Citing Deaths, Docs Urge NCAA to Limit Energy Drink Marketing to Kids

A group of physicians and scientists are calling on the National Collegiate Athletic Association (NCAA) to make changes to its massive collaboration between Big 12 athletics and Monster Energy, citing potential health risks and teen deaths associated with energy-drink consumption.

As part of the partnership announced last month, Big 12 football and basketball athletes will don Monster Energy-branded jerseys during the regular seasons, and the fields and courts where teams play will display the popular energy drink’s logo.

Virginia-based ophthalmologist David Jacobs, MD, noticed the prominent branding of the energy drink when he went to visit his kid’s Big 12 school, and later became concerned about how the campaign could influence children.

Jacobs is an alum of a Big 12 school, as is his friend, Idaho-based cardiologist Matthew Nelson, MD. The two began reaching out to other cardiologists and created the Protect Young Fans public health initiative, which, as of press time, has gathered over 250 signatures on their petition asking the NCAA to end the Monster Energy partnership.

“We’re concerned about an increase in energy drink consumption among children and youth,” Jacobs told MedPage Today. He noted that with high-profile Big 12 sports in particular, impressionable kids will be looking up to and copying their sports idols.

Their concerns are not abstract, according to an email to NCAA leadership from Jacobs, Nelson, and other physicians and scientists that was shared with MedPage Today.

“American teenagers and young athletes — including 14-year-old Anais Fournier, 16-year-old Davis Allen Cripe, and 17-year-old Larissa Rodriguez — have died following cardiac events reported in association with energy-drink consumption,” they wrote.

They cited survey findings on young people who experienced sudden cardiac arrest or death showing that nearly 20% had consumed energy drinks regularly. Randomized trial data in healthy kids have also shown increases in blood pressure and supraventricular extrasystoles after energy drink consumption, along with altered heart-rate variability.

“These findings establish that the cardiovascular effects are real, reproducible, and measurable in children — and that a susceptible child may appear entirely healthy until the moment a stimulant trigger, an occult cardiac substrate, and physiologic stress converge,” according to the letter.

The 17 other physicians and scientists asked that the NCAA:

1. “Refer this issue to the NCAA Sport Science Institute and the Committee on Competitive Safeguards and Medical Aspects of Sports for an independent, multidisciplinary review”
2. “Ask the Big 12 to voluntarily pause youth-facing activation of the partnership — particularly branding on student-athlete uniforms, fields, courts, student sections, and conference-controlled media likely to reach minors — while that review is conducted”
3. “Develop NCAA guidance for member institutions and conferences on youth-visible sponsorship of energy drinks and other high-stimulant products, including the clear distinction between energy drinks and sports or hydration beverages”

While the Big 12 is a college sports conference, Jacobs argues it’s still a youth-facing organization that does outreach to children, including field days.

Jacobs also noted that some studies have shown that “youth perceive sports-themed energy drink advertising as encouraging them to use energy drinks during sports, and exposure to such advertising is associated with greater energy drink use among them.”

The presence of energy drinks in sports is hardly new; some student athletes have signed brand deals and other athletic organizations have had partnerships with energy drink companies. Recently, on July 1, NCAA lifted its longstanding ban on energy drink television advertising. Ironically, NCAA has a threshold for caffeine consumption for its athletes. While not completely banned, caffeine is still listed alongside banned stimulants like cocaine and amphetamine on the NCAA website.

Alcohol brands also sponsor and heavily advertise in sports, but Jacobs noted that there are already federal laws that limit who can purchase those products, whereas kids and teens can walk into a store and buy an energy drink, which most often come in appealing fruit and candy flavors.

Beyond potential heart problems, an American Medical Association (AMA) spokesperson told MedPage Today that highly caffeinated energy drinks “may lead to a host of health problems in young people,” including anxiety and sleep disturbances.

“Banning companies from marketing these products to adolescents is a commonsense action that we can take to protect the health of American kids,” they noted.

An AMA policy initiative supports banning marketing energy drinks to people under 18, “including opposing commercial advertising, sponsorships, and promotional practices that target or appeal to children and adolescents.”

The Protect Young Fans website homes in on the potential cardiac risks of excessive caffeine consumption for young people, citing the policies of AMA and other major medical organizations on energy drinks and kids. For instance, the American Academy of Pediatrics policy states that “energy drinks containing stimulants should never be consumed by children and adolescents.”

While far more research on this topic is needed, especially on younger patients, the existing literature suggests that energy drinks and excessive caffeine place stress on the heart, Gregory Marcus, MD, a cardiac electrophysiologist at the University of California San Francisco, told MedPage Today.

Marcus, who is not involved in the Protect Young Fans initiative, noted that while some research has suggested that adults who consume naturally occurring caffeine like coffee or tea in moderation may glean some heart benefits, research in kids and adolescents is more sparse.

“What little we do know … suggests that energy drinks, in particular, may actually promote dangerous rhythms and heart failure, even in young, otherwise healthy people, such as teenagers,” Marcus said. As people often get dehydrated while playing sports, Marcus noted concern about people drinking highly concentrated energy drinks while volume depleted.

Regarding partnerships between energy drink brands and major athletic organizations, Marcus said, “there is a problematic implication that these energy drinks are somehow related to the athleticism, physical prowess, or the success … of the people promoting it, and there’s really no evidence that these energy drinks improve health really in any circumstance, nor even good evidence they enhance performance.” Even if there was, he said there’s also no good evidence that potential benefits outweigh risks, “especially to the cardiovascular health system, especially in young impressionable kids.”

An NCAA spokesperson told MedPage Today that “NCAA membership is responsible for making rules and regulations, which the national office interprets and enforces for the membership” and that “if members want to make or change a policy, they can do so through the governance process.”

Monster Energy and Big 12 did not respond to MedPage Today‘s request for comment as of press time.