm disturbances, and seizures. Caffeine is addictive which can lead to withdrawal symptoms such as headache, fatigue, nausea, and irritability if caffeine intake is suddenly stopped.

Even more worrisome is the fact that teens and young adults have started mixing these drinks with alcohol and other drugs, increasing the chance of serious side effects and intoxication. Although physicians and coroners routinely check victims of motor vehicle accidents for drugs like alcohol and marijuana, blood caffeine levels have not traditionally been screened. As such, we don't know if taking high doses of caffeine either alone or with other drugs may be a contributing factor is these accidents.

Health Canada has made moves recently to regulate this industry by putting limits on the amount of caffeine these beverages contain. This is certainly a step in the right direction. Unfortunately, many caffeine containing beverages, including the highly caffeinated "energy shots," fall outside these regulations.

Given these concerns, I would advise your teen to steer clear of caffeine containing drinks and certainly would not be purchasing them for him. These drinks, like alcohol containing beverages, are probably best reserved for those 19 years of age and older.

Dr. Michael Dickinson is the head of pediatrics and chief of staff at the Miramichi Regional Hospital in New Brunswick. He's a staunch advocate for children's health in Atlantic Canada through his involvement with the Canadian Paediatric Society.

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