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Emergency calls highlight energy drink danger
Energy drinks have dangerous side effects, according to an Australian study that has reported an increase in energy drink-related calls to emergency departments and poisons centres.
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SYDNEY: The dangerous side effects of energy drinks have been highlighted by a reported increase in calls to emergency departments and poisons centres, say Australian scientists.
A study published this week in The Medical Journal of Australia is the first toxicology study to assess the risks of energy drink consumption by monitoring the caffeine-related toxicity claims received by hospitals and poisons centres.
"The main objective was to look at what is happening [with energy drinks] and better inform the public about the reported benefits of energy drinks - which are pretty much not true - and the potential dangers of energy drinks," said lead author and toxicologist Naren Gunja from the University of Sydney, and medical director of the New South Wales Poisons Information Centre in Sydney. "We found that there were almost 300 calls increasing over the seven-year period between 2004 and 2010."
An energised nation
Consumption of energy drinks such as Red Bull, V, Rockstar and Mother have risen significantly in the past 10 years, comprising 20% of the total convenience store beverage market. Red Bull and V account for over 97% of this multi-million dollar industry.
Caffeine toxicity (or overdose) can mimic amphetamine poisoning and lead to seizures, psychosis, cardiac arrhythmias and potentially but rarely, death.
For some adults it only takes 50 milligrams of caffeine to feel adverse effects, but in most people it takes 200 mg. A cup of coffee typically has between 20 and 200 mg of caffeine, a can of cola 40 mg and energy drinks can range from 80 to 200 mg of caffeine in each can.
"The majority of adverse effects were due to the caffeine alone in the drinks, as opposed to the sugar or added substances like guarana or taurinel," said Gunja.
Identifying the energy drink danger
The study showed that most people consume energy drinks recreationally, typically adolescents and young adults. The average age for consumption is 17 years. Sixty per cent of energy drink-related emergency calls were received between 5pm and 3am - a time when party-goers and study-crammers seek the advertised 'energy boost' of these drinks.
Some people also mixed the drink with other substances, most commonly alcohol, but also caffeine tablets, ecstasy, amphetamines and other illicit substances.
The researchers found that the number of drinks consumed per session varied greatly, with an average of five cans, and one example of 80 cans in one session. "The recreational users tended to get problems like palpitations of the heart, shaking and tremor, restlessness, agitation, nausea and vomiting, and a few [people] got chest pains like they were having a heart attack," said Gunja. Some people reported that they had trouble sleeping after consuming the beverage.
"But it's written on the label"
Although labelling the contents of energy drinks is enforced by the Australian Food Standards Code 2.6.4, a typical energy drink can may contain up to 300 mg of caffeine from added sources such as guarana, which can contain 40 to 80 mg of additional caffeine. Symptoms of caffeine toxicity have also been recorded by people adhering to the manufacturer's recommendation of a maximum of two 250 mL cans per day.
Gunja said there should be better labelling and regulation of energy drinks from authorities, saying that the labelling and marketing of these products should include more accurate health warnings. She added that energy drinks should be treated in the same way as non-prescription drugs. "There should be contact details of where to get help if [people] have problems with an energy drink, like the poison centres phone number," she said.
"We don't expect that people should end up in an emergency ward just from drinking energy drinks, so even this low level of toxicity is worrying," said pharmacologist Ian Musgrave from the University of Adelaide in South Australia, who was not involved in the study. He said the paper is important because it is "the first time anyone has looked systematically at adverse events from energy drinks".
However, he said the number of people who reported caffeine poisoning from recreational exposure (217 over seven years) is relatively small, given the population the poison centre covers. "The results are sufficiently worrying for altered labelling of energy drinks [and] should be considered. Increased education for young people about energy drink consumption by the various state health authorities should be prioritised," he said.