Monday, August 26, 2013

The Battle Over Energy Drink Safety: Doctors vs. Beverage Industry

As energy drink-related emergency room visits among children and adolscents continue to rise, the medical community remains adament that energy drinks, the sugary, highly caffeinated beverages like Monster, Bawls, Red Bull, 5-Hour Energy and RockStar, are unsuitable for young people. The companies, conversely, fire back that their drinks are safe and contain no more caffeine than the cups of coffee millions consume every day at Starbucks. This is not always the truth.

Most energy drinks list caffeine at 70 to 80 mg per eight-ounce serving. But caffeine counts of 350 mg have been registered in some products -- the equivalent of 10 cans of caffeinated soda.
The Food and Drug Administration imposes a limit of 71 mg of caffeine per 12 fluid ounces of soda but energy drink manufacturers can circumvent this limit by touting their products as “natural dietary supplements.”

In addition, energy drinks often add hidden caffeine through “energy blend” additives like guarana, glucose, kola nut, yerba mate, L-carnitine and cocoa. Monster’s “energy blend” mix in a single eight-ounce can is 2,500 mg, not counting the 27 grams of sugar. (The recommended intake of sugar is 40 grams -- for the entire day.)

A gram of guarana can contain 40 to 80 mg of caffeine but companies are not required to list the caffeine content from these additives. So, the caffeine count can be much higher than the can’s nutritional label, according to a 2012 University of Miami study of energy drinks and their health effects on children, adolescents and young adults, published in Pediatrics, the official journal of the American Academy of Pediatrics.

An analysis of energy drink toxicity in the National Poison Data System by a team of doctors from various universities and hospitals was published in June by Informa Healthcare. The report said the threshold of caffeine toxicity for healthy adults is 400 mg per day and the numbers decline the younger one gets. An adolescent’s threshold is 100 mg per day; children younger than 12 should tolerate no more than 2.5 mg per day. Energy drinks top most of these numbers.

Caffeine intoxication is a clinical syndrome marked by nervousness, irritability, anxiety, insomnia, rapid heartbeat, or tachycardia and stomach upset.

A recent report from the American Medical Association supported a ban on the marketing of energy drinks to children younger than 18. The American Academy of Pediatrics added that “energy drinks have no place in the diet of children and adolescents.”

“The industry says they don’t market to kids but it’s totally marketed to kids,” Dr. Steven Lipshultz argued, noting names like Rock Star and Monster that appeal to a young demographic.

“People buy them because they have an effect on the body but none of the effects are therapeutic for kids,” he said, rebuking the drinks’ promises.

“‘Take this, you’ll be more awake,’ but we found medical studies suggesting that taking energy drinks all the time reduced the amount of REM sleep, so you get more tired. ‘Take this, it will help you lose weight.’ But with all the sugar, you get all these unneeded calories so you don’t lose weight.

“The issue is, for a lot of kids this may not necessarily be harmful, but, on the other hand, if you’re a child who has an unhealthy heart, even if you don’t know it, we don’t think it’s a good idea to take stimulants. A lot of people who get sick are not just the average but there are vulnerable populations,” Lipshultz said.

“It’s not like we take every child in school and do an ultrasound on their heart to see if their heart is normal or not.”

Myerly Kertis, a pediatric registered dietician for Holtz Children’s Hospital, says that parents need to read the labels for products they have around the house that can prove attractive to little fingers.

“I know a lot of times there’s sugar in there and sometimes added herbs or various things. As far as the clinical side, some of these herbs can harmfully interact with medications,” Kertis said. “Some are fine, but read the label and be knowledgeable about what you are putting into your body especially if you are on medications and taking things with herbs. Always check with a doctor.”

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