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Beware of Energy You Can Drink

According to the Substance Abuse and Mental Health Services Administration, in 2016 more than 20,000 people visited emergency departments for complaints associated with high caffeine stimulant drinks, also known as energy drinks. In 2011, the U.S. government reported a real concern about the emerging problem posed by increasing consumption of energy drinks and shots.

Today in the U.S., the energy drink business is a multibillion dollar industry estimated to reach $61 billion by 2020. That’s serious cash. But, aren’t those drinks just flavored, caffeinated, sugar water?

These stimulant drinks — including such brands as Red Bull, Monster Energy and the smaller 5-Hour energy shots — traditionally have been non-alcoholic beverages that can contain as much as 500 mg of caffeine, which is five times that in a typical cup of coffee and 10 times as much as a 12-ounce of soda.

A variety of other ingredients, including B vitamins, taurine, L-carnitine herbal supplements, guarana (a plant extract with caffeine-like stimulant properties) and often large amounts of sugar are combined in the recipe. Although there are hundreds of different types of energy drinks on the market, the top sellers typically include a mixture of the above contents.

U.S. energy drink companies at their discretion may label their products as either beverages or dietary supplements. Many choosing the supplement classification bypass the U.S. Food and Drug Administration’s caffeine limit for beverages. Each designation has differing requirements to label the specific ingredients in each beverage. Therefore, it is important to remember that energy drinks are not regulated and vary greatly in their composition with no standard formula.

So what are the potential health effects of energy drinks? Caffeine has a powerful stimulant effect on many of our vital organs, particularly the cardiac and nervous systems. After taking a shot or emptying a can of an energy drink, heart rate increases, blood vessels constrict and your blood may actually thicken. These all are changes that increase chances for heart attack and stroke in those with other cardiovascular risks. Recent studies indicate that the other ingredients with stimulant potential, such as taurine and guarana, may increase heart rate and blood pressure, as well as risk for heart rhythm irregularities, independent of the caffeine content.

These drinks can cause periods of anxiety, mood swings and changes in sleep patterns, particularly in children and adolescents. In rarer examples, energy drinks have been associated with serious complications, including seizures, stroke and sudden cardiac death. Hence, visits to the emergency room.

Unfortunately, many of these products have been marketed directly to children and adolescents. Who doesn’t desire a quick boost of energy to get one successfully through the day? Yet, to the contrary, there is evidence that coordination and fine motor skills actually may be diminished by energy drinks.

In addition to risks caused by even infrequent consumption, other adverse reactions and serious health consequences can result from combining energy drinks with other substances, such as alcohol, opiates or other stimulants. Remember, thousands of emergency room visits per year are a result of energy drinks’ use and misuse.

What can we do to manage these risks? The World Health Organization has stated that energy drinks “may pose a danger to public health.” The American Academy of Pediatrics has recommended that “children should not consume” these drinks.

Young adults who choose to consume these beverages must be sure to read labels for serving sizes and caffeine content, and absolutely avoid mixing them with alcohol. Parents, teachers, sports coaches and community leaders must communicate to teenagers and young adults the harm energy drinks may cause.

Too much of anything can be dangerous. So to young adults and adults, moderation is recommended when consuming energy drinks.

C. Clark Milton, D.O., is a Fellow of the American College of Osteopathic Internists and the medical director of Corporate Health at Wheeling Hospital.

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