Tag Archives: caffeine

Beware of Energy Shots, the modern-day breakfast of champions

Energy shots are the latest thing. It’s rocket fuel for a flagging will and the chance to capture youth in a bottle.

Of course, Coca-Cola was the original energy drink – cocaine, caffeine and sugar – that became breakfast of champions for some folks. Kind of puts the New Coke controversy in perspective. It was about 100 years ago that Coke changed the formula, but it hasn’t seemed to hurt sales much.

The other traditional energy drink is coffee – my personal favorite. Just typing the word has me looking toward the kitchen – was that a bell?

Those little aluminum cans certainly look powerful, all red and silver, and a screw cap to imply the liquid inside could otherwise not be contained. And they contain only a precious ounce, suggesting any larger amount might achieve critical mass.

The ingredient list sounds complicated and exotic, which no doubt is also part of the appeal. Taurine, glucuronolactone, guarana, ginseng, gingko, and a handful of B vitamins are thrown in to obscure the only active ingredient – caffeine. The average energy shot has about the same caffeine content as a good cup of coffee – 80 milligrams.

That is not to malign caffeine, a drug that we have been searching for a dark side for most of this century. Before you are too critical of energy shots, know that the average American takes in over 200 mg of caffeine per day. That dose of caffeine is considered safe even for pregnant women.

Caffeine is a legal mood altering drug, the most widely used on the planet. Caffeine reduces physical and mental fatigue, improves thinking, memory and coordination.

The distance between therapeutic range and toxic range is one of the widest of known drugs. An energy shot is less than 100 mg of caffeine, and the LD50 is somewhere around 10 grams or 100 cups of coffee.

LD50 is short hand for the dose that will kill half the people who take it. Every drug has one, and almost all take considerably less than a 100-fold increase to become dangerous.

Your body adapts to caffeine consumption relatively quickly – roughly a week or so. It takes about two weeks to get your brain settled down if you give up caffeine.

If you consume enough caffeine (a couple of dozen energy shots) you will become a quivering mess. Mania (elevated irritability), hallucinations and psychosis are all possible, but you eventually “run out of neurotransmitters,” and crash.

Caffeine and alcohol are a particularly troublesome combination. The caffeine helps counteract the sedative effects of alcohol, keeping you up to drink some more. The LD50 of alcohol is way less than 100 times the therapeutic range. There are times when you should just stay down.

Energy shots are an expensive cup of coffee and lack the reassuring warm weight of a coffee mug. Cold steel just isn’t as cozy; although the upside is fewer trips to the bathroom.

Personally, I’ll keep drinking coffee and making those annoying treks to the bathroom.

Take care,

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.


photo credit: ~Prescott via photopin cc

 

Coffee and Kids: Wonder Beverage or Devil’s Brew?

There has recently been a lot of talk about a very old beverage, coffee.

The occasion for this has been the admission by seemingly responsible parents that they actually give their young child a cup of coffee with breakfast. Egads – what is the world coming to?

With some guilt, I admit my 8-year-old had a cup with her Fruit Loops this morning, as she does most mornings. (Please don’t report me to CPS).

So is coffee bad for kids? The old cup-a-joe has a long and somewhat sordid history. Going back to the days of dirt and plague, coffee was associated with all manner of dark things, like most of what went on in the Middle Ages, with no scientific basis.

Yet coffee is one of the most studied beverages on the planet, not surprisingly as there are nearly 1000 organic chemicals in a cup of brew. Caffeine is the one that everyone talks about. This is an interesting chemical, a mild stimulant in the methyl xanthene family. This is closely related to adrenalin and medications that are used to treat asthma. Coffee is a well known bronchodilator. So coffee certainly isn’t bad for kids with asthma.

One of the other effects of coffee is to mildly raise dopamine levels in the brain. You’ve heard of raising dopamine in talking about antidepressants, like Prozac. In fact kids who drink a cup of coffee with milk per day have a significantly lower rate of depression. So coffee isn’t bad for sad kids.

Caffeine is a stimulant and recently parents of kids with attention deficit disorder have been experimenting on their kids.

The thought goes something like this: if the stimulant amphetamine helps kid with ADHD focus and concentrate, maybe a good cup of coffee will do the same. Funny thing is, it does seem to help. We don’t have any huge definitive studies to quote, but limited research shows coffee helps kids with ADHD focus and concentrate. It doesn’t help as much as Adderall, but it does help. For some kids, coffee is all they need. For other kids who don’t get enough benefit from medications, adding a cup of coffee helps. So coffee isn’t bad for kids with attention deficit disorder.

What about other kids? My daughter had a cup this morning. She isn’t challenged by ADD, or depression, thankfully. She just likes a cup in the morning like I do. Coffee doesn’t stunt your growth or hurt your development in any way we have found. It actually does some good stuff. Parkinson’s disease is reduced in coffee drinkers as is colon cancer, liver disease and Type 2 diabetes. All well proven. Early research on Alzheimer’s disease suggests its occurrence is reduced in coffee drinkers.

For those still thinking coffee is an adult only vice, I invite you to consider normal kid breakfast drink alternatives. What do your kids drink for breakfast? Popular orange drinks have many times the sugar of coffee. Other beverage choices have higher fat or cholesterol content. In this epidemic of obesity, nobody ever got fat on coffee.

So tomorrow morning when I pour my cup, I will cheerfully give some to my 8-year-old; she gets her own cup because I don’t like to share.

Take care

Dr B

Best of Our Blog: A Cup of Joe and Carpal Tunnel Syndrome

We’ve culled through the statistics and pulled together some of our most-read blog items since we launched. Below are two of the favorites.

A Cup of Joe — Stuff of Life or Poison?

In this country, we drink 400 million cups of coffee per day. We consume over 45% of the world’s coffee production. For the record, some of the Scandinavian countries consume three times more coffee per person.

Given all this coffee drinking, it’s no surprise that this is one of the most researched beverages on the planet. And yet there is almost universal confusion on the health consequences of coffee drinking.
Read More

Carpal Tunnel Syndrome Made Clear in 10 Paragraphs

Carpal Tunnel Syndrome (CTS) is an occupational medical diagnosis that often gives employers, patients, and sometimes even medical providers, undue levels of frustration. Like a lot of other things in medicine, reasonably simple concepts are hidden behind Latin words. You just need a basic understanding of how things are put together – in other words, anatomy.

Let’s start with the hands. The hands are absolute miracles of micro-engineering. They are capable of generating tremendous force, while being compact and delicate enough to pay a violin. They pull this off by putting the muscles that work the fingers in the forearm. These muscles are connected by cables, called tendons, to the fingers. Contract a muscle in the forearm, it pulls the cable (tendon) and moves the finger. I never fail to be impressed by the cleverness with which the human body is put together.

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Energy Drinks – Boost or Bust?

The popularity of energy drinks over the last 15 years is astounding but not surprising. Targeted at a market segment of the young and on the go, the drinks promise increased alertness and stamina. A single major brand whose name is recognized by everyone recently announced that they sold more than 4 billion cans worldwide in over 150 countries. That was just one brand in one year!

Energy drinksphoto © 2008 Tambako The Jaguar | more info (via: Wylio)

Although their primary demographics are young adults and athletes, the average person on the go is often looking for a morning boost or mid-afternoon energy. So why not grab an energy drink? Is it really a good boost or a bad bust?

The active ingredient that provides energy is typically caffeine and lots of it. It is very common for an energy drink to contain 2 to 5 times the caffeine in a cup of coffee or an average soft drink. There is also a lot of sugar as well. The amount of sugar is equivalent to 4 to 8 teaspoons of sugar in a single 8-ounce serving. There are other ingredients that contribute to the energy effect including guarana, an herb that metabolizes to caffeine. Other herbs such as ginseng have an energizing effect in humans although somewhat inconsistently. Naturally occurring amino acids taurine and carnitine have variable effects in different people. Some of the B-vitamins can provide a pick-me-up in some individuals. The amounts and sensitivity to these effects vary a great deal across the population.

There is no argument that energy drinks provide “energy” – temporarily; however, it is short-lived and typically results in a rebound “lack of energy” from caffeine withdrawal and the blood sugar level plummeting following the ingestion of concentrated refined sugars such as high fructose corn syrup and sucrose. Too much caffeine can be very harmful, especially in selected individuals or under specific circumstances of strenuous exercise or relative dehydration. It has a direct effect on increasing blood pressure to dangerously high levels, rapid heart rate, anxiety and insomnia. This clearly puts people at risk for heart attack or stroke.

A disturbing trend is to mix energy drinks with alcohol. The combination has potentially dangerous side effects. Caffeine does not change the amount of impairment from alcohol. One may feel more alert and less sedated but remain as slow to react or make poor decisions due to the effects of alcohol.

tall drinksphoto © 2008 Melody Gutierrez | more info (via: Wylio)

There is little protection or warning for consumers about potential side effects. According to the Food and Drug Administration, energy drinks are supplements and not subject to the same regulations as medications, soft drinks or even food products. They are not obligated to disclose how much an active ingredient is contained in a single serving. Soft drinks are required to have no more than 71 mg of caffeine per serving and most contain much less.

As dangerous as the short-term effects are, there is no research regarding the long-term effects of regular use of energy drinks. It is very possible that regular consumption of high doses of sugar and stimulants leads to bigger problems. One has to doubt the wisdom and safety in the regular use of these products.

What is the alternative? There is no substitute for adequate sleep, regular exercise and a balanced diet. If you suffer from chronic fatigue, there may be an important metabolic reason, which needs evaluation by a medical professional.

Energy drinks are everywhere and seem seductive, even benign. It is still important to be aware. Is it worth the risk?

– Dr. Bruce Kaler

A Cup of Joe, Stuff of life or Poison?

In this country, we drink 400 million cups of coffee per day.  We consume over 45% of the world’s coffee production.  For the record, some of the Scandinavian countries consume three times more coffee per person.

Given all this coffee drinking, it’s no surprise that this is one of the most researched beverages on the planet.  And yet there is almost universal confusion on the health consequences of coffee drinking.

The problem is, we started our coffee studies 40 years ago when we were just starting to suspect cigarettes were a bad thing.  The early coffee studies showed people dying of heart attacks, mouth, throat and lung cancer.   It turns out in those days, coffee drinking was accompanied by cigarette smoking, and the control group didn’t drink coffee or smoke.  So all the bad stuff that we thought was associated with coffee drinking, was actually associated with smoking, and had nothing to do with coffee.

In case you think studying coffee is a light weight task for the scientists that got “C”s; coffee has more that 1,000 different chemicals identified.  Apparently a few of them cause cancer in rats.  In fact, it’s pretty hard to pick 1,000 chemicals and not have a few of them be bad for somebody.

Coffee does some well-known bad stuff.  It can be associated with anxiety and sleep disturbance.  It modestly raises both blood pressure and pulse.  It increases the acid in your stomach, and it stains your teeth.  That is the crime list for coffee.

Ah, but the benefits.

Coffee, first and foremost, increases memory, performance and wakefulness.  That just might keep you awake at the next meeting, thus keeping your job, which is a major health benefit.  All this wakefulness results in a lower risk of Alzheimer’s disease.   Some gastrointestinal cancers occur less frequently in coffee drinkers; especially throat, liver and prostate cancers.  Parkinson’s Disease is less frequent among the well-caffeinated.  Type 2 diabetes also is reduced in coffee drinkers.  Caffeine is also known to potentiate pain medication (it makes it work better).

All in all, coffee is a lousy replacement for a good night’s sleep, and should be avoided by those with sensitive stomachs.  For the rest of us, a cup a Joe is a safe warm spot in a cold and stressful world; and that’s another health benefit.

- Dr Don Bucklin, National MRO – AKA “Dr B”


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