Think Before You Drink
by Rhonda Ross
Energy drinks have come a long way since Red Bull first hit the US market in 1997. Popular with high school and college students, amateur and professional athletes, and even the over-tired everyday person in the office next to yours, the cup of energy drinks has literally runneth over. Sporting catchy names like Monster, Rockstar, Amp, and Nos, analysts from Goldman-Sachs, a global investment firm, predict industry sales to be upwards of $10 Billion for 2011. With popularity soaring and revenue pouring in, all indications are that energy drinks have become a permanent fixture in our culture. But, the larger question remains, "are energy drinks safe?"
With the ever-increasing volume of consumption and cultural penetration into the young adult markets a number of medical professionals have been questioning the long-term effects of energy drinks. According to a 2005 report by the federal government’s Substance Abuse and Mental Health Services Administration, in there were 1,128 emergency room visits directly related to energy drinks. More alarming is the fact that in just four years the incidence of ER visits had increased more than tenfold to 13,114 in a 2009 study. Researchers are beginning to gather data that leads many to question how much we need to think before we drink.
Recipe for Disaster?
Bold colors, bold marketing and flashy spokespeople abound; there is no arguing the attractiveness of the energy drink market. Regardless of what is on the can, it's what is in the can that has the medical community buzzing. A cursory glance at the label will always show caffeine at or near the top of the list of ingredients. The unregulated slight of hand begins after that.
In the US, soda and juice-like drinks are strictly regulated by the US Food and Drug Administration (FDA) and manufacturers are required to not only put the amount of caffeine on the label but to limit its amount to 71 milligrams per 12-ounce serving. No such limits apply to energy drinks that are marketed as “dietary supplements” and are not subject to the same FDA regulations. Manufacturers are not even required to list all ingredients on the label so not only will the caffeine content be missing but also unregulated combinations of ingredients are often inappropriately labeled, “energy blend.”
Commonly found in most energy drinks, Taurine, according to nutritionists at the Mayo Clinic, supports neurological development and helps regulate the level of water and mineral salts in the blood. Some studies have suggested that Taurine may improve athletic performance and when combined with caffeine may improve mental performance, but the findings have been controversial.
Just as controversial, the popular ingredient Guarana, derived from a South American shrub, whose seeds contain a considerable amount of caffeine. The addition of Guarana to most energy drinks increases the caffeine level but without FDA regulation is not part of the caffeine disclosed on the label. The result is a hyped-up caffeine level consumers may never notice.
Hip, Hyped and Mainstream
From the folksy singing of "Perfect Harmony" and icy, cold polar bears to the market research turned adsy "Pepsi Challenge"- it is no secret that beverage companies know how to package their products to the world. When it comes to energy drinks alone, close to ten percent of revenues are re-invested in brand awareness campaigns aimed at teens and young adults. In 2009, more than $948 million was spent on advertising highlighting more than a few professional athletes who don fluorescent logos while touting the wonders of their athletic performances.
In the early days athletes were selected from aggressive sports like BMX racing, skateboarding and motorsports. Yet with increasing popularity and mainstream consumption energy drinks have now permeated America's pastime, Major League Baseball. C.J. Wilson, a World Series starting pitcher for the Texas Rangers, was quoted in a recent article in USA Today saying, “The bottom line is, it’s a long season. You’re going to do what you have to do, whether you feel like you have to jump into a cryogenic freezing tank or a hyperbaric chamber or drink a Red Bull.” Wilson stated that he regularly drinks Red Bull to prepare himself to pitch saying, “I see nothing wrong with drinking Red Bull.”
Under the Microscope
The question of safety in energy drinks has prompted a number of studies among the medical community. A recent study, “Health Effects of Energy Drinks on Children, Adolescents and Young Adults” was conducted by the University of Miami Miller School of Medicine and published in the journal Pediatrics in February of 2011. In the article, the authors stressed the importance of educating families and children at risk for energy drink overdose as well as the importance for pediatric health care providers to screen for heavy use, both for energy drinks consumed alone and in conjunction with alcohol. Dr. Steven E. Lipschultz, Chair of Pediatrics at Miami said, “Until further research establishes their safety, routine energy drinks usage by children and teenagers should be discouraged. “ He urged, “We need long-term research to define maximum safe doses of these beverages and the effects of chronic use, especially in at-risk populations.”
Right here at home, a review by three University of Texas Science Center at Houston researchers, working together with their counterparts at the University of Queensland in Australia, published in the Mayo Clinic Proceedings the risks of such effects as insomnia, nervousness, nausea, and rapid heartbeat – and in more rare cases, seizures, cardiac arrhythmias and cardiac arrest, particularly in people with underlying medical conditions. The Mayo review also cited four documented cases of caffeine-associated deaths involving individuals who had consumed energy drinks.
Dr. John P. Higgins, one of the authors of the 2011 Mayo article, wrote, “Teens and young adults, both athletes and non-athletes, are consuming energy drinks at an alarming rate, we need to determine whether long-term use of energy beverages by this population will translate into deleterious effects later.” Co-author, Troy D. Tuttle, an exercise physiologist at the Houston University, said in an interview, “Almost all the studies done on energy drinks have involved small sample sizes of young, healthy individuals in whom you’re unlikely to see short-term ill effects. But what about the long term? What about liver and cardiovascular disease, insulin resistance, and diabetes? We could speculate about a lot of possible problems, but we just don’t know.” The bottom line is, we need to think before we drink.
Data from a survey taken in 2007 reported that 27% of the college students surveyed said they mixed alcohol and energy drinks at least once in the last month. The problem is that mixing a stimulant with a depressant can be a recipe for disaster. Under the caffeine stimulation of energy drinks, the signs of intoxication are often masked leading a person to think they are sober when, in fact, they are not. As one researcher put it, “What you have is a very awake drunk.”
Just Do It?
No longer do we want to “Be Like Mike” believing as we did in the 90s that if we drank Gatorade like Michael Jordan we would take on his almost magical qualities. Mr. Tuttle who works with many sports teams and athletes is concerned about the effects of energy drinks on those in his care. “A lot of kids are reaching for energy drinks instead of sports drinks, which unlike the energy drinks are mostly water with a nominal amount of sugar and electrolytes,” he said. “The energy drinks contain a slew of ingredients, most of which are unresearched, especially in combination with one another.” Tuttle also noted that the high sugar content of energy drinks could impair the absorption of fluids and cause dehydration for an athlete engaged in intense exercise.
In October of this year, the National Federation of State High School Associations (NFHS) and their Sports Medicine Advisory Committee (SMAC) issued a “Position Statement and Recommendations for the Use of Energy Drinks by Young Athletes,” citing the growing popularity of the consumption of energy drinks as the basis for a number of strong recommendations. The NFHS recommends, “Energy drinks should not be used for hydration prior to, during, or after physical activity.” The position statement also advises, ”Information about the absence of benefit and the presence of potential risk associated with energy drinks should be widely shared among all individuals who interact with young athletes.”
The University Interscholastic League (UIL), created by the University of Texas at Austin in 1910, is the largest inter-school organization of its kind in the world existing to provide educational extracurricular academic, athletic, and music contests. Following in the footsteps of the NFHS the UIL offers guidelines and recommendations designed to protect the health of our Texas school athletes. The UIL reiterates the importance of proper hydration together with cautionary statements to better inform coaches, parents, and student athletes in a section entitled “What not to drink.” One of the statements reads, “Many of these drinks are being produced by traditional water, soft drink, and sports drink companies and may provide confusion to the sports community. As is true with other forms of supplements these “power drinks or fluid supplements” are not regulated by the FDA. Thus, the purity and accuracy of contents on the label are not guaranteed.” As a parent, this should make you stop and think. They continue, “Many of these beverages, which claim to provide additional power, energy, etc., have additional ingredients that are not necessary, some that are potentially harmful, and some that actually include substances banned by such governing bodies as the NCAA and the USOC.”
You Make the Call --- let us know your thoughts
The bottom line is each of us needs to stay informed on the subject of energy drinks and be aware of the possible dangers to our families and ourselves. It’s time for all of us to come down on the parental side of being hip and make the call. You be the judge, energy drinks are here to stay but think about whether the latest craze is the right choice for your family.