JAMA Report Details Energy Drink Health Risks, Caffeine Levels

A new report published by the Journal of the American Medical Association (JAMA) provides information about the known health risks of energy drinks and lists the caffeine levels contained in major brands of the popular beverages, including 5 Hour Energy, Monster, Red Bull, Rockstar and others. 

The energy drink report was published online by the journal on December 19, and JAMA has provided free public access to the article.

According to the report, energy drinks can have four times the amount of caffeine as is found in a can of Coca-Cola on an ounce-per-ounce basis, and are often sold in jumbo-sized servings of 24 ounces.

The report warns that potential energy drink health risks may include:

• Increased heart rate
• Irregular heart beat and palpitations
• Sleep disturbances and insomnia
• Diuresis
• Hyperglycemia

JAMA reports that the American Academy of Pediatrics (AAP) warns that children should not consumer any energy drinks, the as risk of caffein overdose may be especially harmful for children, who should not consumer more than 100 mg of caffeine in a day. Most energy drinks currently on the market contain more than that amount and some have nearly three times as much.

The product with the most caffeine was SPIKE Shooter, which had 286 mg. Other products with especially high caffeine levels were NOS, which contained 260 mg in a 16-oz can, Rockstar 2X, with 240 mg. in 12-ounce cans, and 24-ounce cans of Rockstar and Monster both had 240 mg. That compares with 35 mg in a 12-ounce can of Coca-Cola and 170 mg in a large 16-ounce serving of coffee.

Wrongful Death Lawsuit Led to Energy Drink Concerns

Increased scrutiny was turned toward the energy drink industry after the death of a 14-year-old girl, who died after drinking two cans of Monster in a 24-hour period. Her parents have filed a wrongful death lawsuit against Monster Beverage Corp., alleging that the manufacturer failed to adequately warn about the health risks and negligently promoted high consumption of the drinks among children.

According to information released in recent weeks by the FDA, there have been at least four deaths linked to Monster Energy Drinks and 13 deaths linked to 5 Hour Energy Shots.  In addition, side effects of Rockstar Energy Drinks have been cited in at least 13 non-fatal adverse event reports submitted to the FDA in recent years.

The JAMA report was accompanied by two editorials; one by Dr. Kent A. Sepkowitz of the Memorial Sloan-Kettering Cancer Center’s Infectious Disease Service, and the other by Drs. Jonathan Howland and Damaris J. Rohsenow, from Boston University’s Department of Emergency Medicne and the Center for Alcohol and Addiction Studies at Brown University, respectively.

Sepkowitz warned that many people are likely unaware of the amounts of caffeine they are ingesting when drinking energy drinks, and said that unintentional caffeine overdoses have caused serious illnesses and deaths.  Only recent studies have revealed the risks of caffeine poisoning, particularly due to cardiac arrhythmias.

The other editorial warned of the risks associated with mixing alcohol with energy drinks, reporting that 56% of college students reported mixing the two together.

The combination of alcohol and energy drinks was linked to a number of health risks, especially among underage drinkers and college students, often involving binge drinking and other reckless behavior. 

A 2007 study by researchers from Wake Forest University found that mixing alcohol, a depressant, and caffeine, a stimulant, can cause the drinker to be unaware of how intoxicated they actually are. The study found that college students who mixed caffeine and alcohol were more likely to be hurt, injured, ride with an intoxicated driver, or take advantage of someone else sexually.

In late 2009, the FDA issued a letter to the manufacturers of alcoholic energy drinks, indicating that the practice of adding caffeine to alcoholic beverages fell under the control of the Federal Food, Drug and Cosmetic Act, and asked the manufacturers to provide evidence establishing that it is safe and legal.  The move essentially resulted in the shut down of the alcoholic energy drink market.