Faced with the challenge of sweltering heat and the need to keep cool and well hydrated, our supermarket shelves and our gas station carousels offer a variety of fluids to the consumer. While bottled water, coconut water and sports drinks are appropriate options to beat the heat, energy drinks can cause short-term health problems – some severe – and sugar-sweetened beverages (soft drinks), in excess, are linked to chronic diseases.
Sports drinks are water-based flavoured beverages specifically made to be superior to plain water in terms of how fast they can be absorbed into the body. They are designed to be consumed before or during any form of strenuous physical activity that lasts more than 15-30 minutes, to prevent dehydration. They consist of water with small amounts of electrolytes such as sodium, calcium, potassium, magnesium, and others, and will generally have small quantities of added sugars. They are designed to be used by athletes and other people who are losing water and electrolytes during heavy exercise and sweating. They can also be used after strenuous activity, to replace some of the water and electrolytes lost through heavy sweating, but this is not their optimal use.
Energy drinks, on the other hand, may also contain some water, electrolytes and added sugars, but their main purpose is to serve as a stimulant, something that raises the level of normal metabolic activity in the body. The most common stimulant ingredient is caffeine, but other stimulants in energy drinks include guarana, taurine and l-carnitine. They increase short-term alertness (good thing that!), energy and attention. They are not designed for, and should not be used to replace electrolytes and fluids lost during exercise. They may or may not be carbonated and may also contain sugar, other sweeteners, or herbal extracts, among numerous other possible ingredients. Energy drinks may be particularly dangerous when mixed with alcohol.
Drinking a lot of energy drinks can be dangerous because of excessive caffeine or other stimulant consumption. A large amount of caffeine can cause rapid heartbeat. People can become jittery and anxious. They may have trouble sleeping, which paradoxically causes more fatigue and less energy over time. Those who consume energy drinks thinking that they replenish electrolytes and fluids may become dehydrated, especially as caffeine is a diuretic that promotes urination.
Large amounts of caffeine consumption can lead to caffeine intoxication. This is uncommon but can be dangerous, even life-threatening, especially when the heart rhythm is disrupted. Individuals could suffer cardiac arrest as well as other severe symptoms such as brain swelling and kidney failure.
More than 400 milligrams of caffeine daily is considered excessive for most adults, this is the equivalent amount of four or five cups of coffee. Someone drinking 400 milligrams of caffeine is unlikely to have the severe effects of caffeine intoxication, but they could certainly experience jitteriness and sleep disruption. Some energy drinks can contain as much as 300 milligrams of caffeine in each bottle or can.
Children and adolescents should not consume energy drinks at all. Drinks that contain caffeine and added sugar should not be consumed; as such beverages can increase the risk of anxiety, hyperactivity and even excessive weight gain, heart disease and liver disease. Parents should be really careful to look at the label of each drink that their kids are drinking. Some drinks are packaged to look similar but actually contain very different amounts of ingredients.
There may be some adults who use energy drinks as a performance enhancer in competitive formal sport. This may run afoul of anti-doping regulations, as stimulants are not allowed in competitive sport. They should not use energy drinks for this purpose. Energy drinks may offer a quick energy boost, but they have potential risks and are not a good long-term solution.
Other people who should be cautious about energy drinks include those with chronic heart problems or high blood pressure since caffeine and other stimulants in energy drinks could increase heart rate and blood pressure. Caffeine can also interfere with certain medications, including some anti-depressants, seizure medications and diabetes medications. People who have underlying medical conditions and who are on prescription medications should check with their family physicians about energy drink use.
If you are suffering from ongoing exhaustion, it’s important to make sure there aren’t underlying medical issues, such as anaemia, hypothyroidism or sleep apnea. Take a look at your sleep schedule and see if changing some sleep habits could help. A change to your diet may also give you more energy, as could adding physical activity to your regular schedule. And be sure to keep well-hydrated; something simple like drinking plenty of fluids throughout the day could help you more than an energy drink, and without the risk that comes from consuming excessive amounts of stimulants. This is especially true in these very hot days that we are currently experiencing.
The very hot weather we are experiencing and will continue to experience, makes dehydration and other serious heat-related illnesses a cause for great concern, especially as the fairly high proportion of our population with one or more chronic illnesses are at higher risk for heat-related illnesses. Prevention is important. Drink your fluids to keep well hydrated. Our soft drinks, i.e. sugar-sweetened beverages, tend to have large quantities of sugar, and in addition to warnings that consumption of these drinks can lead to obesity and chronic non-communicable diseases (NCDs), in the short term, the high sugar content can lead to dehydration. But while water and sports drinks are recommended, approach energy drinks with the appropriate caution, and they are definitely not to be used for sustained periods of time.
Dr Colin V Alert is a family physician and former researcher with the Chronic Disease Research Centre.
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