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Canadian Journal of Cardiology

Energy Drink Overconsumption in Adolescents: Implications for Arrhythmias and Other Cardiovascular Events

Published:March 26, 2015DOI:https://doi.org/10.1016/j.cjca.2014.12.019
      Energy drinks (EDs) have increased in popularity and are now consumed by 30%-50% of adolescents (ie, aged 10-19 years) and young adults.
      • Seifert S.M.
      • Schaechter J.L.
      • Hershorin E.R.
      • Lipshultz S.E.
      Health effects of energy drinks on children, adolescents, and young adults.
      It is now estimated that 31% of 12- to 19-year old adolescents regularly consume EDs.
      • Oddy W.H.
      • O'Sullivan T.A.
      Energy drinks for children and adolescents.
      • Emond J.A.
      • Gilbert-Diamond D.
      • Tanski S.E.
      • Sargent J.D.
      Energy drink consumption and the risk of alcohol use disorder among a national sample of adolescents and young adults.
      Alcohol mixed with energy drinks has also become increasingly popular among adolescents and college students.
      • Emond J.A.
      • Gilbert-Diamond D.
      • Tanski S.E.
      • Sargent J.D.
      Energy drink consumption and the risk of alcohol use disorder among a national sample of adolescents and young adults.
      • Howland J.
      • Rohsenow D.J.
      Risks of energy drinks mixed with alcohol.
      EDs mainly differ from other soft and sports drinks regarding their high caffeine content and their promotion as a means to relieve fatigue and improve physical and cognitive performance. The problem with ED consumption is that these beverages often contain high amounts of labeled and even masked caffeine, as well as other substances such as guarana, ginseng, and taurine in variable quantities, which may generate uncertain interactions.
      • Glatter K.A.
      • Myers R.
      • Chiamvimonvat N.
      Recommendations regarding dietary intake and caffeine and alcohol consumption in patients with cardiac arrhythmias: what do you tell your patients to do or not to do?.
      • Babu K.M.
      • Church R.J.
      • Lewander W.
      Energy drinks: the new eye-opener for adolescents.
      • Higgins J.P.
      • Tuttle T.D.
      • Higgins C.L.
      Energy beverages: content and safety.
      Guarana (Paullinia cupana of the Sapindaceae family) is a Brazilian plant containing “guaranine,” which is nothing more than caffeine, in about twice the concentration of the caffeine found in coffee beans (about 2%-4% caffeine in guarana seeds compared with 1%-2% in coffee beans).
      • Espinola E.B.
      • Dias R.F.
      • Mattei R.
      • Carlini E.A.
      Pharmacological activity of Guarana (Paullinia cupana Mart.) in laboratory animals.
      According to the Biological Magnetic Resonance Data Bank, guaranine is only defined as the caffeine chemical in guarana, which is identical to the caffeine chemical derived from other sources, such as coffee, tea, and yerba mate. Therefore, guaranine, theine, and mateine are all synonyms for caffeine.
      • Weinberg B.A.
      • Bealer B.K.
      The World of Caffeine: The Science And Culture of The World's Most Popular Drug.
      Conversely, ginseng, the extract of 3 similar species of the genus Panax (Panax ginseng, P quinquefolius, and P japonicus), exerts its stimulating effects through a mixture of ginsenosides, polysaccharides, peptides, polyacetylenic alcohols, and fatty acids.
      • Attele A.S.
      • Wu J.A.
      • Yuan C.S.
      Ginseng pharmacology: multiple constituents and multiple actions.
      The major active components of ginseng are ginsenosides, which act on several different tissues and cells and produce a kaleidoscope of biological effects. Taurine is an amino acid that exerts a number of physiological functions, including cell volume regulation and inhibitory neuromodulation. It was also evaluated as a potential pharmacologic agent in many pathologic states, but there is scant evidence so far to corroborate this hypothesis. Although its properties have been only partially explored, taurine and many of its derivatives have been proposed in several “energizing” compounds, including EDs.
      • Oja S.S.
      • Saransaari P.
      Pharmacology of taurine.
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