Energy drinks: taking you to the dawn (of misery)

7. October 2013
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Sophisticated marketing and a mixture including caffeine, taurine and sugar have over the past decade helped energy drinks reach great popularity. From time to time however, the stimulant-driven soaring ends in the emergency department.

Toss down a few glassfuls and you make it through the hottest party all the way to dawn”: using this theme nightclub operators, together with the market leader in energy drinks, direct their target group. The content of 5.2 billion cans of one Austrian brand of these uplifting beverages in unmixed form were emptied last year into the mouths of energy-greedy people between 10 and 40 years of age. Caffeinated thirst quenchers are the fastest growing segment in the beverage market, about 5 litres per person per year in Germany, more than twice that amount again in Germany’s southeast neighbour Austria.

Energy shot: backfire?

The “vod-bomb”, or “Flügerl” as insiders in German speaking lands know it, refers to a combination of energy drink and vodka and raises the mood barometer level even more effectively than does caffeine-carrying soft drink alone. Yet there also exist other statistics related to the popularity of these drinks. Eight years ago, American emergency clinics recorded around 1,500 admissions which were directly linked to the consumption of energy drinks. By 2007, the number had risen to around 10,000. Four years later, that number more than doubled again. Over the same time, the consumers’ upper age range has for quite some time no longer been about 40 years of age, but has continued to increasingly include people of an age beyond that. Slightly more than half of the cases are due to the side effects of the energy drinks alone, the rest arise from the simultaneous use of alcohol or other stimulants such as methylphenidate (= Ritalin®). According to these statistics one in ten Americans, in addition to consuming liquid pep-up in a drink-can, also use illegal drugs.

The caffeine content of a 250ml serving is about the same as that of a cup of coffee. Only in the rarest of cases during an extended party night or a long car ride in the hot summer does intake however end up being kept to one or two doses. And whoever wants to have something a little more concentrated does not reach for a “normal” energy drink but rather an “energy shot”. Instead of the usual 80 mg of caffeine in a quarter litre can, in this case there are 50-200 mg shoved into 25 to 100 ml of liquid. This is reason enough for Foodwatch to have made a demand a few weeks ago for a ban on “shots”. In 2009 the German Federal Institute of Risk Assessment voiced serious concerns about this legal doping source.

Improved performance: often feels more than real

In addition to caffeine, the beverages further contain vitamins, plant extracts, sugar and in many cases taurine. This sulphonic acid derivative is supposed to equally stimulate the metabolism in cooperation with the caffeine and thus also contributes to the experience of pleasure until well after midnight. Taurine ensures that the volume of muscle cells increase by way of water influx. Together with muscle hypertrophy, the performance and endurance of the muscles are increased. In nerve cells taurine causes hyperpolarisation via ion in-streaming and thus leads to neural inhibition. Normally however the body itself provides a sufficiently large taurine supply, so that in previous studies no clear trend in increased physical performance via taurine alone was detectable.

In general, caffeinated beverages actually provide more energy to the body and mind. Studies prove this clearly. This fact also nonetheless applies for example to coffee, tea or cola – or caffeine in tablet form, as studies by Andreas Franke and Klaus Lieb of the University of Würzburg show. What also often goes up is the drinker’s own assessment of performance capacity, because in reaction tests the energy drink-doped participants fared worse than others. With more than 500 mg of caffeine the hands begin to shake; this excitation is then often no longer able to be controlled and sleep subsequent to this is disrupted.

Sex, drugs and heart attack

When somebody throws down several cans to sweeten up the party they are usually however not thinking about sleep, but have something different in mind. The beverage contents provide – when mixed with alcohol – more appetite for adventure and thus significantly more often this leads to unprotected sex, aggression, drug use, as two publications from Virginia and Wisconsin reported during the last two years. In experiments with mice high taurine doses given together with alcohol were even fatal.

Because of the many side effects of the pep-up drinks – which when taken in high doses include heart rhythm disruptions and in the worst cases myocardial infarctions by way of endothelial dysfunction and coagulation – children and pregnant women should exercise extreme caution with it. Despite this, according to surveys already two out of three young people from 10-19 years of age have used the trendy drinks to spark themselves up, one in ten even doing this several times a week. Deaths among young people after excessive consumption of energy drinks have also already been reported in the United States. Whether the consumption itself was responsible for these deaths is being ascertained at the moment by the U.S. Food and Drug Administration.

Whoever also adds alcohol to the caffeine-taurine-sugar mixture loses ability to perceive an increasing level of alcohol content. Seven years ago Sionaldo Ferreira of Brazil’s University of Sao Paolo described the consequences of Red Bull® taken together with vodka as such: fewer headaches, problems with coordination, or dry mouth, as perceived by the consumers. Objective tests of reflexes and motor coordination nevertheless clearly showed visible deficits.

Marketing: promises and other tricks

The fact that the demand for energy drinks is still on the rise is something probably related to large expenditure on advertising and marketing. Whether the promises of performance without side effects is based on reliable data is something which was examined by Carl Henneghan and his colleagues from the University of Oxford, who published their results last year in the British Medical Journal: of the more than 400 health claims made in magazines and web advertisements, fewer than half indicated underpinning studies. Even with these studies only three percent were of high quality and gave descriptions using accurate information involving blind-studies and randomisation. In no piece of promotion was there any indication of a systematic review to be found as a supporting document for their assertions.

Thus many nutrition experts also consider energy shots to be a clever marketing ploy. Since 2012, the EU’s upper limit for caffeine has been 32 mg per 100 ml of energy drink. The “shots” are however not registered as food, but as “dietary supplement” and can therefore bypass this control. Even where the necessary declaration, stating consumption of a maximum of one portion a day, is not absent from the labelling on the can, the German Federal Institute of Risk Assessment (BfR) also harbours definite doubts as to whether (would-be) athletes really take this suggestion to be meaningful. Therefore a simple recommendation is in the opinion of BfR not enough. The intake of a number of cans of shots in one given day is not safe with respect to adverse effects.

“Increased risk of illness or even death”

In the United States as well, an open letter sent to the FDA which was written by a number of distinguished professors recently made headlines. In it they write that there is “evidence in the published scientific literature that the amounts of caffeine in energy drinks pose serious health risks, an increased risk of disease or even death”. Therefore, the undersigned call on the FDA to especially protect children and young people from these dangers.

20 cubes of sugar per serving

The current edition of the magazine “Test” from the German foundation Warentest lists a number of energy drinks available in Germany. The authors here have also pointed out an additional risk: a half litre of one such popular drink contains about 70g of sugar per 500ml can, which is more than 20 sugar cubes. Thus the daily needs for instance of women or children would be far exceeded. In such volumes, sugar in energy drinks represent a health risk. Warentest finds for almost all of these drinks this declaration to be appropriate: “not suitable for quenching thirst”.

The energy drink made by one Austrian manufacturer is “valued by high performance athletes, students, those in highly demanding professions and by long-distance drivers” it states on the product website. So far, there is little conclusive study that proves that the effect of energy drinks does anything more than a cup of good coffee can. Whoever uses them in addition to quench their thirst is running the danger of all at once quickly overshooting on their caffeine intake. Use in combination with alcohol allows those consuming the drinks to perceive themselves to be more capable performers than they actually are. Although a few sips of liquid energy might yield a spurt of inspiration, they surely don’t make a Formula 1 world champion out of a couch-potato.

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General medicine, Medicine

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1 comment:

Md Ashore Mahmmoodashore
Md Ashore Mahmmoodashore

I don’t know what the redbull, it self contains but it makes me to read a lot; and makes me feel lonely, and at end if I don’t take it, brings me headache.

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