![]() ![]() One case involved a 17-year-old male who had severe coronary artery spasm in association with energy drink consumption with a resulting STEMI on ECG and significantly elevated cardiac troponin. Consumed by children or adolescents: cases of children who have developed cardiac arrhythmias, psychiatric symptoms, as well as sudden cardiac death in association with consumption of energy drinks have been reported.Other adverse effects associated with energy drink consumption include epileptic seizures, stroke, subarachnoid hemorrhage, pontine myelinolysis, hallucinations, anxiety, agitation, headaches, hepatitis, gastrointestinal upset, acute renal failure, rhabdomyolysis, metabolic acidosis, insulin resistance, obesity, acute psychosis, insomnia, high risk/aggressive behavior and caffeine withdrawal. 5,9 Possible side effects from long term use are shown in Figure 2. The cardiac adverse events associated with acute energy drink consumption are likely related to increased heart rate and blood pressure, together with changes in conduction system associated with acute consumption of energy drinks, and include tachycardia, hypertension, supra- and ventricular arrhythmias, STEMI, aortic dissection and others shown in Figure 2. In 2011, there were 4,854 logged calls to US Poison Control Centers regarding adverse energy drink exposures, most deemed secondary to their caffeine and stimulant toxicity. 9 Several studies have reported improved endurance or muscle performance however, others demonstrate no benefits, with some documenting a negative effect as evidenced by increased muscle fatigue and reduced cerebral blood flow. With respect to improving aerobic/anaerobic performance and/or reaction time after energy drink consumption, studies are inconsistent. 14 However, the evidence for energy drinks as "performance-enhancing" is mixed. The caffeine contained in energy drinks has ergogenic potential, with doses of pure caffeine of 3-6 mg per kilogram of body weight associated with an increase in power and aerobic activity (e.g., split times) by approximately 4%. 3 The health effects of these additives are not well documented. 11 In addition, energy drinks frequently include significant amounts of carbohydrates (usually glucose), taurine (an amino acid), niacin, pyridoxine, cyanocobalamin (B12), riboflavin (B2), ginseng extract, glucuronolactone (a glucose metabolite), inositol (B8), guarana (contains caffeine, theobromine, and theophylline), ephedra, Yohimbine, gingko, kola nut, theophylline, vitamins, herbs, and/or L-carnitine. serving, which exceeds the FDA-imposed limit of 71 mg of caffeine per 12 fluid oz. Importantly, levels of caffeine in energy drinks vary between 71-316 mg of caffeine per 8 oz. As such, the total amount of caffeine in energy drinks may not be accurately reflected on the label. However, guarana and yerba mate, which can be contained as part of the energy blend of energy drinks, are also natural and an additional source of caffeine in these products. 16 When added to energy drinks, caffeine is typically a synthetic alkaloid rather than a naturally-occurring constituent of plant based beverages (e.g., tea or coffee). Note red horizontal line specifies the FDA imposed limit of 71 mg caffeine/12 fl oz soda.Ĭaffeine is a core ingredient in energy drinks and is rapidly and completely absorbed, peaking in concentration in approximately 30-120 minutes post-ingestion. 9įigure 1: Various drinks in their caffeine concentration. Thus, youthful athletes are more subject to adverse effects, particularly when consuming large and rapid doses of caffeine present in energy drinks in combination with exercising around the same time. In addition, compared to adults, younger teens generally have limited tolerance to caffeine due to infrequent consumption. ![]() with comorbid cardiovascular or other medical conditions.Įnergy drinks and shots are unique in that the caffeine concentration is comparatively higher than other caffeinated beverages, such as sodas, which are subject to a limit imposed by the FDA (Figure 1).taking stimulants or other caffeine-based medications.The scientific community, media, governments, athletic departments and the general public have expressed safety concerns over energy drinks specifically for vulnerable populations, including those: 4,6 4,11,15 Marketed for and used to boost performance, they often have high concentrations of caffeine and other stimulants that can cause serious side effects. Energy drinks are frequently consumed by athletes, weekend warriors, service members, college students, secondary school students, and are heavily marketed to children and adolescents. ![]()
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