Kara Breymeyer SU ’11 Community Rotation SPORT AND ENERGY DRINKS: SUPPLEMENTS for School-age Children There has been a rise in consumption of sport drinks, flavored water, and energy drinks. The marketing for these beverages may mislead the public portraying them as a healthier option to soda. This handout looks at these beverages as they should be better understood and recommendations from leaders in pediatric health care for children and adolescents should be followed. Sport Drinks/Flavored waters are flavored beverages that often contain carbohydrates (or non-nutritive sweeteners), minerals, electrolytes such as sodium, potassium, calcium, magnesium, and sometimes vitamins or other nutrients. The Academy of American Pediatrics (AAP) published a position paper in June 2011 that has strong recommendations and considerations for the consumption in this population. 1 Promote water as the primary source of hydration for children and adolescents Understand the difference between sport and energy drinks Energy drinks potentially pose a health risk because of stimulant content, should be avoided by children and adolescents Routine consumption of carbohydrate containing beverages should be restricted or avoided to limit excessive calorie intake which can lead to risk of obesity and dental erosion Sport drinks should be used in combination with water ONLY for periods of prolonged, vigorous sports participation or other physical activities The AAP reports there are no advantages to ingesting vitamins and minerals in beverages. A well-balanced diet will provide adequate nutrient intake and is the preferred source for all vitamins and minerals.1 The most appropriate use of sports drinks are for youth engaged in prolonged vigorous intense activity who need to maintain levels of blood glucose supply with carbohydrates to replenish available energy as muscle glycogen stores decrease. Electrolytes are necessary to replenish those lost through sweating.1 Listed are the most popular sport drinks and flavored waters in America1 note: most bottles are 20oz Sport Drink/ Calories/16oz Electrolytes Other Ingredients Flavored Water Carbohydrate/16oz Gatorade – Original 100 kcal Sodium, potassium -- PepsiCo, Inc 28g CHO Gatorade – Propel 20kcal/ 6g CHO Sodium Vitamins B3,B5,B6,B12,C,E Gatorade – Endurance 100 kcal/ 28g CHO Sodium, potassium Calcium, magnesium All Sport – Body Quencher 120 kcal Sodium, potassium Vitamin C All Sport, Inc 32g CHO All Sport – Naturally Zero 0 kcal/ 0 CHO Sodium, potassium Vitamins B3,B5,B6,B12 Accelerade 160 kcal Sodium, potassium Vitamin E, calcium, protein Pacific Health Lab, Inc 30g CHO Powerade - Original 156 kcal Sodium Iron Coca Cola Company 38g CHO Powerade - Zero 0 kcal/ 0 CHO Sodium, potassium Vitamins B3,B6,B12 Powerade – Ion4 100 kcal/ 28 CHO Sodium, potassium Vitamins B3,B6,B12 Sobe Lifewater ~ 80 kcal Sodium, potassium Vitamins B3,B5,B6,B12,C,E Distributed by PepsiCo, Inc ~ 32g CHO and more Many flavors varies by flavor varies by flavor Vitamin Water ~100kcal Potassium Vitamins B3,B5,B6,B12,C,E, Glaceau ~15g CHO folate, pantothenic acid, Coca Cola Company varies by flavor guarana, magnesium, Many flavors calcium – varies by flavor See other side for Energy drinks definitions and examples Energy Drinks contain caffeine, carbohydrates, and legal stimulants such as guarana, taurine, ginseng, and vitamin B complex. They are often marketed to adolescents as natural alternative beverages to increase fun, promote alertness, cognitive performance, and focus attention.2 At this time, there are no solid data that shows the long-term effects of energy drinks on the human body. Several small studies have looked at the impact of energy drinks on sports performance and indicators of cardiac disruption such as ECG, blood pressure, and pulse. The results were mixed and inconclusive in addition to being among small specific sample groups.2,3 There have been many reported and published case studies in which healthy and unhealthy people have had adverse reaction as serious as death after the consumption of energy drinks. 2,3 More research is needed to understand the possible deleterious effects of these beverages over time. 2,3 These beverages can vary in caffeine content, often higher than caffeinated sodas. Nutrition fact labels should be looked at closely as caffeine content is not always easily identified on packaging. 2,3 Binge drinking energy drinks and consumption with alcohol is another potential health risk adolescents may be exposed to, as this is becoming a popular pairing. Energy drinks can mask the effects of intoxication and lead to more alcohol intake and dehydration. 2,3 AAP takes the position that energy drinks are not appropriate for children and adolescents because the stimulants used as ingredients pose a potential health risks to them. They should not be sold in schools.1 It is recommended to limit intake of energy drinks to 16oz or less per day, do not use for exercise hydration or enhancement, and report any adverse reaction to health care practitioners.3 Listed below are the four best selling energy drinks in America3 Brand Name Calories/16 oz Caffeine/16 oz Stimulant ingredients Manufacturer Red Bull 220 kcal 160mg taurine, glucuronolactone, niacin(B3), inositol(B8), Red Bull GmbH 54g CHO pyrixodine hydrochloride(B6), cyanocobalamin(B12), Pantothenic acid (B5) RockStar 280 kcal 160mg, part of taurine, niacin(B3), inositol(B8), pyrixodine hydrochloride Distributed by 62g CHO 1.35g “energy blend” (B6), riboflavin(B2), PepsiCo cyanocobalamin(B12), pantothenic acid(B5), ginseng, guarana, ginko biloba, milk thistle, L-carnitine, Monster 200 kcal ??, listed as part of taurine, glucuronolactone, niacin(B3), riboflavin(B2), Hansen Natural 54g CHO 5000mg “energy blend” inositol(B8), pyrixodine hydrochloride(B6), cyanocobalamin(B12), ginseng, guarana, L-carnitine, Full Throttle 220 kcal 141mg, part of taurine, niacin(B3), pyrixodine hydrochloride (B6), Coca Cola 57g CHO 3000mg “energy blend” cyanocobalamin (B12), ginseng, guarana, L-carnitine, Reference: 1Schneider MB, Benjamin HJ et al. Clinical Report–Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Pediatrics. 2011;127(6): 1182-89. 2Kaminer Y. Problematic use of energy drinks by adolescents. Child and Adolescent Psychiatric Clinics of North America. 2010;19(3):643-50. 3Higgins JP, Tuttle TD, Higgins CL. Energy beverages: content and safety. Mayo Clinic Proceedings. 2010;85(11):1033-41. .