Energy Drinks

Energy drinks have been linked to kidney failure, cardiac arrest, stroke, and death, but their warning labels remain woefully inadequate.

Energy drinks are highly caffeinated beverages like Red Bull, Monster, and Rockstar. (5-hour Energy is an energy shot: a smaller, more concentrated form of the same kind of energy blend.) In addition to caffeine, they contain extreme levels of sugar: this double whammy is part of the reason energy drinks are so dangerous.

Equally worrisome is the combination of relatively unknown ingredients such as taurine, ginseng, guarana (which packs two to five times the caffeine of a coffee bean), L-carnitine, and inositol. Though each of these ingredients might be fine in isolation, there is little-to-no research on their effects in large doses, long-term, and in combination with each other.

Energy drink companies are also a growing threat because they target children and adolescents in their marketing. They advertise heavily on youth-oriented networks like MTV and Adult Swim, have strong social media presences, and often sponsor extreme sporting events that draw a young crowd. This isn’t an accident. The energy drink industry has taken a page out of Big Tobacco’s marketing guide, and aims to amass lifelong consumers of their toxic products.

Making matters worse, energy drinks are not subject to even the same kind of FDA regulation as sodas, which have a caffeine limit that most energy drinks exceed. They are sold in school vending machines and at sporting events. Despite dozens of deaths, a mountain of troublesome research, and calls for more regulation, the energy drink industry remains almost untouchable.

A Brief History of Energy Drinks

The energy drink industry is a relatively young one, with standard-bearer Red Bull charging onto the scene in 1987 with a promise to give consumers wings.

In the early ’00s, the success of Red Bull inspired followers like Rockstar (2001) and Monster (introduced by Hansen’s Natural in 2002). These companies copied the Red Bull blueprint of selling not just a drink but a lifestyle, and sponsoring extreme sports athletes and events. In 2009, 5-hour Energy appeared, packing a highly concentrated dose of caffeine and B vitamins in just a two-ounce shot.

Initially, all of these companies labeled their products not as beverages but as dietary supplements, allowing them to skirt pesky FDA requirements. But a rash of energy drink-related deaths between 2011 and 2013—including Anais Fournier, Alex Morris, and Cory Terry—brought energy drinks under greater scrutiny. In response to mounting public pressure, Monster Energy and others reclassified as beverages in 2013.

These companies also faced several wrongful death and false advertising lawsuits, most or all of which they have settled out of court.

The Center for Science in the Public Interest (CSPI) has linked 34 deaths to energy drinks, and mounting research shows that energy drinks raise blood pressure and stress hormones and can trigger arrhythmias. The data suggests they aren’t safe for a broad swath of people, including children and adolescents, diabetics, people with heart conditions or seizure disorders, and people on medication.

But despite all the damning research, litigation, and controversy, energy drink sales have never been higher. They climbed to $50 billion worldwide in 2015, and are expected to hit $60 billion by 2021.

Energy Drink Ingredients 

First and foremost, energy drinks contain caffeine: a lot of it, and often from multiple sources (which studies suggest is more dangerous than single-source caffeine).

A 2012 Consumer Reports article, “The buzz on energy-drink caffeine,” found that many energy drinks under-report how much caffeine is in their products by as much as 20%. A single drink can contain as much as 242 mg of caffeine—nearly three times the amount in a cup of coffee. A two-ounce 10-Hour Energy Shot contains 422 mg. And these numbers don’t even account for these drinks’ excessive sugar content, or other stimulants like guarana (more on this below).

The FDA does not require energy drink companies (or anyone else) to disclose how much caffeine is in their products because dietary information is only required for nutrients, while caffeine is a “natural chemical.” This allows energy drinks to conceal or undersell their caffeine content—legally.

Energy drinks also contain a truckload of sugar. Most 8-ounce energy drinks have between 25 and 30 grams—comparable to a 12-ounce can of soda. A 16-ounce energy drink, then, contains 50-60 grams, roughly twice the recommended daily intake.

Sixty-nine percent of energy drinks also contain artificial sweeteners, but because more than half of these drinks are not labeled “diet,” they are not required to disclose the presence of these sweeteners to consumers.

As if that’s not bad enough, energy drinks also contain a surprising amount of sodium—three to four times the average amount found in soda. A 16-ounce can of Monster contains 180 mg: nine times the average.

Finally, energy drinks frequently include a potpourri of B vitamins and other supplements—usually an unsettling mix of taurine, guarana, ginseng, L-carnitine, and inositol. Shockingly little research has been done on the combined effects of these ingredients, or on their long-term side effects.

A 2013 New York Times report, “Energy Drinks Promise Edge, but Experts Say Proof Is Scant,” determined that “the energy drink industry is based on a brew of ingredients that… have little, if any benefit for consumers.”

Growing Concerns Over Safety

As energy drinks’ popularity has soared in this country, so have emergency room visits involving their consumption. The number of these visits more than doubled between 2007 and 2011—from 10,064 in 2007 to 20,783 in 2011.

These drinks can be lethal. The Center for Science in the Public Interest (CSPI) has linked 34 deaths to energy drinks since 2004, with half of those occurring in just the past few years. Of these 34 deaths, 22 involved 5-hour Energy, 11 Monster, and one Rockstar.

2015 study by the International Journal of Cardiology found a strong correlation between energy drinks and patients with heart palpitations. These patients were deemed otherwise healthy and not at a higher risk for cardiovascular disease: those who consumed two or more energy drinks a day had a significantly higher occurrence of heart palpitations and chest pain.

The study above echoes a November 2015 study by the American Heart Association, which found that drinking a single 16-ounce energy drink raises blood pressure and doubles stress hormones in young, healthy adults.

Doctors and Lawmakers Call for More Regulation, To No Avail

At its 2013 meeting in Chicago, the 200,000-strong American Medical Association (AMA) voted to support a ban on the marketing of energy drinks to minors, citing potential heart problems and other adverse side effects.

That same year, Senators John D. Rockefeller IV, Edward J. Markey, Dick Durbin, and Richard Blumenthal held a Congressional hearing to address the growing energy drink crisis. They also sent an open letter to 17 major energy drink manufacturers requesting that they stop targeting children, pull their products from K-12 schools, label all caffeine content, and file Adverse Event reports with the FDA. Only four complied.

In 2014, the Center for Science in the Public Interest (CSPI) linked 34 deaths to energy drinks and pleaded for more FDA regulation, stating, “How many deaths will it take to get the FDA to protect consumers from energy drinks, with their high levels of caffeine and untested herbal and chemical ingredients?”

In 2016, Morgan & Morgan launched a White House petition calling for more regulation of the way the energy drink industry markets and sells to minors. The petition quickly amassed nearly 3,000 signatures.

In response to all of the above, the FDA has enacted exactly zero regulation.

Energy Drink Bans

In 2013, in response to a spate of energy drink-related deaths and other adverse events, Canada capped the caffeine levels allowed in single-serving beverages at 180 mg. To do so, it forced 28 companies—including Monster, Red Bull, Rockstar, and 5-hour Energy—to reclassify as food products. (They had previously been regulated as “natural health products.”)

In May 2014, Lithuania became the first EU country to ban the sale of energy drinks to minors. In January 2016, neighboring Latvia followed suit, enacting a similar law which will take effect this June.

In 2015, India banned energy drinks containing caffeine and ginseng—including Monster Energy—deeming the mixture “irrational and impermissible.”

More recently, here in the U.S., Middlebury College banned the sale of energy drinks on campus, citing health hazards and links to problem behaviors.

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