Healthy Living: June 18, 2019

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BANGOR, Maine (WABI) - Energy drinks have been very popular since the late 1990's with the emergence of Red Bull, Monster, and Rockstar. These drinks claim to provide "lasting energy", improve athletic performance, and enhance mental sharpness, but these caffeine and sugar-laden drinks can be very dangerous. Health care professionals have been publicizing the risk and what the label actually hides for many years. Most energy drinks lack label transparency and can be classified as a "dietary supplement" to take certain liberties when it comes to what it puts on the label.

In a recent study published in the May Journal of the American Heart Association, participants between the ages of 18 and 40 were given 32 ounces of a commercially available energy drink to consume within 60 minutes for four days in a row, or were given a placebo of flavored sparkling water. Participants were monitored by electrocardiogram and blood pressure. The energy drinks contained between 300-340 milligrams of caffeine. The results are eye opening to say the least and affirm what we have traditionally thought about the dangers of energy drinks.

Researchers found in the group that consumed the energy drinks, that their QT interval on the EKG was 6.0 - 7.7 milliseconds higher than pre-consumption and it sustained that change for four hours after consumption. The QT interval is important because it is the length of time it takes the ventricles in the heart to generate a beat again. Any increase or decrease in the time, even milliseconds, can lead to an abnormal arrythmia with dangerous consequences. Researchers also found that blood pressure numbers rose by an average of four to five mm Hg in the energy drink group. Add in the element of playing sports and being active after consumption and the risk of life-altering effects occurring, even death, increases significantly.

Interestingly, researchers stated that the study's results cannot be attributed to caffeine and don't know which ingredient may have caused the findings, so more research into ingredients needs to be done. Which brings the issue of having label transparency into the discussion.
The American College of Sports Medicine (ACSM) released a statement in February of 2018 about new recommendations and warnings for energy drinks. Here's how you can protect yourself and your children, especially when mixing energy drinks and activity.
Protect children at risk: Children and adolescents are at high risk due to body size and risk of heavy consumption. Reinforce that these drinks are not for them.

Do not use energy drinks before/during/after strenuous exercise: A study in 2010 by cardiologist Dr. John Higgins concluded that energy drinks have an adverse effect on the cardiovascular system and can cause neurological, gastrointestinal, renal and endocrine system problems. After consuming energy drinks, the arteries are unable to open properly for blood to flow. This flow imbalance plus strenuous exercise and sports is the perfect recipe for serious cardiac events like ventricular tachycardia, ventricular fibrillation and sudden cardiac arrest. Yes, especially in children.

Increase education and research: Efforts should be made to educate children on the large differences between soda, coffee, sports drinks, and energy drinks. The growing number of cardiac events involving energy drinks needs more research as well as the ingredients in each can.

Some countries have come down hard on the sale of energy drinks to children. Latvia, in 2016, started prohibiting the sale of energy drinks to anyone under the age of 18. The U.K. did the same for anyone under 16 in 2018. Some schools in the U.S. have even prohibited students from competing in athletics if they are seen drinking an energy drink before a game or practice. There are, however, no restrictions on the sale of energy drinks to children in the U.S.

Higgins, J., Babu, K., Deuster, P. and Shearer, J. (2018). Energy drinks: A contemporary issues paper. Current Sports Medicine Reports, 17(2), pp.65-72.
Sachin A. Shah, Andy H. Szeto, Raechel Farewell, Allen Shek, Dorothy Fan, Kathy N. Quach, Mouchumi Bhattacharyya, Jasmine Elmiari, Winny Chan, Kate O'Dell, Nancy Nguyen, Tracey J. McGaughey, Javed M. Nasir, Sanjay Kaul. Impact of High Volume Energy Drink Consumption on Electrocardiographic and Blood Pressure Parameters: A Randomized Trial. Journal of the American Heart Association, 2019; 8 (11) DOI: 10.1161/JAHA.118.011318