Toxicity of Energy Drinks

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The new millennium has ushered in a wave of synthetic, caffeinated high-energy drinks targeted at the youth market. Over the past 10 years, the consumption of caffeinated beverages intended to “energise” has increased significantly. Energy drinks were recently shown to comprise 20% of the total convenience store beverage market, with “Red Bull” and “V” accounting for over 97% of sales in this multimillion-dollar industry.1 Increasingly, toxicity from caffeine overdose is being reported to hospitals and poisons centres.

The main active constituents of energy drinks include varying amounts of caffeine, guarana extract, taurine and ginseng. Additional amino acids, vitamins and carbohydrates usually complete the list of purportedly beneficial ingredients.2 The intended effects of energy drinks are to provide sustenance and improve performance, concentration and endurance. Manufacturers pitch their product to athletes, students and people in professions that require sustained alertness. These drinks are also commonly consumed at dance parties, which require sustained energy for prolonged activity into late hours. In this setting, they may also be combined with alcohol and recreational drugs such as ecstasy (MDMA; 3,4-methylenedioxymethamphetamine) or other amphetamines. Young adults and adolescents are particularly attracted to energy drinks because of effective product marketing, peer influence and a lack of knowledge of the potential harmful effects.3-5 The high sugar content in caffeinated energy drinks is similar to other soft drinks and is known to contribute to obesity.6Adverse reactions and toxicity from high-energy drinks stem primarily from their caffeine content.7 The sympathomimetic effects of high-dose caffeine mostly explain the symptoms and hospital presentations related to energy drinks. There is little published literature on the extent and epidemiology of this problem. Indeed, a recent literature review on the effects of energy drinks in children...
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