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Energy Drinks: Performance over Health?

October 28th, 2014

By Ryley Uber, PharmD Student

An energy drink (ED) is a supplement commonly used to combat sleepiness and to increase the physical and mental performance of an individual. These drinks can be defined as, “an alternative to coffee as a source of caffeine and also contain other functional ingredients such as antioxidants, ginseng, taurine, and B vitamins.”1 The exact ingredients, however, differ among the companies who offer these products. Despite the health effects of these drinks having been continually called into question, their market has been steadily increasing.2 One instance where these health concerns can be seen is in the case study of a 17-year-old.3 The patient was admitted to an emergency room with an increased heart rate and arrhythmia that started shortly after consuming an ED. He had no history of cardiac issues. This patient was found to have Wolff-Parkinson-White (WPW) syndrome, which is the most common pre-excitation disorder (improper electrical conduction in the heart) with an incidence of 0.1–0.3% in the general population and an associated sudden cardiac death risk of less than 0.6%.3 This disorder can lead to increased heart rates which was likely exacerbated by the ED. After treatment, he was released from the hospital once his heart rate and rhythm returned to normal. Since this was only a report of a single medical case, it cannot be applied to all circumstances. However, it does offer some insight to what side effects can come of consumption of EDs. This should cause concern among consumers regarding the safety of these drinks.

In a recent review published in 2013, a total of 15 studies on EDs were evaluated based on the effects they produced.4 Unfortunately, due to the differences among the studies, no solid conclusions could be drawn. This was due to the fact that substantial differences existed between participants, ED used, study design strength, and outcomes. However, since then there have been multiple other studies conducted evaluating this potential health hazard. One such study conducted by Grasser et. al suggested that Red Bull slightly increased blood pressure.5   Blood flow in the brain decreased, likely due to constriction of arteries. Based on this data, the researchers called into question the manufacturers’ claims that this drink increases mental abilities. While not immediately dangerous to an adult in perfect health, the researchers mention that increased blood pressure could pose a problem to patients with heart diseases.

The athletic advantages of these energy supplements should not be ignored. In one study that was published in 2013 and conducted by Burrows et. al, professional rugby players were each given an ED prior to a simulated game and a placebo prior to a different simulated game.6 During both of these trials, the distance that the players ran while playing a simulated rugby match was measured. In the placebo trial, the players ran an average of 4749 meters. After consuming an ED, however, the players ran an average of 5139 meters. One limitation to this study is the fact that every rugby match has many variables that could lead to a higher amount of distance ran. The matches that included the EDs could have simply required more running due to an increase in overall game intensity. This study concluded that EDs increased the athletic performance of the athletes who participated. A similar study published in 2010 and conducted by Kazemi et. al involved female athletes, it was also concluded that athletic performance was increased among the participants after drinking an ED.7 Performance was measured by the participants’ oxygen intake, heart rate, and time to exhaustion, among other variables. According to these studies, athletic performance does increase with the use of EDs. However, an athletic advantage does not justify the use of these supplements. This is because of the proven temporary increase in blood pressure that many of these drinks cause, which is harmful to one’s heart.8 The effects of EDs on other organs in the body have yet to be thoroughly researched (kidneys, liver, etc…).

Due to the lack of conclusive data regarding the long-term and short-term health effects of EDs, consuming these drinks to increase performance cannot be recommended. More conclusive studies must be conducted in order to learn more about the health effects of EDs. Some individuals have encouraged the FDA to further regulate this quickly growing industry in order to produce energy supplements that are both effective and pose little to no risk to the customer’s health.9 Although the large amount of caffeine found in EDs is not generally recommended, caffeine can provide a neutral effect or perhaps even a positive effect on one’s health when taken in moderation.10 Between 3 and 4 cups of coffee that are 8 ounces each is considered a moderate amount of caffeine. Though the promise of increased performance may be tempting for some, the health and promised effectiveness still remains unknown and requires further conclusive research to fully reveal the nature of these supplements.

Are the performance advantages that energy drinks advertise worth the potential risk to your personal health? How often do you use energy drinks for “quick” energy?

References

  1. Tamamoto LC, Schmidt SJ, Lee S. Sensory profile of a model energy drink with varying levels of functional Ingredients—Caffeine, ginseng, and taurine. J Food Sci. 2010;75(6):S271-S278. Accessed: October 6, 2014.
  2. Heckman MA, Sherry K, De Mejia EG. Energy drinks: An assessment of their market size, consumer demographics, ingredient profile, functionality, and regulations in the united states. Comprehensive Reviews in Food Science and Food Safety. 2010;9(3):303-317. Accessed: October 6, 2014.
  3. Candilio L, Chen AWY, Iqbal R, Gandhi N. An interesting case of tachyarrhythmia. BMJ Case Reports. 2014;2014. Accessed: October 6, 2014.
  4. Burrows T, Pursey K, Neve M, Stanwell P. What are the health implications associated with the consumption of energy drinks? A systematic review. Nutr Rev. 2013;71(3):135-148. Accessed: October 6, 2014.
  5. Grasser E, Yepuri G, Dulloo A, Montani J. Cardio- and cerebrovascular responses to the energy drink red bull in young adults: A randomized cross-over study. Eur J Nutr. 2014;53(7):1561-1571. Accessed: October 6, 2014.
  6. Del Coso J, Ramírez JA, Muñoz G, et al. Caffeine-containing energy drink improves physical performance of elite rugby players during a simulated match. Applied Physiology, Nutrition & Metabolism. 2013;38(4):368-374. Accessed: October 6, 2014.
  7. Kazemi F, Gaeini A, Kordi M, Rahnama N. The acute effects of two energy drinks on endurance performance in female athlete students. Sport Sciences for Health. 2010;5(2):55-60. Accessed: October 7, 2014.
  8. Chrysant SG, Chrysant GS. Cardiovascular complications from consumption of high energy drinks: Recent evidence. J Hum Hypertens. 2014. Accessed: October 18, 2014.
  9. Thorlton J, Colby DA, Devine P. Proposed actions for the US food and drug administration to implement to minimize adverse effects associated with energy drink consumption. Am J Public Health. 2014;104(7):1175-1180. Accessed: October 6, 2014.
  10. Mejia EGd, Ramirez-Mares M. Impact of caffeine and coffee on our health. Trends in Endocrinology & Metabolism. 2014;25(10):489-492. Accessed: October 6, 2014.

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4 Responses to “Energy Drinks: Performance over Health?”

  1. Danielle Grear Says:

    Hey Ryley,
    Good article! Energy drinks seem to be expanding in the market today, but I’ve always been cautious on trying them. I will admit, however, that I have used an energy drink before to get me through a long night of studying. While I was able to stay awake long enough (almost too long) I found that my mental performance did not keep up with my physical state and I became mentally exhausted, but unable to sleep. For this reason, I tend to stay away from energy drinks because of their excess amounts of sugar, but instead grab a cup of coffee or tea that contains caffeine to keep me alert. I was wondering, however, did you find out in your research how the young man was treated who suffered from WPW syndrome? It would be interesting to see if more cases of WPW were advertised in the media if that would have an effect on the amount of EDs consumed. While athletes might turn to this source of “quick” energy to enhance their performance, I would tend to be cautious of the potential risks outweighing the benefits because of such cases, and would warn athletes of the damage of long-term use.

  2. Lindsay Mailloux Says:

    Ryley, I thought you did a great job on this. I have always been somewhat opposed to energy drinks but did not know much about the risk involved. From my perspective, I don’t think the risk of heart problems is worth the benefit of improved athletic performance especially since the benefits haven’t been soundly proven. On the other hand, I’d be curious to know more about general effects of caffeine and how much is okay. You mentioned 3 to 4 cups of coffee is considered a moderate amount of caffeine. Is this 3 to 4 cups of coffee a day? Also, how much caffeine is in a cup of coffee compared to the amount of caffeine in a typical energy drink?

  3. Mike Kapraly Says:

    Hey Ryley! Solid article. I will agree that the amount of research on energy drinks is far from complete. I find it strange that the FDA has not done more studies on it. Like Danielle, I too have consumed my fair share of energy drinks in order to get myself through a study session. I found that my energy level was higher, but I think the raised energy level made me jumpy and not able to focus as well as if I was fully rested. I thought the study on the rugby players was interesting as well. I feel like giving someone an energy drink, which will most likely increase BP and heart rate, and then combined with serious CV activity is a recipe for a bad time. Once again man great article.

  4. Jacob Davis Says:

    I’m definitely guilty of using energy drinks. Working at a Coca-Cola distribution warehouse I can buy an energy drink for $1. When it comes to the late night shifts sometimes I’d need that energy drink to get me through when I don’t have enough sleep. I totally agree that they can’t be good for your health, the effects that they have on the heart alone is scary. I would say that they do help my physical performance throwing pop around and mental performance to stay awake, but I would rather sleep than drink an energy drink. If you’re in a pinch and need to stay awake then I’d say go for it, otherwise I recommend against it and your research shows. The FDA should definitely step in and do some more research on this!

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