Professor Christina Vogel, Director of the Centre for Food Policy at City, University of London, discusses how the July election offers a window of opportunity to reduce food and drink-related inequalities affecting young adults.
The delay in banning the sale of energy drinks to individuals under the age of 18 has led to a continuation of the consumption of energy drinks in deprived areas amid widening inequality in the UK.
While a long overdue advertising and promotions ban are both due to come in next year for individuals aged under 16 years, many energy drinks continue to be promoted to and purchased by children and young people. My colleagues and I have previously highlighted the need for a clear ban on the sales of energy drinks to all those aged under 18 years. Including 16–18-year-olds within the ban is important because they are the biggest consumers of energy drinks.
Regulation helps to level the playing field between businesses. While many supermarkets and schools have introduced voluntary bans, industry self-regulation has been shown to be mostly ineffective and smaller stores and takeaways are still widely selling energy drinks to children and young people.
A ban on sales would be maximally effective if it were coupled with minimum-pricing strategies, placement restrictions and a communications campaign detailing their harmful effects.
We encourage all parties to make banning the sale of energy drinks an election promise, alongside other food policies, that will comprehensively tackle poor diet and reduce health inequalities.
Energy drink impact
Concerns about energy drink intake among children and young people have been growing, as have the number of products and size of the industry.
With colleagues at the University of Southampton, I led an investigation into whether energy drink intake differs between children and young people from poorer and wealthier families.
The study used data on 2,587 participants from the National Diet and Nutrition Survey (NDNS), collected between 2008 and 2016. Each participant, aged 11 to 18 years, completed a food diary for four days providing information about what they ate and drank.
The findings showed that children and young people living in more deprived areas and lower income families were more likely to consume energy drinks than those in more affluent areas and more wealthy families. We also found that this gap had increased between 2008 and 2016. Adolescents living in the most deprived areas continued to increase their energy drink intake over this time period, but consumption dropped among those living in wealthier neighbourhoods.
We also found that energy drink intake increases with age, regardless of gender. Markers of poor health, including poorer dietary quality, higher calorie intake and higher body weight were also associated with higher energy drink intake.
Collectively, these findings provide a worrying picture of inequalities among children and young in the UK, and that it is getting worse.
Raise ban to 18
Published in the journal Public Health Nutrition, we called for a ban on the sale of energy drinks to young people under 18 years of age. With this policy topic back on the political agenda in the midst of an election campaign, we are renewing this call.
Restrictions on selling energy drinks to under-16s were originally proposed in ‘Advancing our Health: prevention in the 2020s’. Released in 2019, it said that the UK Government intended to introduce a ban on the sale of energy drinks to that age group, but further action was not taken and a critical age group, 16–18-year-olds, was missing.
Energy drinks contain large amounts of caffeine and sugar, and current UK sales are estimated at 790 million litres per year, with older young people the biggest consumer group.
While many major retailers have imposed voluntary bans on the sale of energy drinks to under 16s and schools have banned consumption of energy drinks on their premises, data from our research suggests many young people think these voluntary bans do not work.
Young people taking part in our study told us that voluntary bans in large supermarket chains and schools are not implemented effectively and are undermined by smaller convenience stores that continue to sell these products to them and their friends. This situation means that energy drink intake has not been curbed among children and young people, particularly in poorer areas where there are more convenience stores and takeaway outlets.
Policy proposals
Banning sales to all children and young people aged under 18 years would align this policy with existing limits for smoking and alcohol products. It would facilitate consistent enforcement across all retail premises and also provide a clear message to the public that these drinks are not suitable for anyone not yet an adult.
Additional policy actions, including minimum pricing of energy drinks, restricting advertising of energy drinks and positioning them in restricted areas of food outlets were also proposed by young people in our study. These proposals would increase impact and should be considered by policymakers as part of a bundle of policies to address the issue.
Young people told us that they did not truly understand the health concerns about energy drinks which suggests the need for a communications campaign. Energy drinks cause harmful physiological effects on the cardiovascular system which are not directly attributable to the large caffeine content. It is likely that the additional energy-boosting substances such as taurine, guarana and vast quantities of sugar are at play. Overuse of energy drinks has caused sudden cardiac death, poor mental health and hinders academic performance; warnings about these health risks need to be clearly communicated to young people and their families.
Implementing these proposals would be a strong step towards supporting better health among under-18s from disadvantaged backgrounds. Strong policy action is needed to enable all children and young people to develop healthily and reach their full potential. The current election campaign provides an opportunity for political parties to properly address this issue and put forward bold and appropriate evidence-informed policy options.
About the author
Professor Christina Vogel is the Director of the Centre for Food Policy, Professor of Food Policy and a registered nutritionist. Her research aims to inform the development, implementation and evaluation of food policies and interventions to improve population health, reduce inequalities and protect our planet.
Christina leads several major research grants from NIHR PHR, NIHR PRP and the Wellcome Trust. Some of her currently projects include product placement trials with a national supermarket chain, evaluations of the UK Government’s Food (Promotions and Placement) legislation and the Healthy Start scheme, and systems investigation of the UK convenience store sector. Her work has received national and international press coverage, and she is Deputy Editor of the scientific journal Public Health Nutrition.