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Gualberto PIB, Benvindo VV, Waclawovsky G, Deresz LF. Acute effects of energy drink consumption on cardiovascular parameters in healthy adults: a systematic review and meta-analysis of randomized clinical trials. Nutr Rev 2024; 82:1028-1045. [PMID: 37695306 DOI: 10.1093/nutrit/nuad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
CONTEXT Energy drinks (EDs) are beverages that contain ingredients that may pose a risk to consumers' cardiovascular health. But current evidence is conflicting and warrants further investigation. OBJECTIVE A systematic review and meta-analysis was conducted on studies that examined the acute effects of ED consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate, cardiac output (CO), endothelial function, and QT/QTc interval in healthy adults. DATA SOURCES The databases PubMed, EMBASE, Cochrane, LILACS, Web of Science, SportDiscus, and the gray literature were searched to identify randomized controlled trials (RCTs). DATA EXTRACTION Two independent evaluators screened 2014 studies and extracted relevant data from those selected for the analysis. A risk of bias assessment was also performed with the RoB 2 tool and a strength of evidence assessment was performed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE). DATA ANALYSIS A total of 17 RCTs were included in the meta-analysis. With regard to risk of bias, 11 studies were rated as having "some concerns" and 6 as "high risk of bias." The consumption of EDs increased SBP, DBP, and CO in different time frames. More pronounced effects were seen on SBP at 60-80 minutes (4.71 mmHg; 95% CI: 2.97-6.45; GRADE: moderate), DBP at 120 minutes (4.51 mmHg; 95% CI: 2.60-6.42; GRADE: low), and CO at 30-40 minutes after consumption (0.43 L; 95% CI: 0.08-0.77; GRADE: very low). The effects of ED consumption on resting heart rate and QT/QTc interval were not significant (P ≤ 0.05). The assessment of endothelial function effects was not performed due to the absence of any RCTs meeting the inclusion criteria. CONCLUSIONS Acute consumption of EDs increases SBP, DBP, and CO in healthy adults. However, no alterations were observed in other cardiovascular parameters. The results should be interpreted with caution due to the limited number of studies included in the analysis. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022295335.
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Affiliation(s)
- Pedro I B Gualberto
- Universidade Federal de Juiz de Fora (UFJF), Minas Gerais, Brazil
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde da UFJF, Governador Valadares, Minas Gerais, Brazil
| | - Vinícius V Benvindo
- Universidade Federal de Juiz de Fora (UFJF), Minas Gerais, Brazil
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde da UFJF, Governador Valadares, Minas Gerais, Brazil
| | - Gustavo Waclawovsky
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
- Programa de Pós-Graduação em Ciências da Saúde: Cardiologia do IC/FUC, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luís F Deresz
- Universidade Federal de Juiz de Fora (UFJF), Minas Gerais, Brazil
- Programa de Pós-Graduação em Ciências Aplicadas à Saúde da UFJF, Governador Valadares, Minas Gerais, Brazil
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Speck NE, Dreier K, Fluetsch A, Ranacher C, Babst D, Lardi AM, Farhadi J. Flying high?-Exploring the effect of red bull on blood pressure after microsurgical breast reconstruction in a randomized controlled trial. J Plast Reconstr Aesthet Surg 2024; 90:200-208. [PMID: 38387416 DOI: 10.1016/j.bjps.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 11/26/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND A sufficiently high blood pressure (BP) is essential for flap perfusion after microsurgical breast reconstruction. However, postoperative hypotension is common after these procedures. Perioperative volume overload may increase flap-related complications, and postoperative vasopressor use may be limited depending on institutions. Red Bull has been shown to increase BP in several studies. We aimed to evaluate the effect of Red Bull on perfusion-related variables after microsurgical breast reconstruction. METHODS We conducted a multicenter, prospective, randomized controlled trial. Female patients undergoing unilateral microsurgical breast reconstruction from June 2020 to October 2022 were randomly assigned to the intervention or control groups. The intervention group received 250 ml of Red Bull 2 h after surgery and twice on postoperative day (POD) 1. The control group received 250 ml still water at the respective intervals. BP was measured using a 24-hour monitoring device. Vasopressor use, fluid balance, and flap outcomes were compared. RESULTS One hundred patients were included in the study. Both groups were comparable concerning age, body mass index, and caffeine consumption. Mean arterial and diastolic BP were significantly higher in the Red Bull group after the second drink in the morning of POD1 (p-value = 0.03 and 0.03, respectively). Vasopressor use was similar, with a tendency for less postoperative etilefrine in the Red Bull group (p-value = 0.08). No flap loss was observed. CONCLUSIONS We observed increased mean arterial and diastolic BP in the Red Bull group after the second drink. Red Bull may be a useful adjunct after microsurgical breast reconstruction. LEVEL OF EVIDENCE I, therapeutic.
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Affiliation(s)
- Nicole E Speck
- Plastic Surgery Group, Zurich, Switzerland; Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland.
| | - Kathrin Dreier
- Department of Anesthesiology, Klinik Pyramide am See, Zurich, Switzerland
| | - Andrin Fluetsch
- Novartis Institutes for Biomedical Research, Basel, Switzerland
| | | | | | | | - Jian Farhadi
- Plastic Surgery Group, Zurich, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland
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Speck NE, Michalak M, Dreier K, Babst D, Lardi AM, Farhadi J. Effect of the Red Bull Energy Drink on Perfusion-Related Variables in Women Undergoing Microsurgical Breast Reconstruction: Protocol and Analysis Plan for a Prospective, Multicenter Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e38487. [PMID: 37159251 DOI: 10.2196/38487] [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: 05/01/2022] [Revised: 03/27/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Maintaining a sufficiently high systolic blood pressure is essential for free flap perfusion after microsurgical breast reconstruction. Yet, many women undergoing these procedures have low postoperative systolic blood pressure. Intravenous volume administration or vasopressors may be needed to maintain systolic blood pressure above a predefined threshold. However, excessive volume administration may lead to volume overload and flap stasis, and the postoperative use of vasopressors may be limited depending on institutional standards. Additional nonpharmacological measures to raise blood pressure might be beneficial. Evidence suggests that the Red Bull energy drink could raise blood pressure. It has been shown to increase systolic and diastolic blood pressure in healthy volunteers and athletes. OBJECTIVE The primary objective of this study is to determine the difference in systolic blood pressure between an intervention group receiving Red Bull and a control group receiving still water after microsurgical breast reconstruction. Secondary objectives include postoperative heart rate, 24-hour fluid balance, pain level, or necessity for revision surgery due to flap complications. METHODS The Red Bull study is a prospective, multicenter randomized controlled trial comparing the effect of postoperative ingestion of Red Bull energy drink against still water in female patients undergoing unilateral microsurgical breast reconstruction. A total of 250 mL of Red Bull (intervention group) or 250 mL of still water (control group) will be administered to the study participants 2 hours postoperatively as well as for breakfast and lunch on postoperative day 1, amounting to a total volume of 750 mL per 24 hours. Female patients between 18 and 70 years of age undergoing unilateral microsurgical breast reconstruction will be included. Exclusion criteria are a history of arterial hypertension, cardiac rhythm disorder, diabetes mellitus, gastric or duodenal ulcer, thyroid disease, and current use of antihypertensive or antiarrhythmic drugs or thyroid hormones, as well as intolerance to Red Bull. RESULTS Recruitment for the study started in June 2020 and was completed in December 2022. There is evidence that the Red Bull energy drink increases blood pressure in healthy volunteers and athletes. We hypothesize that postoperative ingestion of Red Bull will increase systolic blood pressure in women after microsurgical breast reconstruction. Red Bull could hence be used as a nonpharmacological adjunct to vasopressors or volume administration in women with hypotensive blood pressure after microsurgical breast reconstruction. CONCLUSIONS This paper describes the Red Bull study trial protocol and analysis plan. The information will increase the transparency of the data analysis for the Red Bull study. TRIAL REGISTRATION ClinicalTrials.gov NCT04397419; https://clinicaltrials.gov/ct2/show/NCT04397419. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38487.
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Affiliation(s)
- Nicole Edith Speck
- Plastic Surgery Group, Zurich, Switzerland
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - Michal Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Kathrin Dreier
- Department of Anesthesiology, Klinik Pyramide am See, Zurich, Switzerland
| | | | | | - Jian Farhadi
- Plastic Surgery Group, Zurich, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
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AdibSaber F, Ansari S, Elmieh A, Rajabzadeh H. Effect of an Energy Drink On Muscle and Liver Damage Enzymes, And Cardiovascular Indices in Soccer Players. SCI MED FOOTBALL 2023; 7:8-14. [PMID: 35260042 DOI: 10.1080/24733938.2022.2051728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Despite emerging evidence about the influence of energy drinks on the quality of athletes' performance, there is little information about their effects on exercise-induced damage markers after long-term activities. This study aimed to investigate the acute effects of hype energy drink (HED) to ameliorate liver and muscle damage enzymes and cardiovascular indices-induced by a soccer match. A total of 22 elite male soccer players (age 20.36 ± 1.91) were recruited. Participants performed two experimental conditions, separated by a 14-day washout period. They consumed 2 × 250 ml of HED or placebo for 5 d before the soccer match, on match day, and for 1-day post-match. Measurements of muscle (CK and LDH), and liver (ALT, AST, and ALP) damage indices, and blood pressure (BP) parameters were taken at baseline, pre-match, post-match, and 24 h post-match. The results showed that the levels of ALT, AST, ALP, CPK, and LDH enzymes significantly decreased in HED condition from pre-match to 24 h post-match, compared with placebo (p < 0.001). Also, consumption of energy drinks reduced systolic, diastolic, and mean BP. In conclusion, elevated serum levels of muscle and liver damage enzymes and higher values of BP indices are improved 24 hours after soccer match following HED ingestion, compared to placebo. Therefore, it seems that consuming HED can lead to faster recovery of muscle and liver damage and improve recovery in soccer players.
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Affiliation(s)
- Fahimeh AdibSaber
- Department of Physical Education, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Soleyman Ansari
- Department of Physical Education, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Alireza Elmieh
- Department of Physical Education, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Hadi Rajabzadeh
- Department of Physical Education, Faculty of Humanities, Islamic Azad University, Rasht Branch, Rasht, Iran
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Costa R, Rocha C, Santos H. Cardiovascular and Cerebrovascular Response to RedBull® Energy Drink Intake in Young Adults. Anatol J Cardiol 2023; 27:19-25. [PMID: 36680443 PMCID: PMC9893714 DOI: 10.14744/anatoljcardiol.2022.2315] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/21/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Energy drinks contain caffeine, taurine, sucrose, vitamins, and other amino acids. The dosage of these varies depending on the drink chosen. Several studies on energy drinks have been carried out, but the results obtained are still inconsistent as well as the risk associated with consumption. This study analyzed the cardio- and cerebrovascular responses after consumption of an energy drink - RedBull® - under standardized pre- and post-ingestion conditions and its impact on the cardiovascular and cerebrovascular system. METHODS A sample of 30 healthy young adult females was recruited and subjected to 3 moments of evaluation: at baseline, 30 minutes after ingesting the energy drink, and 60 minutes after ingesting it according to a non-randomized pre-post intervention study design. RESULTS It is found that over time there are significant changes in peak systolic velocity (P =.006) and endodiastolic velocity (P <.001) of common carotid artery, peak systolic velocity (P =.007), and endodiastolic velocity (P <.001) of internal carotid artery, peak systolic velocity (P =.004), end endodiastolic velocity (P =.013) of the external carotid artery, endodiastolic velocity (P =.042) of the middle cerebral artery, cardiac output (P =.004), and heart rate (P <.001). CONCLUSIONS After the consumption of Redbull®, there was a decrease in the velocities of the carotid arteries and the middle cerebral artery as well as a decrease in cardiac output accompanied by a decrease in heart rate and a slight, although not significant, increase in systolic and diastolic blood pressures. However, it is still unclear which pathophysiological mechanisms are responsible for these changes.
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Affiliation(s)
- Rita Costa
- Department of Clinical Physiology, Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
| | - Clara Rocha
- Department of Complementary Sciences, Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
- Department of Electrical and Computer Engineering, INESC Coimbra, University of Coimbra, Coimbra, Portugal
- Laboratory for Applied Health Research (LabinSaúde), Coimbra, Portugal
| | - Helder Santos
- Department of Clinical Physiology, Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal
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Ravussin Y, Montani JP, Grasser EK. Sucrose dampens caffeine-induced blood pressure elevations - A randomized crossover pilot study in healthy, non-obese men. Front Nutr 2022; 9:896055. [PMID: 35990317 PMCID: PMC9386265 DOI: 10.3389/fnut.2022.896055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Sales for sugar-sweetened and caffeinated beverages are still rising globally and their consumption has been linked to the development of cardiovascular diseases. However, direct evidence from human interventional studies in response to such beverages is still scarce. Methods Seven young, non-obese men participated in a randomized crossover study where four test drinks [60 g sucrose + 50 mg caffeine, 60 g sucrose + caffeine-placebo, 50 mg caffeine, and caffeine-placebo] were investigated. Each drink was brought to a total volume of 500 mL with water. Continuous and beat-to-beat hemodynamic monitoring was conducted for 30 min baseline and continued for 90 min after the ingestion of each drink. Measurements included blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, index of contractility, and double product. Results Two-factor ANOVA analysis revealed significant treatment-by-time effects for diastolic blood pressure, heart rate, stroke volume, cardiac output, total peripheral resistance, index of contractility, and double product (all p < 0.01). Diastolic blood pressure and total peripheral resistance increased significantly to caffeine-only (all p < 0.05), while sucrose + caffeine-placebo and sucrose + caffeine both decreased resistance responses (all p < 0.05). Cardiac output increased significantly to sucrose + caffeine-placebo and sucrose + caffeine (all p < 0.05), and on trend for heart rate, stroke volume, and index of contractility (all p between 0.05 and 0.09). Conclusion In young, non-obese men, a caffeinated and sucrose-sweetened beverage at concentrations similar to classical commercial Cola products exhibited distinct hemodynamic actions where the presence of sucrose dampened caffeine-induced blood pressure elevations, but at the expense of a tendency to increase cardiac work.
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Affiliation(s)
- Yann Ravussin
- Department of Endocrinology, Metabolism, and Cardiovascular System, University of Fribourg, Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Endocrinology, Metabolism, and Cardiovascular System, University of Fribourg, Fribourg, Switzerland
| | - Erik Konrad Grasser
- Department of Endocrinology, Metabolism, and Cardiovascular System, University of Fribourg, Fribourg, Switzerland
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Chronic Red Bull Consumption during Adolescence: Effect on Mesocortical and Mesolimbic Dopamine Transmission and Cardiovascular System in Adult Rats. Pharmaceuticals (Basel) 2021; 14:ph14070609. [PMID: 34202876 PMCID: PMC8308486 DOI: 10.3390/ph14070609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/17/2022] Open
Abstract
Energy drinks are very popular nonalcoholic beverages among adolescents and young adults for their stimulant effects. Our study aimed to investigate the effect of repeated intraoral Red Bull (RB) infusion on dopamine transmission in the nucleus accumbens shell and core and in the medial prefrontal cortex and on cardiac contractility in adult rats exposed to chronic RB consumption. Rats were subjected to 4 weeks of RB voluntary consumption from adolescence to adulthood. Monitoring of in vivo dopamine was carried out by brain microdialysis. In vitro cardiac contractility was studied on biomechanical properties of isolated left-ventricular papillary muscle. The main finding of the study was that, in treated animals, RB increased shell dopamine via a nonadaptive mechanism, a pattern similar to that of drugs of abuse. No changes in isometric and isotonic mechanical parameters were associated with chronic RB consumption. However, a prolonged time to peak tension and half-time of relaxation and a slower peak rate of tension fall were observed in RB-treated rats. It is likely that RB treatment affects left-ventricular papillary muscle contraction. The neurochemical results here obtained can explain the addictive properties of RB, while the cardiovascular investigation findings suggest a hidden papillary contractility impairment.
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Chowaniak M, Niemiec M, Zhu Z, Rashidov N, Gródek-Szostak Z, Szeląg-Sikora A, Sikora J, Kuboń M, Fayzullo SA, Mahmadyorzoda UM, Józefowska A, Lepiarczyk A, Gambuś F. Quality Assessment of Wild and Cultivated Green Tea from Different Regions of China. Molecules 2021; 26:3620. [PMID: 34199199 PMCID: PMC8231865 DOI: 10.3390/molecules26123620] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Natural products have always enjoyed great popularity among consumers. Wild tea is an interesting alternative to tea from intensive plantations. The term "wild tea" is applied to many different varieties of tea, the most desirable and valued of which are native or indigenous tea plants. Special pro-health properties of wild tea are attributed to the natural conditions in which it grows. However, there are no complex studies that describe quality and health indicators of wild tea. The aim of this research was to evaluate the quality of wild and cultivated green tea from different regions of China: Wuzhishan, Baisha, Kunlushan, and Pu'Er. The assessment was carried out by verifying the concentration of selected chemical components in tea and relating it to the health risks they may pose, as well as to the nutritional requirements of adults. Wild tea was characterized by higher micronutrient concentration. The analyzed teas can constitute a valuable source of Mn in the diet. A higher concentration of nitrates and oxalates in cultivated tea can be associated with fertilizer use. The analyzed cultivated tea was a better source of antioxidants with a higher concentration of caffeine. There were no indications of health risks for wild or cultivated teas.
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Affiliation(s)
- Maciej Chowaniak
- Department of Agroecology and Crop Production, Faculty of Agriculture and Economics, University of Agriculture in Krakow, Al. Mickiewicza 21, 31-120 Krakow, Poland;
| | - Marcin Niemiec
- Department of Agricultural and Environmental Chemistry, Faculty of Agriculture and Economics, University of Agriculture in Krakow, Al. Mickiewicza 21, 31-120 Krakow, Poland; (M.N.); (F.G.)
| | - Zhiqiang Zhu
- Department of Agricultural Resources and Environment, College of Tropical Crops, Hainan University, Renmin Avenue, Haikou, Hainan Province 570228, China;
| | - Naim Rashidov
- Department of Food Products and Agrotechnology, Polytechnical Institute of Tajik Technical University by Academician M.S. Osimi in Khujand, Lenin St. 226, Khujand 735700, Tajikistan;
| | - Zofia Gródek-Szostak
- Department of Economics and Enterprise Organization, Cracow University of Economics, 31-510 Krakow, Poland;
| | - Anna Szeląg-Sikora
- Faculty of Production and Power Engineering, University of Agriculture in Krakow, 30-149 Kraków, Poland; (A.S.-S.); (J.S.); (M.K.)
| | - Jakub Sikora
- Faculty of Production and Power Engineering, University of Agriculture in Krakow, 30-149 Kraków, Poland; (A.S.-S.); (J.S.); (M.K.)
| | - Maciej Kuboń
- Faculty of Production and Power Engineering, University of Agriculture in Krakow, 30-149 Kraków, Poland; (A.S.-S.); (J.S.); (M.K.)
- Eastern European State College of Higher Education in Przemyśl, Książąt Lubomirskich 6, 37-700 Przemyśl, Poland
| | | | - Usmon Mamur Mahmadyorzoda
- Tajik Agrarian University Named After Shirinsho Shotemur, Rudaki Avenue 146, Dushanbe 734003, Tajikistan;
| | - Agnieszka Józefowska
- Department of Soil Science and Agrophysics, Faculty of Agriculture and Economics, University of Agriculture in Krakow, Al. Mickiewicza 21, 31-120 Krakow, Poland;
| | - Andrzej Lepiarczyk
- Department of Agroecology and Crop Production, Faculty of Agriculture and Economics, University of Agriculture in Krakow, Al. Mickiewicza 21, 31-120 Krakow, Poland;
| | - Florian Gambuś
- Department of Agricultural and Environmental Chemistry, Faculty of Agriculture and Economics, University of Agriculture in Krakow, Al. Mickiewicza 21, 31-120 Krakow, Poland; (M.N.); (F.G.)
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The Effects of Direct Red Bull Administration to Isolated Hearts of Trained and Untrained Rats Who Regularly Consumed or Did Not Consume Energy Drink: Focus on Cardiodynamics and Oxidative Stress. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2019-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Energy drinks (EDs) contain caffeine and other active ingredients which affect cardiovascular system. The aims of this study were to examine direct effects of Red Bull (RB) on cardiodynamics and oxidative stress in isolated hearts of rats. The rats were divided into four groups: untrained rats who never consumed ED (dEDUT); untrained rats who consumed ED 5 days a week during 4 weeks (ch+dED-UT); rats trained 5 times a week for 4 weeks, but did not consume ED (dED-T); rats trained and consumed ED 5 times a week for 4 weeks (ch+dED-T). After sacrificing, hearts were isolated and perfused according to Langendorff technique. Through the isolated heart of all rats in each group, RB was administered. The parameters of cardiac function were recorded, and the levels of prooxidants were measured in the coronary effluent during coronary autoregulation. Rats in ch+dED-UT group had significantly lower rates of myocardial contraction and relaxation compared to rats in dED-UT group. The same effect was recorded in the dED-T group compared to dED-UT group. The levels of hydrogen peroxide were significantly higher in trained rats. Rats in ch+dED-T group also had significantly higher levels of superoxide anion radical and index of lipid peroxidation, as well as lower levels of nitrites when compared to ch+dED-UT group, while opposite effect was recorded in rats in dED-T group compared to dEDUT group. The RB could have a potentially negative inotropic effect in chronic consumers. Prooxidative effect of RB was most pronounced in trained chronic consumers.
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La Vieille S, Gillespie Z, Bonvalot Y, Benkhedda K, Grinberg N, Rotstein J, Barber J, Krahn AD. Caffeinated energy drinks in the Canadian context: health risk assessment with a focus on cardiovascular effects. Appl Physiol Nutr Metab 2021; 46:1019-1028. [PMID: 34000209 DOI: 10.1139/apnm-2021-0245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In Canada, caffeinated energy drinks (CEDs) currently sold under Temporary Marketing Authorizations must meet strict eligibility criteria. These criteria, which include compositional and labelling requirements, were developed based on the outcome of a health risk assessment conducted by Health Canada (HC) in 2013. HC updated its assessment by reviewing new information with the focus on potential cardiovascular effects associated with the consumption of CEDs available for sale in Canada. Due to limited data on CED consumption among Canadians to derive accurate exposure information, the composition of a typical CED was characterized to assess the potential effects of single ingredients and synergistic interactions between ingredients on the cardiovascular system. Surveillance data on potential adverse effects related to CED consumption was also analyzed. After extensive review, HC's updated assessment confirms the current risk management approach for CEDs is health protective for Canadian consumers, including the potential for cardiovascular effects. The available evidence supports that moderate consumption (up to 500 mL per day) of a typical CED authorized for sale in Canada is safe for the general population of healthy adults and adolescents. It also re-confirms that vulnerable sub-populations (i.e., children, pregnant and/or breastfeeding women, and caffeine-sensitive individuals) should not consume CEDs. Novelty: Consumption up to 500 mL per day of a typical CED is not associated with an increased risk of cardiovascular effects. Children, pregnant and/or breastfeeding women, and caffeine-sensitive individuals should not consume CEDs.
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Affiliation(s)
| | - Zoe Gillespie
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Yvette Bonvalot
- Biostatistics and Modelling Division, Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Karima Benkhedda
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Nancy Grinberg
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Joel Rotstein
- Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Jennifer Barber
- Bureau of Nutritional Sciences, Food Directorate, Health Canada, Ottawa, ON, Canada
| | - Andrew D Krahn
- Center for Cardiovascular Innovation, Division of Cardiology, The University of British Columbia, Vancouver, BC, Canada
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Energy Drinks and Sports Performance, Cardiovascular Risk, and Genetic Associations; Future Prospects. Nutrients 2021; 13:nu13030715. [PMID: 33668219 PMCID: PMC7995988 DOI: 10.3390/nu13030715] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/05/2021] [Accepted: 02/20/2021] [Indexed: 12/29/2022] Open
Abstract
The consumption of energy drinks (e.g., containing caffeine and taurine) has increased over the last decade among adolescents and athletes to enhance their cognitive level and improve intellectual and athletic performance. Numerous studies have shown that drinking moderate doses of such drinks produces beneficial effects, as they considerably boost the sporting performance of elite athletes in various sports, including both endurance and explosive events. However, apart from their ergogenic effects, the regular consumption of energy drinks also increases blood pressure and consequently incites problems such as hypertension, tachycardia, and nervousness, all of which can lead to cardiovascular disorders. A potential positive correlation between genetics and the moderate consumption of energy drinks and athletic performance has recently been reported; notwithstanding, a better understanding of the genetic variants involved in metabolism is a key area for future research to optimize the dose of energy drink consumed and obtain the maximal ergogenic effect in elite sports. The aim of this literature review, therefore, is to present the results of recent studies, classifying them according to the differences in the associations between energy drinks and: (i) Athletic performance; (ii) cardiovascular risk factors while practicing sports; and (iii) genetic associations and future prospects between the consumption of energy drinks and performance.
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The impact of acute energy drink consumption on electrical heart disease: A systematic review and meta-analysis. J Electrocardiol 2021; 65:128-135. [PMID: 33631440 DOI: 10.1016/j.jelectrocard.2021.01.020] [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: 10/09/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 11/22/2022]
Abstract
AIMS Energy Drink (ED)-associated cardiovascular emergency visits have increased in recent years. Although a toxicity threshold has been established for caffeine, the safety profile of whole ED consumption has not yet been defined. METHODS This systematic review was conducted following the PRISMA guidelines. Three reviewers conducted two separate systematic searches on PubMed on October 24 and December 3, 2019. Out of 250 potential records, 43 prospective clinical studies assessing the effects of ED on heart rate (HR) and/or any electrocardiographic (ECG) parameters were included. A meta-analysis was conducted to estimate pooled p-values using metap command for STATA 10.0. RESULTS After ED consumption, resting HR increased in 71.1% of studies (pooled p-value <0.001) but was only significant in 38%; HR during and after exercise increased in 55.5% (pooled p-value <0.001) and 71.4% of studies, respectively; QRS increased in all but two protocols; evidence on PR interval was contradictory, and corrected QT interval (QTc) increased compared to baseline in all but one study, exceeding the pathological limit value in two of them. T wave changes were seen in two studies, and one study reported a ratio of 5 to 1 in the number of ectopic beats. CONCLUSION Acute consumption of ED can alter the ECG in certain risk populations, posing a risk whose magnitude is yet to be determined. Caution should be exercised among at-risk and underage individuals but further research in these populations is warranted before restrictions are made.
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13
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Luo YS, Chen Z, Blanchette AD, Zhou YH, Wright FA, Baker ES, Chiu WA, Rusyn I. Relationships between constituents of energy drinks and beating parameters in human induced pluripotent stem cell (iPSC)-Derived cardiomyocytes. Food Chem Toxicol 2021; 149:111979. [PMID: 33450301 DOI: 10.1016/j.fct.2021.111979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/24/2022]
Abstract
Consumption of energy drinks has been associated with adverse cardiovascular effects; however, little is known about the ingredients that may contribute to these effects. We therefore characterized the chemical profiles and in vitro effects of energy drinks and their ingredients on human induced pluripotent stem cell (iPSC)-derived cardiomyocytes, and identified the putative active ingredients using a multivariate prediction model. Energy drinks from 17 widely-available over-the-counter brands were evaluated in this study. The concentrations of six common ingredients (caffeine, taurine, riboflavin, pantothenic acid, adenine, and L-methionine) were quantified by coupling liquid chromatography with a triple quadrupole mass spectrometer for the acquisition of LC-MS/MS spectra. In addition, untargeted analyses for each beverage were performed with a platform combining LC, ion mobility spectrometry and mass spectrometry (LC-IMS-MS) measurements. Approximately 300 features were observed across samples in the untargeted studies, and of these ~100 were identified. In vitro effects of energy drinks and some of their ingredients were then tested in iPSC-derived cardiomyocytes. Data on the beat rate (positive and negative chronotropy), ion channel function (QT prolongation), and cytotoxicity were collected in a dilution series. We found that some of the energy drinks elicited adverse effects on the cardiomyocytes with the most common being an increase in the beat rate, while QT prolongation was also observed at the lowest concentrations. Finally, concentration addition modeling using quantitative data from the 6 common ingredients and multivariate prediction modeling was used to determine potential ingredients responsible for the adverse effects on the cardiomyocytes. These analyses suggested theophylline, adenine, and azelate as possibly contributing to the in vitro effects of energy drinks on QT prolongation in cardiomyocytes.
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Affiliation(s)
- Yu-Syuan Luo
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, USA
| | - Zunwei Chen
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, USA
| | - Alexander D Blanchette
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, USA
| | - Yi-Hui Zhou
- Departments of Statistics and Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Fred A Wright
- Departments of Statistics and Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Erin S Baker
- Department of Chemistry, North Carolina State University, Raleigh, NC, USA
| | - Weihsueh A Chiu
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, USA
| | - Ivan Rusyn
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, USA.
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14
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Monnard CR, Montani JP, Grasser EK. Short-term cardiovascular responses to ingestion of mineral water in healthy non-obese adults: Impact of mineral components. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.104017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Red Bull Increases Heart Rate at Near Sea Level and Pulmonary Shunt Fraction at High Altitude in a Porcine Model. Nutrients 2020; 12:nu12061738. [PMID: 32532046 PMCID: PMC7352389 DOI: 10.3390/nu12061738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022] Open
Abstract
Red Bull energy drink is popular among athletes, students and drivers for stimulating effects or enhancing physical performance. In previous work, Red Bull has been shown to exert manifold cardiovascular effects at rest and during exercise. Red Bull with caffeine as the main ingredient increases blood pressure in resting individuals, probably due to an increased release of (nor)-epinephrine. Red Bull has been shown to alter heart rate or leaving it unchanged. Little is known about possible effects of caffeinated energy drinks on pulmonary ventilation/perfusion distribution at sea level or at altitude. Here, we hypothesized a possible alteration of pulmonary blood flow in ambient air and in hypoxia after Red Bull consumption. We subjected eight anesthetized piglets in normoxia (FiO2 = 0.21) and in hypoxia (FiO2 = 0.13), respectively, to 10 mL/kg Red Bull ingestion. Another eight animals served as controls receiving an equivalent amount of saline. In addition to cardiovascular data, ventilation/perfusion distribution of the lung was assessed by using the multiple inert gas elimination technique (MIGET). Heart rate increased in normoxic conditions but was not different from controls in acute short-term hypoxia after oral Red Bull ingestion in piglets. For the first time, we demonstrate an increased fraction of pulmonary shunt with unchanged distribution of pulmonary blood flow after Red Bull administration in acute short-term hypoxia. In summary, these findings do not oppose moderate consumption of caffeinated energy drinks even at altitude at rest and during exercise.
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16
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Ehlers A, Marakis G, Lampen A, Hirsch-Ernst KI. Risk assessment of energy drinks with focus on cardiovascular parameters and energy drink consumption in Europe. Food Chem Toxicol 2019; 130:109-121. [PMID: 31112702 DOI: 10.1016/j.fct.2019.05.028] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 01/01/2023]
Abstract
To assess the possible cardiovascular risks associated with energy drink (ED) consumption in Europe, a comprehensive literature research was performed in regard to (i) possible ED-induced dose-dependent cardiovascular outcomes, (ii) ED consumption patterns in Europe and (iii) the risks of EDs in combination with alcohol. The identified intervention studies primarily investigated acute ED effects in young healthy adults. Moderate consumption of EDs corresponding to an acute caffeine intake of up to 200 mg did not result in clinically relevant cardiovascular changes in young healthy adults. However, high intake of EDs (about 1 L) was associated with moderate to severe adverse effects in some participants (i.a. prolonged QTc interval, palpitations). Studies have indicated that on some occasions, a substantial proportion of ED consuming children and adolescents (12% in 16 EU Member States) drink EDs in high quantities (≥1 L). This could pose a possible health risk to this group since adverse effects by such high ED consumption have been observed already in young healthy adults. Among further measures that might be considered to minimize this identified risk, policy makers could develop information and educational programs with the aim of raising public awareness.
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Affiliation(s)
- Anke Ehlers
- German Federal Institute for Risk Assessment, Department of Food Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany.
| | - Georgios Marakis
- Hellenic Food Authority, Directorate of Risk Assessment and Nutrition, Kifisias Av. 124 & Iatridou Str. 2, 11526 Athens, Greece
| | - Alfonso Lampen
- German Federal Institute for Risk Assessment, Department of Food Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Karen Ildico Hirsch-Ernst
- German Federal Institute for Risk Assessment, Department of Food Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
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17
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Nowak D, Gośliński M, Nowatkowska K. The Effect of Acute Consumption of Energy Drinks on Blood Pressure, Heart Rate and Blood Glucose in the Group of Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030544. [PMID: 29562659 PMCID: PMC5877089 DOI: 10.3390/ijerph15030544] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/02/2018] [Accepted: 03/14/2018] [Indexed: 02/08/2023]
Abstract
Background: Energy drinks (EDs) are very popular among young people, who consume them for various reasons. A standard ED typically contains 80 mg of caffeine, as well as glucose, taurine, vitamins and other ingredients. Excessive consumption of EDs and accumulation of the above ingredients, as well as their mutual interactions, can be hazardous to the health of young adults. The purpose of this study was to assess the effect of acute consumption of energy drinks on blood pressure, heart rate and blood glucose. Methods: The study involved 68 volunteers, healthy young adults (mean age 25 years), who were divided into two groups: the first consumed three EDs at one-hour intervals, and the second drank the same amount of water. All participants had their blood pressure (BP)—systolic and diastolic (SBP and DBP)—as well as heart rate (HR) and blood glucose (BG) measured. In addition, participants could report any health problems before and after consuming each portion of ED. Results: In the above experiment, having consumed three portions of ED (240 mg of caffeine), the participants presented a significant increase in DBP (p = 0.003), by over 8%, which coincided with a lack of any significant impact on SBP (p = 0.809). No significant changes were noted in HR (p = 0.750). Consumption of EDs caused a significant increase (p < 0.001) in BG, by ca. 21%, on average. Some participants reported various discomforts, which escalated after 2 and 3 EDs. Conclusions: Acute consumption of EDs contributed to increased diastolic blood pressure, blood glucose and level of discomfort in healthy young people. Our results reinforce the need for further studies on a larger population to provide sufficient evidence.
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Affiliation(s)
- Dariusz Nowak
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Dębowa 3, 85-626 Bydgoszcz, Poland.
| | - Michał Gośliński
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Dębowa 3, 85-626 Bydgoszcz, Poland.
| | - Kamila Nowatkowska
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Dębowa 3, 85-626 Bydgoszcz, Poland.
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18
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Caffeine and cardiovascular health. Regul Toxicol Pharmacol 2017; 89:165-185. [DOI: 10.1016/j.yrtph.2017.07.025] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/21/2017] [Accepted: 07/23/2017] [Indexed: 02/07/2023]
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19
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Carbone A, D’Andrea A, Riegler L, Scarafile R, Pezzullo E, Martone F, America R, Liccardo B, Galderisi M, Bossone E, Calabrò R. Cardiac damage in athlete’s heart: When the “supernormal” heart fails! World J Cardiol 2017; 9:470-480. [PMID: 28706583 PMCID: PMC5491465 DOI: 10.4330/wjc.v9.i6.470] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/05/2017] [Accepted: 04/10/2017] [Indexed: 02/07/2023] Open
Abstract
Intense exercise may cause heart remodeling to compensate increases in blood pressure or volume by increasing muscle mass. Cardiac changes do not involve only the left ventricle, but all heart chambers. Physiological cardiac modeling in athletes is associated with normal or enhanced cardiac function, but recent studies have documented decrements in left ventricular function during intense exercise and the release of cardiac markers of necrosis in athlete’s blood of uncertain significance. Furthermore, cardiac remodeling may predispose athletes to heart disease and result in electrical remodeling, responsible for arrhythmias. Athlete’s heart is a physiological condition and does not require a specific treatment. In some conditions, it is important to differentiate the physiological adaptations from pathological conditions, such as hypertrophic cardiomyopathy, arrhythmogenic dysplasia of the right ventricle, and non-compaction myocardium, for the greater risk of sudden cardiac death of these conditions. Moreover, some drugs and performance-enhancing drugs can cause structural alterations and arrhythmias, therefore, their use should be excluded.
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20
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Mangi MA, Rehman H, Rafique M, Illovsky M. Energy Drinks and the Risk of Cardiovascular Disease: A Review of Current Literature. Cureus 2017; 9:e1322. [PMID: 28690955 PMCID: PMC5501707 DOI: 10.7759/cureus.1322] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Energy drinks (EDs) are commonly used as a dietary supplement by young adolescents and adults. They are often used as a source of energy in order to enhance physical and mental performance. EDs contain a variety of substances, but caffeine is the main component. Safety has been the biggest concern associated with consuming EDs. Case reports, observational studies, and meta-analyses have been done in order to determine the effects of EDs on cardiovascular changes. The detrimental effects of EDs are cardiac arrhythmias, myocardial infarction, prolonged QT interval, aortic dissection, and death. In this article, we review case reports, observational studies, and meta-analyses of EDs and the risk of cardiovascular events and mortality. We also review active ingredients, pharmacokinetics, and the mechanism of action of EDs.
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Affiliation(s)
| | - Hiba Rehman
- GME Internal Medicine, Orange Park Medical Center
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21
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Temple JL, Bernard C, Lipshultz SE, Czachor JD, Westphal JA, Mestre MA. The Safety of Ingested Caffeine: A Comprehensive Review. Front Psychiatry 2017; 8:80. [PMID: 28603504 PMCID: PMC5445139 DOI: 10.3389/fpsyt.2017.00080] [Citation(s) in RCA: 235] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/24/2017] [Indexed: 12/12/2022] Open
Abstract
Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.
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Affiliation(s)
- Jennifer L. Temple
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | | | - Steven E. Lipshultz
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Jason D. Czachor
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Joslyn A. Westphal
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
| | - Miriam A. Mestre
- Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, MI, USA
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22
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Enriquez A, Frankel DS. Arrhythmogenic effects of energy drinks. J Cardiovasc Electrophysiol 2017; 28:711-717. [PMID: 28387431 DOI: 10.1111/jce.13210] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/26/2017] [Accepted: 03/26/2017] [Indexed: 12/26/2022]
Abstract
Energy drinks (ED) are increasingly popular, especially among adolescents and young adults. They are marketed as enhancers of energy, alertness, and physical performance. ED contain high doses of caffeine and other active ingredients. Their safety has come under question due to reports temporally linking ED consumption with serious cardiovascular events, including arrhythmias and sudden cardiac death. In this article, we report 2 cases of life-threatening ventricular arrhythmias in young patients after consuming ED. We also review the ingredients of ED, the physiologic effects on the cardiovascular system, and the available evidence suggesting arrhythmogenecity.
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Affiliation(s)
- Andres Enriquez
- Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David S Frankel
- Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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23
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Sarafian D, Miles-Chan JL. The Influence of Gender and Anthropometry on Haemodynamic Status at Rest and in Response to Graded Incremental Head-Up Tilt in Young, Healthy Adults. Front Physiol 2017; 7:656. [PMID: 28101061 PMCID: PMC5209346 DOI: 10.3389/fphys.2016.00656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/14/2016] [Indexed: 01/02/2023] Open
Abstract
The body's ability to rapidly and appropriately regulate blood pressure in response to changing physiological demand is a key feature of a healthy cardiovascular system. Passively tilting the body, thereby changing central blood volume, is a well-recognized and controlled method of evaluating this ability. However, such studies usually involve single tilt angles, or intermittent tilting separated by supine, resting periods; valuable information concerning the adaptive capacity of the regulatory systems involved is therefore currently lacking. Furthermore, despite increasing recognition that men and women differ in the magnitude of their haemodynamic response to such stimuli, little is known about the degree to which gender differences in body composition and anthropometry influence these regulatory pathways, or indeed if these differences are apparent in response to graded, incremental tilting. In the present study we measured, in 23 young, healthy adults (13 men, 10 women), the continuous beat-to-beat haemodynamic response to graded, incremental tilting (0°, 20°, 40°, 60°, and back to 40°) with each tilt angle lasting 16 min. On average, we observed increases in heart rate (+41%), blood pressure (+10%), and total peripheral resistance (+16%) in response to tilting. However, whilst men showed an immediate decrease in cardiac output upon tilting (−8.9%) cardiac output in women did not change significantly from supine values. Interestingly, the decrease in stroke volume observed in women was significantly less than that observed in men (−22 vs. −36%, p < 0.05); although the present study could not determine if this difference was due to gender per se or due to differences in body size (in particular height) between the two gender groups. Such disparities in the magnitude of autonomic response may indicate (in the case of our gradual incremental tilt procedure) a better buffering capacity to progressive changes in central blood volume in women; which warrants further investigation, particularly in light of the well-recognized differences in cardiovascular disease risk between men and women.
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Affiliation(s)
- Delphine Sarafian
- Laboratory of Integrative Cardiovascular and Metabolic Physiology, Division of Physiology, Department of Medicine, University of Fribourg Fribourg, Switzerland
| | - Jennifer L Miles-Chan
- Laboratory of Integrative Cardiovascular and Metabolic Physiology, Division of Physiology, Department of Medicine, University of Fribourg Fribourg, Switzerland
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24
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Cheung M, Quach J, Chan A, Nguyen NN, Shah SA. Effects of Energy Shots on Blood Pressure in Caffeine-Naive Versus Caffeine-Consuming Healthy Volunteers. JOURNAL OF CAFFEINE RESEARCH 2016. [DOI: 10.1089/jcr.2016.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michael Cheung
- Department of Pharmacy Practice, University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California
| | - Joanna Quach
- Department of Pharmacy Practice, University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California
| | - Amanda Chan
- Department of Pharmacy Practice, University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California
| | - Nancy N. Nguyen
- Department of Pharmacy Practice, University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California
| | - Sachin A. Shah
- Department of Pharmacy Practice, University of the Pacific, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California
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25
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Grasser EK, Miles-Chan JL, Charrière N, Loonam CR, Dulloo AG, Montani JP. Energy Drinks and Their Impact on the Cardiovascular System: Potential Mechanisms. Adv Nutr 2016; 7:950-60. [PMID: 27633110 PMCID: PMC5015039 DOI: 10.3945/an.116.012526] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Globally, the popularity of energy drinks is steadily increasing. Scientific interest in their effects on cardiovascular and cerebrovascular systems in humans is also expanding and with it comes a growing number of case reports of adverse events associated with energy drinks. The vast majority of studies carried out in the general population report effects on blood pressure and heart rate. However, inconsistencies in the current literature render it difficult to draw firm conclusions with regard to the effects of energy drinks on cardiovascular and cerebrovascular variables. These inconsistencies are due, in part, to differences in methodologies, volume of drink ingested, and duration of postconsumption measurements, as well as subject variables during the test. Recent well-controlled, randomized crossover studies that used continuous beat-to-beat measurements provide evidence that cardiovascular responses to the ingestion of energy drinks are best explained by the actions of caffeine and sugar, with little influence from other ingredients. However, a role for other active constituents, such as taurine and glucuronolactone, cannot be ruled out. This article reviews the potentially adverse hemodynamic effects of energy drinks, particularly on blood pressure and heart rate, and discusses the mechanisms by which their active ingredients may interact to adversely affect the cardiovascular system. Research areas and gaps in the literature are discussed with particular reference to the use of energy drinks among high-risk individuals.
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Affiliation(s)
- Erik Konrad Grasser
- Department of Medicine/Physiology, University of Fribourg, Fribourg, Switzerland
| | | | - Nathalie Charrière
- Department of Medicine/Physiology, University of Fribourg, Fribourg, Switzerland
| | - Cathríona R Loonam
- Department of Medicine/Physiology, University of Fribourg, Fribourg, Switzerland
| | - Abdul G Dulloo
- Department of Medicine/Physiology, University of Fribourg, Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Medicine/Physiology, University of Fribourg, Fribourg, Switzerland
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26
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García A, Romero C, Arroyave C, Giraldo F, Sánchez L, Sánchez J. Acute effects of energy drinks in medical students. Eur J Nutr 2016; 56:2081-2091. [PMID: 27312565 DOI: 10.1007/s00394-016-1246-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 06/08/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE To determine the acute effects of a variety of recognized energy drinks on medical students, based on the hypothesis that these beverages may affect negatively cardiovascular parameters, stress levels and working memory. METHODS Eighty young healthy medical students were included in the study. 62.5 % of the participants were male, and the age mean was 21.45 years. Each person was evaluated via measurement of systolic and diastolic blood pressure, electrocardiogram (ECG), heart rate, oxygen saturation, breath rate, temperature, STAI score (to assess anxiety state), salivary cortisol and N-back task score (to determine cognitive enhancement). These evaluations were performed before and following the intake of either carbonated water or one of three energy drinks containing caffeine in similar concentrations and an undetermined energy blend; A contained less sugar and no taurine. RESULTS Thirty-minute SBP increased significantly in the A and C groups. The B group exhibited a diminution of the percentage of the 1-h SBP increase, an increase of 1-h DBP and QTc shortening. HR showed an increase in the percent change in the A and C groups. Cortisol salivary levels increased in the B group. The STAI test score decreased in the C group. The percent change in N-back scores increased in the A group. CONCLUSIONS The data reinforce the need for further research on the acute and chronic effects of energy drinks to determine the actual risks and benefits. Consumers need to be more informed about the safety of these energy drinks, especially the young student population.
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Affiliation(s)
- Andrés García
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, AA 97, La Julita, Pereira, Colombia
| | - César Romero
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, AA 97, La Julita, Pereira, Colombia
| | - Cristhian Arroyave
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, AA 97, La Julita, Pereira, Colombia
| | - Fabián Giraldo
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, AA 97, La Julita, Pereira, Colombia
| | - Leidy Sánchez
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, AA 97, La Julita, Pereira, Colombia
| | - Julio Sánchez
- Faculty of Health Sciences, Universidad Tecnológica de Pereira, AA 97, La Julita, Pereira, Colombia.
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27
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Zulli A, Smith RM, Kubatka P, Novak J, Uehara Y, Loftus H, Qaradakhi T, Pohanka M, Kobyliak N, Zagatina A, Klimas J, Hayes A, La Rocca G, Soucek M, Kruzliak P. Caffeine and cardiovascular diseases: critical review of current research. Eur J Nutr 2016; 55:1331-43. [PMID: 26932503 DOI: 10.1007/s00394-016-1179-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 02/06/2016] [Indexed: 12/21/2022]
Abstract
Caffeine is a most widely consumed physiological stimulant worldwide, which is consumed via natural sources, such as coffee and tea, and now marketed sources such as energy drinks and other dietary supplements. This wide use has led to concerns regarding the safety of caffeine and its proposed beneficial role in alertness, performance and energy expenditure and side effects in the cardiovascular system. The question remains "Which dose is safe?", as the population does not appear to adhere to the strict guidelines listed on caffeine consumption. Studies in humans and animal models yield controversial results, which can be explained by population, type and dose of caffeine and low statistical power. This review will focus on comprehensive and critical review of the current literature and provide an avenue for further study.
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Affiliation(s)
- Anthony Zulli
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Renee M Smith
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Jan Novak
- 2nd Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic.,Department of Physiology, Masaryk University, Brno, Czech Republic
| | - Yoshio Uehara
- Division of Clinical Nutrition, Faculty of Home Economics, Kyoritsu Women's University, Tokyo, Japan
| | - Hayley Loftus
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Tawar Qaradakhi
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic
| | | | | | - Jan Klimas
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University, Odborarov 10, 832 32, Bratislava, Slovak Republic
| | - Alan Hayes
- Centre for Chronic Disease (CCD), College of Health and Biomedicine, Victoria University, Melbourne, VIC, Australia
| | - Giampiero La Rocca
- Human Anatomy Section, Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy
| | - Miroslav Soucek
- 2nd Department of Internal Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic
| | - Peter Kruzliak
- Laboratory of Structural Biology and Proteomics, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Palackeho tr 1/1946, Brno, 612 42, Czech Republic.
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28
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Sanchis-Gomar F, Leischik R, Lippi G. Energy drinks: Increasing evidence of negative cardiovascular effects. Int J Cardiol 2016; 206:153. [PMID: 26797159 DOI: 10.1016/j.ijcard.2016.01.107] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/05/2016] [Indexed: 12/27/2022]
Affiliation(s)
| | - Roman Leischik
- Faculty of Health, School of Medicine, University Witten/Herdecke, Hagen, Germany
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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