Energy drinks and their adverse health effects – by Tim Adler

 

Tim is a nurse here at Health, Counselling and Disability Services.

One of the great things about having Tim on the team is he enjoys writing and has started preparing interesting articles on a range of different student wellbeing topics.

In his latest article, he looks at energy drinks (like Red Bull and Mother), and whether their claims of enhancing your performance are valid and whether they might actually be doing you harm. 

I used to have a bit of an addiction to V, but after they started making me really jittery (even in small doses), I gave them the flick.

Gareth


So, it’s coming up to the beginning of a new academic year and (hopefully) we are all feeling nice and fresh for the start of the year. Some of you are starting new at university whilst others are returning to finish off their course or may even be somewhere in between.

I’m sure most people would like to stay in that state of relaxation, however as the university year starts to wind up and the pressures start to pile on there are going to be many people looking at ways to help get that vital energy lift in order to get through the day, complete assignments or to get an energy boost to focus on those lectures.

Some studies have found that up to 65% of university students have turned to energy drinks such as Red Bull, Monster or V in order to achieve this energy hit. It’s no wonder really when you consider the pressures to perform academically, socially and occupationally. The most common group to turn to these energy drinks, at least as far as studies are concerned? Young men <25 years of age who also secondarily engage with substance abuse.

So what is the deal with energy drinks?

First, it is important that we distinguish between energy drinks, soft drinks and sports drinks.

The term soft drink was originally used to distinguish the difference between hard liquor and other such drinks. Nowadays, it is used to describe a range of carbonated drinks that usually contain artificial flavours such as Coke, Fanta, etc. Due to the regulation of soft drinks they are limited to the amount of caffeine that is used in these drinks.

Sports drinks (e.g. Gatorade, Powerade) are designed for athletes to rehydrate and replace electrolytes usually containing minerals such as potassium, calcium, sodium and magnesium that help maintain optimum hydration.

Energy drinks are any drinks that contain high levels of stimulant ingredients and get promoted as being able to enhance mental alertness and physical performance. Unfortunately, due to energy dinks being classed as a ‘health supplement’ there are less stringent regulations.

Whilst caffeine is generally the primary stimulant in energy drinks, it is added in its synthetic form, and whilst the dose is generally accurately displayed on the packaging, other plant-based sources of caffeine such as Guarana and yerba mate which also contain caffeine are not included on the labelling as caffeine.

Concerningly, the claims made by energy drink manufactures are typically aimed towards teenagers and young adults and are largely unsubstantiated in any clinical trials. Further to this, whilst studies have found it difficult to link energy drinks with adverse events there is enough anecdotal evidence of harms that the medical community is concerned with the over use of energy drinks, particularly those in the community who are pregnant, breast feeding, under 18 or those who might have cardiac conditions. Some of this has to do with caffeine intake.

What is the deal with caffeine?

Caffeine acts to inhibit or activate a range of receptors throughout the body. Modest use is associated with a range of positive effects (https://blogs.flinders.edu.au/student-health-and-well-being/2018/09/06/caffeine-cognitive-enhancer/) but the effect is limited. In other words that extra cup of coffee you have to try and keep you going will improve your concentration and alertness, but not really make you smarter or more capable.

Even in relatively low doses, caffeine can cause increased blood pressure and heart rate as well as dehydration. Excessive caffeine use however can cause acute caffeine intoxication: tachycardia, vomiting, arrhythmias seizures, and disruption of sleep patterns and exacerbation of psychiatric disease. Studies have shown that after caffeine consumption a statistically significant drop in myocardial blood flow during exercise can take place. In extreme cases acute caffeine intoxication can lead to poor blood flow to the heart on exercise leading to heart damage.

Higher caffeine users (i.e. regular consumers of energy drinks) have caffeine in their systems for a lot longer leading to an increased risk of caffeine toxicity. This is because the effects of caffeine take approximately 45 minutes to peak and can last up to 5 hours before caffeine levels start to drop.

Furthermore, energy drinks contain additional ingredients that increase the effects of caffeine such as taurine, guarana, glucuronolactone, ginseng and vitamin B.

Consistent with all this, the most common presentations to emergency departments related to energy drink consumption include cardiac problems, arrhythmias, seizures, agitation, aggression and neurological conditions – all related to the actions of caffeine. Worse still, it is common to mix energy drinks with alcohol, which is already known to cause a range of problems when consumed in excess.

Take home Message

At the end of the day there isn’t good evidence of the usefulness of energy drinks such as Red Bull, V and other such energy drinks. What has been shown is that the perceived health benefits of these energy drinks are largely misplaced and actually decrease overall wellness – causing sleeplessness or nervousness. Studies have shown that the cognitive improvement given by caffeine is limited. In other words that extra cup of coffee you have to try keep you going may not give you any added advantage.

Any positive (and certainly some negative) effects of these drinks come from the caffeine content and the data on caffeine generally supports usefulness at moderate doses but negative impacts at large doses. Energy drinks deliver high doses of caffeine, both directly, but also indirectly via other stimulants. Since there is no evidence that these other stimulants have added benefits it may be the case that a good old-fashioned cup of coffee may do the same job whilst saving you money.

The use of energy drinks to combat fatigue is fraught with the same problems as using coffee. In the short-term it will reduce the effects of fatigue, but at the end of the day you will still be fatigued.

Some time ago I wrote a blog regarding the benefits of getting a healthy sleep pattern (https://blogs.flinders.edu.au/student-health-and-well-being/2018/09/01/sleep-regularity-academic-performance-tim-adler/). I would strongly encourage students to utilise this as a means of preventing fatigue rather than trying to manage fatigue with unhealthy practices that put extra stress on multiple body systems.

This blog also contains many articles on how to better manage the stresses of university (e.g. self-care guide – https://blogs.flinders.edu.au/student-health-and-well-being/2018/07/25/dr-gs-guide-self-care/). All which in the long term are far more sustainable practices with far better health outcomes.

 

Additional reading

Energy drinks and their adverse health effects: A systematic review of the current evidence

https://www.tandfonline.com/doi/abs/10.1080/00325481.2015.1001712

 

The Consumption of Energy Drinks Among a Sample of College Students and College Student Athletes

https://flinders-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_springer_jour10.1007%2Fs10900-015-0075-4&context=PC&vid=FUL&lang=en_US&search_scope=Search%20All&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,The%20Consumption%20of%20Energy%20Drinks%20Among%20a%20Sample%20of%20College%20Students%20and%20College%20Student%20Athletes&sortby=rank&offset=0

 

STIMULANT-CONTAINING ENERGY DRINKS What You Need to Know

https://journals.lww.com/acsm-healthfitness/Fulltext/2018/05000/STIMULANT_CONTAINING_ENERGY_DRINKS__What_You_Need.7.aspx

 

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