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Costantino A, Maiese A, Lazzari J, Casula C, Turillazzi E, Frati P, Fineschi V. The Dark Side of Energy Drinks: A Comprehensive Review of Their Impact on the Human Body. Nutrients 2023; 15:3922. [PMID: 37764707 PMCID: PMC10535526 DOI: 10.3390/nu15183922] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
In recent years, the consumption of energy drinks by young adults and athletes has risen significantly, but concerns have been raised about the potential health risks associated with excessive consumption. These concerns include cardiovascular problems, nervous system disorders, and the potential for addiction. This review aims to examine the reported effects of acute or chronic abuse of energy drinks on human health. The analysis shows a significant prevalence of adverse effects, particularly on the cardiovascular and neurovegetative systems. In particular, the analysis identified nine cases of cardiac arrest, three of which were fatal. The aetiology of these adverse effects is attributed to the inherent neurostimulant properties of these beverages, of which caffeine is the predominant component. A comparison of documented effects in humans with experimental studies in animal models showed an overlap in results. This review highlights the need for greater rigour in the assessment of sudden cardiac death, particularly in young people, as legal substances such as energy drinks may be involved. We propose stricter limits on the consumption of these beverages than for caffeine, based on the evidence found and the data in the literature. This review also calls for the establishment of regulations governing the consumption of these products in view of their potential impact on human health.
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Affiliation(s)
- Andrea Costantino
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma, 55, 56126 Pisa, Italy; (A.C.); (A.M.); (J.L.); (C.C.); (E.T.)
| | - Aniello Maiese
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma, 55, 56126 Pisa, Italy; (A.C.); (A.M.); (J.L.); (C.C.); (E.T.)
| | - Julia Lazzari
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma, 55, 56126 Pisa, Italy; (A.C.); (A.M.); (J.L.); (C.C.); (E.T.)
| | - Chiara Casula
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma, 55, 56126 Pisa, Italy; (A.C.); (A.M.); (J.L.); (C.C.); (E.T.)
| | - Emanuela Turillazzi
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Via Roma, 55, 56126 Pisa, Italy; (A.C.); (A.M.); (J.L.); (C.C.); (E.T.)
| | - Paola Frati
- Institute of Legal Medicine, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy;
| | - Vittorio Fineschi
- Institute of Legal Medicine, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy;
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Costa-Valle MT, Gomes JF, De Oliveira CR, Scherer A, Franco De Oliveira SCWDSE, Menezes RCR, Leal MB, Romão PRT, Dallegrave E. Energy drinks and alcohol in a binge drinking protocol in Wistar rats: Male and female behavioral and reproductive effects. Pharmacol Biochem Behav 2022; 221:173487. [PMID: 36341912 DOI: 10.1016/j.pbb.2022.173487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
The consumption of energy drinks is common among adolescents and young adults. The possible effects (mainly behavioral and reproductive) of ingestion in this population remain unknown. For this reason, this study aimed to evaluate the behavioral and reproductive effects of energy drinks and their main constituents (caffeine and taurine), as well as their combinations with alcohol, via a binge drinking protocol in male and female Wistar rats during puberty. In this study, 100 male and 100 female rats were treated with a binge drinking protocol 3 days a week over 4 weeks from postnatal day (PND) 28 to PND 60, which included 10 mL/kg by oral gavage of distilled water, energy drink, caffeine (3.2 mg/kg), taurine (40 mg/kg), and their combinations with alcohol (2 g/kg). The animals were evaluated by behavioral tests from PND 56 to PND 60 (open field, plus maze and object recognition) and reproductive parameters (estrous cycle regularity, weight of sexual organs, oocyte quality, spermatid and sperm count, sperm morphology and testosterone level). Locomotor activity was increased in females in the groups combined with alcohol (except alcohol + caffeine) and in the caffeine group. Long-term memory was increased in males in the caffeine and taurine groups even when combined with alcohol. The combination of energy drinks and alcohol did not have significant effects on the reproductive parameters of either sex of rats during puberty. We concluded that energy drinks (and their main constituents) and alcohol combinations did not cause alterations in reproductive profiles, and locomotor activity and long-term memory were increased in females and males, respectively.
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Affiliation(s)
- Marina Tuerlinckx Costa-Valle
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; Laboratório de Imunologia Celular e Molecular, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; Laboratório de Pesquisa em Toxicologia (LAPETOX), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliana Fank Gomes
- Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; Laboratório de Pesquisa em Toxicologia (LAPETOX), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Caroline Rodrigues De Oliveira
- Laboratório de Pesquisa em Toxicologia (LAPETOX), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Andressa Scherer
- Laboratório de Pesquisa em Toxicologia (LAPETOX), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Rafaella Câmara Rocha Menezes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Mirna Bainy Leal
- Laboratório de Farmacologia e Toxicologia Neurocomportamental, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Pedro Roosevelt Torres Romão
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; Laboratório de Imunologia Celular e Molecular, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Eliane Dallegrave
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil; Laboratório de Pesquisa em Toxicologia (LAPETOX), Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
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Williams KL, Parikh UK, Doyle SM, Meyer LN. Effect of intermittent access to alcohol mixed in energy drink during adolescence on alcohol self-administration, anxiety, and memory during adulthood in rats. Alcohol Clin Exp Res 2022; 46:1423-1432. [PMID: 35778776 DOI: 10.1111/acer.14897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/26/2022] [Accepted: 06/14/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Mixing alcohol with caffeinated energy drinks is a common practice among young people. Consumption of alcohol mixed in energy drink is associated with increased risk of binge drinking and alcohol dependence. The purpose of this study was to determine whether voluntary intermittent access to alcohol mixed in energy drink in adolescent rats alters adult self-administration of alcohol, anxiety, and memory. METHODS For 10 weeks in the home-cage, two groups of adolescent female Sprague-Dawley rats had intermittent access to energy drink (ED) or 10% alcohol mixed in energy drink (AmED) with water concurrently available. Other rat groups had daily continuous access to ED or AmED. Anxiety was measured with an open field test and memory was assessed with a novel place recognition test. For self-administration, rats pressed levers for 10% alcohol alone on a fixed ratio (FR1) and on a progressive ratio (PR). RESULTS Intermittent access to AmED generated greater intake during the initial 30 min of access (AmED 1.70 ± 0.04 g/kg vs. ED 1.01 ± 0.06 g/kg) and during the subsequent 24 h (AmED 7.04 ± 0.25 g/kg vs. ED 5.60 ± 0.29 g/kg). Intermittent AmED caused a significant but small decrease in anxiety while neither ED nor AmED altered memory. During alcohol self-administration, group differences emerged only during PR testing during which intermittent AmED rats responded more than all other groups. CONCLUSIONS These findings suggest that intermittent access to AmED generates binge-like consumption that supports human findings that AmED generates greater alcohol consumption. Furthermore, experience with AmED may alter the motivational properties of alcohol into adulthood without necessarily causing a major impact on anxiety or memory.
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Affiliation(s)
- Keith L Williams
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Urja K Parikh
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Shannon M Doyle
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Lindsey N Meyer
- Department of Psychology, Oakland University, Rochester, Michigan, USA
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Petribu BN, Abrahao KP, Souza-Formigoni MLO. Ethanol combined with energy drinks: Two decades of research in rodents. Front Behav Neurosci 2022; 16:1100608. [PMID: 36938100 PMCID: PMC10017554 DOI: 10.3389/fnbeh.2022.1100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/26/2022] [Indexed: 03/06/2023] Open
Abstract
Many studies raised concerns on alcoholic beverages consumption mixed with energy drinks (AmED), which can induce higher rates of binge drinking and earlier development of alcohol use disorders. After 20 years of research, few studies with laboratory animals have focused on the effects of this mixture and the neurobiological and pharmacological mechanisms underlying them. We found 16 articles on AmED administration to rodents evaluating its effects on voluntary consumption, locomotion, anxiety-like behavior, memory, influence on the onset time of seizures, biochemical and neurochemical measures. Some of these studies indicated energy drinks (ED) can alter the pattern of use and motivation to consume ethanol (EtOH); increase the expression of sensitization to EtOH stimulant effect and the proportion of sensitized mice; decrease the aversiveness of high concentrations of EtOH, among other effects. In addition AmED hastens the loss of righting reflex and its effects on memory are controversial. After acute administration no difference was found in blood ethanol concentration (BEC) of rodents which received EtOH with or without ED, but after 60 days of treatment, AmED group had lower BEC levels than EtOH group. Data on biochemical and neurochemical parameters after AmED are not consistent. Although the AmED group presented higher glucose levels than the EtOH group when drugs were administered by gavage, this was not observed in a self-administration protocol. AmED may induce higher kidney damage, higher levels of plasma urea, uric acid and creatinine when compared to EtOH. Chronic consumption of AmED causes an inflammatory response and oxidative stress, which may induce cell death in the cortex and hypothalamus of adult rats. These controversial results show that AmED diverse effects depend on sex, age and lineage of the animals, duration of the treatment and route of administration. Further research is necessary to evaluate the mechanisms underlying AmED biological effects.
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Effects of Caffeine and Caffeinated Beverages in Children, Adolescents and Young Adults: Short Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312389. [PMID: 34886115 PMCID: PMC8656548 DOI: 10.3390/ijerph182312389] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022]
Abstract
The prevalence of ED consumption has increased over the past 10–15 years. Studies describing the effects of caffeine and caffeinated beverages show confusing results, so it seems important to regularly summarize the available facts, and in more detail. By a thorough analysis of more than 156 scientific papers, the authors describe the molecular background of absorption, as well as the positive and negative effects of different dosages of caffeine, just like its effects in physical activity and performance. ED and EDwA consumption is a regular habit of not only adults, but nowadays even of children and adolescents. There are no safe dosages described of caffeine or ED consumption for children. There are no positive short- or long-term effects of these compounds/products concerning developing brain functions, psycho-motor functions, or social development. Instead, there are many unpleasant side effects, and symptoms of regular or higher-dose ED consumption, especially at younger ages. This mini review describes many details of these unpleasant side effects, their severity, and motivations for consuming these compounds/products. In a quantitative research in Hungary (10–26 years, mean age: 15.6 ± 3.8 y, 1459 subjects, randomly chosen population), a survey based on a questionnaire asking people about their ED consumption habits was conducted. According to the data, 81.8% of the participants consumed EDs at least once, and 63.3% tried several products of the kind. A positive correlation was found between age and consumption (p < 0.001). The results show that a high proportion of this group often consumed EDwA, in many cases leading to harmful side-effects of caffeine overdose. In a sample of Hungarian high school and college students (17–26 years), ED consumption matched the international data, and only 19.7% of respondents did not use EDs at all (had never tasted an ED in their life).
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Smoker MP, Hernandez M, Zhang Y, Boehm SL. Assessment of Acute Motor Effects and Tolerance Following Self-Administration of Alcohol and Edible ∆ 9 -Tetrahydrocannabinol in Adolescent Male Mice. Alcohol Clin Exp Res 2019; 43:2446-2457. [PMID: 31524960 DOI: 10.1111/acer.14197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cannabinoids and their principle psychoactive target, the cannabinoid type 1 receptor (CB1R), impact a number of alcohol-related properties, and although alcohol and cannabis are often co-used, particularly in adolescence, few animal models of this phenomenon exist. We modeled the co-use of alcohol and ∆9 -tetrahydrocannabinol (THC) in adolescent mice using ingestive methods popular during this developmental period in humans, namely binge-drinking and edible THC. With this model, we assessed levels of use, acute effects, and tolerance to each substance. METHODS Adolescent male C57BL/6J mice had daily, limited access to 1 of 2 edible doughs (THC or control), to 1 of 2 fluids (ethanol (EtOH) or water), and in 1 of 2 orders (dough-fluid or fluid-dough). Home cage locomotor activity was recorded both during access and after access. On the day following the final access session, a subset of mice were assessed for functional and metabolic tolerance to alcohol using accelerating rotarod and blood EtOH concentrations, respectively. The remaining mice were assessed for tolerance to THC-induced hypothermia, and whole-brain CB1R expression was assessed in all mice. RESULTS EtOH intake was on par with levels previously reported in adolescent mice. Edible THC was well-consumed, but consumption decreased at the highest dose provided. Locomotor activity increased following EtOH intake and decreased following edible THC consumption, and edible THC increased fluid intake in general. The use of alcohol produced neither functional nor metabolic tolerance to an alcohol challenge. However, the use of edible THC impaired subsequent drug-free rotarod performance and was associated with a reduction in THC's hypothermic effect. CONCLUSIONS Adolescent mice self-administered both alcohol and edible THC to a degree sufficient to acutely impact locomotor activity. However, only edible THC consumption had lasting effects during short-term abstinence. Thus, this adolescent co-use model could be used to explore sex differences in self-administration and the impact substance co-use might have on other domains such as mood and cognition.
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Affiliation(s)
- Michael P Smoker
- From the, Department of Psychology, Indiana Alcohol Research Center, Indiana University - Purdue University Indianapolis, Indianapolis, Indiana
| | - Maribel Hernandez
- From the, Department of Psychology, Indiana Alcohol Research Center, Indiana University - Purdue University Indianapolis, Indianapolis, Indiana
| | - Yanping Zhang
- From the, Department of Psychology, Indiana Alcohol Research Center, Indiana University - Purdue University Indianapolis, Indianapolis, Indiana
| | - Stephen L Boehm
- From the, Department of Psychology, Indiana Alcohol Research Center, Indiana University - Purdue University Indianapolis, Indianapolis, Indiana
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Nazir M, Arif S, Khan RS, Nazir W, Khalid N, Maqsood S. Opportunities and challenges for functional and medicinal beverages: Current and future trends. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.04.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Costa-Valle MT, Tonieto BD, Altknecht L, Cunha CD, Fão N, Cestonaro LV, Göethel G, Garcia SC, Leal MB, Dallegrave E, Arbo MD. Energy drink and alcohol combination leads to kidney and liver alterations in rats. Toxicol Appl Pharmacol 2018; 355:138-146. [DOI: 10.1016/j.taap.2018.06.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 12/20/2022]
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Asorey LG, Carbone S, Gonzalez BJ, Cutrera RA. Behavioral effects of the combined use of alcohol and energy drinks on alcohol hangover in an experimental mice model. Neurosci Lett 2018; 670:1-7. [PMID: 29355695 DOI: 10.1016/j.neulet.2018.01.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/07/2018] [Accepted: 01/16/2018] [Indexed: 11/16/2022]
Abstract
In last few years it has been a significant increase in the consumption of alcohol combined with energy drink. The aim of this work was to study the effect of this mixture in motor and affective behaviors during an alcohol hangover episode. Male Swiss mice received one of the following treatments: saline + sucrose; saline + energy drink; ethanol + sucrose; ethanol + energy drink. Ethanol dose was 3.8 g/kg BW (i.p.) and energy drink dose was 18 ml/kg BW (gavage) at ZT1 (8 am) (ZT: Zeitgeber time; ZT0: 7 am; lights on). The behavioral tests used were tight rope test to determine motor coordination; hanging wire test to study muscular strength; elevated plus maze and open field tests to evaluate anxiety like-behavior and locomotor activity. Tests were carried out at basal point that matched with lights onset and every 6 h up to 18 h after treatments. Hangover onset was established at ZT7 when blood alcohol concentration (BAC) was almost zero. Our results showed that the mixture of alcohol and energy drink altered significantly motor skills. Specifically, a significant decrease was observed in the performance of the animals in the tightrope and hanging wire tests in groups treated with the mixture of alcohol and energy drink. A significant impairment in the anxiety-like behavior was observed mainly at the beginning of alcohol hangover. These findings suggest that energy drink added to alcohol extends motor disabilities observed during an alcohol hangover episode in comparison with animals that received alcohol alone.
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Affiliation(s)
- Lucas G Asorey
- Universidad de Buenos Aires, CONICET, Instituto de Fisiología y Biofísica "Bernardo Houssay" (IFIBIO), Buenos Aires, Argentina
| | - Silvia Carbone
- Universidad de Buenos Aires, CONICET, Departamento de Ciencias Fisiológicas, Buenos Aires, Argentina
| | - Bárbara J Gonzalez
- Universidad de Buenos Aires, CONICET, Departamento de Ciencias Fisiológicas, Buenos Aires, Argentina
| | - Rodolfo A Cutrera
- Universidad de Buenos Aires, CONICET, Instituto de Fisiología y Biofísica "Bernardo Houssay" (IFIBIO), Buenos Aires, Argentina.
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Curran CP, Marczinski CA. Taurine, caffeine, and energy drinks: Reviewing the risks to the adolescent brain. Birth Defects Res 2017; 109:1640-1648. [PMID: 29251842 PMCID: PMC5737830 DOI: 10.1002/bdr2.1177] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/02/2017] [Indexed: 01/04/2023]
Abstract
Energy drinks are emerging as a major component of the beverage market with sales projected to top $60 billion globally in the next five years. Energy drinks contain a variety of ingredients, but many of the top-selling brands include high doses of caffeine and the amino acid taurine. Energy drink consumption by children has raised concerns, due to potential caffeine toxicity. An additional risk has been noted among college-aged consumers of energy drinks who appear at higher risk of over-consumption of alcohol when the two drinks are consumed together. The differential and combinatorial effects of caffeine and taurine on the developing brain are reviewed here with an emphasis on the adolescent brain, which is still maturing. Key data from animal studies are summarized to highlight both reported benefits and adverse effects reported following acute and chronic exposures. The data suggest that age is an important factor in both caffeine and taurine toxicity. Although the aged or diseased brain might benefit from taurine or caffeine supplementation, it appears that adolescents are not likely to benefit from supplementation and may, in fact, suffer ill effects from chronic ingestion of high doses. Additional work is needed though to address gaps in our understanding of how taurine affects females, since the majority of animal studies focused exclusively on male subjects.
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Affiliation(s)
- Christine Perdan Curran
- Department of Biological Sciences, Northern Kentucky University, Highland Heights, KY, USA 41099
| | - Cecile A. Marczinski
- Department of Psychological Science, Northern Kentucky University, Highland Heights, KY, USA 41099
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