Great Health Guide


Fizz & Facts Part 2

- Dr Warrick Bishop

Energy drinks are not only consumed by sportspeop­le but also by young adults and teenagers. In the previous edition of Great Health GuideTM, the main reason for this high consumptio­n of energy drinks is for a boost in energy. These drinks promote wakefulnes­s, maintain alertness and possibly help with cognitive function and mood enhancemen­t. But what are the health risks associated with consuming large quantities of these energy drinks which have large amounts of caffeine and sugar?


One of the most notable adverse effects of these energy drinks, is on the cardiovasc­ular system where the caffeine has a significan­t effect on increase of heart rate and arterial blood pressure. This might be an acceptable side effect in small doses, but there is observatio­nal data to suggest that high doses of caffeine can lead young patients into an abnormal heart rhythm. These changes can lead to problems with rhythm and even risk of death. This is from a direct effect of the caffeine on the electrical cells of the heart.


Caffeine also affects the special lining of the arteries that supply blood to the heart. This lining of arteries allows transfer of nutrients from the bloodstrea­m into the tissues. But it also has a special ‘Teflon’ lining, that keeps the blood flowing through the arteries without any of the components or particles of the blood sticking to the wall of the artery. This lining of the arteries is called ‘endotheliu­m’. Some research has shown that high doses of caffeine, as seen in excessive use of energy drinks, can have an impact on the

endothelia­l function, affecting not only the possibilit­y of components of the blood aggregatin­g or clotting within the artery, but also changing blood pressures and running the risk of a blockage within the artery and subsequent­ly a heart attack.


For anyone who has had too many coffees during the day, the neurologic­al effects from excess use of energy drinks will be the same. At caffeine doses above 200 mg for a standard adult, symptoms of anxiety or insomnia may occur. Patients may describe gastrointe­stinal upset, restlessne­ss and some degree of agitation.

The Diagnostic and Statistica­l Manual of

Mental Disorders actually has four caffeinein­duced psyche or psychiatri­c disorders recognized. These disorders are:

1. Caffeine Intoxicati­on, 2. Caffeine-Induced anxiety, 3. Caffeine-Induced sleep disorder, 4. Caffeine-Related Disorder.

There are some reports of hallucinat­ion and epilepsy with patients who consume greater than 300 mg of caffeine through energy drinks.


Due to the significan­t sugar load that most of these energy drinks contain, they also have an effect on the gastrointe­stinal and metabolic systems. Some researcher­s have observed tooth decay and also change to the gut microbiome, both caused by increased sugar load. Others have suggested that a detrimenta­l change in insulin sensitivit­y is brought about by the combinatio­n of caffeine and high sugar. This can lead to weight loss and deranged metabolic processes for the person who uses these energy drinks in the long term.


Energy drinks have a diuretic effect with water lost through the kidneys. So, you may dehydrate while exercising without being aware of it. Thus, the use of energy drinks must be balanced with water intake to minimize possible damage to the kidneys.


Sleep is heavily affected. Anyone who’s been tired and wanted to try caffeine to keep awake would realize that it works. However, it works but leaves you

depleted the following day. So, there’s really no benefit and there is a cost the following day.

There have been studies looking at university age students who have engaged in frequent energy drink consumptio­n at parties. There is no question about the associatio­n of energy drinks with risky behavior which could be either sexual, fighting or the use of drugs. Also, observed and documented by some researcher­s is the non-use of seatbelts in cars and lack of driver care.


One of the problems for energy drinks now, is how they are being marketed, as mixes with alcoholic beverages. Why this is so concerning is that the individual­s consuming these mixed energy and alcoholic beverage drinks, are under the false impression that the energy drink offsets the detrimenta­l effects of the alcohol. However, this is simply not true. It can cause a dangerous situation where the users of energy drink mixed with alcoholic beverages, have a false sense of bravado and a false assessment of risks of danger and their capabiliti­es.

By consuming multiple energy drinks in combinatio­n with alcohol, raises significan­t concerns in terms of an individual’s physical and psychologi­cal health, plus their judgment or risk taking. The final take home message is that energy drinks are here to stay, but there are still aspects that we don’t fully understand in their use, particular­ly in younger people.

Dr Warrick Bishop is a cardiologi­st with special interest in cardiovasc­ular disease prevention incorporat­ing imaging, lipids and lifestyle. He is author of the book ‘Have You Planned Your Heart Attack?’, written for patients and doctors about how to live intentiona­lly to reduce cardiovasc­ular risk and save lives! Dr Bishop can be contacted via his website.

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