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Energy Drinks: Is It Time To Tighten Regulation?

By Phungushead, Nov 6, 2010 | | |
  1. Phungushead
    Concerns about energy drinks have been gathering pace, with some groups, particularly in the US and the UK, now calling for them to be more tightly regulated and for greater public awareness of what they contain, their potential side-effects and risk of addiction.

    Although their history dates back to the early 1900s, energy drinks started coming into vogue in the 1970s and 1980s as performance-enhancing products sought by young people who wanted to prolong their enjoyment of physical activities.

    View attachment 17703 In the US, Gatorade was probably one of the first performance-enhancing drinks to be manufactured as such: it was originally produced by a team of researchers at the University of Florida in the 1960s in response to a request from the Gators football coach who was fed up with his team's performance during practices. The first Gatorade thirst-quenching formula included water, sodium, sugar, phosphate, lemon juice and potassium.

    In the UK, it was Lucozade that came to prominence: a beverage originally introduced in 1929 as a hospital drink for aiding recovery. In In 1938, Beecham (now GlaxoSmithKline) acquired Lucozade from its inventor W.W. Hunter, to enter the "health-drink field", and by the early 1980s Lucozade was being promoted as a drink to "replenish" lost energy.

    However, since then, public perception and consumption of energy drinks appears to have shifted from dietary supplementation to recreational use, and some might now even say, recreational abuse, with the latter perhaps boosted by the arrival of alcoholic energy drinks, the dangers of which have been illustrated with the recent hospitalization of nine US students aged 17 to 19, allegedly for consuming too much Four Loko, an alcoholic energy drink that is colloquially referred to as "blackout in a can" or "liquid cocaine".

    Energy drinks are "soft" drinks (that is non-alcoholic beverages) marketed as "energy boosters", but even under this definition, there is confusion, because often, the marketing that accompanies these drinks does not dwell on the sugars they contain (which is where energy comes from), but stresses other ingredients such as stimulants, vitamins and herbal extracts.

    The confusion around the expression "energy drink" has now escalated to a nonsensical level, with the arrival of products like Impulse Energy's Extreme brand, marketed as a "sugar-free energy drink"; while an even more peculiar contradiction in terms is the phrase "zero-carb, zero-calorie" energy drink, used to describe Impulse Zero: literally an energy drink that delivers no energy.

    So, if energy drinks aren't necessarily supplying us with energy, what is their appeal? The answer is, caffeine. And that is where the concern arises, for caffeine in excess, particularly for young people consuming too much too soon, can lead to some unpleasant, and dangerous symptoms.

    Consider the story of "Amy", whose first and she says now last, experience with energy drinks, was posted recently on the website of Think Before You Drink, a watchdog organization.

    Amy tells of when she finished high school and was asked to make the Valedictorian graduation speech. She spent weeks preparing the speech, and because she could not sleep the night before the big day, she felt "groggy" the next morning.

    As the moment to deliver the speech drew nearer, she felt her brain become "completely scattered". So she went to the vending machine and bought three cans of energy drinks and drank them all. She said she felt "great", like "a light bulb turned on in my brain", as she stepped up to the podium. She remembers greeting all her classmates, but then ... the next thing she knew she woke up in hospital.

    "Apparently I crashed hard, fainted, and ended up urinating myself," she wrote. She added that she has never "lived this down", and can't drink caffeine ever again. She asked the website owners to "share my story with your community".

    What happened to "Amy", was not surprising. Adults who drink tea and coffee regularly gradually build up a tolerance, but for young people, the risk of caffeine intoxication, especially if they have no tolerance, and drink too much too soon, is much higher.

    Caffeine is a compound that is naturally present in the leaves and seeds of many plants. Man-made forms are also added to foods. In its natural state it tastes very bitter.

    Caffeine stimulates the central nervous system and makes us feel alert, gives us a temporary energy boost and improves mood. It is not stored in the body but its effects can last for up to 6 hours.

    It is present in chocolate, coffee, tea and many soft drinks. It is also present in pain-relievers and over the counter medications.

    Caffeine intoxication is a clinical syndrome that is accepted by authorities such as the Diagnostic and Statistical Manual of Mental (DSM) Disorders and the World Health Organization's International Classification of Diseases (ICD). They say that caffeine intoxication can lead to nervousness, anxiety, restlessness, pacing (psychomotor agitation), insomnia, stomach upset, tremors, rapid heartbeat, and in rare cases, even death.

    View attachment 17701 In October 2008, one hundred scientists and doctors became so concerned they signed a letter to the US Food and Drug Administration (FDA), asking for regulation on energy drinks to be tightened up because their high caffeine content puts younger drinkers at risk of being intoxicated with caffeine.

    The letter was written by Dr Roland Griffiths, a neuroscientist at Johns Hopkins School of Medicine in Baltimore, who with his colleagues had just published a paper in the journal Drug and Alcohol Dependence, calling for clear labelling of energy drinks to show the amount of caffeine they contain.

    Griffiths said the caffeine content of energy drinks varies over a "ten-fold range": it is possible to buy a can of energy drink with the same amount of caffeine as 14 cans of Coca-Cola, and not realize this because there is no label showing how much caffeine it contains, and few include warnings about the possible health risks of caffeine intoxication.

    He and his colleagues reviewed caffeine levels in energy drinks widely sold in the US and found they varied from 50 mg of caffeine in a can of "Whoop Ass", to 505 mg in another called "Wired X505". For comparison, a standard 12-oz can of cola has about 35 mg of caffeine and a 6-oz cup of brewed coffee has between 80 and 150 mg.

    They also pointed out that since energy drinks are marketed in the US as "dietary supplements", they don't have to obey the FDA limit on the caffeine content of soft drinks, which is 71 mg for a 12-oz can, and they highlighted the curious inconsistency that exists where over the counter products containing caffeine have to carry warning labels while energy drinks do not.

    Griffiths told the press that since energy drinks first arrived, there has been a "sea change" in how they are being marketed.

    He said the FDA should require manufacturers to put warning labels on their energy drink cans, list their caffeine content on the cans, and limit the amount of stimulant they contain.

    Also in the UK, concern is growing about the amount of energy drinks being consumed by young people, including schoolchildren.

    Drug Education UK delivers drug awareness classes in schools. Their drug expert Bob Tait told a nursing conference reported by Nursing Standard magazine in September 2008 that they were becoming increasingly concerned about the growing problem of schoolchildren consuming energy drinks, which they say is causing them to become hyperactive and disruptive in class.

    Tait said drinking too many energy drinks can lead to caffeine intoxication and cause chest pains and headaches and asked that school nurses keep a lookout for such problems in schools.

    He said as he goes round schools giving talks to children he asks them who is drinking energy drinks like Red Bull and they put their hands up. He said there was one boy who was drinking eight cans a day, "that is too much", he added.

    One can of Red Bull energy drink has the same amount of caffeine as a cup of coffee.

    According to the manufacturer's information, Red Bull energy drink has been developed "for times of increased mental and physical exertion". They say their drink increases "performance, concentration and reaction speed", improves "vigilance and emotional status," and "stimulates metabolism". A spokesperson for the company told the BBC when they reported Tait's comments that their energy drink was not aimed at children.

    But Tait, who describes energy drinks as "fashionable", said part of the problem is that parents give the drinks to their kids, but he also blamed shopkeepers.

    There is also a worry that young people will fall foul of the "gateway" effect: where becoming addicted to energy drinks could make it more likely that they will move onto riskier substances. Marijuana, for example, has been termed a gateway drug because it has been linked to the increased use of alcohol and drugs.

    Dr Conrad Woolsey, Assistant Professor of Health and Human Performance at Oklahoma State University and a sport psychology consultant, talked earlier this year at a conference about his research on college students that suggests energy drinks could be the "next gateway drug".

    He told delegates at the American Alliance for Health, Physical Education Recreation and Dance (AAHPERD) conference in Indianapolis in March, that studies he and his colleagues carried out involving 700 students indicated that energy drink users "consumed more than double the amount of alcohol and had far riskier drinking habits than those who drank alcohol only". They also found that energy drink users were significantly more likely to practise risky behaviours such as drinking and driving and using amphetamines.

    Woolsey, whose research expertise includes brain chemistry, addiction and health behavior change, said that stimulants in energy drinks (for example guarana, ginseng, yohimbine HCL, evodiamine, yerba-mate, N-Acetyl-L-Tyrosine, and others) have similar effects on the brain's neurotransmitters dopamine, serotonin and epinephrine, as other drugs of abuse, and that adolescents and young adults are more vulnerable to addictions because their memory and reward centers in the brain are underdeveloped.

    He said it "makes sense for alcohol and energy drink advertising campaigns to target populations who are vulnerable to coercion and more likely to become long term users of their products", and as an example of this described how companies give students on campus free samples of energy drinks during athletic events and times of "increased academic stress", and then once they are "hooked", take advantage of their products' addictive properties and start charging high prices (2 to 4 dollars a can).

    Woolsey suggests that such aggressive marketing is how sales of energy drinks in North America have shot up from 200 million dollars in 2002, to 3.5 billion in 2006 and 4.7 billion in 2007.

    In the UK, the Food Standards Agency advises pregnant women to consume no more than 200 mg of caffeine a day, which according to their own advice is about 2 mugs of instant coffee, about 1.4 mugs of filter coffee, nearly 3 mugs of tea, and about 2.5 cans of "energy drink".

    They state their reason as high levels of caffeine can cause miscarriage, and result in babies having a lower birthweight, which increases their risk of developing health problems.

    Another emerging concern is the "alcoholic energy drink", which has a strong alcohol and caffeine content and appear in cans similar to non-alcoholic energy drinks. In November 2009, the FDA sent letters to nearly 30 manufacturers of these drinks demanding that they produce evidence that their "caffeinated alcoholic beverage" products were safe and wrote they would take regulatory action, including product seizures, if their information did not show adequate proof of safety.

    There has been no public announcement of what the FDA has done since their letter to the manufacturers, which has prompted a group of Senators to write to the FDA calling on them to make public their findings from their investigations into the possible health risks of alcoholic energy drinks.

    According to a news item from alcohol industry watchdog The Marin Institute, the senators also say that alcoholic energy drinks appear to be marketed to underage teenagers, and the labels and containers are so similar to non-alcoholic energy drinks, that they mislead parents and law enforcers.

    The problem of alcoholic energy drinks has been highlighted by reports last month that nine students from Central Washington University (CWU) were hospitalized after attending a party in Roslyn where about 50 people had been drinking.

    Chief of CWU Police Department, Steve Rittereiser, told the press that their investigation showed that every one of the hospitalized students had drunk Four Loko, an alcoholic energy drink that contains 12 per cent alcohol plus the equivalent of two shots of espresso.

    Thus a 23-ounce can of Four Loko contains the same amount of alcohol as about six beers and as much caffeine as in five regular cups of coffee.

    The nine students, six women and three men, were freshmen aged between 17 and 19 years and were inexperienced drinkers, reported the Money Times.

    Public health officials in the US are concerned that the increasing popularity of caffeinated alcoholic drinks like Four Loko among college students is increasing their risk of cardiovascular damage, and that it is also increasing their personal safety risk because the stimulant effect of the caffeine makes them think they are not as drunk as they really are.

    Washington State and New Mexico have now proposed legislation to ban the sale of alcoholic energy drinks.

    For concerned parents, and others who would like to be kept informed of what goes into our food and drink, especially if it contains substances that could be harmful when taken in excess, it does not seem unreasonable to ask for content information to appear on the packaging.

    Then we can all make up our own minds and take responsibility for our own consumption and its effects on our health.

    Sources: USA Today, Marin Institute, thinkdrink.org, sciencecases.org, MNT archives, BBC News, Money Times, AAHPERD Abstracts (March 2010), Guardian, wikipedia, FSA.

    Note: this article was amended 2 Nov 10 to take out an uncorroborated reference to comments reportedly made by former Surgeon General of the United States, David Satcher on the potential "gateway" effect and to insert the notes on Conrad Woolsey's research.

    02 November 2010

    Written by: Catharine Paddock, PhD

    View attachment 17701

    View attachment 17702

    View attachment 17703


  1. Code9
    "Medical News Today" is a medical tabloid rather than a new source. The quality of this and their articles are absolutely terrible and only serve to feed hypochondriacs.

    "Real" medical texts and editorials wouldn't use USA Today, wikipedia and all the others here as sources.

    This sentence is full of propagandist rhetorical devices but doesn't say anything at all. The sentence doesn't connect the hospitalizations with the energy drinks, but it provokes the reader to read between the lines and assume that the hospitalizations were due to mixing. It states that 50 people were drinking, but doesn't say what and how much they were drinking. Also the author cites "reports" as source for her information which means her argument is entirely built on hearsay.

    Every sentence in this article is written with this pathetic kind of ambiguity.

    This kind of stuff is funny to read and fun to critique but it doesn't add much to DF.
  2. C.D.rose
    Well, I don't think that the question of the status of energy drinks can somehow be likened to the question of the status of drugs as discussed on this forum, but, that being said, I do find it - how can I say - "peculiar" to see the widespread use of caffeinated drinks (whether it's coffee or Red Bull) among school-"children" and students. I mean, everyone who's fashionable comes to school with a coffee-to-go, I don't think that that is good or healthy. I am not in favor of regulating access to coffee or anything, and I think the underlying problem, with adults just as much as with teenagers, is the lack of knowledge of one's own mental and physical capabilities. Coffee cannot permanently offset a lack of sleep, and yet that's what many people seem to believe how it works. I don't really get that, because I notice when I am not really up to my full capacities, and I hate that feeling, but it seems to me that others sometimes mistake alertness for being fit and "capable". I believe that many of the people at my age would be healthier if they slept one hour more at night and drank one cup of coffee a day less.

    Of course, though, this "coffee craze" is just the immediate effect of kids seeing adults doing the same thing.
  3. sparkling_star
    I think it's funny that in every class I've taken that has discussed substance abuse and dependence, caffeine has been explicitly discussed as a substance that is not addictive. Now, depending on which definition you would like to use of addiction (I'll go with the more common and less medical usage), common sense tells anyone who regularly uses caffeine that it has some kind of addictive qualities--those painful headaches are so common some researchers want to create a diagnostic tool for those who do use caffeine regularly to see if they are addicted or not.

    The reason I mention this is only because I find it funny that the government basically says caffeine isn't dangerous and addictive and whatever else until they want to consider regulating it--and then the worst case scenarios start popping up like mad.

    I wish parents would not load their children with caffeine, but I disagree with regulating yet another substance (this one clearly used by millions without harmful effects).
  4. war209
    Health Minister may label energy drinks as 'drugs'

    Read more here: http://www.canada.com/health/Health+Minister+label+energy+drinks+drugs/5506771/story.html#ixzz1Zw7sOIZR

    Wow this is the first time I read you can get high of energy drinks !!! And now the government is peeing their pants that young people are getting high off energy drinks !!

    It is all over the news here today.

    I'm like what !!! This is the first time I read people getting high of energy drinks .

  5. DiabolicScheme
    Absolutely love how they use a overdose situation as an indication of how dangerous energy drinks are. Literally anything when taken in excess amounts can cause some sort of damage, even water.

    Though I do think they should require them to list the amount of caffeine per serving on the drinks, some don't contain them or they are included under "energy blend" ingredients which don't show the amount.

    Other than that this article is nothing more than propaganda, I mean a gateway drug? Get real.
  6. jon-q
    Government eyes popular malt liquor Four Loko.

    A carbonated brew guzzled on college campuses is the focus of an intense write-in campaign urging federal regulators to take some buzz out of a sweet alcoholic drink sometimes referred to as "blackout in a can."

    The Federal Trade Commission is looking at a wave of complaints about the popular fruit-flavored malt liquor Four Loko. Under review: the amount of alcohol in the brightly colored, supersized cans and how they are marketed.

    The drink gained national attention in 2010 following the hospitalization of college students in New Jersey and Washington state. Some states banned the drink, worried about the caffeine in Four Loko and its potential to mask how much alcohol one could safely consume. Amid a crackdown by the Food and Drug Administration, the drink's makers removed the caffeine and started selling Four Loko without the energy kick but with plenty of alcohol.

    The FTC charges that the drink's creator, Chicago-based Phusion Projects, has implied in ads that its 23.5-ounce can is equal to one or two regular 12-ounce beers. The agency says the can, which contains up to 12 percent alcohol, is really more like four to five beers and shouldn't be consumed in one sitting.

    Under a deal the agency brokered late last year with Phusion, new labels would be required on its products with more alcohol than 2-1/2 regular beers, and they would have to state how much alcohol, compared with a regular beer, is in the drink. The can also would have to be redesigned so that it can be resealed and would not necessarily need to be downed in one sitting.

    Before a final vote to implement the settlement, the FTC asked the public to offer comments. Sentiment has been overwhelmingly against the deal.

    More than 200 opposing comments were received, many saying the deal doesn't go far enough and some wanting a ban on the product — something the FTC does not have the authority to do. About a dozen comments expressed support for the agreement.

    It is rare for the commission to get this many comments on a proposed settlement. In its recent privacy settlement with Facebook, which has 845 million users, the FTC received only 59 comments.

    One commenter on Four Loko, Maryann Strauss, wrote the agency, "Please reconsider ... and save all of us a lot of heartache, headaches and money."

    Another, Julie Bos of the Van Buren/Cass District Health Department in Michigan, wrote: "In light of the evidence about the dangers of supersized alcopops, especially with underage drinkers, this agreement is unacceptable. Please withdraw this agreement and require much stronger changes from Phusion Products and other alcopop producers to protect public safety and health."

    The American Medical Association is also opposed, as is the Beer Institute, an industry lobbying group that says it would be unprecedented in U.S. alcohol-labeling history to compare the alcohol content of one product with the alcohol content of another.

    The FTC's Janet Evans says there are limits to the commission's authority.

    "If I had a magic wand, this would be a smaller product with less alcohol," Evans, a senior staff attorney, said in an interview. "But I do not have a wand. I operate within my agency's jurisdiction, and the FTC does not have the jurisdiction to ban this product or to force a company to limit its size or potency."

    What the commission can do, Evans said, is regulate how alcohol is marketed to prevent deception about alcohol content.

    Phusion said it could not comment on the pending settlement. The company has maintained that its packaging does not contain statements or graphics that are misleading or intended to attract underage drinkers. Brightly colored packaging and products with higher alcohol by volume than regular beer have been in the marketplace for years, the company has said.

    The settlement with Phusion has also attracted the attention of more than 30 state attorneys general who want a stronger agreement.

    Led by attorneys general Douglas Gansler of Maryland and Mark Shurtleff of Utah, the group wrote the FTC to express its concerns about young people and binge drinking. The AGs are asking the commission to limit Four Loko to two servings of alcohol per can — the equivalent of two regular beers.

    As precedent, they cite a 1991 case involving the Canandaigua Wine Co. and its marketing of a high-alcohol wine called Cisco.

    The FTC said Cisco's packaging and advertising misrepresented it as a low-alcohol wine cooler, leading to the alcohol poisoning of several consumers. Canandaigua was ordered to stop representing the wine as a low-alcohol, single-serving product.

    Evans says that case required changing the product's packaging, but didn't limit the amount of alcohol or the size of the containers. She says states can limit what kinds of malt beverages can be sold within their borders, but no federal agency has that authority.

    A final decision from the FTC on the settlement — whether to approve it or change it — is expected in the next couple of months.

    JENNIFER C. KERR Associated Press
    ABC News 1st March 2012

  7. Terrapinzflyer
    For the record- the case at central washington university had originally been reported by the always on top of it press as a "date-rape drug" spiking...and was discussed here: Dozen girls OD on date-rape drug spiked vodka

    I will say I have misgivings about the rise in caffeinated alcohol drinks. I think they are predominantly targeted at younger users, and that caffeine tends to counteract one of the natural warning signs of alcohol- sleepiness, or its acting as a depressant. And while adding something that may allow people to drink more may be a brilliant sales ploy, I do find it rather distasteful...

    But my dog! a ban on caffeine/alcohol mixtures could outlaw one of my favorite drinks after a fine dinner- Irish coffee :eek:

    But I do hope that in the not too distant future, as we move to legalizing more drugs- that the realization that advertising and marketing is often counterproductive to the aims of harm reduction that the abuses the alcohol and tobacco companies have so long gotten away with will be curtailed.
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