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Potential risks of energy drinks underestimated

Mike Mozart

Energy drinks have become increasingly popular in the last 15 years, becoming a staple on college campuses. But are they safe? And how do they impact the health of teens and young adults? This week on Take Care, WRVO's health and wellness show, hosts Lorraine Rapp and Linda Lowen speak with Kathleen Miller, a senior research scientist at the University at Buffalo, who has extensively researched the effects of energy drinks.

Lorraine Rapp: By definition, what exactly is an energy drink and why is there concern?

Dr. Kathleen Miller: Well, that’s a bigger question than it sounds like. An energy drink is a stimulant beverage. Its primary ingredient is caffeine but it also includes sugar and usually several other ingredients: amino acids, often massive doses of  B vitamins and other plant and herbal extracts of various kinds. The distinction between energy drinks and other forms of caffeinated drinks is fairly important, in part because caffeine is everybody’s favorite stimulant drug -- a vast majority of us use it. We use it relatively safely. So, when energy drinks came on the market, back in the late 1990s, nobody quite knew how to classify them. Where does this fall on the great drug continuum between aspirin on one end and math on the other? We knew that it wasn’t that serious, but we tended to underestimate the potential risks because we thought of it as just another soft drink. In fact, energy drinks have about three times as much caffeine as most soft drinks do; about the same amount as coffee, but they differ from coffee, in that, they tend to be consumed differently. We tend to slug back an energy drink quickly and more likely to be drunk by young adults, not only for the caffeine buzz and the stimulation, but also because they’re marketed as being edgy and dangerous and risky.  

Rapp: So, let’s talk about some of those effects of caffeine and large quantities of caffeine on the body. How is the body affected?

Miller: Well, the immediate thing to know about caffeine is that the reason everybody likes it is because it feels good. Caffeine is an adenosine blocker and it increases dopamine levels in the brain. Dopamine levels means it makes you happier and blocking adenosine receptors means it stops you from getting drowsy. So just like any other stimulant like cocaine or amphetamines, but milder, it feels good. Low to moderate doses are generally pretty harmless, even potentially beneficial because they might help us concentrate better and might help increase reaction time. But higher doses can be problematic, even dangerous. The high dose effects tend to include things like irritability, jitters and anxieties and sleep disturbances. Once you get to level of what’s called caffeine intoxication -- that’s maybe 500 milligrams or the equivalent four cups of coffee or a handful of red bulls -- then you start running into things like headaches, tremors, heart palpitations, nausea. Toxic doses -- getting closer to a gram of caffeine -- can actually be extremely dangerous.

Linda Lowen: What levels of caffeine are we talking about? What would one drink be, and what would be considered safe?

Miller: There is some debate on this in the research community. But generally speaking, doctors will tell you that for a healthy adult, say 400 milligrams of caffeine over the course of a day, is perfectly safe. That’s the equivalent of about five Red Bulls. Caffeine sensitive populations include people who have just a biological sensitivity to caffeine, but it also includes children and pregnant women. As matter of fact, the American Academy of Pediatrics says there is no therapeutic benefit to energy drinks and that children should not be drinking them at all. Kids should not have caffeine at all, if possible. None at all is virtually impossible because we have a very caffeinated society. But, adolescents probably shouldn’t be getting more than 100 milligrams, 200 milligrams at the most, over the course of the day.