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Are Caffeine Drinks Worth The Energy Boost?

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Consumption of energy drinks such as Red Bull has increased significantly in recent years.

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By CHARLES R. LAMBERT, MD, PhD, MBA

Tribune correspondent

Published: September 5, 2008

Did you know that Tampa has been listed as the second-most caffeinated city in the United States? We finished second only to Chicago, according to the HealthSaver 2007 Caffeinated Cities Survey conducted by an independent marketing research company.

Although most caffeine consumed in the United States comes from coffee, other sources have significantly increased. These include tea, soft drinks and, perhaps more importantly, energy drinks such as Red Bull, Rockstar, Monster and others. The caffeine content of these drinks varies widely. A Diet Coke has 45 milligrams of caffeine; a Red Bull, 80 milligrams; Rockstar, 160 milligrams; a Starbucks Grande coffee has 320 milligrams; and a Fixx, 500 milligrams!

Energy drinks are consumed by people of all ages, but the beverages have been heavily marketed to younger people, prompting questions regarding safety. Most emergency room or call center encounters related to caffeine toxicity or adverse effects (especially mixing alcohol with energy drinks) involve young people.

Caffeine is completely absorbed and reaches a peak in the blood about 30 to 60 minutes following consumption. The metabolized substance quickly enters tissues, including the brain, to produce a range of stimulatory effects. It increases alertness, decreases fatigue and improves motor reaction time for some tasks. Individuals who consume caffeine regularly can develop tolerance within a few days. Headache, fatigue, anxiety and nausea may result when caffeine consumption is discontinued by someone with a high degree of tolerance. These withdrawal symptoms usually pass once caffeine intake is resumed.

The cardiovascular effects of caffeine include small increases in blood pressure and usually a small decrease in heart rate, although an increase in pulse also may occur depending on the amount of caffeine consumed. In certain people prone to abnormal heart rhythms (arrhythmias), caffeine may worsen or trigger the condition. In patients with underlying heart disease, such as coronary artery disease or hardening of the arteries, caffeine may produce chest pain (angina). Those who already suffer from high blood pressure, arrhythmias and other types of heart disease would do well to limit their caffeine intake.

Despite all the recent hype about the protective health benefits of coffee, research examining the association between caffeine consumption and heart disease has been inconclusive. Some studies suggest a link between long-term coffee consumption and the risk for future development of coronary heart disease, likely related to certain compounds in unfiltered coffee that may increase cholesterol. The latest information suggests that very high coffee consumption (more than six cups a day) is needed to significantly raise cholesterol levels. In contrast, other recent studies found a lower risk of coronary heart disease in moderate coffee drinkers, possibly due to antioxidants that help counter the effects of inflammation-provoking free radicals. Also, in certain genetically-predisposed individuals, differences in the way caffeine is metabolized may determine cardiovascular risk or benefit.

Until more definitive information is available, consuming caffeine in moderation - say, no more than two to three cups of coffee a day - may be the most prudent. Those diagnosed with heart disease should discuss caffeine intake with their physicians, along with other important lifestyle considerations such as diet, exercise, alcohol intake and smoking.

Dr. Lambert is professor of cardiology at USF Health and medical director of the Pepin Heart Hospital and Kiran Patel Research Institute at University Community Hospital.

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