Saturday, December 8, 2012

Why Do Kids Need an Energy Boost?

Energy is a good thing and children seemingly have and should have an endless supply of it.  Unfortunately a growing number of kids are resorting to artificial means in order to get a jolt.  I will get into some of the reasons kids lack energy a bit later but this issue is red hot right now as Federal lawmakers are pushing the Food and Drug Administration (FDA) to restrict caffeine levels in certain energy drinks, which have been linked to multiple deaths.

A pair of United States Senators want caffeine limits on the beverages after emergency room visits involving such drinks jumped 10-fold from 2005-09.  The Senators are also concerned about other ingredients contained in these drinks, such as guarana, taurine and ginseng. These are generally considered safe when used as food flavorings, but in these drinks, they are used in much higher doses as energy-boosting supplements. The Senators worry that mixed with the caffeine, these stimulants may be unsafe.

5-Hour Energy drinks have been cited in the deaths of 13 people in the past four years, according to reports received by the Food and Drug Administration.

5-Hour Energy has been associated with 92 adverse event reports in that time, including 32 hospitalizations, Shelly Burgess, an FDA spokeswoman said Wednesday. The death reports are open cases being investigated by the FDA, she said.

It was revealed last month that Corona, Calif.-based Monster's drinks have been cited in the deaths of five people in the past year, according to incident reports that doctors and companies voluntarily file with the FDA.

5-Hour Energy said on its website that its energy shot contains the same amount of caffeine as 12 ounces of the leading cup of premium coffee.

In a statement, Living Essentials spokeswoman Elaine Lutz said, "it is important to note that submitting a serious adverse event report to the FDA, according the agency itself, is not construed by FDA as an admission that the dietary supplement was involved, caused or contributed to the adverse event being reported or that any person included in the report caused or contributed to the event." [1]

Energy drinks were the topic of one of my recent articles and earlier in the summer I touched on the importance of sleep to youth athletic development.  The following research shows a potentially strong association between energy drinks and poor sleep quality.

To determine the extent of energy drink use and the association with sleep problems and sleepiness during combat operations, Walter Reed Army Institute of Research analyzed data collected by Joint Mental Health Advisory Team 7 (J-MHAT 7) to Operation Enduring Freedom in Afghanistan in 2010. The analysis showed that 44.8% of deployed service members consumed at least one energy drink daily, with 13.9% drinking three or more a day. Service members drinking three or more energy drinks a day were significantly more likely to report sleeping 4 hours or less a night on average than those consuming two drinks or fewer. Those who drank three or more drinks a day also were more likely to report sleep disruption related to stress and illness and were more likely to fall asleep during briefings or on guard duty.  [2]

The above study must be taken with some reservation considering the high stress environment that is experienced by active duty service members.  I know that kind of environment would negatively impact my ability to sleep.  It is unclear whether service members with sleep problems used more energy drinks to stay alert, or if heavy use of energy drinks led to sleep disruptions; published studies suggest a cyclical combination of both.

So why is poor sleep quality such a big deal especially for developing young athletes?

Med Page Today has an article discussing the correlation between a lack of sleep and increased rate of injuries.  The article cites a paper from the American Academy of Pediatrics and notes that sleeping less than 8 hours showed a statistically significant increase in injuries in adolescent sports.  I was more surprised to read that 77% of the students reported sleeping less than 8 hours. Perhaps all these energy drinks…

According to Matthew Milewski, MD, of Children's Hospital Los Angeles,
"Adolescent athletes may benefit from additional sleep as they get older. We'd like injury prevention programs to focus on sleep education."

Of the more than 38 million children who participate in organized sports each year, about 10% will receive medical treatment for sports injuries. Roughly half of the injuries are believed to be related to overuse, and about 50% of those are believed to be preventable, Milewski said. [3]

Several factors are thought to be associated with a greater risk for sports injury, including increased participation and specialization, strength training, and decreased time off, but it's possible that lack of sleep contributes as well.

Insufficient sleep -- defined by the CDC and the National Sleep Foundation as less than 8 hours per night among high school students -- is epidemic in this age group, Milewski said, pointing to a CDC study that found that about 68.9% of high school students were getting an inadequate amount of sleep.

Over a 21-month period, 57% of the athletes sustained injuries that were recorded by athletic trainers at the school; 38% of all athletes suffered multiple injuries.

Injuries affected a wide range of body parts, most commonly the hand or wrist (30 injuries), knee (28), shoulder (24), ankle (19), back (18), and head (17).

After multivariate adjustment, getting insufficient sleep was the strongest independent predictor of injury. [3]

The study joins previous analyses that have found associations between getting enough sleep and benefits for adolescents. For example, delaying the start of the school day at a private high school in Rhode Island resulted in teens getting more sleep, which in turn was associated with improvements in alertness and motivation and less daytime sleepiness, fatigue, and depressed mood. [3]

I have a strong sense that the current youth sport and technology culture are partially responsible for poor sleep quality in children. Young athletes experience competitive demands that closely rival that of fully developed professionals.  Kids play late at night and often has to get up early the next morning for school, maybe even an early practice or game. The quality of their nutrition is poor and they live this cycle nearly year round.  They have little downtime for physical and mental recovery, despite bodies that are literally changing everyday due to growth and development and restoration is exactly what is required for them realize and sustain physical and mental performance improvement.  Contrast this to pro athletes that travel on charter flights, have trained nutrition, fitness and therapeutic professionals at their beckon call and most importantly have at minimum an off-season of 3-4 months.  What ever lead us to believe kids could handle a pro-style schedule when they clearly are under equipped to do so?  Many kids are also over-stimulated due to constantly being connected via technology such as cell phones.  I am sure I am not the only one that knows a kid that text at all hours of the night?  Is it any wonder they may resort to something like an energy drink? 

This type of lifestyle for children can be the start of a slippery slope of behaviors that result from poor sleep quality and the ensuing fatigue that accompanies it.  Any program that hopes to maximize a child’s athletic development or classroom performance must address the importance of quality sleep.

Additional reading:

The importance of sleep for youth athletic development

Energy Drinks useful or slippery slope

As if energy drinks weren’t enough for parents to worry about now food companies are juicing up snack foods like Cracker Jacks!

The Detroit Free Press’ Mitch Albom also recently touched on this topic:

5-Hour Energy warned about deceptive ads:

Statistically Speaking
Military and civilian findings show that more than half of adolescents and young adults drink at least one energy drink per month, with approximately 6% consuming energy drinks daily. [2]

According to a study published in the journal Pediatrics, the total amount of caffeine contained in some cans or bottles of energy drinks "can exceed 500 mg (equivalent to 14 cans of common caffeinated soft drinks) and is clearly high enough to result in caffeine toxicity." 

The Monster Beverage Corporation has stated that a 16-ounce can of Monster Energy contains 160 milligrams of caffeine (equivalent to more than four cans of Coke). A 24-ounce can of Monster contains 240 milligram of caffeine (equal to nearly seven cans of Coke).

Because of their high caffeine content, the American Academy of Pediatrics concluded that energy drinks "should never be consumed" by children or adolescents. 


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