By Mary Abbott, PhD, RN
As a slender guy of 25, Sam was the youngest worker on the 10-person crew. It was midnight, the temperature was 28° and falling, the wind was gusting up to 20 mph, and stinging sleet was beginning to mix with the snow. We had three snowplow trucks and two motorized sidewalk snowplows servicing the first property on our list, helped along with the usual shovel crew supplemented by a couple of guys with backpack liquid deicer units.
As I finished plowing one of the parking lots, Sam flagged me down to grab several bags of granular deicer out of my utility truck. He was new to our crew but seemed to be easily keeping up. As he paused to pull out the deicer bags, he pulled two cans of a popular energy drink out of his coat pocket and placed them on top of my utility box. I reminded him that we carried water in our trucks and encouraged him to stay hydrated. He acknowledged my comment, took a large gulp out of one can while grabbing the other, and went on working.
Eight hours later, he quit. He had been dragging for a while, and he apologized for not being able to keep up; but he admitted he was feeling dizzy, nauseated and exhausted and just could not keep going for the next eight hours I estimated were left in our workday. As the rest of us continued working, Sam called his wife and left the job site.
Our youngest worker was the only one to fail that day. I blamed the energy drinks. Was I right?
Energy product sales in the United States topped $11 million in 2017, according to Beverage Industry magazine. Over 500 energy drink products are available, over 800 if supercharged coffees are added to the list. Over the last decade or so, health professionals worldwide have been trying to alert the public to the potential dangers of these products; but effective marketing and the popularity of the drinks have muffled public announcements regarding associated risks and potential ill effects associated with their use.
What’s in the mix?
Why is the regular cup of “joe” not exhilarating enough? Why drink hyper-caffeinated products at all? The modern consumer has many more choices in product type, flavor and form than their predecessors. Aside from energy drinks, a high-caffeine thrill can come in the form of energy shots, gels, tablets, powders or liquids.
Due to their potentially toxic and lethal concentrations, however, caffeine sold in bulk as concentrated powders or liquids is considered a significant public health danger and companies that have been selling them (usually via online outlets) are currently under investigation or review by the U.S. Food and Drug Administration (FDA).
How much is too much?
The allure of caffeine is simple: It is a legal stimulant. Caffeine consumption can create feelings of exhilaration, euphoria, enhanced alertness, and increased motivation — attributes desired by many of us who face long workdays, tight deadlines or the need for a competitive edge. The effects are usually fleeting, though, since caffeine tolerance can occur within a few days, leaving the consumer wanting higher and higher quantities in subsequent doses. Some folks learn to drink in moderation; others continue to seek a stronger effect.
How much caffeine is enough? The FDA-recommended maximum daily intake for healthy adults is 400 mg. If you start your day drinking a standard cup of coffee, you will consume 50-100 mg of caffeine per cup. If you prefer a certain designer brand, you might wake up sooner with 190 mg or more per cup. Supercharged brews can contain 400-plus milligrams of caffeine per cup. You would have to chug 4 to 8 cups of standard coffee to match that kind of a kick.
If you would rather get your jolt from an energy drink, the caffeine content in one 2-ounce bottle of a popular brand contains the equivalent of 907 mg per cup. More importantly, energy drinks are usually gulped quickly as cold drinks while most coffees are sipped more slowly. The more quickly the drink is consumed and the more concentrated it is, the faster it is absorbed into the bloodstream and the quicker the jolt. Energy drinks are more easily stored and packaged in a sealed, convenient container, making them more alluring to tired workers wanting a quick energy boost at odd hours.
Unfortunately, abnormal heart rhythms such as atrial and ventricular fibrillation have been linked to the rapid consumption of high caffeine doses. In April 2017, an otherwise healthy 16-year-old high school student in South Carolina died suddenly from what was officially labeled as a “caffeine-induced cardiac event.” He had a coffee latte, a large caffeinated soda and a 16-ounce energy drink within a span of two hours.
It’s not just the caffeine
Interestingly, the exhilarating charge provided by energy drinks is sometimes attributable more to their sugar content than to their caffeine amount. A 24-ounce can of Rock Star Energy drink contains 390 calories of sugar that is quickly absorbed into the bloodstream. Unfortunately, the energy rush does not last long and is followed by the inevitable energy crash as blood sugar levels drop quickly. Additionally, the sugar that the body cannot immediately use is stored in fat cells, leading to weight gain over time.
While high levels of caffeine and sugar are often associated with health problems purportedly caused by energy drinks and energy products, it is less clear what effects are related to or compounded by the other ingredients found in these beverages.
Non-nutritive additives in energy drinks usually include some mixture of vitamins, minerals, herbal supplements, taurine and guarana. The concentrated caffeine found in the plant extract guarana, for example, is in addition to the caffeine added to typical energy drinks. Of note, the seeds of the guarana plant contain four times the concentration of caffeine found in most coffee beans. Since energy products are considered supplements, however, a listing of caffeine amounts is not required on their ingredient labels.
Health effects of energy drinks
Negative effects associated with the consumption of energy drinks include headaches, chest pain, dehydration, jitteriness, heart palpitations, poor dental health, risky behaviors, insomnia, obesity, diabetes, high blood pressure, nausea and vomiting, convulsions, and, rarely, death. The World Health Organization issued a statement confirming that energy drinks may pose a danger to public health. The American Academy of Pediatrics recommends that energy drinks not be given to children. Since 2014, European countries have required labeling that warns against consumption by children or women who are pregnant or breastfeeding.
In 2017, over 20,000 emergency room visits in the United States were related to the ingestion of energy drinks. Additionally, a popular practice of mixing alcohol with energy drinks results in a condition known as “wide awake drunkenness” and is believed to lead to increasingly risky behaviors.
Despite the growing market and popularity of energy drinks, their potential for harm is getting the attention of a different audience: companies whose employees are prone to consuming such products. Some oil field companies have recently banned the use of energy drinks at their job sites.
Energy drink alternatives
The long shifts of winter workers may make consumption of energy drinks and super-coffees an irresistible temptation. The high caffeine and sugar content of these substances provides the illusion of more energy with a need for less sleep; but in reality, these products tend to be an energy drain and may result in nervousness, headaches, insomnia, sluggishness and dehydration. Sidewalk crews are more prone to dehydration and should avoid energy drinks altogether, while all winter workers should consider healthier alternatives.
Drink plenty of water, a calorie-free and inexpensive option without the energy crash. Consider ways to get more rest, avoid prolonged sedentary activities, and eat a well-balanced diet whenever possible. Pack healthy snacks and lunches that consist of lean proteins (such as white-meat poultry), healthy fats (e.g., avocados or walnuts) and complex carbs (e.g., whole-wheat bread and blueberries) that provide an energy source that lasts longer and helps avoid the crash of simple sugars.
If you must enjoy caffeine and sugar, stick to a standard cup of coffee in moderation. Focus on staying on the job. Avoid having to quit due to the aftereffects of an energy drink. Stay in good health.
Mary Abbott, PhD, RN, MSF, is an owner/manager of Mow Beta! Mowing & Snowplowing in central Arkansas. She also is a nursing instructor and retired Navy veteran. Email her at firstname.lastname@example.org.