Raising a Red Flag on Some Energy Drinks
In recent years energy drinks have enjoyed a surge in popularity—Beverage Digest estimates that energy drinks are now a $7.7 billion industry1. In spite of their increasing popularity, there’s still controversy over the safety and suitability of these products for daily use, and many people do not realize the danger that some can pose. Several states have attempted to pass legislation that would ban the sale of such drinks to minors. While the bills did not pass, they did serve as a warning to manufacturers of energy drinks.
If you choose to consume energy drinks, it’s important to be educated about them, what they do and the possible side effects.
Energy Drinks vs. Sports Drinks
Energy drinks should not be confused with sports drinks, which are intended to rehydrate the body. Sports drinks such as Gatorade or Powerade provide sugars, which the body burns to create energy, and replenish electrolytes, helping to maintain salt and potassium balances in the body. Energy drinks containing large amounts of caffeine can produce the opposite effect and cause dehydration, which can lead to fatigue as well as increased body temperature and heart rate, potentially placing an individual in a compromised position to perform. This is true for weekend warriors, active fitness enthusiasts and members of a college or major league sport.
Energy drinks are generally formulated to deliver high concentrations of caffeine to give a rush of energy. But many other beverages contain caffeine as well. For example, 8 ounces of coffee has about 108 milligrams of caffeine, brewed tea has 50 milligrams and 12 ounces of coke has 34 milligrams. Eight ounces of Red Bull, which is part of NSF’s Certified for Sport® program, has about 75 milligrams of caffeine. However, very highly caffeinated energy drinks can contain between 150 - 500 milligrams in 8 ounces. Consumption of caffeine at these rates can lead to caffeine intoxication, and at these high levels caffeine is a stimulant drug.
It’s also important to pay attention to serving size. Some energy drinks are packaged in containers that contain multiple servings, so consuming a full container in a single sitting could introduce an unsafe level of caffeine into the body. There can also be an added risk due to the additive effect of other stimulants. Some energy drinks contain not only high levels of caffeine, but other stimulant ingredients as well, such as guarana, green tea, yohimbine, vinpocetine, 5-hydroxyl trypophan methylphenylethylamine (5-HTP) and ginseng. When multiple stimulants are used in combination and mixed into one beverage, serious cardiovascular issues can occur.
Because very little is known about the combination of ingredients in some energy drinks and their effects, some organizations have raised questions about the safety of these products, especially for athletes. In fact, in 2008 the National Federation of State High School Associations, which recommends water and sports drinks for rehydration, specifically did not recommend energy drinks because they did not prove to have a positive effect on performance and could cause health risks2. Additional concerns often cited about energy drinks include:
- Drug Interactions. Concerns exist about the ingestion of large amounts of ingredients found in energy drinks and how they may adversely affect patients with poorly controlled or undiagnosed psychiatric conditions. Additionally, some energy drink ingredients are known to interact with certain prescription and over-the-counter drugs, causing adverse health effects or reducing the effectiveness of the drug.
- Blood Thinners. Vinpocetine, an ingredient found in some energy drinks, can increase blood flow to the brain. If you are taking blood thinners, including aspirin, Coumadin, Plavix, Tidid, Pentoxifylline, vitamin E or garlic or gingko supplements, avoid consuming products containing this ingredient.
- Blood Pressure. Yohimbine is also frequently found in energy drinks. It should not be taken in combination with antidepressants, drugs for lowering blood pressure, amphetamines or any other central nervous system stimulants as the combination of yohimbine with these substances can lower blood pressure to dangerous levels and make the blood pressure medication inactive. Conversely, yohimbine should not be consumed alongside nasal decongestants, diet products containing phenylpropanolamine, cheese and red wine as it can result in high blood pressure and heart palpitations.
- Interaction With Alcohol. Although the U.S. Food and Drug Administration (FDA) banned the sale of energy drinks containing alcohol, some individuals still risk their health and safety by mixing high-caffeine energy drinks with alcohol. A recent study in the Journal of American Medical Association (JAMA) found that individuals who combine energy drinks with alcohol significantly underestimate their true level of impairment.12
There is still much to learn about energy drinks and their effects. Athletes especially need to understand both the diuretic and stimulant effects of caffeine and other stimulant ingredients present in many energy drinks. If you choose to consume these products, carefully read labels and thoroughly research the contents of the products. Always follow the manufacturer’s recommended serving size and don’t consume multiple servings in a single sitting. For added peace of mind, look for certification before purchasing any energy drinks or sport supplements. For additional information about sports supplements, visit the NSF Certified for Sport® website.
About the Author
Dr. Lori L. Bestervelt holds dual positions with NSF International: senior vice president of NSF’s health sciences division and chief technical officer overseeing NSF’s global network of engineering, chemistry and microbiology laboratories and toxicology services. Dr. Bestervelt holds a Ph.D. in toxicology, a master’s degree in nutritional biochemistry and a bachelor’s degree in microbiology and immunology, all from the University of Michigan. She completed her post-doctoral work in the University of Michigan Medical School’s Biochemistry Department. Prior to joining NSF, she was a scientist at Pfizer. Dr. Bestervelt is a member of the Society of Risk Analysis, the Michigan Society of Toxicology and the advisory board for molecular biology/biology at Eastern Michigan University.
1Energy Drink Growth Accelerating. Category Becoming A Story of Three Brands. (2011). Retrieved December 2, 2011, from
2Seifert, S., Schaechter, J., Hershorin, E., Lipschultz, S. (2011). Health Effects of Energy Drinks on Children, Adolescents, and Young Adults. PEDIATRICS, 3, 511 -528 Retrieved from http://pediatrics.aappublications.org/content/127/3/511.full
3Non-alcoholic energy drinks may pose 'high' health risks. PhysOrg.com. Retrieved from http://www.physorg.com/news/2011-01-non-alcoholic-energy-pose-high-health.html