LeBron James in spotlight off-court, too. Is he selling caffeine to kids?

LeBron James and his Miami Heat will face the Dallas Mavericks in Game 4 of the NBA Finals Tuesday. Off the court, however, he is being challenged by pediatricians over his new caffeine-heavy energy product, Sheets Energy Strips.

As basketball star LeBron James tries to take a step closer to the championship that has so far eluded him in Game 4 of the NBA Finals Tuesday, his off-the-court activities are drawing the ire of a number of pediatricians nationwide.

James is a cofounder of Sheets Energy Strips – small strips infused with caffeine and other chemicals that, when placed on the tongue, purportedly boost energy and performance. In one ad, James claims the strip helps him practice and play at his best.

The strips, which became available this month, are part of a worrying trend, say nutritionists. The American Academy of Pediatrics last week released a study advising that children avoid energy drinks altogether and condemning the industry for marketing them to children.

Sheets strips are targeted to compete with energy drinks, with one of James's business partners, Warren Struhl, telling NPR that they are superior to energy drinks because they don’t have calories, “don’t require a pit stop,” and are flavored. And the ads clearly target children, critics say.

The result has been a storm of protest against a product that, according to cofounder Jesse Itzler, went through several iterations to ensure it would not result in positive drug tests for athletes.

“It is a terrible message to send children and adults alike that in order to get the best possible workout, Mr. James uses a cocktail of caffeine, a dependence-producing stimulant, and other substances that had to be cleared by the NFL policy against doping in sports,” says Andrea Barthwell, former president of the American Society of Addiction Medicine. “These instances where top tier athletes attempt to increase their performance using chemicals rather than hard work are at the root of doping in sports and linked to the chemical culture where we are always looking for something to do for us what we should do for ourselves.”

Others say more research is needed on the long-term effects of caffeine before a product like this should be marketed.

“We simply don’t know what the use of this drug does to a human body over time, especially younger bodies,” says John Higgins, director of exercise physiology at Memorial Hermann Sports Medicine Institute in Houston. “A majority of the studies examine what is the effect for today, or this week. The literature for what the effects are over years is very thin. That is what’s needed.”

The strips’ packaging carries an admonition saying that children under 12 should not use the product, which is supposed to provide caffeine comparable to one cup of coffee, plus a vitamin boost. But the marketing campaign undermines that message, some say.

“The question is really who are they going to be marketing and selling these strips to?” asks Elizabeth Dowdell, an associate professor of nursing at Villanova University in Pennsylvania. “Having a top sports star say it enhances his fabulous play sends a conflicted message and negates his great natural talent and hard work. Kids are really susceptible to appeals like that.”

But critics say the age limit should be 18 and are calling on James to take what they see as a more responsible position.

“I would fault him for not understanding the platform on which he stands,” says Dan Lebowitz, executive director of the Center for the Study of Sport in Society at Northeastern University in Boston. “And I call on him to be as responsible as he has been in other areas – in which he has been quite well behaved.”

[Editor's note: A paragraph has been deleted from the original version because it implied tacit approval of energy strips by a source with whom the reporter did not speak.]