Do Energy Drinks Contribute to Kids’ Hyperactivity and Inattentiveness?

Jessica Tomaszewski, MD

Schwartz DL, Gilstad-Hayden K, Carroll-Scott A, et al. Energy drinks and youth self-reported hyperactivity/inattention symptoms. Acad Pediatr. 2015;15(3):297-304.

The Centers for Disease Control and Prevention recently reported that that 62.8% of surveyed high school students drank sweetened beverages daily, and 32.9% drank them 2 or more times a day.1 A significant body of work examines trends in the consumption of sweetened beverages among children and adolescents by sex, income, and race/ethnicity. Previous studies have suggested a link between sweetened beverage consumption and symptoms hyperactivity/inattention.

Due to the shift away from soda and toward so-called energy drinks, Schwartz and colleagues investigated the patterns of sweetened beverage consumption in a middle school cohort by race/ethnicity and sex, looking at the amount and types of beverages consumed. They also examined hyperactivity/inattention symptoms in relation to consumption of these drinks.

Study data came from the Yale School of Public Health’s Community Alliance for Research and Engagement (CARE), in New Haven, Connecticut. A CARE survey including questions about sweetened beverage consumption, physical activity levels, and smoking status was administered to middle school students from 12 randomly selected schools in a single urban district. Data from 1,649 students were examined. The Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire was used to measure outcomes.

Overall, boys reported consuming more sweetened beverages than did girls. The reported amount and variety of consumption also was greater among black and Hispanic students compared with white students. On average, black students consumed 2.37 beverages and 2.22 types of beverages per day, Hispanic students consumed 2.30 beverages and 2.31 types per day, and white students consumed 1.78 beverages and 1.55 types per day. A higher percentage of black students reported consuming fruit drinks compared with Hispanic students, who correspondingly reported more soda consumption.

Interestingly, the first logistic regression model indicated that for each additional sweetened beverage consumed, the odds of a student being at risk for hyperactivity/inattention increased by 14%, holding all other variables constant. Black and Hispanic students and students with a 2-parent family structure were significantly less likely to be at risk for hyperactivity/inattention. Energy drinks were the only specific beverage type that had an independent association with the risk of hyperactivity/inattention, even after adjusting for the number of drinks consumed and other potential confounding variables. The association of hyperactivity/inattention symptoms with the number of drinks consumed and family structure remained significant.

In bivariate analysis, students in the normal range for hyperactivity/inattention symptoms consumed fewer sweetened beverages per day (2.17 vs 2.72) and were significantly less likely to consume energy drinks compared with those determined to be at risk for these symptoms based on their survey responses.

While the mechanism of the link between hyperactivity/inattention and energy drink consumption is unclear, the association definitely is noteworthy. This study may have a number of limitations due to recall bias and geographic restriction, but the results certainly are strong enough to support the American Academy of Pediatrics recommendation that parents limit children’s consumption of sweetened beverages and discourage children’s consumption of energy drinks altogether.

Jessica Tomaszewski, MD, is an assistant clinical professor of pediatrics at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania, and a hospitalist pediatrician at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware.

Charles A. Pohl, MD—Series Editor, is a professor of pediatrics, senior associate dean of student affairs and career counseling, and associate provost for student affairs at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania.


1. Centers for Disease Control and Prevention (CDC). Beverage consumption among high school students—United States, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(23):778-80.