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By: Dave Gordon

You see them all the time in supermarket aisles, vending machines and grocery stores: a vast array of flavors and sizes to suit the caffeine-craved consumer. With names like Monster, Red Bull, Rockstar, Amp, Full Throttle, 5-Hour Energy and Street King, it’s not your Sito’s Coca-Cola.

Once upon a time, a “cup of Joe” would be enough to kick-start the morning. And for some of us, that’s still all it takes. 

But in recent years, a whole subset of young people have been downing cans of high-dose caffeine beverages that contain between two and nine times the amount of caffeine as a regular cup of coffee.

According to various reports, high schoolers to young professionals indulge in these drinks for a number of reasons: they enjoy the buzz, the need to stay up for studying or late-night work, experimentation, or a simple pick-me-up.

Whatever the reason, health professionals have been sounding the alarm about the $12 billion “energy-drink” industry. They warn that excessive intake of caffeine can result in restlessness, nervousness, insomnia, vomiting, and worse of all, tremors. In rare cases, news reports have revealed teenagers have knocked back a can that triggered seizures and abnormal heart rhythm. 

“Drinking in Ignorance”

A scientific study on the topic, entitled, “Energy Drinks: Health Risks and Toxicity,” written by Naren Gunja and Jared A Brown, appeared two years ago in the Medical Journal of Australia. The researchers found that the most common side effects of drink overdose were “palpitations, agitation, tremor and gastrointestinal upset.” According to their findings, “Twenty-one subjects had signs of serious cardiac or neurological toxicity, including hallucinations, seizures…” At least 128 subjects required hospitalization.

Their conclusion? “Reports of caffeine toxicity from energy drink consumption are increasing, particularly among adolescents, warranting review and regulation of the labelling and sale of these drinks.” In the authors’ estimation, “Educating adolescents and increasing the community’s awareness of the hazards from energy drinks is of paramount importance.”

Dr. Mehmet Oz, an American cardiothoracic surgeon, author and popular health expert, has serious reservations about the new craze surrounding these beverages. More specifically, he’s expressed concern over the absence of information on each can.

 “Labels typically don’t tell you exactly how much caffeine is in a product,” he wrote in a report. “Whether by commission or willful omission, manufacturers’ hiding this information means our youth are drinking in ignorance.” 

While it’s true that Coke lists caffeine on its ingredient list, its label does not state how much of the drug is in each can or bottle. In the case of energy drinks, however, thedoses are so high that possible adverse effects could occur. This isn’t, of course, just another can of soda.

In one study published in Oct. 2012, Consumer Reports investigated energy drinks and found that out of 27 popular beverages, 11 did not list theamount of caffeine in the bottle. And of the 16 which did list caffeine amounts, five contained over 20 percent more caffeine than the label claimed. 

“The amount of caffeine in these products is worrisome,” Gayle Williams, Consumer Report’s deputy health editor says. “They tout that they are as safe as coffee, but maybe not. They have a lot more caffeine than an 8-ounce cup of coffee.”

Roland Griffiths, a professor of psychiatry and neuroscience at Johns Hopkins University School of Medicine, Baltimore,authored a scathing report on these beverages. 

“Caffeinated energy drinks that promise super alertness – and sometimes imply better sports performance – should carry labels that specify their amount of caffeine,” he wrote. “Drinks with the highest caffeine content should also warn of potential health dangers.”

“No Sugar Crash”?

Health experts, such as those from Consumer Reports, say that each cup of coffee could contain up to 100mg of caffeine, and the maximum healthy dose for an adult for one day should not exceed 400mg, or four cups of coffee. Coca-Cola has just 34mg of caffeine, and so it would take more than 12 cans of cola to reach the threshold. In contrast, according to, a five-ounce bottle of Monster Energy M-3 Super Concentrate contained 206mg of caffeine, simulating two cups of coffee. A 5-Hour Energy bottle contained about the same amount – but in just two ounces. 

The caffeine, ounce per ounce, in 5-Hour Energy is nine times more than in a regular cup of coffee.

Dr. Oz warns that the risk is posed not only by the amount of caffeine per se, but also by the speed in which it is ingested. Coffee is sipped slowly over the course of several minutes, as the body acclimates to the caffeine and digests it. The body receives a gradual dose of caffeine while also given time to eliminate it. By contrast, a quick knock back of a two-ounce shot of an energy drink slips into the system immediately, giving the body a jolt. 

“And since it’s such a small amount of liquid,” says Dr. Oz, “youmay be inclined to drink more than one bottle. Drink two little bottles and you’ve just downed 415 mg of caffeine.”

In one particular twist of marketing, the 5-Hour Energy Drink boasts “no sugar crash.” But while that may be technically true, it contains artificial sweeteners, which to the company do not qualify as sugar, but aren’t necessarily any less harmful to one’s health.

To its credit, Red Bull, one of the most popular energy drinks, places the amount of caffeine on the label. The company has voluntarily joined the American Beverage Association (ABA), the trade group that represents the soft drink industry, which follows the policy to inform consumers of what’s inside the drinks.

“As an association, we are setting a leadership example in the energy drink category through our adoption of voluntary policies, including listing total caffeine amounts from all sources on beverage labels,” said the ABA in response to the Consumer Report survey. 

The association touts its Guidance for the Responsible Labeling and Marketing of Energy Drinks as its guiding document in this sphere, which includes rules for whether a beverage should be marketing to children, and whether it is sold to schools. But that does not apply to the majority of
so-called energy drinks on the market. It should also be noted that a company’s membership in such a regulatory body does not mean that its drinks are FDA approved. 

The Gateway Drink

How popular are energy drinks? From 2012 to 2013,Red Bull sold $3.4 billion of energy drink products. Monster sold $3.1 billion. Now imagine how many $1.79 cans need to be sold to add up to nearly seven billion dollars. And that’s in one year alone. 

Plenty of them have been sold over a long enough period of time for academic and medical studies to research their long-term effects on youth. 

One such study, out of the Journal of Addiction Medicine, revealed that one-third of youths are drinking energy drinks regularly, and, more alarmingly, that youth who drink these types of beverages are twice as likely to indulge in alcohol and take drugs. They now call energy drinks “the gateway drink,” as risk-taking and mind-altering experimentation with comparatively benign drugs, like caffeine, is a dangerous first step to worse drug abuses.

Among the other negative effects the researchers say are connected with energy drinks are the unhealthy high sugar content, the possibility of increased blood pressure, increased heart rate, insomnia and potential addiction.Some youth surveyed developed a dependency on these drinks to pull themselves out of caffeine withdrawal, and to maintain their perceived boost of energy. Moreover, because caffeine is a natural diuretic – meaning, it stimulates the bladder to eliminate fluids faster – the body can quickly become dehydrated with high doses of caffeine. That makes the drinker thirsty and thirstier, at times leading to even more energy drink intake. 

“A Rising Public
Health Problem”

Overall, these drinks are being abused much like drugs. One state’s statistics might leave some jaws dropping.

 The Oklahoma City Poison Control Center saw a 258 percent increase in calls for caffeine poisoning in the two-year period from 2006 to 2008. Emergency room doctors have had to use stomach pumps to suck out the energy drink liquid from the patient.

 The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related emergency room visits, and their conclusions fall in line with those of other experts. Their report from Jan. 2013 said it plainly: “Consumption of energy drinks is a rising public health problem because medical and behavioral consequences can result from excessive caffeine intake.” The researchers found that hospital visits for caffeine overdose doubled from 2007 to 2011, with the demographic of 18-25 year olds most affected. Nearly 21,000 emergency rooms visits took place in 2011 that were directly related to energy drink consumption. Patients reported irregular heartbeats, heart attacksand severe anxiety. About 42 percent of those taken to hospital had mixed their energy drinks with alcohol or prescription drugs.

 This final statistic underscores another hazard associated with energy drinks – the risks of mixing them with other substances. These risks were the subject of a recent study published in the journal Alcoholism: Clinical and Experimental Research, which found that consuming an energy drink with alcohol is more dangerous than drinking alcohol alone. The researchers suggest thatdrink cans should contain warning labels advising against mixing with alcohol. They’ve discovered that, paradoxically, college students have reported feeling less drunk when consuming an energy drink with alcohol. But although they may feel less drunk, they in fact are not.

According to the DAWN report, “A growing body of scientific evidence documents harmful health effects of energy drinks, particularly for children, adolescents and young adults.” These adverse effects aren’t just seen and felt through typical visual cues. Medical examiners are now able to use state-of-the-art imaging technology to analyze the impact of energy drink consumption on a consumer’s heart. Dr. Jonas Dorner, a radiology resident of the cardiovascular imaging section at the University of Bonn in Germany, along with colleagues, brought in 18 healthy male volunteers averaging
27.5 years old to be scanned by MRIs. The subjects were scanned before, and one hour after, consuming an energy drink, and the doctors discovered heart irregularities even an hour after drinking. Dorner and colleagues reported these findings at the Radiological Society of North America’s annual meeting in Chicago.

 Their conclusion? Energy drinks may cause serious increases in heart contraction rates within an hour of drinking the beverage. They recommend that energy drinks should be subject to regulation, as most people do not know what effects will occur, or how much caffeine they’re ingesting.

It is that ignorance which could cause great harm to youth.
To a young person, that can of Red Bull might look as innocent as a can of Coca-Cola. It may seem like just another version of vitamin water, with that extra kick, perhaps. It makes them feel a little more energetic, awake, alert.  And besides, everyone else isdrinking it. With the proliferation of energy drinks, it may indeed appear to the innocent as just another beverage out on the market, harmless
and refreshing.

Moreover, in this “coffee shop culture,” when there’s a cup of coffee available on nearly every street corner, caffeinated beverages have become an acceptable mainstream cultural norm.

But those seeking a shortcut to a quick boost ought to be aware that though they are getting a short-term rush of energy, they are also getting potentially grave long-term problems.