Wednesday, February 16, 2011

Energy Drinks - A Quick Fix Cover Up

Six in the morning comes way too early for that annoying alarm clock when all you want to do is sleep another 15 minutes.  But, unfortunately, that's the last thing you can afford to do at least if you want to make it to work or class on time.  And then once you've made it to your desk those eyelids feel like they're anchored down with 12 lb bowling balls.  All you want is some energy.  So what do you do?

Energy drinks to the rescue!!  Right?  How about not right.  While those 2-oz shots or 16-oz beverages may pack a punch in getting you back on track in the middle of a dreaded Monday morning they are simply a quick fix that carry potentially harmful health effects.

What's In Those Drinks Anyways?

The two major ingredients in most energy drinks are caffeine and sugar which is why you get a "rush" not long after swigging down one of these puppies.

The average amount of caffeine contained in a 16-oz energy drink is approximately 150-200 mg.  A 12-oz soda contains approximately 40-50 mg of caffeine and a 6-oz cup of coffee contains approximately 100 mg of caffeine.  Keep in mind that the caffeine content of energy drinks, soda, and coffee all vary depending on the brand you drink.  Not only do energy drinks contain caffeine but they also may contain ingredients such as guarana or yerba mate which are additional sources of caffeine.

Sugar is also a favorite ingredient for manufacturers to add to energy drinks.  The original 16-oz Monster energy drink contains 54 grams of sugar.  The original 16-oz Rockstar energy drink contains 62 grams of sugar.  Both of these drinks contain more than Mountain Dew which is considered to be one of the highest sugar containing sodas on the market.  A 12-oz Mountain Dew contains 46 grams of sugar.

But what about the sugar free versions of all those energy drinks?  Well, they may be sugar free but that doesn't mean they don't try and compensate for that with artificial sweeteners.  Most sugar free versions of energy drinks use one or more of the following artificial sweeteners - Acesulfame K or Ace-K (Sunett or Sweet One), Sucralose (Splenda), Saccharin (Sweet 'N Low), or Erythritol.

So What's So Bad About Energy Drinks?

While energy drinks have been shown to significantly increase focus and attention in subjects [1] these effects only lasted about 90 minutes [2].  So energy drinks are clearly only quick fixes for the fatigue that we may be feeling due to lack of sleep, lack of exercise, or even poor nutrition.  There are also some health risks that may be associated with consuming energy drinks especially if you opt for drinking more than one on a regular basis.  Let's take a look at what a few of these are.

1)  Caffeine - This substance is a central nervous system stimulant and when used in moderation is not harmful to the human body.  According to the Mayo Clinic moderation would be considered 200-300 mg/day of caffeine.  This would be equal to one 16-oz energy drink.  One drink won't overload you on caffeine but if you drink another one or add in a few sodas or a cup of coffee on top of that you can easily get more caffeine than you need.  In all actuality, the human body has no biological requirement for caffeine [3].  What it does require is sufficient sleep.  In fact, one study showed that napping 60-90 minutes improved memory function more than a 200 mg dose of caffeine did [4].

Acute caffeine consumption has been found to lead to insulin resistance [5] which is not welcome news for diabetics who love their energy drinks.  Regular consumption of high amounts of caffeine have also been found to be a risk factor for chronic daily headaches [6].  There are also cardiovascular concerns that have been raised with high caffeine intake.

One other area of concern with caffeine in energy drinks was brought to light in the fall of 2010 when the FDA banned caffeine in alcoholic energy drinks as discussed in a recent JAMA article.  The ban was put in place because the combination of caffeine and alcohol led to drinking higher volumes of alcohol, prolonging the drinking sessions, and a higher prevalence of risky behaviors including sexual assaults and DUI's [7].  The article also spoke of a possible risk between the consumption of energy drinks and alcohol dependence and prescription drug abuse regardless if energy drinks were mixed with alcohol or not [7].

2)  Sugar - There is obviously a tremendous amount of sugar in many of these drinks.  And it comes in the form of simple sugars too which have been shown to lead to a spike in blood sugars also known as a "sugar high" followed by a crash when the blood sugars quickly fall back again.  This can lead to fatigue, lethargy, and headaches.  In a study done on college students who regularly consumed energy drinks there was a significant dose related effect associated with these "jolt and crash" episodes so the more drinks that were consumed the more likely a "jolt and crash" episode was to occur [3].  Not exactly what you were looking for to get you through that Monday morning.

3)  Artificial Sweeteners - Those zero calorie or low carb energy drinks might be appealing for those "health conscious" individuals out there looking for a better option than the sugar packed original energy drinks but don't be fooled because the artificial sweeteners they contain do not exactly promote health.  In fact, artificial sweeteners such as saccharin have been shown to increase appetite due to their sweetness leading to the consumption of more calories for individuals at their next meal [8].  Sucralose has also been reported to be a possible trigger for migraine headaches in some individuals [9].

There is a lot of controversy over whether or not artificial sweeteners pose harmful health risks and one of the biggest reasons for this is that there are no long term studies to determine this in humans.  Many of the short term studies have been sponsored by the food industry.  Until long term studies that are performed by third party independent testers without the potential for bias come forth it's really hard to prove beyond a shadow of a doubt if artificial sweeteners are bad for you or not.  What is interesting is that much of the talk in the medical community focuses on whether or not these substances pose health risks instead of whether or not they actually promote positive health outcomes.  That in and of itself speaks volumes to the fact that if you are trying to achieve optimal health then consuming artificial sweeteners isn't going to help you get there.

To Summarize

Energy drinks have become wildly popular in recent years especially with the younger generation of adolescents and college age kids.  Their contents may improve your ability to function and stay alert in the short term but they also come with many downsides that far out weigh any benefits they may give.  Their high caffeine and sugar content don't bode well for your overall health.  And the artificial sweeteners in the low or no calorie versions aren't exactly the picture of health and vitality that some are led to believe.

You're best bet is to drink what we all require to stay alive - ice cold, refreshing water!  Or if you need to add some flavor to your life then try some green tea, a smoothie, or 100% fruit juice.  And if it's really a boost of energy that you're looking for then nothing beats getting back to the basics by eating a healthy diet, exercising regularly, and developing better sleeping habits.

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by Dustin Rudolph, PharmD
Clinical Pharmacist

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1 van den Eynde F, van Baelen PC, Portzky M, Audenaert K. The effects of energy drinks on cognitive performance. Tijdschr Psychiatr. 2008;50(5):273-81.
2 Smit HJ, Cotton JR, Hughes SC, Rogers PJ: Mood and cognitive performance effects of "energy" drink constituents: caffeine, glucose and carbonation. Nutritional Neuroscience 2004 , 7:127-139.
3 Malinauskas BM, Aeby VG, Overton RF, Carpenter-Aeby T, Barber-Heidal K. A survey of energy drink consumption patterns among college students. Nutr J. 2007 Oct 31;6:35.
4 Mednick SC, Cai DJ, Kanady J, Drummond SP. Comparing the benefits of caffeine, naps and placebo on verbal, motor and perceptual memory. Behav Brain Res. 2008 Nov 3;193(1):79-86.
5 Lee SJ, Hudson R, Kilpatrick K, Graham TE, Ross R: Caffeine ingestion is associated with reductions in glucose uptake independent of obesity and Type 2 diabetes before and after exercise training. Diabetes Care 2005 , 28:566-572.
6 Scher AI, Stewart WF, Lipton RB: Caffeine as a risk factor for chronic daily headache: A population-based study. Neurology 2004 , 63:2022-2027.
7 Arria AM, O'Brien MC. The "high" risk of energy drinks. JAMA. 2011 Feb 9;305(6):600-1.
8 Rogers PJ, Blundell JE.   Separating the actions of sweetness and calories: effects of saccharin and carbohydrates on hunger and food intake in human subjects. Physiol Behav. 1989 Jun;45(6):1093-9.
9 Patel RM, Sarma R, Grimsley E. Popular sweetner sucralose as a migraine trigger. Headache. 2006 Sep;46(8):1303-4.


  1. Aww man.
    This was one great, informative article. Just NOT what I wanted to hear, ha! I soOo look forward to my morning monster drink, Dustin. I have one left in the fridge...hmmmmm. I think I may go look into green tea instead. Thanks for your brutal dose of honesty- I wonder if there's a ten step program for those coming off these?

    Truly though thanks for such an in-depth article, I'm passing on to my friends ;) Keep up the great work!

  2. Now let's be honest; no one said Monster Lo-Carb (my personal choice) was pure, freshly squeezed fruit juice that will work wonders for your body. But it's not harmful when used as an occasional "upper" for most of us. Unless one has an allergy to the ingredients in the drink, they are a great way to give a boost of energy. They can even aid in weigh loss and they act as very mild appetite suppressants.

    Don't attack something just because it isn't as healthy as an organic product. It's actually just a bit behind coffee in terms of health value. And people have been drinking that for years. No ill affects.

    Please, be reasonable.


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