by Keren Landman, MD
If you watch the ads, energy drinks turn ordinary idiots like you and me into thin, bad, disgusting machines. They promise to give you wings, unleash the beast, make you the boss of time, and allow you to dominate your enemies.
It’s no surprise that sales have skyrocketed in recent years, expanding by 73% between 2018 and 2023. Almost a portion of consumers drink it several times a week. In addition to retail and convenience store offerings, chains like Starbucks, Dunkin, and Caribou Coffee are adding energy drinks to their menus. Over the next five years, energy drink sales are expected to reach $30 billion in the United States.
The vast majority of people who drink energy drinks (most commonly teenagers and men between the ages of 18 and 34) do not die from them. However, sometimes, some do. The Center for Science in the Public Interest counted 34 deaths similar to these products between 2004 and 2014. More recently, the families of a student and a 46-year-old man sued Panera for the deaths of their loved ones after ingesting its product. with high caffeine content. loaded lemonade drinks.
As a result, a much larger number of people who consume energy drinks experience other unpleasant side effects, ranging from insomnia and contractions to anxiety and gastrointestinal disorders. Still, demand for these products is growing, even outside of your sweaty zones. main visitor base.
It’s no coincidence: As today’s male market approaches energy drink saturation, brands have set their appeal on adults beyond school age, specifically women, according to a recent report from market research firm Mintel. They’re achieving those new mouths by capitalizing on a developing and somewhat fanciful claim that the fluids we drink not only quench our thirst, but also decrease our stress, focus our minds, and focus our physical performance.
That’s why, despite the persistent death toll in the industry, energy drink makers are optimistic (sorry) about their future.
The exciting qualities of energy drinks come from their ability to introduce stimulants into the bloodstream with cold, sweet efficacy and an occasional metallic aftertaste.
In addition to a large amount of sugar, almost all energy drinks add caffeine to their formulas. Many also contain guarana, an Amazonian plant that contains high levels of natural caffeine and other stimulants. Another common element is taurine, a building block of protein. This occurs on an herbal basis in the human body and slows down the activity of certain nerve cells.
In moderate amounts, caffeine makes other people more alert, attentive, and energetic. However, in larger quantities, its negative effects (adding nervousness, nausea, and tremors) can outweigh the positive effects.
Scientists know strangely little about the toxicity of taurine and guarana in humans (most of the knowledge about protecting those products comes from animal studies), but they know much more about caffeine’s effects on various human organ systems. Many of those effects depend on how and how much you consume: Although a giant cup of coffee doesn’t particularly have effects on blood pressure or heart rate in other people who drink coffee daily, it may simply accumulate in those who don’t drink coffee, and large amounts can lead to serious side effects, such as severe recurrent vomiting. seizures and muscle breakdown.
There is also a large variation in the amount of caffeinated energy drinks. A typical 8-ounce cup of coffee contains between one hundred and 150 milligrams of caffeine. Filling the same glass with Monster Energy only gives you 80 milligrams, while filling it with 5-Hour Energy (the equivalent of four bottles, which I implore you not to do) would give you 800 milligrams. (The Food and Drug Administration recommends a maximum of 400 milligrams of caffeine for up to adults, a guideline based on recommendations issued by Canadian public health authorities. )
Meanwhile, a giant cup of Panera Charged Lemonade, now discontinued, without ice, can contain only 390 milligrams of caffeine. Since they were initially sold in self-service dispensers, consumers can seamlessly and free refill the amount of caffeine for several days in one go. (The largest length of Starbucks’ Iced Energy comes in at 205 milligrams and refills for free. )
Although energy drinks have been linked to a variety of concerning effects on fitness, some of the most significant concerns relate to their effects on cardiovascular function and, specifically, heart rate. Several studies have shown that energy drinks increase heart rate and blood pressure, which in excessive cases can lead to spasms, tears, or clotting of blood vessels. They have also been linked to interruptions in the center’s wiring, which in some people at higher risk can lead to cardiac arrest, when the center stops beating completely.
One in 200 people has a genetic condition that puts them in this high-risk category, says Michael Ackerman, a cardiologist at the Mayo Clinic in Rochester, Minnesota. The most common circuit challenge in this organization is called long QT syndrome, which affects about one in 2000 people.
Ackerman advises others with this syndrome to avoid medications, foods, and drinks (such as energy drinks) that aggravate the heart’s wiring, and sometimes prescribes medications to decrease the risk of having a rhythm problem. However, the condition is asymptomatic and therefore may not be diagnosed until the user has symptoms.
It is known exactly which ingredients in energy drinks are responsible for altering the central circuits.
Caffeine turns out to be the most likely cause (in its pure, highly concentrated forms, the drug can be fatal), but in clinical studies with smaller amounts of caffeine, it does not appear to cause changes in central wiring or rhythm. (However, outside of closely monitored study settings, people most likely drink larger amounts of energy drinks at a much faster rate; researchers may never have studied caffeine-related effects at actual levels. intake of energy drinks).
An even bigger question mark is the effects of other energy drink ingredients on core rhythm; Some studies recommend that interactions between multiple ingredients can alter the central rhythm.
“Consumption is at unprecedented levels and people are not dropping like flies left and right”
Ackerman has been asking his patients about their energy drink consumption since 2000 and recently conducted a small study of the medical records of the 144 patients he evaluated after surviving cardiac arrest. Seven of them, five percent of them, had fed on an energy drink at some point before their centers stopped beating. Only one of those seven patients had been diagnosed with a central disease that is known to make ingesting energy drinks more risky.
One detail of the study caught my attention: six of the seven patients who suffered cardiac arrest after an energy drink were women. Ackerman said this is probably similar to estrogen’s propensity to induce central rhythm shivering in other people with long QT syndrome. However, this location is deeply ironic given that women have traditionally consumed far fewer energy drinks than men.
This is a small study, and Ackerman cautions against overreacting to its findings. “Consumption is at unprecedented levels and people are not dropping like flies left and right,” he says. “The absolute risk, if your heart is healthy, is enormous. ” , super, super low. “
However, many energy drinks advertise themselves as supplements and may claim to do all sorts of things without testing, says Joseph Jensen, who works on similar regulatory issues to food additives, food chemicals, and nutritional supplements at the Center for Science in the Public. Interest.
They would possibly do this without giving you the information you want to moderate your consumption of caffeine or other compounds proven or potential to stimulate or aggravate the cardiovascular system. Although a product label likely includes caffeine and guarana extract, José says, “You have no idea how much caffeine you get from any of those ingredients. ” An FDA loophole means there are no legal limits on the amount of caffeine in any of those products, nor does the company require brands to tell it how much caffeine they contain.
How do consumers who enjoy energy drinks ensure their safety?”There’s no answer to your question,” José says, largely because so little is known about what’s in many of those drinks and what degrees of intake make the most sense. Still, eating only beverages with rated caffeine content (and consuming them in moderation, making sure to stay within the FDA’s recommended daily limit) is, he says, more than mindlessly pounding one can after another.
Although Ackerman does not believe that the sale of these drinks should be restricted, the risk-benefit equation does not lean at all in favor of their consumption. “There’s not much redeeming value for fitness anyway,” he says. The Centers for Disease Control and Prevention recommends that young people and teens avoid energy drinks altogether.
Probably the closest ancestor of trendy energy drinks is Japan’s Lipovitan D, first introduced in 1962. Powered by a mix of taurine, caffeine, and other ingredients, those drinks were advertised with a hegemonic fight/burn/roar tone. . It is a type of masculinity for the weak.
In the 1980s, an Austrian entrepreneur’s encounter with a Thai drink containing taurine and caffeine led to the creation of Red Bull, the first entry into the canon of trendy Western energy drinks. The market has only grown since then, driven by partnerships with the growing sports and video game industries, which have already attracted hordes of teenagers who are overly receptive to messages aimed at their preference for proving their masculinity.
In 2015, psychologist Ronald Levant found that among college-aged white men, energy drink consumption was due to adherence to classic male ideology, which defines “real men” as tough, domineering, practical, homophobic, and impassive (unless they’re angry). ). or triumphant). Much of this effect was due to boys looking for tactics to be more manly, he tells Vox: “They’re looking for tactics for their masculinity, and they saw energy drinks as a way to achieve that. “
The longing for this kind of masculinity is still alive and well in what commentator Max Read has called Zynternet, the “fraternal and wildly provocative” online corners. The other people who occupy those corners and the men on their social networks still make it constitutes a giant component of the goal of many energy drink brands.
Because energy drinks rely heavily on their associations with classic male norms, one would think they would find it difficult to locate an audience among teams less interested in beating each other’s chests and urinating on each other.
“Hydration has been the trend for the last year and a half. It’s out of the ordinary.
However, several years ago, brands introduced a concerted effort to replace this and began targeting tired, distracted women and post-college adults looking for answers to their sagging. Delve into the saturated tropical swirls of Alani, the fruity flavors and packaging of Celsius, the Red Bull’s Curuba elderflower “Summer Edition” and the outgoing Go Girl. Russell Zwanka, director of the food marketing program at Western Michigan University, says the pivot toward young adults and women is unequivocal and long overdue.
The trend that enables this broader public view of energy drinks is the beverage consumers’ preference for doing things, Zwanka says. “All marketing is now focused on the question, ‘What’s the benefit of the drink?'” In the language of food marketing, serving salt beverages involves biologically active compounds that provide them with explicit fitness benefits. Currently, the most sought-after benefit is what you think is a hit for anything you drink from a can: “Hydration has been the trend for more than a year and a half. It’s something out of the ordinary,” says Zwanka.
To take the word for energy drinks, it has to be said that they are unlikely to provide better hydration than Gatorade or milk, especially since in higher doses, caffeine works as a diuretic, meaning that it actually causes water loss by increasing the amount of water. urination. Energy drinks promise it anyway, and much more, because there simply isn’t much regulatory oversight over what they contain or how they’re marketed. It doesn’t do Americans any favors, José says.
“We have transparency in our food system,” he says, “and we think this is a pretty obvious first step. »
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