Caffeine has long been a go-to aid for enhancing alertness and combating fatigue, with coffee standing as one of the most widely consumed beverages globally, an estimated 1.6 billion cups are consumed daily. While caffeine’s role in human performance is well established, the introduction of modern energy drinks has transformed the landscape of stimulant-containing beverages.
Despite their popularity, energy drinks raise important clinical concerns, including potential adverse effects on cardiovascular, neurological, and metabolic health.
This article provides a research-informed overview of energy drinks, examining their ingredients, purported benefits, health risks, and how they compare to traditional caffeinated beverages like coffee. Additionally, evidence-based alternatives for supporting energy and cognitive performance are explored to guide safe and effective patient recommendations.
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Energy Drinks and Their Ingredients
According to the National Institutes of Health (NIH), energy drinks are any product promoted to increase energy, enhance physical performance, and enhance mental alertness. This includes soft drinks and “energy shots," beverages usually sold in 2 oz of concentrated liquid.
Common ingredients of energy drinks include:
- Caffeine
- Taurine (an amino acid)
- Sugar
- B Vitamins
- Guarana (a plant extract)
- Ginseng (an herb)
- L-carnitine (an amino acid)
- Inositol (a sugar alcohol)
Health Risks and Concerns
Energy drinks often contain high levels of caffeine, sugar, and various other stimulants and additives. While they may provide a temporary energy boost, regular or excessive consumption may pose several health risks, especially for adolescents, athletes, and individuals with underlying medical conditions.
Common Side Effects of Energy Drink Consumption
With high levels of caffeine and sugar, along with other ingredients, there are some potential adverse effects from drinking energy drinks, including:
- Insomnia
- Diarrhea
- Cardiovascular disease
- Kidney disease
- Hypertension
- Depression
- Tachycardia
- Irritability
- Anxiety
- Headaches
Potential Cardiovascular Risks
One of the most concerning effects of energy drinks is their potential effect on the heart. A study reported that energy drinks may significantly increase heart rate and cause spikes in blood pressure, which may lead to cardiac arrhythmias, which are potentially life-threatening irregular heart rhythms.
Prolonged use has also been associated with cardiomyopathy, a condition in which the heart becomes abnormally enlarged and weakened, impairing its ability to pump blood effectively. An article in The Journal of Pediatrics highlighted concerns about cardiovascular toxicity in adolescents who regularly consume energy drinks.
Sugar Content and Metabolic Risks
Many energy drinks contain up to one-third of a cup of sugar per serving. This high sugar content can contribute to:
- Obesity
- Type 2 diabetes
- Sugar addiction and cravings
Risks in Physically Active Individuals
The U.S. Air Force has issued warnings about energy drink use, especially among military personnel in training. These beverages may increase the risk of dehydration, particularly when consumed before or during intense physical activity.
Regulation of Energy Drinks
Several regulatory agencies and associations have made recommendations about energy drinks.
Food and Drug Administration (FDA)
Due to the high levels of caffeine and sugar, in 2018, the FDA released new guidelines for labelling energy drinks. Labels must show how much caffeine is in a drink, and that information must be shown separately from the ingredient lists.
In addition, manufacturers are encouraged to add a label warning, "Not recommended for children, pregnant or breastfeeding women, or those sensitive to caffeine."
International Society of Sport Nutrition (ISSN)
An ISSN report found that consuming energy drinks 10-60 minutes before exercise may improve mental focus, alertness, anaerobic performance, and endurance in adults, predominantly through caffeine.
The ISSN then cautioned that higher-calorie energy drinks can lead to weight gain and negatively affect blood glucose and insulin levels.
The American Academy of Pediatrics’ (AAP) Committee on Nutrition and the Council on Sports Medicine and Fitness
The AAP has encouraged pediatric health care providers to discourage stimulant ingredients in energy drinks and recommend that parents limit or avoid sugar-sweetened beverages for their children.
Association of Directors of Public Health (ADPH)
In 2024, the ADPH joined more than 40 health-related organizations in calling on the US Government to restrict the sale and marketing of energy drinks to children and youth.
Alternatives to Energy Drinks
Maintaining energy throughout the day doesn’t have to require high-caffeine or high-sugar beverages. The most effective and sustainable energy source for the human body comes from a balanced diet, adequate hydration, regular sleep, and consistent physical activity.
A nutrient-rich diet, including whole grains, leafy greens, lean proteins, and healthy fats, can naturally support optimal vitamin levels and sustained energy.
Lifestyle Strategies to Support Natural Energy
The following strategies may help support balanced energy levels:
- Stress management (like cognitive behavioral techniques, therapy, and journaling)
- Mindfulness and meditation to improve focus and reduce mental fatigue
- Time management and work-life balance
- Adequate sleep
- Regular physical activity
Beverage-Based Alternatives
For individuals aiming to reduce or replace energy drink consumption, several beverages may offer more moderate caffeine levels or contribute to hydration and overall well-being when incorporated into a balanced lifestyle:
- Green Tea: This naturally caffeinated beverage typically contains less caffeine than coffee and provides polyphenols, including catechins, which have been studied for their potential antioxidant properties. Green tea may be a suitable option for individuals seeking a gentler stimulant effect.
- Black Tea: With a moderate caffeine content, generally higher than green tea but lower than coffee, black tea is another option that offers dietary polyphenols. Its effects on alertness may vary depending on individual tolerance and consumption patterns.
- Coffee (in moderation): Coffee is a widely consumed source of natural caffeine. Intake of up to 400 mg of caffeine per day (approximately 3–4 cups of brewed coffee) is generally considered safe for most healthy adults. As with any caffeinated product, individual sensitivity and overall dietary context should be considered.
- Coconut Water: Naturally free of caffeine, coconut water contains small amounts of electrolytes such as potassium and magnesium. While not a direct energy booster, it may contribute to fluid intake and support hydration.
Key Takeaways
- Energy drinks may pose health risks. While they can temporarily enhance alertness, many contain high levels of caffeine and sugar, which may contribute to adverse effects such as insomnia, irritability, elevated blood pressure, and, in some cases, heart rhythm disturbances, particularly in sensitive individuals or with excessive use.
- Certain groups may be at higher risk. Adolescents, individuals with underlying conditions, and those engaging in intense physical activity may be more vulnerable to potential side effects, including dehydration and cardiovascular strain.
- Regulatory guidance urges caution. U.S. and international agencies recommend clearer caffeine labeling and limiting access for children. Healthcare providers are encouraged to discuss safe caffeine intake and sugar consumption with patients.
- Alternative beverages may offer gentler options. Green tea, black tea, and moderate coffee intake provide lower caffeine levels. Coconut water and caffeine-free electrolyte drinks can support hydration without stimulants.
- Lifestyle strategies remain key. Balanced nutrition, sleep, physical activity, and stress management are core contributors to sustained energy and cognitive function.
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