Energy drinks and children: what the evidence shows on caffeine, sleep, behavior and the heart

College football jerseys in a major US athletic conference now carry the logo of an energy drink, and a group of doctors wants it removed. Their coalition formed in the wake of a sponsorship deal between Monster Energy and the Big 12 Conference, the Associated Press reported on October 3, 2026. The group has asked the conference to pause the deal and the National Collegiate Athletic Association, or NCAA, to review how energy drinks are marketed to young people.

“Kids are going to see energy drinks now promoted by the universities and the athletes that they admire and want to emulate,” said Matthew Nelson, an Idaho cardiologist involved in the effort.

The argument is about children, who are not the drinks’ stated market and are among their regular consumers. Here is what research shows about how much they drink, what the drinks contain and what has been linked to them.

What energy drinks contain, and why children differ from adults

The active ingredient is caffeine. Depending on the product, caffeine content can range from 80 to 300 mg per serving. By comparison, a typical 8-ounce coffee contains about 80 to 100 mg and some sodas contain 50 mg or less. The two products tested in one trial also contained taurine, an amino acid, along with vitamins and other proprietary ingredients.

The dose matters more for a small body. A review of caffeine safety in the journal Frontiers in Psychiatry makes the point simply: young children may be vulnerable to the effects of caffeine because they weigh less. The same can that gives a 180-pound adult a moderate dose gives a 90-pound child twice as much per pound.

Energy drinks are often shelved beside sports drinks and confused with them. They are different products. Sports drinks are designed to help replace water and electrolytes lost through sweating after activity. The American Academy of Pediatrics, in a clinical report on both, wrote that the terms should not be used interchangeably. That confusion is the coalition’s specific worry about jersey logos. “The kids will think of them as sports drinks, which they’re not,” Nelson said.

How many children drink energy drinks

Consumption is common and varies widely by country and survey. An overview by researchers at the University of York, commissioned by the UK government, pooled 15 earlier reviews and found that worldwide, from 13% to 67% of children had consumed energy drinks in the past year. Its own analysis of British survey data found that 3% to 32% of children, across UK countries, consumed energy drinks weekly.

American figures point to heavy use. In the federally funded Monitoring the Future survey, 23% of 12th graders, 20% of 10th graders and 18% of eighth graders reported consuming energy drinks daily.

Some patterns recur across studies. Boys drink more than girls. A 2016 review found that taste and energy-seeking were identified as key drivers, and branding and marketing were highlighted as major influences on what young people chose. It added a line that bears on the sponsorship dispute: awareness of possible negative effects was low.

What studies link to energy drinks in children

Two systematic reviews by an overlapping group of researchers in northeast England form the core of the evidence. The first, published in 2016, covered 46 studies. The second, from Teesside University and Newcastle University in 2024, updated it: after weak studies were set aside, a total of 57 studies were included. It covered children and young people up to the age of 21 years.

The associations fall into three groups.

Area	What regular consumption was linked to
Sleep and school	Short sleep duration, poor sleep quality, low academic performance
Behavior and mental health	Smoking, alcohol use, binge drinking, other substance use, psychological distress
Physical health	Headaches, stomach aches, insulin resistance, tooth decay and erosion

On sleep and school, the 2024 review found positive associations with short sleep duration, poor sleep quality and low academic performance. Caffeine’s effect on sleep is the least surprising of these, since delaying sleep is what the drug does.

On behavior, many studies reported a strong association with smoking, alcohol use, binge drinking, other substance use and intentions to start those behaviors. The review also noted links with psychological distress and symptoms of depression.

On the body, the earlier review reported physical health symptoms such as headaches, stomach aches, hyperactivity and insomnia. The update added metabolic and dental associations, among them insulin resistance, dental caries and erosive tooth wear. Insulin resistance means a reduced response to the hormone that controls blood sugar, and dental caries is tooth decay.

One detail strengthens the case that the drinks are involved. In the 2016 review there was some evidence of a dose-response effect, meaning problems were more common the more a child drank. The UK overview found a related pattern: frequent drinking (5 or more days per week) was associated with low psychological, physical, educational and overall well-being.

The reviews also recorded the one benefit on offer. The 2016 authors noted that 2 experimental studies involving small numbers of junior athletes demonstrated a positive impact on limited aspects of sports performance.

Energy drinks, caffeine and the heart

The most serious concern is the heart. Caffeine raises heart rate and blood pressure, and in large doses can disturb the heart’s rhythm.

Experimental evidence comes from adults. In a randomized trial at the University of the Pacific in California, 34 volunteers with an average age of 22 each took part in three sessions a week apart. Participants consumed 32 oz of either energy drink A, energy drink B, or placebo within 60 minutes. Thirty-two ounces is just under a liter, and both drink A and drink B contained caffeine, at 304 to 320 mg.

Over the next four hours the researchers recorded blood pressure and the heart’s electrical activity. They focused on an interval on the heart tracing called QT, which reflects how long the heart muscle takes to reset between beats. A longer QT interval is associated with dangerous rhythm disturbances. After the energy drinks it lengthened by about 18 to 20 milliseconds at its peak, compared with about 12 milliseconds after placebo. Blood pressure rose as well.

The changes were modest, in healthy adults, after a large volume drunk quickly. The authors drew a targeted conclusion: individuals with acquired or congenital long QT syndrome and those with hypertension should be more vigilant and limit their energy drink intake. Long QT syndrome is a heart-rhythm condition that can be inherited.

Serious events do occur. The caffeine safety review counted emergency visits in the United States: between 2005 and 2011, there were 79,438 emergency room visits attributable to overconsumption of energy products containing high levels of caffeine in patients aged 12 years and older. In most such cases, the reviewers wrote, the mechanism seems to be tachyarrhythmia and involves unusually high doses of caffeine. Tachyarrhythmia is an abnormally fast heart rhythm.

Deaths are rare. The coalition cites three in children, including a 16-year-old in South Carolina who died in 2017 after drinking a soda, a latte and an energy drink in one day. “The heart can wear out, the nervous system can go haywire and you can have really serious consequences,” said Tamara Hannon, an Indiana pediatrician who chairs the pediatrics academy’s nutrition committee.

What pediatricians, reviewers and the industry say about energy drinks

Medical bodies have taken a firm line for years. The American Academy of Pediatrics concluded in 2011 that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents.

On caffeine in general, the pediatrics academy recommends children ages 12 to 18 limit caffeine to 100 mg a day. Younger kids are discouraged from consuming any caffeine. A single serving at the upper end of the range holds three times that daily limit.

The British reviewers go further. The 2024 review concludes that the precautionary principle should be considered in regulatory policy and in restricting sales to children and young people. That principle holds that where harm is plausible and serious, regulators need not wait for proof.

The industry’s position is that its products are labeled and not aimed at children. The American Beverage Association told the Associated Press that members voluntarily disclose caffeine totals and carry advisories such as “Not intended for children, pregnant or nursing women, or persons sensitive to caffeine.” Monster Energy said: “Mainstream energy drinks have been marketed worldwide for more than 30 years and more than 100 billion energy drinks have been sold and safely consumed globally.”

The college sports regulator says it cannot intervene. The NCAA doesn’t have the authority to regulate conference or school sponsorship agreements, its chief medical officer told the doctors.

Limits of the evidence on energy drinks and children

The central weakness is study design. In the 2016 review, most studies were one-off surveys, involved participants aged 11-18 years, and were conducted in North America or Europe. A study of that kind questions people once. It can show that teenagers who drink energy drinks sleep less. It cannot show which came first, and a tired or risk-prone teenager may simply be more likely to reach for one.

The UK overview was blunt about this. Most of the evidence is from surveys, making it impossible to distinguish cause from effect. Using a formal grading system, its assessment suggests that the evidence is weak.

Better evidence will be hard to get. Giving children high doses of caffeine in an experiment would be difficult to justify. Trials are unlikely to be ethical; longitudinal studies, which follow the same children over years, could provide stronger evidence, the York team wrote. The 2024 review asks for the same thing: where feasible and ethical, additional longitudinal studies are required to ascertain causality.

The heart trial has its own limits. It tested adults, a single large dose and short-term measurements.

Finally, the drinks are a mixture. Studies rarely separate the effect of caffeine from that of sugar or other ingredients, or from the caffeine a child gets from coffee, tea and soda on the same day.

How much caffeine is reasonable for a particular child depends on age, weight and any heart condition, which is assessed by their doctor.

Energy drinks can put more caffeine into a teenager in one serving than pediatricians recommend in a day, while the studies linking them to poor sleep, low grades and risk-taking are surveys that cannot separate cause from effect.