Warning Labels on Caffeinated Energy Drinks?

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Consumers need to know risks of energy drinks, study says

Bloomberg News Published: 9/29/2008 12:13 AM

Energy drinks can have 10 times or more caffeine as soft drinks,

prompting s Hopkins University scientists to recommend the drinks

carry labels with caffeine content and warnings about the health risks.

Energy drinks are sold as dietary supplements, and the FDA doesn't

regulate their caffeine levels or require warnings. A typical 12-ounce

soft drink includes about 35 milligrams of caffeine, and some energy

drinks have as much as 500 milligrams, researchers said. Consumers may

be unaware of caffeine levels and potential risks, the report said.

" If you are going to use a drug, you should know what it is, what it

does and how to use it effectively, " said Roland Griffiths, a

professor of behavioral biology at s Hopkins University. " If you

don't label that, you don't know that. "

Caffeine intoxication can lead to nervousness, anxiety, restlessness,

insomnia, gastrointestinal upset, tremors, rapid heartbeat and

overdose, Griffiths said.

Americans spent about $5.4 billion on energy drinks in 2006, an amount

growing about 47 percent a year, the report said. The drinks are

promoted as performance enhancers and aimed at young people.

The Hopkins researchers, who have spent decades researching the

effects of caffeine, listed the caffeine content of numerous energy

drinks in the report. Such top-sellers as Red Bull had 80 milligrams

of caffeine per drink, compared with 35 milligrams in a Coca-Cola

Classic. Rockstar, another top seller, had 160 milligrams and No Fear

had 174 milligrams. At the high end, Wired X505 had 505 milligrams per

drink and Fixx had 500 milligrams.

http://www.dailyherald.com/story/?id=238408 & src=120

Experts Call for Health Warning Labels on Caffeinated Energy Drinks

Caroline Cassels

September 26, 2008 — Experts are calling for health warning labels on

so-called " energy drinks " that, due to their high caffeine content,

may pose a significant consumer health risk, particularly in

adolescents and young adults.

In a review paper published online September 20 in Drug and Alcohol

Dependence, investigators at s Hopkins University School of

Medicine, in Baltimore, point out that a single serving of some of

these drinks can contain more than 500 mg of caffeine, an amount

equivalent to 14 cans of Coca-Cola.

Despite this, the caffeine content of these products is frequently not

indicated, and few brands include warnings about potential health

risks, including caffeine intoxication.

" Many products don't label the amount of caffeine they contain, and

the amount of caffeine across different brands is quite variable, so

you can pick up something called a can of energy drink and it may

contain as little as 50 mg of caffeine or it can contain 505 mg of

caffeine, " lead author Roland Griffiths, PhD, told Medscape Psychiatry.

Vulnerable Population

Furthermore, and even more disturbing, said Dr. Griffiths, is the

aggressive marketing of these drinks to young people, who are

frequently caffeine naive and therefore more susceptible to the

negative physical effects of caffeine.

" A caffeine-naive population is going to be much more sensitive to

caffeine, and we really run the risk of caffeine overdose. We don't

really know what the prevalence of this is, but we know it occurs and

this shouldn't surprise us.

" Caffeine intoxication is a well-recognized psychiatric diagnosis with

well-described symptoms, and if you give high doses of caffeine to

caffeine-naive people, some of them are going to get into trouble, "

said Dr. Griffiths.

He added that reports of caffeine abuse to US poison control centers

showed negative reaction to energy drinks.

In a 2007 survey of 496 college students, 51% reported consuming at

least 1 energy drink during the past month. Of these energy-drink

users, 29% reported " weekly jolt-and-crash " episodes and 19% reported

heart palpitations from consuming these beverages.

Gateway to Drug Abuse?

The same survey revealed that 27% of the survey respondents reported

mixing energy drinks and alcohol at least once in the past month.

" When you combine caffeine and alcohol, people are less likely to

perceive the extent to which they are intoxicated and are at greater

risk of alcohol-related injury, " said Dr. Griffiths.

Further, there is a concern that the strong stimulant effect of energy

drinks may increase the risk of nonmedical use of prescription

stimulants such as amphetamines and methylphenidate. A 2008 study of

1253 college students showed energy-drink consumption significantly

predicted subsequent nonmedical prescription stimulant use.

Potentially fueling this " transition " market, there are other energy

drinks, such as the powdered energy drink Blow, which is sold in

vials, and the energy drink Cocaine, that use language on their

products suggesting illicit drugs.

Energy drinks first came on the market in 1987 with the launching of

Red Bull in Australia. Since then, the industry has grown

exponentially worldwide and stands at an estimated $5.4 billion in the

United States and is expanding at a rate of 55% annually.

Given all these factors, Dr. Griffiths believes the US Food and Drug

Administration (FDA) should move to require warning labels on these

drinks. However, it does not appear likely this will occur in the

foreseeable future.

FDA Responds

Medscape Psychiatry contacted the FDA for comment and was told in an

e-mail communication that many so-called " energy drinks " are marketed

as dietary supplements and therefore are not legally required to seek

premarket approval.

For both dietary supplements and food products, the producer bears the

onus of ensuring that it is bringing a safe product to market, the FDA

writes. " In order to require a warning label, FDA must establish that

the lack of such a warning creates a risk to consumers and that the

warning label would effectively remediate that risk. At this time, FDA

has not determined that these products are unsafe because they contain

caffeine or that there is a consumer risk that would effectively be

remediated by a warning label statement, " the FDA writes.

Drug Alcohol Depend. Published online September 20, 2008. Abstract

http://www.medscape.com/viewarticle/581128