research article on sports drinks

Sports Drinks

Sports drinks are advertised to replenish glucose, fluids, and electrolytes (sodium, potassium, magnesium, calcium) lost during strenuous exercise as well as to enhance endurance. [1] Some brands also contain B vitamins associated with increased energy (not to be confused with energy drinks , which are a different product entirely). Sports drinks contain carbohydrate in the form of sugar (e.g., glucose, high-fructose corn syrup, sucrose) or contain no sugar and are flavored instead with low-calorie sweeteners . The specific amount of sugar and electrolytes in sports drinks is intended to allow for quick hydration and absorption.

This type of nutrient depletion generally occurs only with high-intensity exercise that lasts an hour or more. For the non-athlete, a sports beverage is just another sugary drink .

Sports Drinks and Health

Research has shown benefit of sports drinks in adult athletes (though not conclusive as some studies show no benefit), but research in children is lacking. [2] Children sweat at highly variable rates, so it is more difficult to establish an amount of exercise time that the drinks may be useful. [1] However, with monitoring by coaches or parents, providing these drinks to children and adolescents who are exercising vigorously for more than 60 minutes may help to prevent dehydration. For children who are engaged in routine or play-based physical activity, these drinks are usually unnecessary. [1]

Estimates show that sports drinks comprise about 26% of total sugar-sweetened beverage intake in adolescents. [2] Sports drinks contain less sugar than soda and energy drinks, but still contain simple sugars. For example, a nutritional comparison shows that a 12-ounce cola drink contains about 39 grams of sugar, compared with 21 grams of sugar in a popular sports drinks. Drinking too many of these, especially when not performing vigorous exercise, can increase the risk of overweight/obesity and other health problems such as type 2 diabetes, cardiovascular disease, and gout. There is also a risk of dental caries.

A study following more than 4,100 females and 3,400 males for 7 years as part of the Growing Up Today Study II found that the more frequently sports beverages were consumed, the greater the association with an increased body mass index leading to overweight/obesity, especially in boys. [2] The authors cited endorsements of the drinks by sports celebrities as a strong influencer in young male athletes. The drinks may also be perceived as healthy because they are allowed to be sold in schools and sporting events, so may be consumed in excess.

Bottom Line

Water that is calorie-free and accessible without cost to most people is the beverage of choice taken with and between meals. A sports drink may be used by people engaging in exercise of vigorous intensity for more than one hour, especially if sweating heavily. Perhaps of greater importance in athletes of any age, but especially youth, is to encourage a balanced diet , snacks as needed, and adequate water that will best enhance physical and mental performance. Pediatricians should discuss the use of sports drinks with their young patients and parents to ensure that all are aware of the health risks, and if used, are monitored carefully. [3]

Sugary Drinks Energy Drinks

Pound CM, Blair B; Canadian Paediatric Society, Nutrition and Gastroenterology Committee, Ottawa, Ontario. Energy and sports drinks in children and adolescents. Paediatr Child Health . 2017 Oct;22(7):406-410.
Field AE, Sonneville KR, Falbe J, Flint A, Haines J, Rosner B, et al. Association of sports drinks with weight gain among adolescents and young adults. Obesity (Silver Spring, Md) . 2014;22(10):2238–2243.
Schneider MB, Benjamin HJ. Sports drinks and energy drinks for children and adolescents: Are they appropriate? Pediatrics . 2011;127(6):1182–9.

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This article has a correction. Please see:

Errata - September 11, 2012
Deborah Cohen , investigations editor
1 BMJ, London WC1H 9JR, UK
dcohen{at}bmj.com

Sports drinks are increasingly regarded as an essential adjunct for anyone doing exercise, but the evidence for this view is lacking. Deborah Cohen investigates the links between the sports drinks industry and academia that have helped market the science of hydration

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Prehydrate; drink ahead of thirst; train your gut to tolerate more fluid; your brain doesn’t know you’re thirsty—the public and athletes alike are bombarded with messages about what they should drink, and when, during exercise. But these drinking dogmas are relatively new. In the 1970s, marathon runners were discouraged from drinking fluids for fear that it would slow them down, says Professor Tim Noakes, Discovery health chair of exercise and sports science at Cape Town University. At the first New York marathon in 1970, there was little discussion about the role of hydration—it was thought to have little scientific value.

So how did the importance of hydration gain traction? An investigation by the BMJ has found that companies have sponsored scientists, who have gone on to develop a whole area of science dedicated to hydration. These same scientists advise influential sports medicine organisations, which have developed guidelines that have filtered down to everyday health advice. These guidelines have influenced the European Food Safety Authority, the EU agency that provides independent advice on the evidence underpinning health claims relating to food and drink. And they have spread fear about the dangers of dehydration.

Much of the focus on hydration can be traced back to the boom in road running, which began with the New York marathon. Manufacturers of sports shoes and the drink and nutritional supplement industries spotted a growing market.

One drink in particular was quick to capitalise on the burgeoning market. Robert Cade, a renal physician from the University of Florida, had produced a sports drink in the 1960s that contained water, sodium, sugar, and monopotassium phosphate with a dash of lemon flavouring. 1 2

Gatorade—named after the American Football team, the Gators, that it was developed to help—could prevent and cure dehydration, heat stroke, and muscle cramps, and improve performance, it was claimed. 2

The first experimental batch of the sports drink cost $43 (£28; €35) to produce but has spawned an industry with sales of around £260m a year in the UK alone—and consumption is increasing steadily.

“The buzz around sports and energy drinks is here to stay. This has remained the fastest growing sector in the UK soft drinks market in recent years,” an industry report suggests. 3 In the US the market is even bigger. In 2009, forecasters, Mintel, valued it at $1.6bn, and the market is projected to reach $2bn by 2016. 4

The rapid rise in consumption is hardly surprising—sports drinks have the might of multinationals behind them. PepsiCo bought Gatorade in 2001 and both Coca-Cola and GlaxoSmithKline (GSK) have their own sports drinks—Powerade and Lucozade respectively. The companies are a partner and service provider, respectively, to the London 2012 Olympics.

The key behind the meteoric rise in consumption of sports drinks lies in the coupling of science with creative marketing. What started life as a mixture of simple kitchen food stuffs has become an “essential piece of sporting equipment.” 5

According to Noakes, the sports drink industry needed to inculcate the idea that fluid intake was as critical for athletic performance as proper training. “It became common for athletes to state that the reason why they ran poorly during a race was not because they had trained either too little or too much, but because they had dehydrated. This was a measure of the success of the industry in conditioning athletes to believe that what they drank during exercise was as important a determinant of their performance as their training,” he says.

Indeed, after the “invincible” Australian cricket team lost the 2005 Ashes test series to rivals England, a research fellow at the Australian Institute of Sport (AIS) started to monitor players’ levels of dehydration. 6

The previous year (2004), the institute had entered a partnership with Gatorade. The AIS’s first Gatorade fellow, Kelly Drew, conducted a study on hydration among the cricketers, taking urine samples and testing their sweat.

“We do know that 50% of them turned up today dehydrated, which is not a good sign,” she told the Australian press. 6

The AIS is just one organisation backed by Gatorade—other powerful sports medicine organisations also receive funding from drinks companies. The US National Athletic Trainers’ Association (NATA), a representative body of sports health professionals with over 35 000 members, works closely with Gatorade.

The company has taken out advertisements in NATA’s newssheet that look like academic papers. These “research adverts” are just one example of how companies promote the idea that the benefits of their drinks are based on decades of thorough scientific research.

Selling science

Gatorade documents from 2010 show that sales staff are encouraged to watch an internal video called “Selling the Science” and told to “make sure consumers understand the science behind Gatorade.” Promotion also hinges on the notion that sports drinks are among the “best researched food products on the planet,” Bob Murray, a former director of the Gatorade Sports Science Institute wrote in 2001. 7

And they’re not the only ones—when GSK reshuffled its entire communications department earlier this year, it said a key part of its strategy would be promoting the science behind its products. “The science that goes into our brands is a competitive advantage. Lucozade, for example, is subject to more than 100 clinical trials,” a spokesperson said. 8 9 The company has suggested that the “market is all about credibility.” 10

In recognition of this, GSK set up the Lucozade Sports Science Academy (LSSA) in 2003, comprising a sports nutrition website, links with leading universities, and a high-tech gym at the company’s headquarters. 10 Marketers intended that bottles of the drink would be stamped with the LSSA insignia to reaffirm the scientific credibility when sports nutrition toolkits were handed out to gym instructors to educate them in the use of Lucozade Sport products. 10

Indeed, just as drug companies have appointed key opinion leaders to influence doctors’ prescribing patterns, sports drink and supplement companies seek to work with gyms and instructors. Virgin Active has a partnership with Powerade, for example, 11 and the GSK owned supplement brand, Maximuscle, has a partnership with LA Fitness. 12

Like GSK, Gatorade has pushed heavily on the science. In 1985, Gatorade, then owned by Quaker Oats, set up its Gatorade Sports Science Institute (GSSI) in Barrington, Illinois, to conduct and publish research and to educate sports health professionals and athletes on sports nutrition and exercise science.

Just as drug companies held sponsored symposiums in exotic locations, Quaker Oats held invitation only annual conferences in locations around the world . Attendees included advisers to the world’s most influential sports authorities.

Indeed, the editors of a sports medicine book on performance were among them. Ron Maughan, Louise Burke, and Edward Coyle, coeditors of Food, Nutrition and Sports Performance II: The International Olympic Committee Consensus on Sports Nutrition , published in 2004, all have financial links (personal or institutional) to Gatorade and their book was supported by Coca-Cola, the makers of Powerade.

Taking on thirst

Perhaps one of GSSI’s greatest successes was to undermine the idea that the body has a perfectly good homeostatic mechanism for detecting and responding to dehydration—thirst. “The human thirst mechanism is an inaccurate short-term indicator of fluid needs . . . Unfortunately, there is no clear physiological signal that dehydration is occurring,” Bob Murray from the Gatorade Sports Science Institute declared in 2008. 13

Others have followed suit. Powerade say: “Without realising, you may not be drinking enough to restore your fluid balance after working out.” 14

And the International Olympic Committee’s nutrition advice for athletes —published in 2003 and updated in 2008 in conjunction with Powerade—doesn’t mention thirst once, even though it includes detailed advice on fluid intake. “Dehydration impairs performance in most events, and athletes should be well hydrated before exercise,” it says in its booklet, Athletes Medical Information . 15

Athletes are bombarded with different advice and given complex algorithms to calculate their individual hydration needs. They are told, for example, to rehydrate with a pint for every pound in body weight lost—a drop of 2% is considered a cause for concern. They are also told how to calculate their sweat rate and to check the colour of their urine (box). 15 16

“P” charts and urine tests

The science of dehydration has led to another widely held belief that is not based on robust evidence—that the colour of urine is a good guide to hydration levels.

Like athletes, British soldiers are told to check their urine. The Ministry of Defence signed a £1.5m three year deal with GSK in 2005 to supply soldiers with Lucozade. “It is only recently that we have started to examine the science behind what our soldiers drink,” the defence secretary, John Reid, said at the time.

The drink’s packaging includes a “P chart,” a colour code allowing soldiers to check their hydration levels by studying the colour of their urine. 17

The Mayo Clinic’s online guidance to patients also suggests urine is a good guide of hydration. “Unfortunately, thirst isn’t always a reliable gauge of the body’s need for water, especially in children and older adults. A better indicator is the color of your urine: Clear or light-colored urine means you’re well hydrated, whereas a dark yellow or amber color usually signals dehydration,” it says. 18

However, a review of the evidence Oxford University’s Centre of Evidence Based Medicine linked to this investigation has assessed the predictive value of urine colour as a diagnostic test.

“There is a lack evidence for the widely recommended practice of assessing hydration status by looking at the colour of urine,” it suggests. 19

“The limited evidence shows that only first morning urine colour can be reliably used to assess dehydration and rehydration,” it adds.

This advice has filtered down to healthcare organisations giving advice to patients playing sport. Diabetes UK, for example, advises people: “Drink small amounts frequently, even if you are not thirsty— approximately 150 ml of fluid every 15 minutes—because dehydration dramatically affects performance.” 20

Studies suggest that thirst is a more reliable trigger. A meta-analysis of data from cyclists in time trials concluded that relying on thirst to gauge the need for fluid replacement was the best strategy. 21

“The problem was industry wanted to sell more products so it had to say that thirst was not adequate,” Noakes says. And he should know—Noakes developed a sports drink with South African company, Leppin, in the early 1980s.

Link ups with industry

Academics were in the vanguard of the drive against thirst and the promotion of the dangers of dehydration..

In 1993, a group of experts led by Ron Maughan, professor of sport and exercise nutrition at Loughborough University and a member of GSSI’s sports medicine review board since 1990, produced a consensus statement at a meeting funded by Isostar, a sports drink then owned by drug company, Novartis. “There is a need to make athletes more aware of the dangers of dehydration and of the importance of adequate fluid intake. Water is not the best fluid for rehydration, either during or after exercise,” they wrote in an article published in the British Journal of Sports Medicine . 22

In America, the sports drinks industry also made a push into the area of clinical science. In 1992, the American College of Sports Medicine—the “premier organization in sports medicine and exercise science” with over 45 000 members—accepted a $250,000 donation from Gatorade.

Four years later, in 1996, the American College of Sports Medicine produced guidelines that adopted a “zero % dehydration” doctrine, advising athletes to “drink as much as tolerable.” 23 This guidance grew out of a roundtable meeting in 1993 “supported” by Gatorade. 24

Half the guideline’s authors either worked with the US military—the world’s biggest customer of Gatorade—or had a financial relationship with the Gatorade institute. Over time, these authors would strengthen their relationship with the college, with Lawrence Armstrong and Michael Sawka—who both work for the United States Army Research Institute of Environmental Medicine—becoming senior editors of the college’s journal in the past 10 years.

The college’s president during the 2000s, W Larry Kenny, even wrote that the college cautioned against physically active people “letting their thirst guide them.” 25

The 1996 guidance stood until 2007, when in updated guidance the college acknowledged that people should drink according to the dictates of thirst. However, it still promoted the idea that people should lose no more than 2% of body weight during exercise, and this remains the position in the published literature—although how people are meant to know how much weight they are losing while exercising isn’t made clear. 26

Three of the six authors of the updated guidance declared major financial conflicts of interest. Randy Eichner and Nina Stachenfeld had financial ties to Gatorade, and Ronald Maughan had received funding from Coca-Cola and GSK, as well as being on the GSSI review board. Louise Burke had no personal financial ties, although her institution, the AIS, received funding from Gatorade. The other two authors, Michael Sawka (chair of the committee) and Scott Montain, worked for the US military and had attended the exclusive Quaker Oats meetings in the 1990s. Even two of the five reviewers—Michael Bergeron and Mark Hargreaves—declared financial links to Gatorade.

There is nothing wrong with working with industry. Indeed, a UK parliamentary select committee heard in 2006 that “sports science tends to be a Cinderella subject, which does not have the drivers. A lot of the money does come from the drinks industry and so on but it cannot be entirely independent.” Links with industry are also seen as a badge of honour.

However, Paul Laursen, adjunct professor at the Sports Performance Research Institute in New Zealand, thinks that people with conflicts of interest shouldn’t be writing guidance.

“Those people would say that ‘we’ve done all the research, so we know the subject’. You need people who are more objective than that—who can put the studies into context and account for important limitations to the research,” he says.

The BMJ asked the college why it chose people with such conflicts of interest to produce its guidance. A spokesperson said: “ACSM follows best practices regarding corporate relationships, disclosures, and conflicts of interest,” adding that the college has “demanding requirements in the areas of disclosure and avoidance of conflict of interest.” The college also maintains that the “chairs of both the 1996 and 2007 Position Stands on fluid replacement were US federal government employees with no professional affiliations with the sports beverage industry.”

Despite all the guidance about the dangers of dehydration during exercise, Arthur Siegel, associate professor of medicine at Harvard University and adviser to the Boston marathon, says that there is no evidence that anyone doing a marathon has ever died from it.

“Dehydration has gotten all the press and attention partly because of sports medicine associations who have endorsed the dangers of dehydration, but in fact dehydration is not life threatening,” Siegel says.

Fluid is freely available throughout the races should a runner need to drink—they are not stranded in the desert with no access to fluids, he says.

“It [dehydration] is a normal biological response to exercise. You lose water; you get thirsty; you drink. End of story,” Noakes adds. He is, however, considered maverick in his views.

Hyponatraemia

Against this background of what Noakes says is disease mongering, a genuine illness associated with sport has become a real concern—that of exercise associated hyponatraemia. There have been 16 recorded deaths and 1600 people taken critically ill during competitive marathon running due to a drop in their serum sodium (see linked commentary). 27

The cause of this is keenly debated—in particular whether it is the volume or type of fluid consumption that is most to blame. The largest prospective study, conducted in a diverse group of marathon runners (funded by the National Institutes of Health and published in the New England Journal of Medicine ), found no association with the composition of fluids consumed and concluded that it is the volume of fluid that is the main factor leading to hyponatraemia. 28

According to lead author Christopher Almond, assistant professor of paediatrics at Boston Children’s Hospital: “The available evidence indicates that the most effective way to prevent hyponatremia during marathon running is to avoid a positive fluid balance.” 28

A literature review in a nephrology journal also backed this up saying there is no evidence that “consumption of sports drinks (electrolyte-containing hypotonic fluids) can prevent the development of exercise associated hyponatraemia.” 29

However, companies are keen to imply that it is water that is the problem.

Coca-Cola, for example, acknowledges that hyponatraemia is a cause for concern “for anyone doing endurance sports,” but says that this is due to the failure to “replace the sodium lost through sweat or drinking a very large volume of very low-sodium beverages such as water.” The Powerade webpage describing hyponatraemia does not mention that it can also happen if sports drinks are consumed. 30 The company has subsequently said it has updated the advice on its website “to ensure that it is clear that athletes should not over consume any liquids.”

Again, the message that sports drinks confer protection has filtered down. “To prevent hyponatremia and electrolyte imbalances, athletes should replace lost body fluid with drinks that contain electrolytes, such as sports drinks,” MedicineNet website says. 31

Outreach to schools

The industry push has not stopped with adults participating in sports. GSK has developed an educational outreach programme called Scientists in Sport ( www.scientistsinsport.com ) as part of its involvement in the Olympic antidoping operations. The programme includes materials for “GSK Ambassadors to take into schools, and free classroom resources.”

One lesson looks at osmosis and water: “During intense exercise, heavy sweating removes water and salts from the body. If large quantities of water alone are consumed, this will dilute the normal concentrations of sugars and ions in the blood and tissues. Water will enter, by osmosis, and stop the muscles, nerves and the brain from working properly. In extreme cases, water intoxication can occur and may lead to death,” it says. Students are then asked which drinks are closest to being isotonic and whether sports drinks justify their prices.

GSK maintains that the programme does not specifically mention its sports drink. However, it admits that the introduction to the osmosis lesson—as quoted above—could be “made more relevant to the subject.” “We are therefore going to update this section,” a spokesperson told the BMJ .

But efforts to encourage children to drink sports drinks do not end there. This year, Gatorade and the National Athletic Trainers’ Association united to declare 11 July the first annual National Recovery Day for high school athletes. This was “to focus the attention of athletes on the importance of proper athletic recovery.” Children were told to “drink 16-24 ounces of fluid with sodium for each pound of body weight lost during exercise following a workout or game.” 32

Many schools in the UK now encourage children to stop every 15-20 minutes during exercise to drink. Football teams also instruct children to bring a bottle—no football field is seen without a colourful array of sports drinks.

This practice may be one that originated with Gatorade. In 2000, a former professor of paediatrics at McMaster University in Canada, Oded Bar-Or, who was also a member of the GSSI medicine review board, promoted the need for children to stop during sporting activities in order to drink.

“One should make certain that children arrive fully hydrated for a practice session or for competition and enforce drink pauses every 15-20 min during prolonged activities, even when the child does not feel thirsty. If necessary, rules of the sport should be modified to facilitate periodic drinking,” he wrote in 2000. 33 That same year he was the main consultant to the American Academy of Pediatrics guidance on heat illness and exercise. 34

“Children frequently do not feel the need to drink enough to replenish fluid loss during prolonged exercise. This may lead to severe dehydration,” it said, adding: “A major consequence of dehydration is an excessive increase in core body temperature.”

Updated advice in 2011 had Michael Bergeron—who has financial ties to Gatorade— as the main consultant and one of the lead authors. “Appropriate fluid should be readily accessible and consumed at regular intervals before, during, and after all sports participation,” it added giving specific details about sweat replacement and amounts to drink. All references to this were to studies either funded by Gatorade or included authors with financial ties. 35 The Institute of Medicine, however, says: “Thirst and consumption of beverages at meals are adequate to maintain hydration.” 36

A spokesperson for Gatorade also confirmed that there were no systematic reviews on hydration in children. Instead, it pointed to three position papers that consider the relation between exertional heat related illness and hydration. These were from the American College of Sports Medicine and the National Athletics Trainers’ Association and cite “carbohydrate-electrolyte solutions as one of many potential preventative steps.”

In the UK, Maughan took a similar view. He wrote in 2001: “Children are particularly likely to forget to drink unless reminded to do so,” adding that “mild levels of dehydration and hyperthermia will reduce exercise capacity.” 7

This advice was soon adopted by groups lobbying for increased attention to hydration in schools. In the UK, an expert group on hydration was launched in June 2005, supported by the British Soft Drinks Association, with the “goal of improving the nation’s hydration.” Maughan was a key adviser. 37

“If children have no understanding of why they need to drink frequently, and little or no encouragement is given, their health, wellbeing and performance may be at risk,” the group’s report concludes. It also laments the “demonisation of vending machines” in schools. 37

War on water

The promotion of hydration has created a battle ground for the fight between bottled water companies and the sports drinks industry. While they both agree about the need to drink plenty of fluids, 38 there is disagreement on what that fluid should be.

The Natural Hydration Council—which represents the bottled water industry—warns that one in four adults drink sports drinks at their desk, thereby consuming unnecessary calories. 39 It urges that people should be encouraged to drink water rather than sugary drinks. 39 Sports drinks companies, however, promote the notion that their products are a superior source of hydration.

In its guidelines to casual runners taking part in the Lucozade sponsored national UK event Parkrun—Lucozade say that “water alone isn’t enough to maintain hydration.” 40 Powerade’s website also suggests “Water is not enough.” “Water doesn’t have the performance benefits of a sports drink,” it says—but it does not go on to quantify what those benefits are. 41

However, this is permitted. Earlier this year, the UK’s Advertising Standards Authority (ASA) rejected a complaint against Powerade for television advertisements featuring Olympic heptathlon medal hopeful, Jessica Ennis, that said, “Powerade ION4 hydrates better than water.” A national press advert running around the same featured Ennis saying: “So it hydrates me better than water.” 42

How good is the evidence?

Companies claim that the sodium in sports drinks stimulates thirst, resulting in the consumption of a higher volume of fluid and better retention compared with drinking water. Their claims also hinge on the physiological observation that the carbohydrate content of sports drinks aids water absorption from the small intestine. Consumers are told that another key benefit is the taste, as this encourages higher fluid intake.

The ASA’s judgment in favour of Powerade was revealing. Despite over 38 years of research, there was no published meta-analysis of studies in this area to help uphold the complaint. 42 But the reason for this lack of evidence is clear, says Noakes. “A commercial company would never do research that it was not certain of the answer before it did the study,” he says.

Yet Coca-Cola, GSK, and PepsiCo maintain that the scientific evidence supports their case—and they’re not the only ones. In 2006, the European Union adopted new regulation that aimed “to ensure that consumers are not misled by unsubstantiated, exaggerated or untruthful claims about foodstuffs.” The European Food Safety Authority (EFSA) was charged with assessing the evidence supporting health claims.

Two related to sports drinks have been upheld: that they hydrate better than water and that they help maintain performance in athletes doing endurance exercise. This judgment did not apply to the ordinary person going to the gym or children playing football for an hour a week, Albert Flynn, chair of EFSA’s dietetic products, nutrition, and allergies panel, told the BBC.

Because EFSA has reviewed the literature, companies say the evidence supporting the performance benefits of sports drinks is “very strong.” But an analysis of the studies submitted to EFSA accompanying the investigation does not uphold this view. It also finds a troubling circularity in the industry influenced evidence base—and this does not just apply to the funding of the studies. EFSA also says it relied on the American College of Sports Medicine’s 2007 review on hydration. 43 The BMJ asked the college about its methodology. While not providing substantive comment on the methods used in the past, it said it “now uses an independent expert consultant in meta-analysis process.”

When the Institute of Medicine analysed the same dataset in 2004 they concluded that “many of the questions raised about the requirements for and recommended intakes of these electrolytes and of water cannot be fully answered because of inadequacies in the present database”. 44

In their determination to show that a solution of salt and sugar can produce a beneficial effect, companies have funded hundreds of studies over the past 40 years. The BMJ asked several companies for lists of these studies (see box for overview of research). GSK was the only one willing to provide such a list, comprising references to the “100 clinical trials” that suggest its sports drinks have important benefits. Gatorade did not respond, and Coca-Cola sent a detailed response explaining how their drink works. 45 An accompanying analysis of the studies found that the quality of the evidence was so poor that it was impossible to draw firm conclusions about the effects of the sports drink (box). 9

Assessment of evidence behind sports products

A team at the Centre of Evidence Based Medicine at Oxford University assessed the evidence behind 431 performance enhancing claims in adverts for 104 different sports products including sports drinks, protein shakes and trainers.

If the evidence wasn’t clear from the adverts, they contacted the companies for more information. Some, like Puma, did not provide any evidence, while others like GlaxoSmithKline— makers of Lucozade Sport—provided hundreds of studies.

Yet only three (2.7%) of the studies the team was able to assess were judged to be of high quality and at low risk of bias. They say this absence of high quality evidence is “worrying” and call for better research in this area to help inform decisions.

What the research found

As part of the BMJ’ s analysis of the evidence underpinning sports performance products, it asked manufacturers to supply details of the studies. Only one manufacturer, GlaxoSmithKline provided a comprehensive bibliography of the trials used to underpin its product claims for Lucozade—a carbohydrate containing sports drink. 45 Other manufacturers of leading sports drinks did not and in the absence of systematic reviews we surmise that the methodological issues raised apply to all other sports drinks.

Carl Heneghan, Rafael Perera, David Nunan, Kamal Mahtani, and Peter Gill set out to appraise the evidence and found a series of problems with the studies (see online for full article). 9

Small sample sizes limit the applicability of results —Only one of the 106 studies —in 257 marathon runners—exceeded the acceptable target for a small study of 100 participants per group. The next largest had 52 participants and the median sample size was nine. Thus the results cannot be generalised beyond people with the study group characteristics

Poor quality surrogate outcomes undermine the validity —Many studies used time to exhaustion or other outcomes that are not directly relevant to performance in real life events

Poorly designed research offers little to instil confidence in product claims— Most studies (76%) were low in quality because of a lack of allocation concealment and blinding, and often the findings contrasted with each other. The studies often had substantial problems because of use of different protocols, temperatures, work intensities, and outcomes

Data dredging leads to spurious statistical results —Studies often failed to define outcome measures before the study, leaving open the possibility of numerous analyses and increasing the risk of finding a positive result by chance.

Biological outcomes do not necessarily correlate with improved performance —Reductions in use of muscle glycogen, for example, did not correlate with improved athletic performance. Physiological outcomes such as maximal oxygen consumption have also been shown to be poor predictors of performance, even among elite athletes

Inappropriate use of relative measures inflates the outcome and can easily mislead —One study inflated the relative effect of carbohydrate drinks from 3% to 33% by excluding from the analysis the 75 minutes of exercise both groups undertook before an exhaustion test

Studies that lack blinding are likely to be false —Studies that used plain water as the control found positive effects whereas those that used taste matched placebos didn’t

Manipulation of nutrition in the run-in phase significantly affects subsequent outcomes —Many studies seemingly starve participants the night before and on the morning of the research study

Changes in environmental factors lead to wide variation in outcomes —Although dilute carbohydrate drinks may have some benefit in heat, studies found no effect in cold environments. No plausible reason given for benefits

There was no substantial evidence to suggest that liquid is any better than solid carbohydrate intake and there were no studies in children. Given the high sugar content and the propensity to dental erosions children should be discouraged from using sports drinks. Through our analysis of the current sports performance research, we have come to one conclusion: people should develop their own strategies for carbohydrate intake largely by trial and error.

Marketing to athletes or ordinary people?

Noakes has other concerns about the evidence. He questions how generalisable the results are to the ordinary population. The studies feature highly trained volunteers who sustain exercise at high intensity for long periods. “They are never going to study a person who trains for two hours per week, who walks most of the marathon—which form the majority of users of sports drinks.”

Yet it’s precisely these people that companies are targeting. Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University has studied the way sports drinks are marketed. “They are marketed through a general route rather than just in runners’ magazines, which shows they actually want a broad audience,” he says.

Not all companies shy away from this description of their activities. John Brewer, director of the Lucozade Sport Science Academy, told a parliamentary select committee in 2006 that “It is really looking to get elite endorsement for high quality products that would then be preferred by the consumer at the mass market level.”

But GSK’s response suggests it would prefer not to be viewed in this light. A spokesperson told the BMJ : “Lucozade Sport is for adults who train and take part in sport and other vigorous physical exercise and this is stated on the bottle.” The company also says that Lucozade is not marketed to children under 16.

Despite such reassurances, last year the company turned to pop stars Tinie Tempah and Blink 182 drummer, Travis Parker—both popular with younger children— to become “brand ambassadors” and attract “sporty teenagers.” 46

Influence over journals

Another problem with the research is transparency. Even though a large proportion of the studies have been conducted by scientists with financial ties to Gatorade (PepsiCo), GSK, and Coca-Cola, the authors’ individual conflicts of interest are either not published or not declared. Conflicts of interest also exist within the key journals in sports medicine—GSSI funded scientists pepper their editorial boards and editorships.

Around half of the studies supplied by GSK appeared in four journals—the Journal of Applied Physiology (20), Medicine and Science in Sports and Exercise (24), International Journal of Sport Nutrition and Exercise Metabolism (11) and the Journal of Sports Science (9). Several of these journals belong to organisations that have long relationships with Gatorade (box).

Journals’ links to industry

While many journals have scientists on their editorial boards who have links with the manufacturers of sports drinks—including the BMJ Group’s British Journal of Sports Medcine —some have such people in prominent editorial roles.

The one with the biggest reach is Medicine and Science in Sports and Exercise . It’s owned by the American College of Sports Medicine, which has a longstanding financial relationship with Gatorade and now Powerade. Since 1999, there has been a steady increase in the number of Gatorade affiliated scientists who are editors or on the editorial board. Over the past 12 years, the editors in chief have been Kent Pandolf and Andrew Young—both of whom work for the US military, Gatorade’s biggest customer, and have been instrumental in the science of hydration. Pandolf has been a speaker at invitation only GSSI conferences. Another senior editor, Michael Sawka, was chair of the committee who drafted the ACSM’s 1996 “zero% dehydration” guidance on fluids . This was based on a roundtable funded by Gatorade. Sawka has been, and continues to be, a speaker at Gatorade sponsored events since 1989. It is not clear if he receives funding directly.

Ron Maughan, is also a senior editor of the journal. He has a longstanding financial relationship with Gatorade, as well as financial relationships with Coca-Cola and GSK. Maughan has played senior editorial roles on several other journals over the past 20 years including the British Journal of Sports Medicine , Nutrition , the European Journal of Applied Physiology, and the Journal of Sports Sciences, the official journal of the British Association of Sports and Exercise Science, which has a financial relationship with Gatorade. 52

Maughan is also coeditor of the International Journal of Sport Nutrition and Exercise Metabolism with Louise Burke who works at the Australian Institute of Sport, which has a partnership with Gatorade. This journal also has several Gatorade affiliated scientists on its editorial board.

Several other prominent Gatorade scientists sit on the board of the Journal of Sports Science . Mark Hargreaves, professor of exercise physiology and metabolism at Melbourne University and a member of the Science Advisory Board of the Gatorade Sports Science Institute (GSSI), is a consulting editor for the Journal of Applied Physiology —along with Sawka. This journal is owned by the American Physiological Society, which again has financial links to Gatorade.

Another prominent editor of Medicine and Science in Sports and Exercise was Oded Bar-Or, a professor of paediatrics who had a long standing financial relationship with GSSI. He has been a key consultant to the American Academy of Pediatrics on its hydration strategy.

Most of the scientists identified as being on the GSSI board have prominent roles in journals. Even its global senior director, Asker Jeukendrup, professor of exercise metabolism at Birmingham University, is an editor of the European Journal of Sport Science —the official journal of the European College of Sport Science. His biography states that “he has been a member of the advisory editorial board of the Journal of Sports Sciences , and served on the editorial board of the International Journal of Sports Medicine and Medicine and Science in Sport and Exercise. To date, Asker has served as a reviewer for 35 different scientific journals.” 53 Jeukendrup is one of the main authors of a series of research papers given to the BMJ by GSK to demonstrate the effectiveness of its sports drinks. 9

These links between sports medicine journals and the sports drinks industry may help to explain a characteristic of the sports drinks literature that is familiar to those who have analysed drug trials over the past 30 years—the relative (or almost complete) absence of negative studies.

Several people have told the BMJ how difficult it is to publish studies that question the role of hydration. Paul Laursen is one of them. “[A negative study] gets rejected by reviewers and the editors for really spurious reasons—particularly when you consider what does get published. It’s a frustrating experience and it makes you wonder if it’s a case of money winning out.”

In response to concerns that drug companies were burying negative studies or those that demonstrated harm, the US government implemented the FDA Amendment Act. This stipulated that prospective studies had to be registered on a publicly accessible database. However, this has not caught on in nutrition.

When the BMJ asked companies if they had any knowledge of negative trials—where sports drinks have not shown improvement in outcomes—Coca-Cola responded that it didn’t. “We would suggest you direct this question to an active researcher in the field,” a spokesperson said. But finding out what studies are being conducted isn’t easy.

The BMJ turned to Loughborough University, which will form one of the UK’s main hubs directing research into sport and exercise as part of delivering the Olympic legacy. The university receives funding from Gatorade.

Using the Freedom of Information Act, the BMJ asked for the university’s contract with Gatorade and for the protocols of studies conducted on humans. The request was turned down under a commercial interests exemption. A subsequent letter said they didn’t have any studies underway, yet declined to say what they receive funding for.

“The public interest in maintaining the exemption outweighs the public interest in disclosing the information,” the Freedom of Information officer said.

UK Sport, a quango accountable to the UK’s Department for Culture, Media and Sport, has also entered into a “research and development partnership” with GSK. This is “to investigate the role that nutrition has in improving athletic performance through the training process.” They too turned down the Freedom of Information requests for study protocols, calling them “commercial in confidence.”

Links to obesity

As sports drinks rise in popularity among children, there is concern their consumption is contributing to obesity levels. A 500 mL bottle of Powerade Ion4 contains 19.6 g of sugar, and the same sized bottles of Lucozade Sport and Gatorade Perform contain 17.5 g (32g carbohydrate) and 30 g respectively (a teaspoon of sugar weighs about 4 g).

A report in June 2012 by the US philanthropic organisation, the Robert Wood Johnson Foundation, says that “the increased consumption of sports drinks in recent years is of growing concern for parents, health professionals, and public health advocates.” 47

Coca-Cola denies that the drinks are a problem. “No one single food or drink alone is responsible for people being overweight or obese. All foods and soft drinks can have a place in a sensible, balanced diet, as long as over time you do not take in more calories than you burn,” it said.

However, endorsement by elite athletes and claims of hydration benefits have meant that sports drinks have been able to shrug off any unhealthy associations. An analysis by Yale University’s Rudd Center for Food Policy and Obesity found that over a quarter of American parents believe that sports drinks are healthy for children. 48

A recent campaign against the UK government levying value added tax on “sports nutrition drinks” by UK Sports Specialist Nutrition Alliance also shows how sport products are now thought of as essential. “You complain about obesity then charge us to live a healthy lifestyle!” says one signatory. “Why penalise individuals for choosing to use products designed to maintain health and vitality which ultimately help reduce the burden on the already stretched and under resourced NHS. We’re sitting on a diabetes and obesity time bomb,” says another.

This is why New York City’s mayor, Michael Bloomberg, has proposed a ban on supersized bottles of soft drinks, including sports drinks. As one marketing pundit put it, drinking a sports drink “may be a way for consumers to convince themselves that they are looking after the bodies without having to break out into a sweat.” 39

Far from sports drinks turning casual runners into Olympic athletes, Noakes suggests: “If they avoided the sports drink they would get thinner and run faster.”

Lucozade’s transformation

Although it is now associated with sport, Lucozade had a sickly start in life. Initially developed by a pharmacist in Newcastle, Glucozade—as it was then called—was launched as a glucose supplement to help people recover from common illnesses such as influenza and was soon snapped up by Beecham (now part of GSK’s Nutritional Healthcare division). But illness doesn’t sell in quite the same way as strength and health. The Lucozade that is familiar today was effectively created in 1983 by UK branding agency Ogilvy & Mather. It was relaunched with British Olympic gold medal winner Daley Thompson under the proposition that energy and empowerment was a stronger sell than recovery.

Scaremongering over the effects of dehydration

The American College of Sports Medicine (ACSM) guidelines also emphasised the relation between dehydration and serious illness in sport saying that it causes heat exhaustion, heat stroke, muscle cramps, and exacerbates rhabdomyolysis. As well as a few laboratory studies, the ACSM draws on findings that dehydration was present in 17% of hospital admissions for heat stroke in the US military and a similar number in Israel. 24 It did not conduct a systematic review on the area.

Sandy Fowkes-Godek, director of the HEAT Institute and a professor of sports medicine at West Chester University, has conducted dozens of studies on National Football League players in the US and failed to show that dehydration has any effect on core temperature. “It’s a scare tactic that has worked very well,” she says, “We don’t understand what causes exertional heat stroke.”

Studies that have shown that dehydration causes heat illness, she argues, have been set up to show it. Paul Laursen agrees.

“What is done in a lab doesn’t always turn out to be true in outdoor conditions. Studies in hydration are often conducted in a climate chamber without appropriate airflow. They typically don’t use a good fan, so the ability to remove heat from the body is reduced, and core temperature rises. While this might be what happens in an indoor fitness class, it isn’t applicable to what goes on outside. But companies have taken this lab finding and made it gospel,” he says.

A review in the British Journal of Sports Medicine supports this. “There are very few recent well controlled exercise physiology studies of heat and exercise in children that are directly applicable to real world field conditions,” it says. 49 Indeed, a spokesperson from Gatorade confirmed that there have been no systematic reviews that address the relationship between exertional heat-related illness and hydration.

From a health perspective, Fowkes-Godek worries that if people are going to be fooled into thinking that drinking fluids is going to stop them getting heatstroke, they won’t take other preventive measures. This advice has been picked up widely. NHS Choices website says that dehydration in exercise “is the primary cause of heat exhaustion,” it says. 50

Disease mongering is a well documented phenomenon in healthcare, 51 and Noakes suggests that industry has followed a similar pattern with dehydration and exercise.

“When industry wanted to sell more product it had to develop a new disease that would encourage people to overdrink,” he said adding: “Here’s a disease that you will get if you run. Here’s a product that is going to save your life. That’s exactly what they did. They said dehydration is a dreaded disease of exercise.”

Cite this as: BMJ 2012;345:e4737

Energy Drinks and Sports Performance, Cardiovascular Risk, and Genetic Associations; Future Prospects

Affiliations.

1 Exercise and Sport Sciences, Faculty of Health Sciences, Universidad Francisco de Vitoria, 28223 Madrid, Spain.
2 Faculty of Medicine, Research Unit, Universidad Francisco de Vitoria, Pozuelo de Alarcon, 28223 Madrid, Spain.
PMID: 33668219
PMCID: PMC7995988
DOI: 10.3390/nu13030715

The consumption of energy drinks (e.g., containing caffeine and taurine) has increased over the last decade among adolescents and athletes to enhance their cognitive level and improve intellectual and athletic performance. Numerous studies have shown that drinking moderate doses of such drinks produces beneficial effects, as they considerably boost the sporting performance of elite athletes in various sports, including both endurance and explosive events. However, apart from their ergogenic effects, the regular consumption of energy drinks also increases blood pressure and consequently incites problems such as hypertension, tachycardia, and nervousness, all of which can lead to cardiovascular disorders. A potential positive correlation between genetics and the moderate consumption of energy drinks and athletic performance has recently been reported; notwithstanding, a better understanding of the genetic variants involved in metabolism is a key area for future research to optimize the dose of energy drink consumed and obtain the maximal ergogenic effect in elite sports. The aim of this literature review, therefore, is to present the results of recent studies, classifying them according to the differences in the associations between energy drinks and: (i) Athletic performance; (ii) cardiovascular risk factors while practicing sports; and (iii) genetic associations and future prospects between the consumption of energy drinks and performance.

Keywords: Energy drinks; caffeine; genetics; health risk; sports performance; taurine.

Publication types

Athletic Performance / physiology*
Caffeine / adverse effects
Cardiovascular Diseases / chemically induced
Cardiovascular Diseases / genetics
Cognition / drug effects
Energy Drinks / adverse effects*
Heart Disease Risk Factors
Performance-Enhancing Substances / adverse effects*
Sports Nutritional Physiological Phenomena / drug effects*
Sports Nutritional Physiological Phenomena / genetics*
Taurine / adverse effects
Performance-Enhancing Substances

Category Focus

Sports, protein drinks markets evolve beyond athletes, everyday wellness the future for performance beverages.

Image courtesy of Recover 180

When it comes to wellness, everyone has different habits that keep them going. In fact, a 2022 article by Dani Blum titled “The Little Rituals That Keep Us Going” delves into a selection of habits that people shared that helped them live life healthier and happier.

Consumers’ interest in wellness has impacted many beverage categories and the sports and protein drink markets are no different. What is different is these performance beverages were once synonymous with athletes, but instead have embraced the concept of supporting everyday wellness.

“[T]here is a shift toward marketing sports drinks and protein drinks for everyday wellness,” says Cara Rasch, food and beverage research analyst at Packaged Facts, a division of MarketResearch.com, Rockville, MD. “Sports drinks are now marketed as everyday ‘hydration multipliers’ for general well-being, not just for athletes. Unilever’s purchase of Liquid I.V. proves this ― the brand went from a sports drink to a daily wellness drink, driving category growth. Protein drinks are also targeting everyday use occasions for consumers to feel full for longer and have more energy throughout the day.”

Rasch explains that people are more likely to prioritize general wellness versus hardcore fitness, allowing sports and protein drink formulations to target “feel good” and “energized” throughout the day attributes to reach a broader audience.

“Casual users are a much larger present and potential market for these products than athletes and fitness enthusiasts,” she says.

Chicago-based Mintel also pinpoints the potential for sports and protein drinks beyond the traditional athlete consumer group. In its 2023 report titled “Sports and Performance Drinks – US” it notes how expanded functionality could allow brands to reach all consumer corners.

“Clustered consumer interest among non-athletes in additional functionality beyond sports performance proves the value in blurring beverage lines to expand relevance,” the report states. “The audience is there ― and willing to pay premium for these offerings.”

Sports drinks are now marketed as everyday ‘hydration multipliers’ for general well-being, not just for athletes.” — Cara Rasch, food and beverage research analyst at Packaged Facts

As the concept of everyday wellness permeates the industry, traditional sports drinks brands also are seeing opportunities in the hydration mixes segment.

For instance, this past fall, BODYARMOR Sports Nutrition, a division of The Coca-Cola Co., launched BODYARMOR Flash I.V. Hydration Boosters. The announcement came on the heels of the brand’s initial entrance into the rapid rehydration category with Flash I.V. ready to drink. This is BODYARMOR’s first foray into hydration boosters in single-serve powder stick form, it noted at the time of the release.

Packaged in compact single-serve, six-pack and 15-pack offerings, BODYARMOR Flash I.V. Hydration Boosters are available in five flavors ― Tropical Punch, Cucumber Lime, Grape, Strawberry Kiwi and Lemon Lime ― and feature more than 2,200 mg of essential electrolytes plus added functionality with zinc, vitamins B and C to support a healthy immune system, the company says.

Healthy hydration and children also have amalgamated with the rise of everyday wellness. Recently Mott’s, a brand of Keurig Dr Pepper (KDP), launched Mott’s Active, a new fruit-flavored hydrating juice beverage for active kids with naturally sourced electrolytes, no added sugars, and no artificial flavors. This is the first juice drink product from the Mott’s brand to offer hydration benefits via added electrolytes, it says.

Nearly 80% of households with children purchase sports drinks to hydrate, it says citing Circana data, and Mott’s Active provides a sports drink alternative in two juice flavors: Blastin’ Berry and Watermelon Burst, in a blend of apple juice and coconut water.

Yet, the aspect of everyday wellness expands beyond new product releases. Brand owners also are applying those principles to their partnerships.

For example, POWERADE, a brand of The Coca-Cola Co., announced a new partnership with Girls Inc., a nonprofit organization dedicated to inspiring girls to be strong, smart and bold. Together, POWERADE and Girls Inc. are teaming up to help young women reach their full potential through physical activity, mental resilience, and overall well-being. This collaboration represents POWERADE’s commitment to supporting organizations that provide leadership development for girls and youth, it says.

To kick-off the partnership, Girls Inc. unveiled four inaugural “She’s Got More POWERADE Scholarship” recipients, who each received $10,000 for their academic accomplishments and for demonstrating athletic achievement throughout their high school careers, it says.

“POWERADE is a dynamic brand with a deep history in sports and we’re proud to partner with Girls Inc. in an effort to champion the power of sports and the positive impact it has in the long term,” said Tom Gargiulo, BODYARMOR Sports Nutrition chief marketing officer, in a statement. “We are strong believers that sports can help instill confidence, resilience, and leadership skills. Together with Girls Inc., we hope to equip young girls with the tools they need to reach their full potential.”

Positioned for success

The performance beverage markets’ dedication to broader consumer needs has lifted its own performance.

“Sports drinks and the category of protein drinks, nutritional shakes, and meal replacement beverages performed well in the last year,” Packaged Facts’ Rasch says. “Packaged Facts has found that retail sales of sports drinks grew 9% in 2023, while sales in the category of protein drinks, nutritional shakes, and meal replacement beverages increased 6% during that time, compared to growth of 8.1% in the overall functional beverage market.”

Rasch predicts the category will continue to see growth, albeit at a decelerated pace.

“I expect these markets will continue to see growth in 2024,” she says. “Inflationary pressures greatly increased prices in the last few years at a time when volumes were also increasing, leading to an elevated base of sales. In 2024, sales are expected to grow off this elevated base at a slightly decelerated rate compared to 2023 as price inflation calms and volumes continue to increase.”

In Mintel’s report, the market research firm notes that despite budget restraints, the sports and performance drinks market still is a priority of consumers as 32% of surveyed consumers reported more frequent consumption compared with the previous year. Though inflation still will leave its impact on the category.

“Inflation will push sales up until intensity lessens and category sales resume more modest but consistent growth, especially as marketing parameters continue to widen to more consumers through layered functionality and inclusive marketing,” Mintel’s report states.

This all comes as the functionality and attributes of many beverage categories have taken on multiple roles. Case in point, the embracement of hybrid beverages.

“Functional beverages are increasingly blurring the lines between categories,” Packaged Facts’ Rasch says. “Products with multiple claims are on the rise. For example, sports drinks with caffeine offer both energy and hydration. We’re also seeing beverages with gut health benefits, immunity boosters, or weight management claims, all alongside traditional functions like sports recovery or hydration.”

Beyond functionality, Rasch explains additional health-and-wellness trends are likely to impact future formulations within sports and protein drinks.

“A number of trends are influencing and will continue to influence the market for sports drinks and protein drinks, including ‘better-for-you’ trends such as clean label, unrefined sugars, sugar-free and no sugar added claims, low-carb and high protein trends, and natural and organic ingredients, which will become increasingly available, and at lower price points, in the future,” she explains.

The younger generations such as Gen Z and Gen Alpha also are starting to shape the market more, yet everyday use occasions is the future the category, she adds.

“Protein is considered healthy by many consumers, who may look to protein drinks to increase their protein intake and stay full throughout the day without necessarily looking for functions such as sports recovery, bulking up, weight loss or meal replacements,” Rasch says. “Sports drinks will also continue to be sought out by consumers who are placing more attention on everyday hydration, bringing these beverages to more homes and workplaces rather than gyms and sports fields.”

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Jessica Jacobsen, editor of Beverage Industry , visits a range of beverage companies for cover stories and facility tours, represents the magazine at trade shows and industry events, and works with the Beverage Industry team to determine the content and direction of the magazine and its online components. She earned a Bachelor of Arts in Journalism from Marquette University.

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Sports and protein drinks blur the lines

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Meet the New Sports Drink With Zero Sugar, and No Artificial Sweeteners, or Dyes

Updated on 4/18/2024 at 3:15 AM

While staying hydrated is key to a successful workout, water alone doesn't always cut it. At the same time, fueling your fitness with a sugary, artificial drink in the name of electrolytes can actually feel counterproductive to your wellness goals. There's a delicate balance between leveling up your hydration with something more powerful than water and ensuring you're doing so in a clean, feel-good way. The new BODYARMOR ZERO SUGAR strikes that balance by refreshing and replenishing your body without unnecessary additives. It also doesn't hurt that fitness enthusiasts like Olivia Culpo are touting it as their workout-drink-of-choice.

As the name suggests, the sports drink contains no sugar, but that alone doesn't necessarily make it unique. What helps set it apart from other zero-sugar options is the high levels of potassium, magnesium, and zinc. At 620 milligrams, the beverage's potassium content, for example, is almost eight times higher than other zero-sugar sports drinks, which is great news for those looking to increase their electrolytes. Potassium and magnesium are, after all, forms of electrolytes , which are essential elements of an effective sports drink . They're lost through sweat, but necessary to keep the body's fluid levels in balance and help maintain proper muscle functionality.

2024 Zero Sugar Lifestyle ImagesDecember 21, 2023

BODYARMOR ZERO SUGAR also has zero grams of carbs and no artificial sweeteners, flavors, or dyes, which is a big deal for people like Culpo who are highly conscious about what they're putting — and not putting — into their bodies. "It's important to feed my body only the best ingredients," she tells us. And for her, BODYARMOR ZERO SUGAR is part of that commitment. "Whether I'm working out or trying to increase my hydration, BODYARMOR ZERO SUGAR allows me to perform at my best and get through my day," she says.

No matter how beneficial it may be though, if a drink doesn't taste good, you're not going to reach for it. BODYARMOR ZERO SUGAR offers four flavors: fruit punch, lemon lime, orange, and cherry lime. Instead of relying on sugar and artificial sweeteners, the drink is made with real flavors and real sweeteners, such as stevia, to give it a taste that one reviewer says is packed with flavor. Another common comment is that the drink leaves no aftertaste, which is partly why it feels so refreshing.

Delicious flavor, potassium-packed electrolytes, vitamins, and antioxidants: BODYARMOR ZERO SUGAR checks all of the boxes. At the end of the day, it's as simple as this: it's a sports drink that has exactly what you want in a hydrating drink and nothing that you don't. If you're looking for a no-sugar option, it's a no-brainer.

Prime energy, sports drinks contain PFAS and excessive caffeine, class action suits say

YouTubers Logan Paul and KSI founded Prime Hydration in 2022, and while their products have become increasingly popular and profitable, the company continues to face class action suits over the ingredients in their energy and sports drinks.

Prime Hyrdation LLC was sued April 8 in the Southern District of New York over "misleading and deceptive practices" regarding the company's 12-ounce energy drinks containing between 215-225 milligrams of caffeine as opposed to the advertised 200 milligrams, according to the class action suit.

Lara Vera, a Poughkeepsie, New York resident, filed the suit in federal court on behalf of herself and others who bought Prime products across the U.S., the complaint says. Vera purchased Prime's Blue Raspberry products several times in August 2022 for about $3 to $4 each, but she would have never bought the drinks if she had known the actual caffeine content, according to the suit.

Vera's suit is seeking $5 million from the company owned by Paul and KSI, real name Olajide Olayinka Williams "JJ" Olatunji, court records show.

Court records do not say whether Prime Hydration retained legal counsel for Vera's suit.

How much caffeine is in Prime energy drinks?

Prime's advertised 200 milligrams of caffeine is equivalent to "half a dozen Coke cans or nearly two (12-ounce) Red Bulls," Vera's class action suit says.

A 12-ounce can of Red Bull energy drink contains 114 milligrams of caffeine, and a cup of coffee contains around 100 milligrams of caffeine, according to the suit.

The suit continues to say that "there is no proven safe dose of caffeine for children." Side effects of kids consuming caffeine could include rapid or irregular heartbeats, headaches, seizures, shaking, upset stomach and adverse emotional effects on mental health, according to the complaint.

Sen. Charles Schumer , D-N.Y., called on the Food and Drug Administration (FDA) to investigate Prime energy drinks in 2023 because of dangerously high caffeine levels. Schumer alleged in a letter to the FDA that vague marketing targeting young people influenced parents to buy a “cauldron of caffeine" for their kids.

Schumer's call to action to the FDA is referenced in Vera's suit.

USA TODAY contacted Prime Hydration's attorneys Tuesday afternoon but did not receive an immediate response.

What are the Prime Hydration lawsuits?

Vera's legal battle is beginning, but Prime is still dealing with another class action suit from 2023 alleging a flavor of the company's sports drinks contains PFAS, or "forever chemicals."

Independent third-party testing determined the presence of PFAS chemicals in Prime Hydration grape flavor, according to a class action suit filed Aug. 2, 2023, in the Northern District of California by the Milberg law firm on behalf of Elizabeth Castillo and others similarly affected.

"Lead plaintiff Elizabeth Castillo, a resident of California, purchased Prime Hydration on multiple occasions but says she would not have bought it at all if the product had been accurately marketed and labeled as containing PFAS," the Milberg law firm said in an August 2023 news release . "These chemicals were not reasonably detectible to consumers like herself."

Castillo's suit is seeking a $5 million judgment, court records show.

As of April 18, the judge in the case has heard Prime's argument to dismiss the suit due to Castillo not alleging "a cognizable injury" and her not alleging "facts showing a concrete (and) imminent threat of future harm," according to the drink company's motion.

What are forever chemicals?

PFAS are called forever chemicals because they "bioaccumulate, or accrue in the body over time," the Milberg law said in its news release.

"These man-made chemicals are well-studied and have been found to have adverse effects on the human body and environment," the New York City-headquartered law firm said.

Many PFAS are found in people's and animal's blood and can be detected at low levels in a variety of food products and in the environment, the U.S. Environmental Protection Agency (EPA) said. Forever chemicals can be found in water, air, fish and soil at locations across the nation and the globe, according to the EPA.

"There are thousands of PFAS chemicals, and they are found in many different consumer, commercial, and industrial products," the EPA said. "This makes it challenging to study and assess the potential human health and environmental risks."

Who made Prime energy drinks?

Before founding Prime Hydration LLC, Logan Paul, 29, and KSI, 30, were YouTubers who turned their millions of subscribers into supporters of their boxing, wrestling, music, social media content and other endeavors.

Going into the drinks business proved to be profitable for both YouTubers as "Prime Hydration generated more than $250 million in retail sales in its first year, including $45 million in a single month," according to the Milberg law firm.

Paul and KSI continue to keep Prime products in the spotlight whether it is paying for an ad during Super Bowl 57 , having livestreamer IShowSpeed dress up in a Prime sports drink bottle during Wrestlemania 40 or signing athletes including Patrick Mahomes, Aaron Judge, Israel Adesanya, Tyreek Hill, Kyle Larson, Alisha Lehmann and others to sponsorship deals.

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Published: 24 November 2023

Are teenagers ‘drowning' in sports and energy drinks? The need for upstream and downstream interventions

Samantha Watt 1 ,
Thomas A. Dyer 2 &
Zoe Marshman 3

British Dental Journal volume 235 , pages 779–781 ( 2023 ) Cite this article

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Sports and energy drinks are consumed regularly by adults, children and young people (CYP). The dental and wider health implications of their frequent consumption pose a challenge to dental and other health professionals alike, in particular the increasing consumption in CYP, with up to one-third drinking caffeinated energy drinks regularly. The recent popularity of products such as Prime has highlighted the role of social media and marketing on the purchasing and consumption of these drinks, particularly for CYP. This paper describes current consumption of sports and energy drinks nationally and the potential impact on general and dental health. It discusses their popularity in CYP, including purchasing habits and motivations for this age group, and the role of social media in promoting consumption. It then highlights the importance of introducing public health measures to address these factors. Finally, a key role for dental teams is proposed, with an emphasis on the importance of further research to determine the effectiveness of dietary interventions delivered by dental professionals.

Discusses the dental and general health impacts of frequent consumption of sports and energy drinks, particularly in children and young people.

Highlights the role of social media and advertising campaigns in promoting these drinks to adolescents.

Considers public health approaches and the role of the dental team in reducing consumption of sports and energy drinks in this age group.

You have full access to this article via your institution.

Introduction

The past decade has seen a boom in sports and energy drink consumption. In 2021, the UK drank 906 million litres of these drinks, up from 740 million litres in 2013, and market sales increased by 8.4% between 2021 and 2022. 1 , 2 There are growing concerns about increasing consumption in children and young people (CYP), with up to one-third regularly drinking caffeinated energy drinks. 3

Although often referred to collectively, sports and energy drinks differ in their desired effect and ingredients. Sports drinks are flavoured beverages often containing carbohydrates and other nutrients that aim to replenish electrolytes and fluids and enhance performance of consumers. 1 , 4 Energy drinks aim to stimulate and thus have ingredients such as caffeine and guarana, and may contain carbohydrates, protein, amino acids, vitamins and other nutrients. 4

Sports and energy drinks pose a concern to dental professionals. They often have a pH below the critical value for erosive tooth surface loss and free sugar content exceeding the maximum daily recommended intake and thus have cariogenic properties. 5 Frequent consumption may also be associated with increased incidence of type II diabetes, poor mental health and obesity. 3 , 4 , 6

Their growing popularity in CYP may be attributed to the presence of sports and energy drinks on social media. For example, social media has been credited as the key driver of the success of the sports drink Prime, launched in the UK in 2022. 7 Although its popularity may be short-lived, it highlights the role of social media, marketing and advertising on the purchasing of sports and energy drinks. To be able to tackle this growing problem, dental and other health professionals should be aware of the harms, consumption patterns and drivers to purchase sports and energy drinks.

Dental and health consequences of consumption of sports and energy drinks

Increased consumption of caffeinated energy drinks in CYP has been associated with a range of health problems, including headaches, stomach pain, sleep problems, hyperactivity and irritation, and reduced wellbeing. 3 It has also been linked to high-risk behaviours, such as self-harm, alcohol use, smoking and substance misuse. 3 Australian adolescents who reported drinking energy drinks were more likely to be overweight or obese compared with those who did not. 6

Many elite and professional athletes regularly consume sports drinks. 8 Over 80% of athletes reported consuming them during training, yet less than one-third were high consumers of sugar in their regular diet. 9 Despite athletes having positive oral health behaviours, Gallagher and colleagues reported that 49% of athletes had caries and 41% had erosive tooth wear, 10 which may be associated with increased sports drink consumption in this group.

In a survey of 12-14-year-olds in South Wales, almost half of participants consumed sports drinks more than once a week, with 14% drinking one or more every day. 11 Most (80%) reported purchasing sports drinks from the local shop and half (51%) reported consuming them socially. Differences in sexes were observed: boys were more likely to consume sports drinks during physical activity and mealtimes, while girls were more likely to consume them at home or socially. Taste was the most common reason for consumption. Only 18% of participants reported consuming sports drinks to improve performance. 11

The survey also tested participants' knowledge of sports drinks. In free-text responses, participants listed energy drinks they consumed, demonstrating that terms are often used interchangeably and participants could not distinguish between them. 11 In a subsequent study, the authors investigated the sugar content of the top five energy drinks on the market at that time: Lucozade, Red Bull, Monster, Rockstar and Relentless. 5 The amount of free sugar contained in four of the drinks (Lucozade 380 ml, Monster 500 ml, Rockstar 500 ml and Relentless 500 ml) ranged from 146-187% of the recommended daily free sugar intake for 19-24-year-old men. Although the Red Bull 250 ml serving size was smaller, one can per day still provided more than two-thirds of the recommended free sugar intake.

Despite consumer data suggesting consumption of sports and energy drinks by CYP is increasing, there has been relatively little research in this field and only one study which provides a glimpse of the position of sports and energy drinks in CYP's lives and their contribution to their overall sugar consumption. 11

What can be done?

Public health approaches.

It has been long established that the determinants of health-related behaviours, such as consuming sports and energy drinks, are complex and operate at different levels. At a population, community and individual level, these can be related to socioeconomic, educational and environmental factors, all of which are impacted by government policy. In addition, the influence of corporate strategies on government policy, social relationships and individual behaviours have been increasingly recognised. 12 Consequently, contemporary public health approaches should aim to address determinants operating at all levels, but should particularly focus on so-called ‘upstream' factors rather than focusing purely on changing behaviour of individuals. 13

Arguably, the UK Government's obesity strategy launched in 2016 included many such ‘upstream' measures. The initial plan proposed a range of actions, including a number pertinent to sports and energy drinks. This included the Soft Drinks Industry Levy (SDIL) or ‘sugar tax', but also recommended: restrictions on TV advertising of high-fat, high-sugar and high-salt foods until after the 9 pm watershed; preventing the promotion of unhealthy food and drinks in shops by restricting where they can be placed in shops and volume promotions (for example, ‘buy one, get one free' offers); and restricting the sale of energy drinks to adults only. 14

Although the implementation of the obesity strategy is incomplete and under threat, 15 the SDIL has been in place since 2018. The levy is paid by drinks manufacturers at the following rates: 18p per litre on drinks containing between 5-8 g of sugar per 100 ml and 24p per litre on drinks containing more than 8 g of sugar per 100 ml. Its effect on the consumption of sugar through soft drinks has been significant, with a 10% reduction per household per week, yet with no changes to sales overall, as manufacturers had reformulated their products in response to the levy. Consequently, there has been no deleterious impact on the industry. 16 Similar findings have been reported in a range of countries using taxation in this way. 17 , 18

Yet, as described earlier, consumption of sports and energy drinks is increasing, 1 , 2 and measures that may address this have been postponed. Planned bans on pre-watershed and online advertising and volume promotions, due to be introduced in January 2023, have been delayed until October 2025. 19 In addition, following a public consultation in 2018, 20 plans to introduce a ban on sales of energy drinks containing caffeine to those under 16 years have also been delayed. Although supermarkets and other larger retailers have voluntarily restricted sales to adults, many smaller outlets and some online shops have not. 21 Consequently, there may be a three-year period during which no new public health measures will be introduced and damage to teenagers' dental and general health will continue.

Within the relationships, sex and health education curriculum, which has been a statutory requirement in schools in England since September 2021, oral health and healthy eating are both covered within the physical health and mental wellbeing section. It is a requirement for CYP to be taught about the consequences of sugar consumption, including drinks, on dental and general health, and for this teaching to include the adverse effects of consuming too many caffeinated drinks. However, even if all these measures were implemented, it is unlikely that they alone will address the social and environmental factors influencing sports and energy drink consumption and other behaviour change approaches will also be needed.

Role of dental teams

While the role of soft drinks in causing dental disease in children is well-established, it is important dental teams are aware of the increasing popularity of this type of sports and energy drinks and feel able to discuss their consumption with young patients when completing diet diaries and providing dietary advice. However, as noted in the evidence-based toolkit for prevention, Delivering better oral health, there is very little quality evidence about effective interventions to reduce sugar consumption. 22 In fact, while a Cochrane review found evidence to suggest dietary interventions delivered by dental professionals can be effective at changing dietary behaviours, it identified only one trial involving CYP as participants and called for more research underpinned by behaviour change theory to develop this area of clinical prevention. 23 In future, these dietary interventions should be co-designed with CYP, parents and dental teams to ensure they are appropriate and acceptable.

CYP are regularly and increasingly consuming sports and energy drinks with cariogenic, erosive and other adverse health effects. A combination of upstream legislative changes to help limit sugar intake in CYP and dietary interventions by dental teams are suggested to begin to tackle this worrying trend.

Statista. Sports and energy drinks consumption in the United Kingdom from 2013 to 2021. 2023. Available at https://www.statista.com/statistics/284011/soft-drinks-sports-and-energy-drink-consumption-in-the-united-kingdom-uk/ (accessed February 2023).

British Soft Drinks Association. Annual Report. 2022. Available at https://www.britishsoftdrinks.com/write/MediaUploads/BSDA_2022_Annual_Report.pdf (accessed February 2023).

Khouja C, Kneale D, Brunton G et al. Consumption and effects of caffeinated energy drinks in young people: an overview of systematic reviews and secondary analysis of UK data to inform policy. BMJ Open 2022; DOI: 10.1136/bmjopen-2020-047746.

Committee on Nutrition and the Council on Sports Medicine and Fitness . Sports drinks and energy drinks for children and adolescents: Are they appropriate? Paediatrics 2011; 127: 1182-1189.

Clapp, O, Morgan M. Z, Fairchild R M. The top five selling UK energy drinks: implications for dental and general health. Br Dent J 2019; 226: 493-497.

Hardy L L, Bell J, Bauman A, Mihrshahi S. Association between adolescents' consumption of total and different types of sugar-sweetened beverages with oral health impacts and weight status. Aust N Z J Public Health 2018; 42: 22-26.

Partridge J. Customers queue at Aldi at dawn for YouTubers' Prime Hydration drink. 2022. The Guardian (London) 2022 December 29.

Khan K, Qadir A, Trakman G et al. Sports and Energy Drink Consumption, Oral Health Problems and Performance Impact among Elite Athletes. Nutrients 2022; 14: 5089.

Gallagher J, Ashley P, Petrie A, Needleman I. Oral health and performance impacts in elite and professional athletes. Community Dent Oral Epidemiol 2018; 46: 563-568.

Gallagher J, Ashley P, Petrie A, Needleman I. Oral health-related behaviours reported by elite and professional athletes. Br Dent J 2019; 227: 276-280.

Broughton D, Fairchild R M, Morgan MZ. A survey of sports drinks consumption among adolescents. Br Dent J 2016; 220: 639-643.

Peres M A, Macpherson L M, Weyant R J et al. Oral diseases: a global public health challenge. Lancet 2019; 394: 249-260.

Watt R G, Daly B, Allison P et al. Ending the neglect of global oral health: time for radical action. Lancet 2019; 394: 261-272.

UK Government. Childhood obesity: a plan for action, chapter 2. 2018. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/718903/childhood-obesity-a-plan-for-action-chapter-2.pdf (accessed April 2023).

Campbell D. Liz Truss could scrap anti-obesity strategy in drive to cut red tape. The Guardian (London) 2022 September 13. Available at https://www.theguardian.com/politics/2022/sep/13/liz-truss-could-scrap-anti-obesity-strategy-in-drive-to-cut-red-tape (accessed November 2023).

Pell D, Mytton O, Penney T L et al. Changes in soft drinks purchased by British households associated with the UK soft drinks industry levy: controlled interrupted time series analysis. BMJ 2021; 372: 254.

Andreyeva T, Marple K, Marinello S, Moore T E, Powell L M. Outcomes Following Taxation of Sugar-Sweetened Beverages: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; DOI: 10.1001/jamanetworkopen.2022.15276.

Itria A, Borges S S, Rinaldi A E, Nucci L B, Enes C C. Taxing sugar-sweetened beverages as a policy to reduce overweight and obesity in countries of different income classifications: a systematic review. Public Health Nutr 2021; 24: 5550-5560.

UK Government. Introducing further advertising restrictions on TV and online for products high in fat, salt or sugar: consultation on secondary legislation. 2022. Available at https://www.gov.uk/government/consultations/introducing-further-advertising-restrictions-on-tv-and-online-for-products-high-in-fat-salt-or-sugar-secondary-legislation/introducing-further-advertising-restrictions-on-tv-and-online-for-products-high-in-fat-salt-or-sugar-consultation-on-secondary-legislation (accessed April 2023).

UK Government. Ending the sale of energy drinks to children. 2018. Available at https://www.gov.uk/government/consultations/ending-the-sale-of-energy-drinks-to-children (accessed February 2023).

Association of Convenience Stores. Energy drinks: Information for Retailers. 2019. Available at https://cdn.acs.org.uk/public/energy-drinks-guideforretailers.pdf (accessed April 2023).

UK Government. Delivering better oral health: an evidence-based toolkit for prevention. 2021. Available at https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (accessed February 2023).

Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database Syst Rev 2012; DOI: 10.1002/14651858.CD006540.pub2.

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Watt, S., A. Dyer, T. & Marshman, Z. Are teenagers ‘drowning' in sports and energy drinks? The need for upstream and downstream interventions. Br Dent J 235 , 779–781 (2023). https://doi.org/10.1038/s41415-023-6194-x

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What It Means To Be Asian in America

The lived experiences and perspectives of asian americans in their own words.

Asians are the fastest growing racial and ethnic group in the United States. More than 24 million Americans in the U.S. trace their roots to more than 20 countries in East and Southeast Asia and the Indian subcontinent.

The majority of Asian Americans are immigrants, coming to understand what they left behind and building their lives in the United States. At the same time, there is a fast growing, U.S.-born generation of Asian Americans who are navigating their own connections to familial heritage and their own experiences growing up in the U.S.

In a new Pew Research Center analysis based on dozens of focus groups, Asian American participants described the challenges of navigating their own identity in a nation where the label “Asian” brings expectations about their origins, behavior and physical self. Read on to see, in their own words, what it means to be Asian in America.

Introduction, this is how i view my identity, this is how others see and treat me, this is what it means to be home in america, about this project, methodological note, acknowledgments.

No single experience defines what it means to be Asian in the United States today. Instead, Asian Americans’ lived experiences are in part shaped by where they were born, how connected they are to their family’s ethnic origins, and how others – both Asians and non-Asians – see and engage with them in their daily lives. Yet despite diverse experiences, backgrounds and origins, shared experiences and common themes emerged when we asked: “What does it mean to be Asian in America?”

In the fall of 2021, Pew Research Center undertook the largest focus group study it had ever conducted – 66 focus groups with 264 total participants – to hear Asian Americans talk about their lived experiences in America. The focus groups were organized into 18 distinct Asian ethnic origin groups, fielded in 18 languages and moderated by members of their own ethnic groups. Because of the pandemic, the focus groups were conducted virtually, allowing us to recruit participants from all parts of the United States. This approach allowed us to hear a diverse set of voices – especially from less populous Asian ethnic groups whose views, attitudes and opinions are seldom presented in traditional polling. The approach also allowed us to explore the reasons behind people’s opinions and choices about what it means to belong in America, beyond the preset response options of a traditional survey.

The terms “Asian,” “Asians living in the United States” and “Asian American” are used interchangeably throughout this essay to refer to U.S. adults who self-identify as Asian, either alone or in combination with other races or Hispanic identity.

“The United States” and “the U.S.” are used interchangeably with “America” for variations in the writing.

Multiracial participants are those who indicate they are of two or more racial backgrounds (one of which is Asian). Multiethnic participants are those who indicate they are of two or more ethnicities, including those identified as Asian with Hispanic background.

U.S. born refers to people born in the 50 U.S. states or the District of Columbia, Puerto Rico, or other U.S. territories.

Immigrant refers to people who were not U.S. citizens at birth – in other words, those born outside the U.S., Puerto Rico or other U.S. territories to parents who were not U.S. citizens. The terms “immigrant,” “first generation” and “foreign born” are used interchangeably in this report.

Second generation refers to people born in the 50 states or the District of Columbia with at least one first-generation, or immigrant, parent.

The pan-ethnic term “Asian American” describes the population of about 22 million people living in the United States who trace their roots to more than 20 countries in East and Southeast Asia and the Indian subcontinent. The term was popularized by U.S. student activists in the 1960s and was eventually adopted by the U.S. Census Bureau. However, the “Asian” label masks the diverse demographics and wide economic disparities across the largest national origin groups (such as Chinese, Indian, Filipino) and the less populous ones (such as Bhutanese, Hmong and Nepalese) living in America. It also hides the varied circumstances of groups immigrated to the U.S. and how they started their lives there. The population’s diversity often presents challenges . Conventional survey methods typically reflect the voices of larger groups without fully capturing the broad range of views, attitudes, life starting points and perspectives experienced by Asian Americans. They can also limit understanding of the shared experiences across this diverse population.

A chart listing the 18 ethnic origins included in Pew Research Center's 66 focus groups, and the composition of the focus groups by income and birth place.

Across all focus groups, some common findings emerged. Participants highlighted how the pan-ethnic “Asian” label used in the U.S. represented only one part of how they think of themselves. For example, recently arrived Asian immigrant participants told us they are drawn more to their ethnic identity than to the more general, U.S.-created pan-ethnic Asian American identity. Meanwhile, U.S.-born Asian participants shared how they identified, at times, as Asian but also, at other times, by their ethnic origin and as Americans.

Another common finding among focus group participants is the disconnect they noted between how they see themselves and how others view them. Sometimes this led to maltreatment of them or their families, especially at heightened moments in American history such as during Japanese incarceration during World War II, the aftermath of 9/11 and, more recently, the COVID-19 pandemic. Beyond these specific moments, many in the focus groups offered their own experiences that had revealed other people’s assumptions or misconceptions about their identity.

Another shared finding is the multiple ways in which participants take and express pride in their cultural and ethnic backgrounds while also feeling at home in America, celebrating and blending their unique cultural traditions and practices with those of other Americans.

This focus group project is part of a broader research agenda about Asians living in the United States. The findings presented here offer a small glimpse of what participants told us, in their own words, about how they identify themselves, how others see and treat them, and more generally, what it means to be Asian in America.

Illustrations by Jing Li

Publications from the Being Asian in America project

Read the data essay: What It Means to Be Asian in America
Watch the documentary: Being Asian in America
Explore the interactive: In Their Own Words: The Diverse Perspectives of Being Asian in America
View expanded interviews: Extended Interviews: Being Asian in America
About this research project: More on the Being Asian in America project
Q&A: Why and how Pew Research Center conducted 66 focus groups with Asian Americans

One of the topics covered in each focus group was how participants viewed their own racial or ethnic identity. Moderators asked them how they viewed themselves, and what experiences informed their views about their identity. These discussions not only highlighted differences in how participants thought about their own racial or ethnic background, but they also revealed how different settings can influence how they would choose to identify themselves. Across all focus groups, the general theme emerged that being Asian was only one part of how participants viewed themselves.

The pan-ethnic label ‘Asian’ is often used more in formal settings

“I think when I think of the Asian Americans, I think that we’re all unique and different. We come from different cultures and backgrounds. We come from unique stories, not just as a group, but just as individual humans.” Mali , documentary participant

Many participants described a complicated relationship with the pan-ethnic labels “Asian” or “Asian American.” For some, using the term was less of an active choice and more of an imposed one, with participants discussing the disconnect between how they would like to identify themselves and the available choices often found in formal settings. For example, an immigrant Pakistani woman remarked how she typically sees “Asian American” on forms, but not more specific options. Similarly, an immigrant Burmese woman described her experience of applying for jobs and having to identify as “Asian,” as opposed to identifying by her ethnic background, because no other options were available. These experiences highlight the challenges organizations like government agencies and employers have in developing surveys or forms that ask respondents about their identity. A common sentiment is one like this:

“I guess … I feel like I just kind of check off ‘Asian’ [for] an application or the test forms. That’s the only time I would identify as Asian. But Asian is too broad. Asia is a big continent. Yeah, I feel like it’s just too broad. To specify things, you’re Taiwanese American, that’s exactly where you came from.”

–U.S.-born woman of Taiwanese origin in early 20s

Smaller ethnic groups default to ‘Asian’ since their groups are less recognizable

Other participants shared how their experiences in explaining the geographic location and culture of their origin country led them to prefer “Asian” when talking about themselves with others. This theme was especially prominent among those belonging to smaller origin groups such as Bangladeshis and Bhutanese. A Lao participant remarked she would initially say “Asian American” because people might not be familiar with “Lao.”

“[When I fill out] forms, I select ‘Asian American,’ and that’s why I consider myself as an Asian American. [It is difficult to identify as] Nepali American [since] there are no such options in forms. That’s why, Asian American is fine to me.”

–Immigrant woman of Nepalese origin in late 20s

“Coming to a big country like [the United States], when people ask where we are from … there are some people who have no idea about Bhutan, so we end up introducing ourselves as being Asian.”

–Immigrant woman of Bhutanese origin in late 40s

But for many, ‘Asian’ as a label or identity just doesn’t fit

Many participants felt that neither “Asian” nor “Asian American” truly captures how they view themselves and their identity. They argue that these labels are too broad or too ambiguous, as there are so many different groups included within these labels. For example, a U.S.-born Pakistani man remarked on how “Asian” lumps many groups together – that the term is not limited to South Asian groups such as Indian and Pakistani, but also includes East Asian groups. Similarly, an immigrant Nepalese man described how “Asian” often means Chinese for many Americans. A Filipino woman summed it up this way:

“Now I consider myself to be both Filipino and Asian American, but growing up in [Southern California] … I didn’t start to identify as Asian American until college because in [the Los Angeles suburb where I lived], it’s a big mix of everything – Black, Latino, Pacific Islander and Asian … when I would go into spaces where there were a lot of other Asians, especially East Asians, I didn’t feel like I belonged. … In media, right, like people still associate Asian with being East Asian.”

–U.S.-born woman of Filipino origin in mid-20s

Participants also noted they have encountered confusion or the tendency for others to view Asian Americans as people from mostly East Asian countries, such as China, Japan and Korea. For some, this confusion even extends to interactions with other Asian American groups. A Pakistani man remarked on how he rarely finds Pakistani or Indian brands when he visits Asian stores. Instead, he recalled mostly finding Vietnamese, Korean and Chinese items.

Among participants of South Asian descent, some identified with the label “South Asian” more than just “Asian.” There were other nuances, too, when it comes to the labels people choose. Some Indian participants, for example, said people sometimes group them with Native Americans who are also referred to as Indians in the United States. This Indian woman shared her experience at school:

“I love South Asian or ‘Desi’ only because up until recently … it’s fairly new to say South Asian. I’ve always said ‘Desi’ because growing up … I’ve had to say I’m the red dot Indian, not the feather Indian. So annoying, you know? … Always a distinction that I’ve had to make.”

–U.S.-born woman of Indian origin in late 20s

Participants with multiethnic or multiracial backgrounds described their own unique experiences with their identity. Rather than choosing one racial or ethnic group over the other, some participants described identifying with both groups, since this more accurately describes how they see themselves. In some cases, this choice reflected the history of the Asian diaspora. For example, an immigrant Cambodian man described being both Khmer/Cambodian and Chinese, since his grandparents came from China. Some other participants recalled going through an “identity crisis” as they navigated between multiple identities. As one woman explained:

“I would say I went through an identity crisis. … It’s because of being multicultural. … There’s also French in the mix within my family, too. Because I don’t identify, speak or understand the language, I really can’t connect to the French roots … I’m in between like Cambodian and Thai, and then Chinese and then French … I finally lumped it up. I’m just an Asian American and proud of all my roots.”

–U.S.-born woman of Cambodian origin in mid-30s

In other cases, the choice reflected U.S. patterns of intermarriage. Asian newlyweds have the highest intermarriage rate of any racial or ethnic group in the country. One Japanese-origin man with Hispanic roots noted:

“So I would like to see myself as a Hispanic Asian American. I want to say Hispanic first because I have more of my mom’s culture in me than my dad’s culture. In fact, I actually have more American culture than my dad’s culture for what I do normally. So I guess, Hispanic American Asian.”

–U.S.-born man of Hispanic and Japanese origin in early 40s

Other identities beyond race or ethnicity are also important

Focus group participants also talked about their identity beyond the racial or ethnic dimension. For example, one Chinese woman noted that the best term to describe her would be “immigrant.” Faith and religious ties were also important to some. One immigrant participant talked about his love of Pakistani values and how religion is intermingled into Pakistani culture. Another woman explained:

“[Japanese language and culture] are very important to me and ingrained in me because they were always part of my life, and I felt them when I was growing up. Even the word itadakimasu reflects Japanese culture or the tradition. Shinto religion is a part of the culture. They are part of my identity, and they are very important to me.”

–Immigrant woman of Japanese origin in mid-30s

For some, gender is another important aspect of identity. One Korean participant emphasized that being a woman is an important part of her identity. For others, sexual orientation is an essential part of their overall identity. One U.S.-born Filipino participant described herself as “queer Asian American.” Another participant put it this way:

“I belong to the [LGBTQ] community … before, what we only know is gay and lesbian. We don’t know about being queer, nonbinary. [Here], my horizon of knowing what genders and gender roles is also expanded … in the Philippines, if you’ll be with same sex, you’re considered gay or lesbian. But here … what’s happening is so broad, on how you identify yourself.”

–Immigrant woman of Filipino origin in early 20s

Immigrant identity is tied to their ethnic heritage

A chart showing how participants in the focus groups described the differences between race-centered and ethnicity-centered identities.

Participants born outside the United States tended to link their identity with their ethnic heritage. Some felt strongly connected with their ethnic ties due to their citizenship status. For others, the lack of permanent residency or citizenship meant they have stronger ties to their ethnicity and birthplace. And in some cases, participants said they held on to their ethnic identity even after they became U.S. citizens. One woman emphasized that she will always be Taiwanese because she was born there, despite now living in the U.S.

For other participants, family origin played a central role in their identity, regardless of their status in the U.S. According to some of them, this attitude was heavily influenced by their memories and experiences in early childhood when they were still living in their countries of origin. These influences are so profound that even after decades of living in the U.S., some still feel the strong connection to their ethnic roots. And those with U.S.-born children talked about sending their kids to special educational programs in the U.S. to learn about their ethnic heritage.

“Yes, as for me, I hold that I am Khmer because our nationality cannot be deleted, our identity is Khmer as I hold that I am Khmer … so I try, even [with] my children today, I try to learn Khmer through Zoom through the so-called Khmer Parent Association.”

–Immigrant man of Cambodian origin in late 50s

Navigating life in America is an adjustment

Many participants pointed to cultural differences they have noticed between their ethnic culture and U.S. culture. One of the most distinct differences is in food. For some participants, their strong attachment to the unique dishes of their families and their countries of origin helps them maintain strong ties to their ethnic identity. One Sri Lankan participant shared that her roots are still in Sri Lanka, since she still follows Sri Lankan traditions in the U.S. such as preparing kiribath (rice with coconut milk) and celebrating Ramadan.

For other participants, interactions in social settings with those outside their own ethnic group circles highlighted cultural differences. One Bangladeshi woman talked about how Bengalis share personal stories and challenges with each other, while others in the U.S. like to have “small talk” about TV series or clothes.

Many immigrants in the focus groups have found it is easier to socialize when they are around others belonging to their ethnicity. When interacting with others who don’t share the same ethnicity, participants noted they must be more self-aware about cultural differences to avoid making mistakes in social interactions. Here, participants described the importance of learning to “fit in,” to avoid feeling left out or excluded. One Korean woman said:

“Every time I go to a party, I feel unwelcome. … In Korea, when I invite guests to my house and one person sits without talking, I come over and talk and treat them as a host. But in the United States, I have to go and mingle. I hate mingling so much. I have to talk and keep going through unimportant stories. In Korea, I am assigned to a dinner or gathering. I have a party with a sense of security. In America, I have nowhere to sit, and I don’t know where to go and who to talk to.”

–Immigrant woman of Korean origin in mid-40s

And a Bhutanese immigrant explained:

“In my case, I am not an American. I consider myself a Bhutanese. … I am a Bhutanese because I do not know American culture to consider myself as an American. It is very difficult to understand the sense of humor in America. So, we are pure Bhutanese in America.”

–Immigrant man of Bhutanese origin in early 40s

Language was also a key aspect of identity for the participants. Many immigrants in the focus groups said they speak a language other than English at home and in their daily lives. One Vietnamese man considered himself Vietnamese since his Vietnamese is better than his English. Others emphasized their English skills. A Bangladeshi participant felt that she was more accepted in the workplace when she does more “American” things and speaks fluent English, rather than sharing things from Bangladeshi culture. She felt that others in her workplace correlate her English fluency with her ability to do her job. For others born in the U.S., the language they speak at home influences their connection to their ethnic roots.

“Now if I go to my work and do show my Bengali culture and Asian culture, they are not going to take anything out of it. So, basically, I have to show something that they are interested in. I have to show that I am American, [that] I can speak English fluently. I can do whatever you give me as a responsibility. So, in those cases I can’t show anything about my culture.”

–Immigrant woman of Bangladeshi origin in late 20s

“Being bi-ethnic and tri-cultural creates so many unique dynamics, and … one of the dynamics has to do with … what it is to be Americanized. … One of the things that played a role into how I associate the identity is language. Now, my father never spoke Spanish to me … because he wanted me to develop a fluency in English, because for him, he struggled with English. What happened was three out of the four people that raised me were Khmer … they spoke to me in Khmer. We’d eat breakfast, lunch and dinner speaking Khmer. We’d go to the temple in Khmer with the language and we’d also watch videos and movies in Khmer. … Looking into why I strongly identify with the heritage, one of the reasons is [that] speaking that language connects to the home I used to have [as my families have passed away].”

–U.S.-born man of Cambodian origin in early 30s

Balancing between individualistic and collective thinking

For some immigrant participants, the main differences between themselves and others who are seen as “truly American” were less about cultural differences, or how people behave, and more about differences in “mindset,” or how people think . Those who identified strongly with their ethnicity discussed how their way of thinking is different from a “typical American.” To some, the “American mentality” is more individualistic, with less judgment on what one should do or how they should act . One immigrant Japanese man, for example, talked about how other Japanese-origin co-workers in the U.S. would work without taking breaks because it’s culturally inconsiderate to take a break while others continued working. However, he would speak up for himself and other workers when they are not taking any work breaks. He attributed this to his “American” way of thinking, which encourages people to stand up for themselves.

Some U.S.-born participants who grew up in an immigrant family described the cultural clashes that happened between themselves and their immigrant parents. Participants talked about how the second generation (children of immigrant parents) struggles to pursue their own dreams while still living up to the traditional expectations of their immigrant parents.

“I feel like one of the biggest things I’ve seen, just like [my] Asian American friends overall, is the kind of family-individualistic clash … like wanting to do your own thing is like, is kind of instilled in you as an American, like go and … follow your dream. But then you just grow up with such a sense of like also wanting to be there for your family and to live up to those expectations, and I feel like that’s something that’s very pronounced in Asian cultures.”

–U.S.-born man of Indian origin in mid-20s

Discussions also highlighted differences about gender roles between growing up in America compared with elsewhere.

“As a woman or being a girl, because of your gender, you have to keep your mouth shut [and] wait so that they call on you for you to speak up. … I do respect our elders and I do respect hearing their guidance but I also want them to learn to hear from the younger person … because we have things to share that they might not know and that [are] important … so I like to challenge gender roles or traditional roles because it is something that [because] I was born and raised here [in America], I learn that we all have the equal rights to be able to speak and share our thoughts and ideas.”

U.S. born have mixed ties to their family’s heritage

“I think being Hmong is somewhat of being free, but being free of others’ perceptions of you or of others’ attempts to assimilate you or attempts to put pressure on you. I feel like being Hmong is to resist, really.” Pa Houa , documentary participant

How U.S.-born participants identify themselves depends on their familiarity with their own heritage, whom they are talking with, where they are when asked about their identity and what the answer is used for. Some mentioned that they have stronger ethnic ties because they are very familiar with their family’s ethnic heritage. Others talked about how their eating habits and preferred dishes made them feel closer to their ethnic identity. For example, one Korean participant shared his journey of getting closer to his Korean heritage because of Korean food and customs. When some participants shared their reasons for feeling closer to their ethnic identity, they also expressed a strong sense of pride with their unique cultural and ethnic heritage.

“I definitely consider myself Japanese American. I mean I’m Japanese and American. Really, ever since I’ve grown up, I’ve really admired Japanese culture. I grew up watching a lot of anime and Japanese black and white films. Just learning about [it], I would hear about Japanese stuff from my grandparents … myself, and my family having blended Japanese culture and American culture together.”

–U.S.-born man of Japanese origin in late 20s

Meanwhile, participants who were not familiar with their family’s heritage showed less connection with their ethnic ties. One U.S.-born woman said she has a hard time calling herself Cambodian, as she is “not close to the Cambodian community.” Participants with stronger ethnic ties talked about relating to their specific ethnic group more than the broader Asian group. Another woman noted that being Vietnamese is “more specific and unique than just being Asian” and said that she didn’t feel she belonged with other Asians. Some participants also disliked being seen as or called “Asian,” in part because they want to distinguish themselves from other Asian groups. For example, one Taiwanese woman introduces herself as Taiwanese when she can, because she had frequently been seen as Chinese.

Some in the focus groups described how their views of their own identities shifted as they grew older. For example, some U.S.-born and immigrant participants who came to the U.S. at younger ages described how their experiences in high school and the need to “fit in” were important in shaping their own identities. A Chinese woman put it this way:

“So basically, all I know is that I was born in the United States. Again, when I came back, I didn’t feel any barrier with my other friends who are White or Black. … Then I got a little confused in high school when I had trouble self-identifying if I am Asian, Chinese American, like who am I. … Should I completely immerse myself in the American culture? Should I also keep my Chinese identity and stuff like that? So yeah, that was like the middle of that mist. Now, I’m pretty clear about myself. I think I am Chinese American, Asian American, whatever people want.”

–U.S.-born woman of Chinese origin in early 20s

Identity is influenced by birthplace

“I identified myself first and foremost as American. Even on the forms that you fill out that says, you know, ‘Asian’ or ‘Chinese’ or ‘other,’ I would check the ‘other’ box, and I would put ‘American Chinese’ instead of ‘Chinese American.’” Brent , documentary participant

When talking about what it means to be “American,” participants offered their own definitions. For some, “American” is associated with acquiring a distinct identity alongside their ethnic or racial backgrounds, rather than replacing them. One Indian participant put it this way:

“I would also say [that I am] Indian American just because I find myself always bouncing between the two … it’s not even like dual identity, it just is one whole identity for me, like there’s not this separation. … I’m doing [both] Indian things [and] American things. … They use that term like ABCD … ‘American Born Confused Desi’ … I don’t feel that way anymore, although there are those moments … but I would say [that I am] Indian American for sure.”

–U.S.-born woman of Indian origin in early 30s

Meanwhile, some U.S.-born participants view being American as central to their identity while also valuing the culture of their family’s heritage.

Many immigrant participants associated the term “American” with immigration status or citizenship. One Taiwanese woman said she can’t call herself American since she doesn’t have a U.S. passport. Notably, U.S. citizenship is an important milestone for many immigrant participants, giving them a stronger sense of belonging and ultimately calling themselves American. A Bangladeshi participant shared that she hasn’t received U.S. citizenship yet, and she would call herself American after she receives her U.S. passport.

Other participants gave an even narrower definition, saying only those born and raised in the United States are truly American. One Taiwanese woman mentioned that her son would be American since he was born, raised and educated in the U.S. She added that while she has U.S. citizenship, she didn’t consider herself American since she didn’t grow up in the U.S. This narrower definition has implications for belonging. Some immigrants in the groups said they could never become truly American since the way they express themselves is so different from those who were born and raised in the U.S. A Japanese woman pointed out that Japanese people “are still very intimidated by authorities,” while those born and raised in America give their opinions without hesitation.

“As soon as I arrived, I called myself a Burmese immigrant. I had a green card, but I still wasn’t an American citizen. … Now I have become a U.S. citizen, so now I am a Burmese American.”

–Immigrant man of Burmese origin in mid-30s

“Since I was born … and raised here, I kind of always view myself as American first who just happened to be Asian or Chinese. So I actually don’t like the term Chinese American or Asian American. I’m American Asian or American Chinese. I view myself as American first.”

–U.S.-born man of Chinese origin in early 60s

“[I used to think of myself as] Filipino, but recently I started saying ‘Filipino American’ because I got [U.S.] citizenship. And it just sounds weird to say Filipino American, but I’m trying to … I want to accept it. I feel like it’s now marry-able to my identity.”

–Immigrant woman of Filipino origin in early 30s

For others, American identity is about the process of ‘becoming’ culturally American

A Venn diagram showing how participants in the focus group study described their racial or ethnic identity overlaps with their American identity

Immigrant participants also emphasized how their experiences and time living in America inform their views of being an “American.” As a result, some started to see themselves as Americans after spending more than a decade in the U.S. One Taiwanese man considered himself an American since he knows more about the U.S. than Taiwan after living in the U.S. for over 52 years.

But for other immigrant participants, the process of “becoming” American is not about how long they have lived in the U.S., but rather how familiar they are with American culture and their ability to speak English with little to no accent. This is especially true for those whose first language is not English, as learning and speaking it without an accent can be a big challenge for some. One Bangladeshi participant shared that his pronunciation of “hot water” was very different from American English, resulting in confusions in communication. By contrast, those who were more confident in their English skills felt they can better understand American culture and values as a result, leading them to a stronger connection with an American identity.

“[My friends and family tease me for being Americanized when I go back to Japan.] I think I seem a little different to people who live in Japan. I don’t think they mean anything bad, and they [were] just joking, because I already know that I seem a little different to people who live in Japan.”

–Immigrant man of Japanese origin in mid-40s

“I value my Hmong culture, and language, and ethnicity, but I also do acknowledge, again, that I was born here in America and I’m grateful that I was born here, and I was given opportunities that my parents weren’t given opportunities for.”

–U.S.-born woman of Hmong origin in early 30s

During the focus group discussions about identity, a recurring theme emerged about the difference between how participants saw themselves and how others see them. When asked to elaborate on their experiences and their points of view, some participants shared experiences they had with people misidentifying their race or ethnicity. Others talked about their frustration with being labeled the “model minority.” In all these discussions, participants shed light on the negative impacts that mistaken assumptions and labels had on their lives.

All people see is ‘Asian’

For many, interactions with others (non-Asians and Asians alike) often required explaining their backgrounds, reacting to stereotypes, and for those from smaller origin groups in particular, correcting the misconception that being “Asian” means you come from one of the larger Asian ethnic groups. Several participants remarked that in their own experiences, when others think about Asians, they tend to think of someone who is Chinese. As one immigrant Filipino woman put it, “Interacting with [non-Asians in the U.S.], it’s hard. … Well, first, I look Spanish. I mean, I don’t look Asian, so would you guess – it’s like they have a vision of what an Asian [should] look like.” Similarly, an immigrant Indonesian man remarked how Americans tended to see Asians primarily through their physical features, which not all Asian groups share.

Several participants also described how the tendency to view Asians as a monolithic group can be even more common in the wake of the COVID-19 pandemic.

“The first [thing people think of me as] is just Chinese. ‘You guys are just Chinese.’ I’m not the only one who felt [this] after the COVID-19 outbreak. ‘Whether you’re Japanese, Korean, or Southeast Asian, you’re just Chinese [to Americans]. I should avoid you.’ I’ve felt this way before, but I think I’ve felt it a bit more after the COVID-19 outbreak.”

–Immigrant woman of Korean origin in early 30s

At the same time, other participants described their own experiences trying to convince others that they are Asian or Asian American. This was a common experience among Southeast Asian participants.

“I have to convince people I’m Asian, not Middle Eastern. … If you type in Asian or you say Asian, most people associate it with Chinese food, Japanese food, karate, and like all these things but then they don’t associate it with you.”

–U.S.-born man of Pakistani origin in early 30s

The model minority myth and its impact

“I’ve never really done the best academically, compared to all my other Asian peers too. I never really excelled. I wasn’t in honors. … Those stereotypes, I think really [have] taken a toll on my self-esteem.” Diane , documentary participant

Across focus groups, immigrant and U.S.-born participants described the challenges of the seemingly positive stereotypes of Asians as intelligent, gifted in technical roles and hardworking. Participants often referred to this as the “model minority myth.”

The label “model minority” was coined in the 1960s and has been used to characterize Asian Americans as financially and educationally successful and hardworking when compared with other groups. However, for many Asians living in the United States, these characterizations do not align with their lived experiences or reflect their socioeconomic backgrounds. Indeed, among Asian origin groups in the U.S., there are wide differences in economic and social experiences.

Academic research on the model minority myth has pointed to its impact beyond Asian Americans and towards other racial and ethnic groups, especially Black Americans, in the U.S. Some argue that the model minority myth has been used to justify policies that overlook the historical circumstances and impacts of colonialism, slavery, discrimination and segregation on other non-White racial and ethnic groups.

Many participants noted ways in which the model minority myth has been harmful. For some, expectations based on the myth didn’t match their own experiences of coming from impoverished communities. Some also recalled experiences at school when they struggled to meet their teachers’ expectations in math and science.

“As an Asian person, I feel like there’s that stereotype that Asian students are high achievers academically. They’re good at math and science. … I was a pretty mediocre student, and math and science were actually my weakest subjects, so I feel like it’s either way you lose. Teachers expect you to fit a certain stereotype and if you’re not, then you’re a disappointment, but at the same time, even if you are good at math and science, that just means that you’re fitting a stereotype. It’s [actually] your own achievement, but your teachers might think, ‘Oh, it’s because they’re Asian,’ and that diminishes your achievement.”

–U.S.-born woman of Korean origin in late 20s

Some participants felt that even when being Asian worked in their favor in the job market, they encountered stereotypes that “Asians can do quality work with less compensation” or that “Asians would not complain about anything at work.”

“There is a joke from foreigners and even Asian Americans that says, ‘No matter what you do, Asians always do the best.’ You need to get A, not just B-plus. Otherwise, you’ll be a disgrace to the family. … Even Silicon Valley hires Asian because [an] Asian’s wage is cheaper but [they] can work better. When [work] visa overflow happens, they hire Asians like Chinese and Indian to work in IT fields because we are good at this and do not complain about anything.”

–Immigrant man of Thai origin in early 40s

Others expressed frustration that people were placing them in the model minority box. One Indian woman put it this way:

“Indian people and Asian people, like … our parents or grandparents are the ones who immigrated here … against all odds. … A lot of Indian and Asian people have succeeded and have done really well for themselves because they’ve worked themselves to the bone. So now the expectations [of] the newer generations who were born here are incredibly unrealistic and high. And you get that not only from your family and the Indian community, but you’re also getting it from all of the American people around you, expecting you to be … insanely good at math, play an instrument, you know how to do this, you know how to do that, but it’s not true. And it’s just living with those expectations, it’s difficult.”

–U.S.-born woman of Indian origin in early 20s

Whether U.S. born or immigrants, Asians are often seen by others as foreigners

“Being only not quite 10 years old, it was kind of exciting to ride on a bus to go someplace. But when we went to Pomona, the assembly center, we were stuck in one of the stalls they used for the animals.” Tokiko , documentary participant

Across all focus groups, participants highlighted a common question they are asked in America when meeting people for the first time: “Where are you really from?” For participants, this question implied that people think they are “foreigners,” even though they may be longtime residents or citizens of the United States or were born in the country. One man of Vietnamese origin shared his experience with strangers who assumed that he and his friends are North Korean. Perhaps even more hurtful, participants mentioned that this meant people had a preconceived notion of what an “American” is supposed to look like, sound like or act like. One Chinese woman said that White Americans treated people like herself as outsiders based on her skin color and appearance, even though she was raised in the U.S.

Many focus group participants also acknowledged the common stereotype of treating Asians as “forever foreigners.” Some immigrant participants said they felt exhausted from constantly being asked this question by people even when they speak perfect English with no accent. During the discussion, a Korean immigrant man recalled that someone had said to him, “You speak English well, but where are you from?” One Filipino participant shared her experience during the first six months in the U.S.:

“You know, I spoke English fine. But there were certain things that, you know, people constantly questioning you like, oh, where are you from? When did you come here? You know, just asking about your experience to the point where … you become fed up with it after a while.”

–Immigrant woman of Filipino origin in mid-30s

U.S.-born participants also talked about experiences when others asked where they are from. Many shared that they would not talk about their ethnic origin right away when answering such a question because it often led to misunderstandings and assumptions that they are immigrants.

“I always get that question of, you know, ‘Where are you from?’ and I’m like, ‘I’m from America.’ And then they’re like, ‘No. Where are you from-from ?’ and I’m like, ‘Yeah, my family is from Pakistan,’ so it’s like I always had like that dual identity even though it’s never attached to me because I am like, of Pakistani descent.”

–U.S.-born man of Pakistani origin in early 20s

One Korean woman born in the U.S. said that once people know she is Korean, they ask even more offensive questions such as “Are you from North or South Korea?” or “Do you still eat dogs?”

In a similar situation, this U.S.-born Indian woman shared her responses:

“I find that there’s a, ‘So but where are you from?’ Like even in professional settings when they feel comfortable enough to ask you. ‘So – so where are you from?’ ‘Oh, I was born in [names city], Colorado. Like at [the hospital], down the street.’ ‘No, but like where are you from?’ ‘My mother’s womb?’”

–U.S.-born woman of Indian origin in early 40s

Ignorance and misinformation about Asian identity can lead to contentious encounters

“I have dealt with kids who just gave up on their Sikh identity, cut their hair and groomed their beard and everything. They just wanted to fit in and not have to deal with it, especially [those] who are victim or bullied in any incident.” Surinder , documentary participant

In some cases, ignorance and misinformation about Asians in the U.S. lead to inappropriate comments or questions and uncomfortable or dangerous situations. Participants shared their frustration when others asked about their country of origin, and they then had to explain their identity or correct misunderstandings or stereotypes about their background. At other times, some participants faced ignorant comments about their ethnicity, which sometimes led to more contentious encounters. For example, some Indian or Pakistani participants talked about the attacks or verbal abuse they experienced from others blaming them for the 9/11 terrorist attacks. Others discussed the racial slurs directed toward them since the COVID-19 pandemic in 2020. Some Japanese participants recalled their families losing everything and being incarcerated during World War II and the long-term effect it had on their lives.

“I think like right now with the coronavirus, I think we’re just Chinese, Chinese American, well, just Asian American or Asians in general, you’re just going through the same struggles right now. Like everyone is just blaming whoever looks Asian about the virus. You don’t feel safe.”

–U.S.-born man of Chinese origin in early 30s

“At the beginning of the pandemic, a friend and I went to celebrate her birthday at a club and like these guys just kept calling us COVID.”

–U.S.-born woman of Korean origin in early 20s

“There [were] a lot of instances after 9/11. One day, somebody put a poster about 9/11 [in front of] my business. He was wearing a gun. … On the poster, it was written ‘you Arabs, go back to your country.’ And then someone came inside. He pointed his gun at me and said ‘Go back to your country.’”

–Immigrant man of Pakistani origin in mid-60s

“[My parents went through the] internment camps during World War II. And my dad, he was in high school, so he was – they were building the camps and then he was put into the Santa Anita horse track place, the stables there. And then they were sent – all the Japanese Americans were sent to different camps, right, during World War II and – in California. Yeah, and they lost everything, yeah.”

–U.S.-born woman of Japanese origin in mid-60s

As focus group participants contemplated their identity during the discussions, many talked about their sense of belonging in America. Although some felt frustrated with people misunderstanding their ethnic heritage, they didn’t take a negative view of life in America. Instead, many participants – both immigrant and U.S. born – took pride in their unique cultural and ethnic backgrounds. In these discussions, people gave their own definitions of America as a place with a diverse set of cultures, with their ethnic heritage being a part of it.

Taking pride in their unique cultures

“Being a Pakistani American, I’m proud. … Because I work hard, and I make true my dreams from here.” Shahid , documentary participant

Despite the challenges of adapting to life in America for immigrant participants or of navigating their dual cultural identity for U.S.-born ones, focus group participants called America their home. And while participants talked about their identities in different ways – ethnic identity, racial (Asian) identity, and being American – they take pride in their unique cultures. Many also expressed a strong sense of responsibility to give back or support their community, sharing their cultural heritage with others on their own terms.

“Right now it has been a little difficult. I think it has been for all Asians because of the COVID issue … but I’m glad that we’re all here [in America]. I think we should be proud to be here. I’m glad that our families have traveled here, and we can help make life better for communities, our families and ourselves. I think that’s really a wonderful thing. We can be those role models for a lot of the future, the younger folks. I hope that something I did in the last years will have impacted either my family, friends or students that I taught in other community things that I’ve done. So you hope that it helps someplace along the line.”

“I am very proud of my culture. … There is not a single Bengali at my workplace, but people know the name of my country. Maybe many years [later] – educated people know all about the country. So, I don’t have to explain that there is a small country next to India and Nepal. It’s beyond saying. People after all know Bangladesh. And there are so many Bengali present here as well. So, I am very proud to be a Bangladeshi.”

Where home is

When asked about the definition of home, some immigrant participants said home is where their families are located. Immigrants in the focus groups came to the United States by various paths, whether through work opportunities, reuniting with family or seeking a safe haven as refugees. Along their journey, some received support from family members, their local community or other individuals, while others overcame challenges by themselves. Either way, they take pride in establishing their home in America and can feel hurt when someone tells them to “go back to your country.” In response, one Laotian woman in her mid-40s said, “This is my home. My country. Go away.”

“If you ask me personally, I view my home as my house … then I would say my house is with my family because wherever I go, I cannot marry if I do not have my family so that is how I would answer.”

–Immigrant man of Hmong origin in late 30s

“[If somebody yelled at me ‘go back to your country’] I’d feel angry because this is my country! I live here. America is my country. I grew up here and worked here … I’d say, ‘This is my country! You go back to your country! … I will not go anywhere. This is my home. I will live here.’ That’s what I’d say.”

–Immigrant woman of Laotian origin in early 50s

‘American’ means to blend their unique cultural and ethnic heritage with that in the U.S.

“I want to teach my children two traditions – one American and one Vietnamese – so they can compare and choose for themselves the best route in life.” Helen , documentary participant (translated from Vietnamese)

Both U.S.-born and immigrant participants in the focus groups shared their experiences of navigating a dual cultural environment between their ethnic heritage and American culture. A common thread that emerged was that being Asian in America is a process of blending two or more identities as one.

“Yeah, I want to say that’s how I feel – because like thinking about it, I would call my dad Lao but I would call myself Laotian American because I think I’m a little more integrated in the American society and I’ve also been a little more Americanized, compared to my dad. So that’s how I would see it.”

–U.S.-born man of Laotian origin in late 20s

“I mean, Bangladeshi Americans who are here, we are carrying Bangladeshi culture, religion, food. I am also trying to be Americanized like the Americans. Regarding language, eating habits.”

–Immigrant man of Bangladeshi origin in mid-50s

“Just like there is Chinese American, Mexican American, Japanese American, Italian American, so there is Indian American. I don’t want to give up Indianness. I am American by nationality, but I am Indian by birth. So whenever I talk, I try to show both the flags as well, both Indian and American flags. Just because you make new relatives but don’t forget the old relatives.”

–Immigrant man of Indian origin in late 40s

Pew Research Center designed these focus groups to better understand how members of an ethnically diverse Asian population think about their place in America and life here. By including participants of different languages, immigration or refugee experiences, educational backgrounds, and income levels, this focus group study aimed to capture in people’s own words what it means to be Asian in America. The discussions in these groups may or may not resonate with all Asians living in the United States. Browse excerpts from our focus groups with the interactive quote sorter below, view a video documentary focused on the topics discussed in the focus groups, or tell us your story of belonging in America via social media. The focus group project is part of a broader research project studying the diverse experiences of Asians living in the U.S.

Read sortable quotes from our focus groups

Browse excerpts in the interactive quote sorter from focus group participants in response to the question “What does it mean to be [Vietnamese, Thai, Sri Lankan, Hmong, etc.] like yourself in America?” This interactive allows you to sort quotes from focus group participants by ethnic origin, nativity (U.S. born or born in another country), gender and age.

Video documentary

Videos throughout the data essay illustrate what focus group participants discussed. Those recorded in these videos did not participate in the focus groups but were sampled to have similar demographic characteristics and thematically relevant stories.

Watch the full video documentary and watch additional shorter video clips related to the themes of this data essay.

Share the story of your family and your identity

Did the voices in this data essay resonate? Share your story of what it means to be Asian in America with @pewresearch. Tell us your story by using the hashtag #BeingAsianInAmerica and @pewidentity on Twitter, as well as #BeingAsianInAmerica and @pewresearch on Instagram.

This cross-ethnic, comparative qualitative research project explores the identity, economic mobility, representation, and experiences of immigration and discrimination among the Asian population in the United States. The analysis is based on 66 focus groups we conducted virtually in the fall of 2021 and included 264 participants from across the U.S. More information about the groups and analysis can be found in this appendix .

Pew Research Center is a subsidiary of The Pew Charitable Trusts, its primary funder. This data essay was funded by The Pew Charitable Trusts, with generous support from the Chan Zuckerberg Initiative DAF, an advised fund of the Silicon Valley Community Foundation; the Robert Wood Johnson Foundation; the Henry Luce Foundation; The Wallace H. Coulter Foundation; The Dirk and Charlene Kabcenell Foundation; The Long Family Foundation; Lu-Hebert Fund; Gee Family Foundation; Joseph Cotchett; the Julian Abdey and Sabrina Moyle Charitable Fund; and Nanci Nishimura.

The accompanying video clips and video documentary were made possible by The Pew Charitable Trusts, with generous support from The Sobrato Family Foundation and The Long Family Foundation.

We would also like to thank the Leaders Forum for its thought leadership and valuable assistance in helping make this study possible. This is a collaborative effort based on the input and analysis of a number of individuals and experts at Pew Research Center and outside experts.

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EPA designates 2 forever chemicals as hazardous substances, eligible for Superfund cleanup

FILE - Environmental Protection Agency administrator Michael Regan speaks during a press briefing at the White House in Washington, on May 12, 2021. The Environmental Protection Agency has designated two “forever chemicals” that have been used in cookware, carpets and firefighting foams as hazardous substances.(AP Photo/Evan Vucci, File)

Logan Feeney pours a PFAS water sample into a container for research, Wednesday, April 10, 2024, at a U.S. Environmental Protection Agency lab in Cincinnati. The Environmental Protection Agency on Wednesday announced its first-ever limits for several common types of PFAS, the so-called “forever chemicals,” in drinking water. (AP Photo/Joshua A. Bickel)

Sen. Shelley Moore Capito, R-W.Va., speaks to reporters following the Republican policy meeting, at the Capitol in Washington, Wednesday, March 20, 2024. (AP Photo/J. Scott Applewhite)

Jackson Quinn, foreground, places a bottle contains a PFAS water sample into a rotator, Wednesday, April 10, 2024, at a U.S. Environmental Protection Agency lab in Cincinnati. The Environmental Protection Agency on Wednesday announced its first-ever limits for several common types of PFAS, the so-called “forever chemicals,” in drinking water. (AP Photo/Joshua A. Bickel)

FILE - The logo for 3M appears on a screen above the trading floor of the New York Stock Exchange, Oct. 24, 2017. Chemical manufacturer 3M will begin payments starting in the third quarter to many U.S. public drinking water systems as part of a multi-billion-dollar settlement over contamination with potential harmful compounds used in firefighting foam and many consumer products, the company said Monday, April 1, 2024. (AP Photo/Richard Drew, File)

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WASHINGTON (AP) — The Environmental Protection Agency on Friday designated two forever chemicals that have been used in cookware, carpets and firefighting foams as hazardous substances, an action intended to ensure quicker cleanup of the toxic compounds and require industries and others responsible for contamination to pay for its removal.

Designation as a hazardous substance under the Superfund law doesn’t ban the chemicals, known as PFOA and PFOS . But it requires that releases of the chemicals into soil or water be reported to federal, state or tribal officials if they meet or exceed certain levels. The EPA then may require cleanups to protect public health and recover costs that can reach tens of millions of dollars.

PFOA and PFOS have been voluntarily phased out by U.S. manufacturers but are still in limited use and remain in the environment because they do not degrade over time. The compounds are part of a larger cluster of forever chemicals known as PFAS that have been used since the 1940s in industry and consumer products including nonstick frying pans, water-repellent sports gear, stain-resistant rugs and cosmetics.

The term PFAS is short for per- and polyfluoroalkyl substances. The chemicals can accumulate and persist in the human body for long periods. Evidence from animal and human studies indicates that exposure to PFOA or PFOS may lead to cancer or other health problems, including liver and heart damage and developmental problems in infants and children.

FILE - The Fifth Ward Elementary School and residential neighborhoods sit near the Denka Performance Elastomer Plant, back, in Reserve, La., Sept. 23, 2022. More than 20 Republican attorneys general on Tuesday, April 16, 2024, asked the EPA to stop investigating environmental policies that disproportionately harm Black people but aren't intentionally discriminatory. The petition is unlikely to convince the Biden administration to back away from an issue EPA Administrator Michael Regan has taken pains to highlight, like visiting the industrial stretch of Louisiana typically called Cancer Alley. (AP Photo/Gerald Herbert, File)

President Joe Biden’s administration “understands the threat that forever chemicals pose to the health of families across the country,″ EPA Administrator Michael Regan said. “Designating these chemicals under our Superfund authority will allow EPA to address more contaminated sites, take earlier action and expedite cleanups — all while ensuring polluters pay for the costs to clean up pollution threatening the health of communities.”

The final rule issued Friday follows strict limits set by the EPA on certain PFAS in drinking water that will require utilities to reduce them to the lowest level they can be reliably measured. Officials say the drinking water rule, announced April 10, will reduce exposure for 100 million people and help prevent thousands of illnesses, including cancers.

The American Chemistry Council, which represents the chemical industry, said it strongly oppose the EPA’s action and believes it “will undermine overall remediation efforts” for PFAS contamination.

The Superfund law “is an expensive, ineffective and unworkable means to achieve remediation for these chemicals,’' the group said in a statement Friday. The 1980 law “is fraught with unintended consequences and will likely result in extensive, unnecessary delays for cleanups,’' the chemistry council said, adding that there are more effective and timely means to clean up PFAS sites “through existing regulatory processes.’'

Last year, three chemical companies announced they had reached a $1.18 billion deal to resolve complaints of polluting many U.S. drinking water systems with PFAS. DuPont de Nemours Inc., The Chemours Co. and Corteva Inc. said they would establish a fund to compensate water providers for contamination.

And earlier this month, chemical manufacturer 3M Co. announced it will begin payments to many U.S. public drinking water systems as part of a multibillion-dollar settlement over contamination with forever chemicals.

Besides the final rule, the EPA issued a notice clarifying that the agency will focus enforcement efforts on businesses and people who significantly contribute to the release of PFAS chemicals into the environment, including companies that have manufactured PFAS or used it in the manufacturing process, as well as federal agencies and other responsible groups.

PFAS used in firefighting foam has tainted groundwater on and near military bases and other locations where it’s used in training exercises.

The Superfund law allows the EPA to clean up contaminated sites across the country and forces parties responsible for the contamination to either perform cleanups or reimburse the government for EPA-led cleanup work. When no responsible party can be identified, Superfund gives the EPA money and authority to clean up contaminated sites.

The EPA’s action follows a report by the National Academies of Science that calls PFAS a serious public health threat in the U.S. and worldwide. The EPA said in 2022 that PFOA and PFOS are more dangerous than previously thought and pose health risks even at levels so low they cannot currently be detected.

David Uhlmann, the EPA’s assistant administrator for enforcement and compliance, called the Superfund designation “a major step toward holding polluters accountable for significant releases of PFAS into the environment.’' Officials “intend to exercise our enforcement discretion to focus on significant sources of PFAS contamination,’' he said, not farmers, municipal landfills, water utilities, municipal airports or local fire departments.

Water utilities, fire departments and other groups had complained that an earlier EPA proposal could have imposed unfair costs on them without defined cleanup standards.

The federal designation will ensure that manufacturers most responsible for widespread PFAS contamination will bear the costs of cleaning it up, said Jonathan Kalmuss-Katz, a lawyer for the environmental group Earthjustice.

He said it “just got a lot harder” for polluters including chemical companies that long manufactured PFAS “to pass the costs of their PFAS releases off on impacted communities and taxpayers.”

Erik Olson, a health expert at the Natural Resources Defense Council, said the EPA’s action will help protect millions of American families exposed to the toxic chemicals.

“We all learned in kindergarten that if we make a mess, we should clean it up,” he said. “The EPA’s Superfund rule is a big step in the right direction for holding polluters accountable for cleaning up decades of contamination.”

West Virginia Sen. Shelley Moore Capito, the top Republican on the Senate Environment and Public Works Committee, called the EPA’s action “ill-advised” and said it “puts local communities and ratepayers on the hook for PFAS contamination they had nothing to do with in the first place.″

The Superfund designation could have disproportionate effect on water and waste utilities, airports, farmers, ranchers and fire departments, Capito said, adding that the agency’s action underscores the need for Congress to act to address PFAS.

“We must pass legislation to safeguard American ratepayers from the financial burden imposed by this misguided rule,” she said.

Follow the AP’s coverage of the Environmental Protection Agency at https://apnews.com/hub/us-environmental-protection-agency .

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Role of Functional Beverages on Sport Performance and Recovery
Functional sports drinks play an important role in hydrating, in improving athletic performance, and in preventing or helping specific health conditions [ 12 ]. Their formulas can be designed specifically to increase energy, to improve mental focus and/or to prevent bone and joint pain [ 6 ].
The Impact of Sports and Energy Drinks in Performance
Sports drinks' main goal is to promote hydration, sustain endurance performance, and replace electrolytes, whereas energy drinks improves perceptions of attention and vigilance and also function as energizers and performance enhancers. Sports drinks normally contain a small amount of carbohydrate (e.g., 6-8 g/100 mL) and electrolytes ...
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Sports drinks contain less sugar than soda and energy drinks, but still contain simple sugars. For example, a nutritional comparison shows that a 12-ounce cola drink contains about 39 grams of sugar, compared with 21 grams of sugar in a popular sports drinks. Drinking too many of these, especially when not performing vigorous exercise, can ...
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Sports drinks are increasingly regarded as an essential adjunct for anyone doing exercise, but the evidence for this view is lacking. Deborah Cohen investigates the links between the sports drinks industry and academia that have helped market the science of hydration Prehydrate; drink ahead of thirst; train your gut to tolerate more fluid; your brain doesn't know you're thirsty—the ...
A Comprehensive Study on Sports and Energy Drinks
The sports drinks are often consumed during or post-athletic period for rehydration and energy drinks are taken to reduce exhaustion. However, the sports and energy drinks differ from one another in terms of ingredients, functions, and consumers. In case of sports drinks, the main ingredients are carbohydrate of 4%-8% glucose and its polymers ...
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Sports drinks mean different things to different people. In its simplest sense, a sports drink is a drink consumed in association with sport or exercise - either in preparation for exercise, during exercise itself or as a recovery drink after exercise. ... The author has received grants to undertake hydration-related research from Britvic ...
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A potential positive correlation between genetics and the moderate consumption of energy drinks and athletic performance has recently been reported; notwithstanding, a better understanding of the genetic variants involved in metabolism is a key area for future research to optimize the dose of energy drink consumed and obtain the maximal ...
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By the year 2020, the sports drinks segment in the global beverage industry is expected to reach US$6B. In an alternate segment, bottled water is the main competitor. ... Yet there has been limited, if any, research on the effects of the perceived taste of sports drinks, familiarity with the brand, nutrition involvement and colour cue ...
Sports drinks and their impact on dental health
The effects of sports drinks on dental health is a topic which requires more research, particularly if you take into consideration the modern-day obsession with health and well-being, in addition ...
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The reported prevalence of sports drinks consumption for 12-14-year-olds participating in this study was high at 89%, with 68% of these children drinking them regularly (1-7 times a week). Both ...
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We were particularly surprised at the reasons given for drinking sports drinks, with 90% (129/143) saying it was because of their 'nice taste'. We were also surprised at the frequency and context ...
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RESEARCH ARTICLE Open Access Effects of sports drinks on the maintenance of ... Research and by the French Health Products Safety Agency (2010-A00724-35). All procedures were in accordance with the ethical standards of the 1975 Helsinki Declaration, as revised in 1983. The study protocol was also registered at
Caffeinated Drinks and Physical Performance in Sport: A Systematic
The objective of this systematic review is to evaluate the different effects of caffeinated drinks on physical performance in various sports categories such as endurance, power-based sports, team sports, and skill-based sports. A systematic review of published studies was performed on scientific databases for studies published from 2000 to 2020.
SugarScience.UCSF.edu
Our review of the evidence on sports drinks suggests that many assumptions have been derived from industry-funded research. Strong, unbiased evidence is generally lacking. One review paper, in fact, found that research showing that rehydrating with water is fine under normal circumstance, had been suppressed. 2.
The Impact of Sports and Energy Drinks in Performance
Sports drinks' main goal is to promote hydration, sustain endurance performance, and replace electrolytes, whereas energy drinks improves perceptions of attention and vigilance and also function as energizers and performance enhancers. Sports drinks normally contain a small amount of carbohydrate (e.g., 6-8 g/100 mL) and electrolytes ...
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Only a small number (n = 20/1421) of children consumed sports drinks and no difference in consumption of sports drink between sport and non-sport participants (p > .05) was observed. However, children involved in organized sport consumed more total calories, fat, fibre, fruit, vegetables and non-flavoured milk (p < 0.01) than non-sport children.
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BODYARMOR's Refreshing New Sports Drink Has Zero Sugar
Meet the New Sports Drink With Zero Sugar, and No Artificial Sweeteners, or Dyes. By Kathleen Owens. Updated on 4/18/2024 at 3:15 AM. Advertiser Content From. BODYARMOR Zero Sugar.
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EPA designates 2 forever chemicals as hazardous substances, eligible
The Environmental Protection Agency has designated two "forever chemicals" that have been used in cookware, carpets and firefighting foams as hazardous substances. (AP Photo/Evan Vucci, File) Logan Feeney pours a PFAS water sample into a container for research, Wednesday, April 10, 2024, at a U.S. Environmental Protection Agency lab in ...
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