Energy drinks are a type of liquid product that frequently contain caffeine, with or without the addition of other dietary supplements. In 1949, “Dr. Enuf” was the name of the country’s first energy drink. They were originally introduced in Europe in 1987, and after that the market grew globally and they gained enormous popularity following the introduction of Red Bull in 1997. Since then, numerous brands have been introduced globally, and the market for energy drinks has increased significantly. In 2013, more than 5.8 billion liters of energy drinks were consumed annually across around 160 nations. Energy drink sales in the United States were expected to have reached 12.5 billion USD in 2012, a 56% rise from the market’s size in 2006 to 2002.
Now, manufacturers have turned their attention away from athletes and toward young people as consumers. Advertising for energy drinks is strong in locations where teens and young adults congregate. Between the ages of 13 and 35, boys make up around two thirds of the market for energy drinks. Energy drinks are the second most popular dietary supplement taken by young people in the United States; roughly 30% of them regularly use them. Energy drinks appear to be equally popular over the world, including in the Kingdom of Saudi Arabia. The majority of Saudi University students who took part in the study acknowledged that they regularly consume energy.
The safety of these items has recently been the subject of serious questions. Several studies have revealed harmful health impacts linked to energy drinks. Despite this, producers of energy drinks assert that their drinks are suitable for customers and secure. In reality, scientists continue to debate the negative health impacts of energy drinks. There are few thorough literature evaluations that explain in full the suitability and safety connected to the usage of energy drinks, especially among young individuals. Here, we examine the evidence on the positive and negative health impacts of using energy drinks.
Energy drinks’ potential negative consequences in relation to their constituents
Notwithstanding the infrequent instances of cardiac arrest brought on by excessive ED use, frequently documented side effects include alterations to the cardiovascular system (such as tachycardia—rapid heartbeat, high blood pressure (BP)), digestive system, and nervous system (such as anxiety, agitation).
1. The cardiovascular system
Many studies have demonstrated an increase in heart rate and arterial blood pressure following the ingestion of energy drinks. These results were linked to the ergogenic properties of the energy drink’s caffeine concentration. In addition, excessive energy drink use has been linked to serious cardiac symptoms like ventricular arrhythmias, ST segment elevation, and QT prolongation. Atrial fibrillation has also been linked to the consumption of high-energy beverages in two young, healthy boys (ages 14 and 16). Lately, myocardial infarction in healthy 17- and 19-year-old boys has been linked to energy drink usage. This conclusion has been confirmed by research showing that, in healthy young adults, ingesting energy drinks decreases endothelial function and increases platelet activity through arachidonic acid-induced platelet aggregation. Recent studies have shown a connection between excessive energy drink consumption and major artery rupture, dissection, and aneurysm formation.
2. Psychological and neurological impact
Caffeine intoxication symptoms typically appear in people who consume 200 mg or more. Anxiety, sleeplessness, gastrointestinal distress, twitching muscles, restlessness, and spells of inexhaustibility are among the symptoms. Moreover, excessive coffee consumption promotes a pro-nociceptive state of cortical hyperexcitability, which is linked to both acute and persistent daily headaches. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, has identified four caffeine-associated psychiatric disorders: caffeine intoxication, caffeine-induced anxiety, caffeine-induced sleep disturbance, and caffeine related disorder.
Caffeine consumption and violent behavior, as well as conduct issues, are strongly correlated, according to a research of 15- to 16-year-old teenagers. According to several investigations, energy drinks may cause epileptic seizures and ischemic strokes. If a person consumes more than 300 mg of caffeine per day, hallucinations may occur. This might be explained by the high levels of cortisol that follow coffee consumption. Stress’ physiological effects are amplified by cortisol, which makes people more likely to have hallucinations. According to in vitro research, caffeine, taurine, and guarana may increase and promote apoptosis by lowering the activity of the enzymes superoxide dismutase and catalase in human neuronal SH-SY5Y cells.
3. Metabolic and digestive effects
Sugar content in energy drinks typically ranges from 21 g to 34 g per ounce. The majority of the sugar is present as sucrose, glucose, or high fructose corn syrup. As a result, consuming a lot of energy drinks may make you more likely to develop type 2 diabetes and obesity. Moreover, the high sugar content in energy drinks may decrease the diversity, activity, and gene expression of gut bacteria, increasing the risk of metabolic syndrome and obesity. Acute caffeine consumption reduces insulin sensitivity, which may account for the increase in blood glucose levels observed after consuming energy drinks as reported in several studies. With an increase in insulin of 5.8% for every mg/kg increase in caffeine, Beaudoin et al. showed that caffeine use decreases insulin sensitivity in a dose-dependent way.
After consuming too many energy drinks, a woman was found to have jaundice, severe abdominal discomfort, and extremely increased liver enzyme levels. The similar result was noted in a 36-year-old man by Huang et al. More research is required to ascertain who is most at risk and the underlying mechanism by which energy drinks harm the liver.
4. Kidney effects
It has been demonstrated that the caffeine in energy drinks promotes diuresis. Due to the risk of dehydration, energy drinks should not be consumed during extended exertion in a hot environment. According to studies, a 1.5% level of dehydration after extended activity may cause an increase in body temperature, heart rate, and perceived exertion.
Moreover, caffeine increases salt excretion in the urine (natriuresis), which affects plasma volume and significantly alters cardiovascular performance during exercise. Furthermore, a sodium imbalance that results from prolonged exercise in a warm environment may lessen the isometric power in the legs. After using energy drinks every day for around 2-3 weeks, a 40-year-old man developed an acute renal insult, according to Greene et al. Two days after energy drink use was stopped, the serum creatinine climbed five times from the starting point and reverted to normal.
5. Dental outcomes
An extensive link between energy drinks and tooth degradation was found in a Swedish study. Similar findings were also shown in American youngsters by Marshall et al. Dental erosion increased by nearly 2.4 times after using energy drinks. This has been related to energy drinks’ high sugar content and low pH. Moreover, Pinto et al. discovered that by eliminating the smear layer from the teeth, use of energy drinks may cause cervical dentin hypersensitivity.
6. Positive results
The high caffeine content in energy drinks gives users the desired effects of better memory, enhanced alertness, and improved mood. The study carried out by Alford et al. has received the most citations. They looked at 36 people’s reactions to an energy drink that leads the market. Measures covered subjective alertness, physical endurance, and psychomotor performance (reaction time, focus, and memory). They demonstrated that the investigated energy drink considerably improved aerobic performance (maintaining maximum speed) and aerobic endurance (maintaining 65-75% of maximum heart rate) on cycle ergometers.
Significant improvements in memory, choice reaction, focus, and other mental skills suggested elevated subjective alertness. Another study found that when young, physically active volunteers do the “Wingate cycle” repeatedly, the same brand energy drink dramatically boosts their upper body muscle endurance. On the other hand, there was no difference in the average or peak anaerobic power. Hoffman et al. also showed that energy drinks significantly improved exercise-related response times but had no impact on anaerobic power output. Ivy et al. also looked at the effects of energy drink consumption prior to exercise on 12 professional cyclists of both sexes in a double-blinded, randomized, crossover research.
Conclusion
Energy drinks may have good effects on how well athletes perform during physical activity. While energy drinks may improve performance, there have been reports of potential negative health effects, especially in children and adolescents. Energy drink use has a harmful impact on several bodily parts. It is advised to use caution when using energy drinks in light of this fact and their rising popularity. Governments should impose restrictions on too optimistic marketing and unfounded claims until impartial research deem these items safe.
