‘Healthy Drinks’ Mask High Caffeine Content

I was glad to see the Journal for Nurse Practitioners take up an important issue to our health and well-being: Energy Drinks. Pohler, H. (2010). Caffeine intoxication and addiction. Journal for Nurse Practitioners. 2010;6(1):49-52. http://www.medscape.com/viewarticle/714855

These drinks are marketed as a healthy alternative to other choices like soda and coffee, but in my view they potentially have many negative implications. For the past two years, I have observed a 7th grade boy purchase two cans of Red Bull each morning when I purchase my cup of coffee. 2 cans of highly potent, caffeinated Red Bull, which is advertised to “revitalize body and mind”. Some days he buys Full Throttle (which CNN tells me ( http://www.cnn.com/HEALTH/library/AN/01211.html) nearly doubles the dose of caffeine per can (cans are bigger)).

How commonly do children buy these drinks? I wonder a bit about the groups that are the highest consumers of energy drinks like Red Bull or Red Star or Liquid Cocaine? Are we (and our children) unwittingly getting hooked on high doses of stimulants in ‘healthy’ energy drinks? Let’s not forget the little ‘shots’ available for purchase too, so you can quickly get your stimulant without a lot of drinking… Also, check the label of your vitamins, as often vitamin supplements have caffeine in them as well. I had that experience a while back. It isn’t pretty to see me after a cup of coffee and a vitamin with caffeine. We need to look at the labels of the products we buy!!!

Caffeine is one issue, each 8.3oz can of Red Bull contains 75mg of caffeine. The other ingredients have potential effects as well. Here are the ingredients of Red Bull: Carbonated water, sucrose, glucose, sodium citrate, taurine, glucuronolactone, caffeine, inositol, niacinamide, calcium-pantothenate, pyridoxine HCl, vitamin B12, artificial flavors, colors.

I appreciate Pohler telling us that ingredients like guarana and cola nut are synonyms for caffeine in an ingredients list. She also details the physiologic metabolism of caffeine into byproducts theobromine and theophylline (which can be found on labels of nutraceuticals).

Consumers need to be aware of what they are ingesting. I found in the store some vitamin labels might list the name of a stimulant (like guarana or caffeine) and on the external package not print the amount (mg) in each tablet (which made me think at the time of purchase there was no caffeine in there). I didn’t recheck the bottle label inside the packaging until a few days later when I realized I was jittery and overstimulated and knew I hadn’t increased my coffee consumption. My One-A-Day multi-vit actually gave me as much caffeine as my morning coffee. Time to change vitamins, and be careful about reading those labels!

While I readily admit a ‘habit’ (do I really have to call it an addiction?) of a 16oz hazelnut coffee each day, I haven’t moved to even try a product like Red Bull. I am also reticent to drink Vitamin Water and other ‘nutritious’ drinks because the additives that make them ‘healthy’ are not familiar to me. What is taurine? (ok, I looked it up, it is an amino acid) And Glucuronolactone? (an artificially produced stimulant – so adds to the load of stimulant in Red Bull). I recognize some of the nutritional ingredients like niacinamide, pyridoxine and vitamin B-12, which worry me a little less. However it goes back to my argument about using nutraceuticals in general: where is the evidence to tell us the use of ingredients in this way is really healthy? In addition the labels don’t tell us how much of each ingredient we are ingesting, and we all know that many vitamins, minerals and nutritional products can have toxic effects if we ingest too much.

Health professionals are well aware that drugs interact with one another. In addition, at times substances that are seemingly ‘good’ for us have negative effects. This is the reason I don’t drink beverages like that. Nor would I allow my child to drink them! Particularly on a daily basis in high amounts. Do we have long term data on children's brain development to tell us this is not harmful? Do we have any long term data that tells us that these ingredients together won’t harm our kidney function in the future? Or other body systems? What happens 10 years out with daily high dose stimulant, taurine, glucuronolactone and other ingestion? (actually caffeine seems better to me given our lack of knowledge of these other ingredients and the high prevalence and long term use of caffeine in our culture… unless of course some of the common chronic illnesses are fed by caffeine – which of course hypertension is one).

Am I the only one who is worried about the marketing and unwitting consumption of ‘healthy’ beverages like this? I am pleased to see Nurse Practitioners considering the implications of stimulant beverage consumption by their clients. As mental health clinicians we can be no less vigilant...