Energy Drinks and Hospitalizations Checklist: How to Ask The Right Questions

It’s happened again: someone was admitted to the hospital after consuming an energy drink. Reporters covering the story warn readers about the dangers of energy drinks…something is missing. In this post, I’ll review real headlines about energy drink to demonstrate how the omission of a few minor details hurts consumers, as well as the scientists who study energy drinks.

If you read a news story about someone being hospitalized because of a vegetable, you’d have some questions.

On the surface, the mere idea sounds ridiculous.

“Hospitalized…because of a VEGETABLE? People eat veggies all the time without dying, why would someone go to the hospital?”

In fact, leafy green vegetables were the number one source of foodborne illnesses from 1998-2008. Moreover, this hypothetical news story is a perfect example of how asking the right questions can save lives.

When someone is hospitalized because of a vegetable, scientists and doctors are able to piece together the clues and figure out whether or not to issue a recall, if so, what food and even what brand and lot numbers. The end result is information which saves people from eating something that could hurt them. If only we could do the same thing for energy drinks.
(Hint: we are not)

When it comes to energy drink-related hospitalizations, we are not asking the right questions. There are several examples of real energy drink news stories where small but critical details were omitted. Not only does this hurt consumers, but it also hurts scientists who desperately need this data to study the health effects of energy drinks.

The good news is these missing critical details can be summed up in just five questions.
Yes, just FIVE QUESTIONS!
Let me walk you through these five questions and why they matter so much, using real news stories about energy drink-related hospitalizations.

Have we met? I’m Danielle, the “GreenEyedGuide”.
I started studying biochemistry in college the same year Monster Energy hit US markets. Ever since, I’ve put my education to use studying the science behind caffeine and energy drinks. I’ve always been disappointed with the black-and-white “Energy Drinks Will Kill You” messaging because the science is a lot more complex…after all, how can coffee be so good and other forms of caffeine be so bad? My goal is and always has been to answer questions about these controversial energy drinks using the latest research so people can decide what’s right for them based on facts, not fear.
Read more

GreenEyedGuide Caffeine Challenge Day 3/10 – Alcohol and Caffeine (Friday Night Dilemma)

For Day 3 of the GreenEyedGuide Caffeine Challenge, we discuss the Friday Night Dilemma: what do you do when you get tired at 10 pm but you want to enjoy a night on the town and have an alcoholic beverage?

References in the video - FoodNavigator on the DAWN report and Caffeine Informer on alcohol and energy drinks

March is Caffeine Awareness Month – Join the Caffeine Challenge!

Through this challenge, you’ll learn how to use the 5 Levels of Fatigue to reap the benefits of caffeine while avoiding addiction, dependence, tolerance, and toxicity.

PLAY ALONG – post a picture of your WAKE-UP tool/trick on Instagram and tag @GreenEyedGuide, or add your pictures to the Caffeine Challenge Event page at Facebook.com/GreenEyedGuide/events

Open letter to Time regarding energy drink article in “The Answer Issue”

Greetings Ms. Nancy Gibbs and Time Staff,

Normally, I find Time Magazine articles engaging and insightful but the article “Energy drinks have doctors worried—but business is booming” by Ms. Alexandra Sifferlin was severely disappointing.

Did you know that the top-selling energy drink has less caffeine and less sugar per serving than a tall mocha from Starbucks? The Issue Contents page features the question, “Should your kid drink Red Bull”, but Original Red Bull has 80 mg caffeine, 27 g sugar in 8.46 fl oz can versus the 90 mg caffeine, 35 g sugar in tall (12 oz) cafe mocha. This is not to say Red Bull is without its hazards. In fact, the biggest hazard with Red Bull is the alarming frequency with which this drink is mixed with alcohol! Unfortunately, the dangerous combination of alcohol and energy drinks was completely omitted from this article. Read more

Energy Drinks and the ER – perspective

Energy drinks are in the news again, and this time the story is the reported increase in emergency room visits attributed to energy drinks. Consider this brilliant article from Food Navigator USA:
DAWN report on energy drinks and ER visits Correlation is not causation but something is going on here

A few very important points:

* 42% of the visits attributed to energy drinks also involved alcohol or other drugs
Mixing alcohol and energy drinks is indeed very dangerous, as people feel more alert but still have impaired reflexes: “The mix of behavioral impairment with reduced fatigue and enhanced stimulation may lead AmED (alcohol mixed with energy drinks) consumers to erroneously perceive themselves as better able to function than is actually the case.” Published Study: Effects of energy drinks mixed with alcohol on information processing, motor coordination and subjective reports of intoxication.

* The Drug Abuse Warning Network (DAWN) report doesn’t include any data on how much caffeine was consumed prior to the emergency room visit, or over what period of time it was consumed
“…for the healthy adult population, moderate daily caffeine intake at a dose level up to 400 mg day(-1) (equivalent to 6 mg kg(-1) body weight day(-1) in a 65-kg person) is not associated with adverse effects…”Published Study: Effects of caffeine on human health

* DAWN project leader Albert Woodward poses a crucial question: if it’s the high caffeine from the energy drink causing the trips to the ER, why don’t people who’ve consumed high caffeine intakes from coffee come in to the ER?
This is the million dollar question, because we don’t know if the people admitted to the ER have had multiple energy drinks or energy shots in a short amount of time or if they were using the product as directed. How long does it take to drink one energy shot? How long does it take to make/brew/buy coffee? 

Are those admitted to the ER an indication that energy drinks (including energy shots) have some inherent danger that isn’t apparent from the Generally Recognized As Safe ingredients on the label, or should we suspect these people are not using the product as intended – like a small child that likes the taste of vitamin gummies so much they eat half the jar? Would limiting energy drinks to single-serving containers alleviate the problem? (Perhaps, but go ask a New Yorker how much they like it when you try to limit their sodas to single-serving size)

No one knows whether energy drinks are inherently dangerous when used as directed, because the people making the news aren’t always following the instructions and warnings on the label.  We should be cautious of using and abusing these products. We should keep monitoring the situation and collect as much data as possible about all the circumstances involved.

Remember these words from the “Father of Toxicology”, Paracelsus:
All things are poison, and nothing is without poison; only the dose permits something not to be poisonous.

Or, as the band Circa Survive put it, “The Difference Between Medicine And Poison Is In The Dose.”

Other Resources:

Published Review (FULL TEXT – FREE): Caffeine (1, 3, 7-trimethylxanthine) in Foods: A Comprehensive Review on Consumption, Functionality, Safety, and Regulatory Matters 

Letter from FDA to Senator Durbin, addressing his concerns about energy drinks: (available as a pdf file through a link within this article from Food Products Insider)
FDA Tells Durbin It’s Investigating Safety of Energy Drinks