ReviewsSafety issues associated with commercially available energy drinks
Section snippets
Objective
The purpose of this review is to identify the potential for any benefits or adverse effects (AEs) associated with the consumption of energy drinks.
Methods
Searches were conducted using the terms energy drink, sports drink, Red Bull, caffeine, glucose, ginseng, guarana, taurine, bitterorange, ephedra, alcohol, efficacy, and safety using databases such as Medline, IPA (International Pharmaceutical Abstracts), EMBASE, and MANTIS (range 1980 to September 2007), as well as Natural Medicines Comprehensive Database, Natural Standard, ALTMEDEX, and AltHealthWatch. Internet search engines such as Google were also used to locate relevant information. In
Overview of ingredients
Ginseng, taurine, bitter orange, guarana/caffeine, and glucose are among the most common ingredients used in energy drinks. They are used in combination for their real or supposed synergistic effects of increased stimulation. Each of these popular components is discussed in detail in the following sections.
Ginseng
Many varieties of ginseng exist. The most commonly studied variety is Panax ginseng, also known as Korean or Asian ginseng, which is found principally in Korea, Japan, and China.6 Other names
Additional health issues
Energy drinks have been implicated in a number of health-related concerns in recent years. Their effects range from being a contributing factor in obesity to exacerbating symptoms in manic phases in patients with bipolar disorder to causing new-onset seizures. Effective identification of and intervention in at-risk patients by pharmacists is essential. Examples of the potential negative impact of energy drinks and their components on health are provided below.
Discussion
Although all of the natural products contained in energy drinks are touted for their use in various diseases and conditions, with several demonstrating some efficacy at improving either energy or cognitive function, recognizing that energy drinks generally do not contain the therapeutic doses of “natural” dietary supplements necessary to achieve these effects is important. Manufacturers would like consumers to believe that consuming energy drinks has beneficial health effects as opposed to
Conclusion
Little evidence exists in the literature to support beneficial effects of energy drinks. Mechanistically, purported benefits are equally unlikely because the amounts of guarana, taurine, and ginseng found in popular energy drinks are far below the amounts expected to deliver therapeutic benefits. Similarly, the potential for serious AEs is improbable because of the small amounts of those natural products added to the drinks. However, energy drinks can present a safety concern. In particular,
References (55)
- et al.
Ginseng as a cause for Stevens-Johnson syndrome?
Lancet
(1996) - et al.
Therapeutic trial by taurine for intractable childhood epilepsies
Brain Dev.
(1982) Effects of taurine on alcohol withdrawal
Lancet
(1977)Taurine: an overview of its role in preventative medicine
Prev Med.
(1989)- et al.
Biochemical observations following administration of taurine to patients with epilepsy
Brain Res.
(1975) - et al.
Hemodynamic effects of ephedra-free weight-loss supplements in humans
Am J Med.
(2005) - et al.
Exercise-induced syncope associated with QT prolongation and ephedra-free Xenadrine
Mayo Clin Proc.
(2004) - et al.
Effects of Citrus aurantium extract, caffeine, and St. John's wort on body fat loss, lipid levels, and mood states in overweight healthy adults
Curr Ther Res.
(1999) - et al.
Caffeine fatalities: four case reports
Forensic Sei Int.
(2004) - et al.
Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome
J Am Diet Assoc.
(2002)
New-onset seizures in adults: possible association with consumption of popular energy drinks
Epilepsy Behav.
Secondary mania caused by caffeine
Gen Hosp Psychiatry.
Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity
Am J Clin Nutr.
Effects of sports drinks and other beverages on dental enamel
Gen Dent.
Students ride a wave of caffeine to study hall
Billionaires: the soda with buzz. Accessed at
FDA warning letter regarding Cocaine
Redux beverages parties bi-continental style.
Panax ginseng
Am Fam Phys
Natural Medicines Comprehensive Database
Natural Standard: the authority on integrative medicine
Evaluation of the ergogenic properties of ginseng: an update
Sports Med.
Effects of ginseng on secretory IgA, performance, and recovery from interval exercise
Med Sci Sports Exer.
Caffeine content of energy drinks, carbonated sodas, and other beverages
J Anal Toxicol.
BEVNET. Beverage reviews
The ultimate energy drink: Cocaine? ABC News
Ataurine and caffeine-containing drink stimulates cognitive performance and well-being
Amino Acids.
Cited by (196)
Flying high?—Exploring the effect of red bull on blood pressure after microsurgical breast reconstruction in a randomized controlled trial
2024, Journal of Plastic, Reconstructive and Aesthetic SurgeryEfficacy of caffeine on athletic performance: A systematic review and meta-analysis
2022, Science and SportsThe “big red bull” in the esports room: Anti-doping, esports, and energy drinks
2022, Performance Enhancement and HealthCaffeine and high energy drink use and knowledge by nurses in three countries
2021, Applied Nursing ResearchMeals/food/diet/caffeine/hydration
2021, Pediatric HeadacheFrom Boost to Burden: Investigating Energy Drinks and Myocarditis
2023, Research Square
Continuing education credits: See learning objectives below and assessment questions at the end of this article, which is ACPE universal program number 202-000-08-142-H01-P in APhA's educational programs. The CE examination form is located at the end of this article. To take the CE test for this article online, go to www.pharmacist.com/education and follow the links to the APhA CE center.
Disclosure: The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria.
Acknowledgments: To the following students for assisting with manuscript preparation: Princess Dorvilien-Scutt, Franky Jean, and Carrie Starkey.
Published concurrently in Pharmacy Today and the Journal of the American Pharmacists Association.