When you see kids racing around the playground, many if not most look like they have been drinking energy drinks. But when children actually do drink these sugar-sweetened, caffeinated beverages, they run the risk of attention and behavior problems that can cause difficulties at school.

Researchers at Yale University School of Public Health found that those middle school students who drink sugar-sweetened energy drinks have a 66 percent greater risk of hyperactivity and inattention than those who do not drink them.

We were surprised that it was not just the quantity of sugar-sweetened beverages, but the type of beverage.

The findings are especially serious because the inability to sit still and pay attention can affect school performance.

The study findings lend support to recommendations by the American Academy of Pediatrics to limit the amount of sugar-sweetened beverages that children drink.

“We were surprised that it was not just the quantity of sugar-sweetened beverages, but the type of beverage,” Jeannette Ickovics, corresponding author on the study, told TheDoctor in an email.

A lot of research has focused on sugary sodas, she said. However, in this study, the researchers found energy drinks are the real culprit in terms of their association with hyperactivity and inattention symptoms.

The researchers surveyed almost 1,700 middle school students from an urban school district in Connecticut. The average age of the students was about 12 years old. Boys were more likely to drink energy drinks than girls and Hispanic and black students drank more energy drinks that their white peers.

“We don’t know exactly why that is,” said Ickovics. It may be related to advertising and the appeal of the combination of sugar and caffeine.

So what can schoos and parents do? Schools can restrict sales of these drinks in their cafeterias and vending machines, Ickovics said. And advertising aimed at children can also be limited in terms of content and the television programs and times during which energy drinks are promoted.

“We need to understand more about the content of energy drinks,” she added. Scientists know they contain a lot of sugar and caffeine, but are not sure about the effects of other ingredients.

The team plans to continue to examine changes in the consumption of energy drinks among middle school students and their impact on children's performance in school, looking at the association between consumption of energy drinks and other sugar-sweetened beverages with measures of academic achievement, such as grades and test scores, health and mental health issues.

The study was published recently in Academic Pediatrics.