Tuesday, November 18, 2008

Should Energy Drinks Carry a Health Warning?

Should Energy Drinks Carry a Health Warning?

written by James LaValle, R.Ph, ND, CCN

The US has become a "caffeine-dependent nation". As if the traditional coffee, tea, and soft drinks were not enough, we have added caffeine to mints, gum, and a variety of "energy drinks." These drinks happen to be enjoying tremendous sales not only in the US, but in other countries as well. So it caught my eye when Australian researchers recently reported that the energy drink, Red Bull, has the potential to increase the risk of heart attack or stroke.1

The study conducted on college age adults found that Red Bull not only increased blood pressure, it increased the stickiness of blood cells -- after consuming only one can of the drink. It is known that increasing the stickiness of blood cells means our blood will be more prone to forming clots, which can cause a heart attack or stroke. The authors of the study concluded that drinking Red Bull could be dangerous, especially for anyone who may already be predisposed to heart disease.

After the study was published, a spokesperson for Red Bull stated that these effects are similar to the changes found with drinking a cup of coffee, and so the long-term risks of energy drinks could not be determined from these results alone.2
It's true that each can of Red Bull contains about 80 mg of caffeine, the amount typically found in one cup of brewed coffee. Caffeine is a stimulant, and in moderation it has been shown to have some benefits. For instance, it slightly increases the body's rate of metabolism and enhances mental focus and clarity. However, in comparing coffee to energy drinks, are we really comparing apple to apples?

Both drinks contain caffeine. Stimulants in general increase the production of the stress hormones, adrenaline, nor-adrenaline, and cortisol. (Remember, anything that increases the production of stress hormones in the long run has potential for harm, as they are known to interfere with sleep, increase waist to hip ratio, and increase one's risk of heart disease and stroke.)

Nor-adrenaline causes blood vessels to constrict, and that increases blood pressure. One study found that in rats, caffeine and other stimulants increased the production of renin, a hormone made in the kidneys, which also increases blood pressure.3 But the difference between coffee and energy drinks is that coffee is coming from a plant and contains other natural substances that may be moderating its effects.

For instance, while some studies have found that coffee increases blood pressure in occasional drinkers, in habitual coffee drinkers, that effect seems to wear off.4 Longer term studies would need to be conducted on energy drinks to see if this effect would the same.
But what about the blood stickiness? So far there are no studies showing that coffee increases blood platelet stickiness. In fact, it has been found to have the opposite effect. Italian researchers have found that coffee makes blood platelets less sticky, and they have narrowed that effect down to the phenolic compounds contained in coffee.5
Phenolic compounds are the natural antioxidants found in many plant foods -- and coffee is very high in these antioxidants. So this may be part of the reason coffee is not as harmful. (But that does not mean you should drink more than a moderate amount.)

Obviously, the combination of ingredients in Red Bull is somehow exerting an effect resulting in increased blood stickiness -- and this is enough reason to avoid it, even if the blood pressure raising effects are only temporary. The manufacturers of Red Bull even warn consumers not to drink more than two cans a day. I think we would all do well to heed that advice.

However, I must say the negative results of the Red Bull study surprised me. Red Bull does not contain excessive caffeine and even contains some B vitamins and taurine, which should help counteract any of the effects of the caffeine. So when asked if these drinks are OK, I have considered them to be like any other stimulant.
Since they promote the increased production of stress hormones, they should be used with moderation and individual tolerance should be assessed and used as a guideline. For instance, some people don't clear the caffeine as well through their liver, and can't sleep at night with any caffeine at all.

In the meantime, I think we all need to consider why these drinks have become so popular in the first place. People are stressed out, burned out, and are not getting enough sleep. The use of these energy drinks will not remedy that. In fact, another study found that in people who were sleep deprived, the energy drinks were not effective in counteracting feelings of sleepiness, and even slowed reaction times compared to a placebo.6

This may explain why some people keep trying with more and more of these drinks. I see many people consuming ungodly amounts of caffeinated drinks -- 3 pots of coffee or 20 Mountain Dews daily. Even worse, I have seen patients drinking anywhere from 5 to 15 Red Bulls or other energy drinks per day.

Unfortunately, the attempt to get more energy in this way is very short-sighted and it can end up contributing to adrenal fatigue or exhaustion. And I must add that none of this discussion includes consideration of the long term effects of stimulants on our neurotransmitters. In general, we need to remember that too much constant stimulation over time will deplete vitamins and minerals and increase anxiety. It can also contribute to adrenal exhaustion, while increasing other health risks.

So, what should you do if you need more energy?

Consider using the adaptogenic herb, Rhodiola. It has been well-studied and found to increase energy by supporting adrenal function. An added benefit is that at the same time, it reduces the effects of stress on the body.
Finally, if you desire a little caffeine, so far the safest and most beneficial way to get it, seems to be with tea. Tea contains caffeine, but is balanced by the naturally occurring and calming substance, theanine. In addition, tea is very high in health-promoting antioxidants. And that's no bull!


1. http://www.medscape.com/viewarticle/579188?sssdmh=dm1.378116&src=nldne.
2. http://www.reuters.com/article/healthNews/idUSSYD584612008081.
3. Tofovic SP, J Pharmacol Exp Ther. 1991 Mar;256(3):850-60.
4. Science Daily. New Buzz On Coffee: It's Not The Caffeine That Raises Blood Pressure. American Heart Association, 2002, November 19.
5. Natella, F et al. British Journal of Nutrition. 28 Apr 2008.
6. Anderson C. and Horne J. Human Psychopharmacology: Clinical and Experimental. July 2006, 21 (5): 299.

[Ed. Note: James LaValle, R.Ph, ND, CCN, is the founding Director of the LaValle Metabolic Institute, one of the largest integrative medicine practices in the country. He was named as one of the 50 most influential pharmacists in the US by American Druggist magazine. Dr. LaValle is the Executive Editor of THB's The Healing Prescription and the author of more than a dozen books including the bestseller, Cracking the Metabolic Code: 9 Keys to Optimal Health. To learn more, click here.]

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