Energy Drinks Being Investigated in the U.S. by FDA

Energy drink cans. (iStockphoto/Thinkstock)
Energy drink cans. (iStockphoto/Thinkstock)

Being tired is a universal complaint. We are always looking for a quick fix to energize us. Then there are energy drinks. When you see them being advertised on TV, you are really tempted to buy one. This is how the energy drink market has become a multibillion dollar industry. Sales of energy drinks in the United States grew an estimated 16 per cent last year to $8.9 billion, a record level, according to Beverage Digest, a trade publication.

For example, 5-Hour Energy drink is supposed to provide you with immediate boost in your energy level. The drink has no sugar and only four calories. So, where does the energy boosting ingredient come from? It is caffeine. But the company does not tell us how much caffeine is in the drink.

Rockstar Energy, 5-Hour Energy and Monster Energy are marketed as dietary supplements. Other energy drinks like Red Bull, NOS and AMP are marketed as beverages. There isn’t a mandatory reporting requirement for beverages to let you know how much caffeine is in the product, though makers can do so voluntarily.

Now the Food and Drug Administration (FDA) is looking into it. On November 16, 2012 NBC news reported, “The federal government and the New York Attorney General’s office have announced that they are investigating the popular energy drink after the Food and Drug Administration received claims that 5-Hour Energy has over the past four years led to 13 deaths and 33 hospitalizations.”

The FDA has received 92 reports over four years that cite illnesses, hospitalizations and deaths after consumption of 5-Hour Energy. The FDA is also looking into highly caffeinated Monster Energy Drink. The FDA has received reports that Monster Energy Drink may be responsible for five deaths and one nonfatal heart attack. The FDA warns that this is just a preliminary investigation as direct effect of deaths to these drinks has not been established so far. The agency is cautioning consumers that these “energy shots” or “energy drinks” are not alternatives to rest or sleep.

In 2010, makers of caffeinated alcoholic drinks took those products off the market after the FDA sent the companies warning letters saying that combinations of caffeine and alcohol in the drinks was a public health concern and could lead to alcohol poisoning, car accidents and assaults, says NBC news.

The New York Times first reported that 13 deaths were linked to 5-Hour Energy. Since 2009, 5-Hour Energy has been mentioned in some 90 filings with the FDA, including more than 30 that involved serious or life-threatening injuries like heart attacks, convulsions and, in one case, a spontaneous abortion.

We do not know how much caffeine is in Monster Energy and 5-Hour Energy. But a recent article published by Consumer Reports placed that level at about 215 milligrams, says the Times report. An eight-ounce cup of coffee, depending on how it is made, can contain from 100 to 150 milligrams of caffeine. Maximum amount of caffeine you can consume safely a day depends on how sensitive your body is to caffeine. Caffeine is a drug. Use it carefully. Instead of being energized, you may be dead resting for ever.

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Does Your Child Consume Too Much Caffeine?

Many of our kids are “hooked” on energy drinks and soft drinks. Do you know the amount of caffeine in some 500 mL energy drink is equal to caffeine in 10 cans of cola? And we allow our children to drink that.

On October 19, an editorial – “Caffeinating” children and youth – in the Canadian Medical Association Journal (CMAJ) says, “Owing to inadequate labelling requirements, a lack of awareness of caffeine’s harmful effects and marketing campaigns that appeal to children and youth, this is precisely what we are unwittingly allowing in Canada and elsewhere.”

The editorial says that the energy drinks are very effective high-concentration caffeine delivery systems. These sugar-loaded syrups typically contain 80 to 140 mg of caffeine per 250 mL – the equivalent caffeine in one cup of coffee or two cans of cola.

Children who are looking for more caffeine go for drinks which have caffeine concentrations as high as 500 mg per can in US products such as Wired X505TM and FixxTM. Caffeine can also be purchased in 100- and 200-mg tablets in Canada and the United States.

“However, even tablets with two and one-half to five times less caffeine have mandatory health warnings guarding against use in children and cautions to limit use because too much caffeine may cause nervousness, irritability, sleeplessness and occasionally, rapid heart rate,” says the CMAJ editorial.

The question is: Caffeine-loaded energy drinks – are they beverages or drugs delivered as tasty syrups?

Health Canada has to do a better job of regulating products heavily loaded with caffeine. The food labels should clearly say how much caffeine is in the product. These labels should be easily understood by the general public – content of caffeine equivalent in terms of cups of coffee.

Can you compare energy drinks marketed towards youth and consumption of coffee by adults? For example, a 16-oz “grande” coffee at Starbucks contains 330 mg of caffeine. That is lot of caffeine. The editorial says, “Children and youth are notorious for making poor health choices. They can hardly be expected to make appropriate decisions about consuming energy drinks when information on caffeine concentration and appropriate safe amounts is not visible on these products.”

Adolescents and college students often mix energy drinks with alcohol. This is dangerous Studies have shown that the high levels of caffeine can mask the perception – but not the consequences – of acute alcohol intoxication.  

In a survey, college students who mixed alcohol with energy drinks were three times more likely to leave a bar highly intoxicated and four times more likely to drive while intoxicated than bar patrons who did not mix alcohol with energy drinks or drank them separately, says the CMAJ article.

A study of 100 US adolescents aged 12 to 18 found that 73 per cent consumed 100 mg or more of caffeine per day, with most consumption in the evening, the time of day most likely to negatively affect sleep. Poor sleep quality and quantity in adolescents has been associated with mood disorders, exacerbation of asthma, obesity, lower sense of well-being and poor school performance.

CMAJ is asking regulatory authorities such as Health Canada to step in. Regulations could include government-mandated restrictions on labelling, sales and marketing, or self-imposed industry-wide standards with clear labelling accompanied by public education.

Until 2008, France did not even allow the sale of Red BullTM, and in Denmark, sale was prohibited as of 2009. At a minimum, all products with caffeine levels exceeding 100 mg should have labels and advertising that carry warnings comparable to those required for caffeine tablets. There should be no advertising targeting children.  We should invest in public education focused on the health consequences of caffeine in children.

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Drinking tea provides many health benefits (Part 2/2)

For many people, tea is a cup of life. And some women chose their man with just a cup of tea.

As somebody has said, “Never trust a man who, when left alone in a room with a tea cozy, doesn’t try it on.” And a Japanese proverb says, “If a man has no tea in him, he is incapable of understanding truth and beauty.” There you go ladies, no need for a bottle of champagne.

But we have to go beyond truth and beauty and look for other benefits tea provides to the lovers – so to speak- of tea drinkers. Let us look at the content of caffeine first.

People get confused when they find out that coffee contains less caffeine than tea when measured in its dry form. But the caffeine content of a prepared cup of coffee is significantly higher than the caffeine content of a prepared cup of tea. An average serving of coffee contains the most caffeine, yet the same serving size of tea provides only half to one-third as much.

A cup of black coffee has 99 mg. of caffeine. A cup of green or black tea has 34 mg. of caffeine. Decaffeinated black tea has only 4 mg of caffeine. Adding milk to tea does not compromise its healthy benefits. Most of us can drink 10 to 12 cups of regular tea a day and stay within the 400 to 450 mg daily caffeine limit recommended by Health Canada.

Herbal tea is not considered a real tea as it is not made from Camellia sinensis which contains caffeine. So it is called herbal infusion. Herbal infusions are naturally caffeine free. If you want to avoid caffeine completely in your tea then drink herbal infusions like Chamomile, Peppermint and others.

There are some herbs which do have generally recognized benefits. For instance, rose hips contain vitamin C, chamomile helps many people relax and peppermint has a noticeable soothing effect on the stomach. Herbs can also cause problems. Chamomile, for example, can cause allergic reactions in people who are allergic to ragweed.

Black and green teas have comparable health benefits. In my last column, we briefly mentioned about vitamins, minerals and antioxidants in tea. An article titled, “A thought on the biological activities of black tea” (Crit Rev Food Sci Nutr. 2009 May), says black tea acts as an effective antioxidant because of its free radical-scavenging and metal-chelating ability. Some epidemiological studies support the protective role of black tea against cardiovascular diseases but some do not. The article says that although its role in cancers of the gastrointestinal tract, liver and prostate is confirmed, its effect against urinary tract cancer is uncertain.

What about health benefits of green tea? I looked at a couple of review articles. The articles highlight the chemistry of green tea, its antioxidant potential, its immune-potentiating properties and mode of action against various cancer cell lines that showed its potential as a chemo-preventive agent against colon, skin, lung, prostate and breast cancer.

Green tea contains more catechins than black tea or oolong tea. Catechins are strong antioxidants. In addition, its content of certain minerals and vitamins increases the antioxidant potential of this type of tea.

Chinese have used green tea for medicinal properties for centuries. Recent human studies suggest that green tea may contribute to a reduction in the risk of cardiovascular disease and some forms of cancer, as well as to the promotion of general health and combating some bacterial and viral illnesses.

Now we need something to improve our memory to remember everything we need to do to stay active and healthy. Brew a good cup of tea, sit near a fire place, start reading this article all over again and see what happens. Enjoy!

How can you brew a perfect cup of tea?

-Use a good quality loose leaf or bagged tea

-Tea must be stored in an air-tight container at room temperature

-Always use fresh boiling water

-In order to draw the best flavour out of the tea the water must contain oxygen, this is reduced if the water is boiled more than once

-Measure the tea carefully

-Use one tea bag or one rounded teaspoon of loose tea for each cup to be served

-Allow the tea to brew for the recommended time (generally three to five minutes) before pouring

(For more information visit Tea Council of Canada (www.tea.ca) and the British Tea Council)

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Does Coffee Improve Sexual Performance?

Sex has been part of our lives since Adam and Eve decided to have a cup of coffee…ok I am just kidding. Anyway, Adam and Eve did what they had to do without the necessity of having coffee or having a smoke. They just needed and an apple. Now you won’t find an apple in anybody’s bedroom or a hotel room. Instead, you find a small coffee maker.

Coffee is known to do many things. But does it improve sexual performance?

In 1990, a paper was published in the Archives of Internal Medicine looking at sexual function in people over the age of 60 in Washtenaw County, Michigan. Their study showed that estimated proportions of individuals who were sexually active were 73.8 per cent for married men and 55.8 per cent for married women.

Among unmarried men and women the proportions were 31.1 per cent and 5.3 per cent, respectively. The levels of sexual activity decreased significantly with age in both genders. The estimated proportion of married men with erectile impotence was 35.3 per cent. The authors found that consumption of at least one cup of coffee per day was significantly associated with a higher prevalence of sexual activity in women and with a higher potency rate in men.

Ok, one cup of coffee would do the trick? Then why take the blue pill? I doubt whether coffee will ever replace your Viagra, Cialis, or Levitra. But coffee should keep you awake for awhile during sexual performance if you are in a habit of dosing off before the foreplay is over.

Scientists from Southwestern University found caffeine increased the female libido in experiments on rats. The Pharmacology, Biochemistry and Behaviour journal study said the effect was caused by it stimulating the part of the brain regulating arousal. But researchers said a similar effect was only likely to be repeated in humans who do not drink coffee regularly. Well, that study does not help much.

According to a report in the Globe and Mail (February 6, 2009), psychologists at Durham University in Britain questioned 200 people about their daily caffeine intake and whether they had ever had a hallucinatory experience.

The researchers found that hard-core coffee drinkers (those who consume an average of seven cups daily) were three times more likely to report seeing things that weren’t there, hearing voices and feeling as if they were floating above their bodies. I wonder who would like to make love to a person who has had seven cups of coffee. It would be a different kind of experience….levitational love making.

Caffeine is a mild stimulant which acts on the central nervous system and some other organs of the body. It temporarily improves concentration, alertness, reasoning, intellectual effort and vigilance. A prerequisite before love making? The stimulant effects of a small amount (say one cup of coffee) take effect after 15 – 45 minutes and last normally for about four hours.

Caffeine is readily absorbed into the bloodstream and does not accumulate in the body, being rapidly metabolized and excreted. It is interesting to know that the effects of caffeine do not last so long in smokers – nicotine doubles the speed at which caffeine is broken down in the body. Alcohol has a similar effect.

In summary, caffeine is a mild stimulant which may help with your sexual performance but do not make love to a person who has had seven or more cups of coffee. If you do then you will be singing …Love is in the air….

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Caffeine

Dear Dr. B: I have been using caffeine pills to stay awake and study for my exams. Is it a bad thing to do that?

Answer: Caffeine is a drug. It is naturally produced in the leaves and seeds of many plants such as tea leaves and coffee beans. It stimulates the nervous system to cause alertness. It makes the heart beat faster. Some people experience a temporary increase in energy and elevation in mood. It is bitter in taste but the processing of the drinks can hide the bitter taste. It’s also produced artificially and added to certain foods.

It is almost impossible to spend a day without consuming caffeine in some form or the other. Caffeine is in sodas, coffee-flavoured yogurt, coffee ice-cream, chocolate candy or iced tea. Many pain killers and over-the-counter medications have caffeine. Even decaffeinated coffee has some caffeine. Many energy drinks are loaded with caffeine to give a temporary boost to a person’s energy level.

Most teenagers get their caffeine through soft drinks which can also have added sugar and artificial flavors. Sixty eight per cent of Americans say they are hooked on coffee. Caffeine abuse by young people alarms some experts. In one study, researchers from Northwestern University in Chicago tracked calls to the Illinois Poison Center in Chicago for three years and they found that more than 250 cases of medical complications occurred from ingesting caffeine supplements and that 12 per cent of the callers had to be hospitalized. The average age of the callers was 21.

Besides boosting memory and improving concentration, caffeine can lower the risks of diseases such as Alzheimer’s, liver cancer, type 2 diabetes and Parkinson’s disease. It does not significantly increase the risk of heart disease or cancer.

On the other hand, caffeine does cause dependence and trying to go without caffeine may cause withdrawal symptoms. Once you get hooked on caffeine then you need more and more caffeine to feel the same effect. Too much caffeine can raise blood pressure and blood sugar level, decrease the bone density and cause muscle soreness because the body loses calcium and potassium and recovery time after exercise is delayed. Caffeine has a mild diuretic effect (increase need to urinate) which can cause dehydration. Caffeine increases irritability and anger.

Too much caffeine will cause insomnia, tremors, nausea, vomiting, chest pains and palpitations. Caffeine is not stored in the body and it is excreted through the kidneys. In some individual the after effects of caffeine may last up to six hours.

How much is too much caffeine?

This is difficult to define as individual sensitivity to caffeine can vary a lot. A cup of coffee or tea can keep one person awake whole night while it may not have any effect on a second individual. Some experts say that people should consume no more than about 100 milligrams of caffeine daily. That equals to one espresso which contains about 100 milligrams of caffeine.

Other examples of caffeine contents of common drinks are:

-Coca-Cola 355 ml. has 34 mg. of caffeine
-Diet Coke 355 ml. has 45 mg. of caffeine
-Pepsi 355ml. has 38 mg. of caffeine
-7-Up 355 ml. has no caffeine
-Iced tea 355 ml. has 70 mg. of caffeine
-Brewed coffee 150 ml. has approximately 115 mg of caffeine

Depending on your sensitive and tolerance level, caffeine in small amounts and in moderation may not hurt you. You have to know your limit. Personally, I don’t see the need for taking caffeine to stay awake and study. In my life time I have been through many exams and I didn’t have to rely on caffeine to get results. I believe in power naps. If you are sleepy then your body is asking you to rest. Take a nap instead of drugging yourself with caffeine.

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