Cardiologist Warns Coffee Heart Health Study Doesn’t Apply To Energy Drinks

The urge to be healthy is a powerful one. Marketers are well aware of this human drive and they often take full advantage of our willingness to try anything that offers a benefit. Nothing wrong with that. Just don’t forget to read the fine print.

By Ben Bouckley+, 27-Nov-2013

Cup of Coffee Sitting on Coffee BeansEminent cardiologist Gordon Tomaselli has warned against applying the results of a small study linking caffeinated coffee with better blood vessel function to other products such as energy drinks.

It often happens that if something is shown to be of benefit, others jump on the band wagon to claim those benefits by association. Remember all the fuss over red wine’s health benefits? Resveratrol, the substance from grape seeds was studied. Pretty soon everyone started believing red wine was a health food. (It can be in moderation).  This is  the point that is often missed in many cases involving food and nutritional supplements.

In the case of energy drinks, the beverage industry is looking for anything that offers a ray of hope to stave off increased regulation. Consumers require some perspective when the conversation turns to regulation.

Nine out of ten poisoning deaths in the U.S.  related to prescription drugs. In 2006, 275 adverse supplement reactions were reported. Of those 275 dietary supplements calls, 41% involved symptomatic exposures; and two-thirds were rated as probably or possibly related to supplement use. Eight adverse events required hospital admission. Sympathomimetic toxicity was most common, with caffeine products accounting for 47%.

So it’s not surprising that a small study showing that coffee may help perk up your blood vessels gets taken out of contextMonster Rehab and gets applied to an entire beverage category. After all, it’s caffeine and caffeine is good. Must be true that more caffeine is better.

It follows that products with caffeine or caffeine related substances would jump on the band wagon to tout the health benefits even if none exist.  Coffee is a natural substance with complex phytonutrients. Those substances work synergistically in our bodies to deliver the benefits to human health. Just because a product formulation includes healthy individual ingredients, it doesn’t necessarily follow that the consumer is getting the same health benefits those substances were proven to have.



The Wild World Of Caffeinated Snacks

The elements to good health – eating, food, nutrition and health has taken a divergent route. The introduction of additives and nutrients won’t necessarily lead to good health.  However, you might fool your body for a while with some of these snacks that border on food porn.  Clearly, these are not essential but they sure might make you feel lit up.  In the meantime, you can sign up for a healing circle for your adrenal glands in a neighborhood near you.

With the myriad of caffeinated products on store shelves these days, there’s hardly any need for coffee. Everything from jerky and sunflower seeds to waffles and ice cream is offering a buzz. We decided to take a look at some of the products currently providing consumers with a caffeine kick.

Because of this influx of new products and their potential appeal to children, the Food and Drug Administration is evaluating their safety and how to best regulate the changing market.

While it does so, we thought we’d share this quick review from Hella Wella and take a closer look at some of the products currently providing consumers with a caffeine kick. Watch out Starbucks!


Arma Energy Snx Potato Chips & Granola

“It’s not your mom’s granola,” says Arma Energy Snx’s website. The company makes kettle-cooked potato chips, granola, fruit mix and trail mix — all “energy-infused” with caffeine, taurine and B vitamins. One 2-ounce package of BBQ kettle-cooked chips contains 290 calories and 70 milligrams of caffeine — that’s slightly less than a shot of espresso.


Bang! Ice Cream

Even your dessert can bring a buzz. And in the case of Bang! ice cream, you might want to have dessert toward the beginning of the day since one serving dishes out 125 milligrams of caffeine — roughly equivalent to a cup of coffee. The ice cream comes in four flavors: Peanut Butta, Heaps of Gold, Iced Latte-Da and Cooky Mint.


Blue Diamond Roasted Coffee Almonds

Blue Diamond jumped on the bandwagon with its roasted coffee-flavored almonds, which contain 25 milligrams of caffeine per serving. Keep in mind, though, that there are four servings per package, so if you plan on chowing down all of it, you’re looking at the same amount of caffeine that’s in some energy shots.


Cracker Jack’d

Frito Lay made headlines last November when it announced its new line of snacks: Cracker Jack’D. Unlike the famous Cracker Jacks snack that came before it, Cracker Jack’D comes with 70 milligrams of caffeine — about what you’d get from a shot of espresso. The 2-ounce snack mix comes in flavors like zesty queso, PB & chocolate, berry yogurt and cheddar BBQ.


Crackheads2 Gourmet Chocolate Coffee Caffeine

Crackheads2 (squared) makes no apologies for its extreme caffeine content. In fact, it boasts it wherever it can. One box of the candy- and chocolate-coated coffee beans contains 600 milligrams of caffeine — the equivalent of six cups of coffee, 7.5 cans of Red Bull and 11 cans of Mountain Dew, according to the company’s website. Good luck sleeping!


Jelly Belly Sport Beans

You (hopefully) won’t find these jellybeans in a kid’s Easter basket. Jelly Belly’s Extreme Sport Beans are advertised as “quick energy for sports performance.” The website recommends popping the beans 30 minutes before your workout and says they’re “loaded with carbs for fuel, electrolytes to help maintain fluid balance and vitamins to optimize energy release and protect cells against oxidative damage.” A single 1-ounce package packs 100 calories, 25 grams of carbohydrates, 17 grams of sugar and 50 milligrams of caffeine — a little more of a jolt than you’d get from a can of Diet Coke.


Perky Jerky

Perky Jerky found its way onto the market after its creators accidentally drenched their beef jerky in an energy drink and ate it, only to find it boosted their energy as they skied. The brand is advertised as “all natural, ultra premium jerky” that’s made with a seven-ingredient marinade that includes guarana (the stuff you’ll find in energy drinks). One 1-ounce package offers 150 milligrams of caffeine — about what you’d find in a Monster energy drink.



Apparently even sunflower seeds are capable of being infused with caffeine. Sumseeds come in flavors like dill pickle, honey BBQ, ranch, and salt and pepper — in addition to the original flavor — and pack 140 milligrams of caffeine into a single 1.75-ounce bag.


Wired Waffles

You won’t need coffee with this breakfast. Wired Waffles are exactly what they sound like: waffles — even maple syrup — with caffeine. With 200 milligrams per waffle and about 48 milligrams per serving of syrup, you’re looking at a buzz stronger than what you’d get from most energy drinks.



High Blood Caffeine Levels in Older Adults Linked to Avoidance of Alzheimer’s Disease

Those cups of coffee that you drink every day to keep alert appear to have an extra perk – especially if you’re an older adult. A recent study monitoring the memory and thinking processes of people older than 65 found that all those with higher blood caffeine levels avoided the onset of Alzheimer’s disease in the two-to-four years of study follow-up. Moreover, coffee appeared to be the major or only source of caffeine for these individuals.

Researchers from the University of South Florida ( and the University of Miami ( say the case control study provides the first direct evidence that caffeine/coffee intake is associated with a reduced risk of dementia or delayed onset. Their findings will appear in the online version of an article to be published June 5 in the Journal of Alzheimer’s Disease, published by IOS Press ( The collaborative study involved 124 people, ages 65 to 88, in Tampa and Miami.

“These intriguing results suggest that older adults with mild memory impairment who drink moderate levels of coffee — about 3 cups a day — will not convert to Alzheimer’s disease — or at least will experience a substantial delay before converting to Alzheimer’s,” said study lead author Dr. Chuanhai Cao, a neuroscientist at the USF College of Pharmacy and the USF Health Byrd Alzheimer’s Institute. “The results from this study, along with our earlier studies in Alzheimer’s mice, are very consistent in indicating that moderate daily caffeine/coffee intake throughout adulthood should appreciably protect against Alzheimer’s disease later in life.”

The study shows this protection probably occurs even in older people with early signs of the disease, called mild cognitive impairment, or MCI. Patients with MCI already experience some short-term memory loss and initial Alzheimer’s pathology in their brains. Each year, about 15 percent of MCI patients progress to full-blown Alzheimer’s disease. The researchers focused on study participants with MCI, because many were destined to develop Alzheimer’s within a few years.

Blood caffeine levels at the study’s onset were substantially lower (51 percent less) in participants diagnosed with MCI who progressed to dementia during the two-to-four year follow-up than in those whose mild cognitive impairment remained stable over the same period.

No one with MCI who later developed Alzheimer’s had initial blood caffeine levels above a critical level of 1200 ng/ml – equivalent to drinking several cups of coffee a few hours before the blood sample was drawn. In contrast, many with stable MCI had blood caffeine levels higher than this critical level.

“Moderate daily consumption of caffeinated coffee appears to be the best dietary option for long-term protection against Alzheimer’s memory loss,”

“We found that 100 percent of the MCI patients with plasma caffeine levels above the critical level experienced no conversion to Alzheimer’s disease during the two-to-four year follow-up period,” said study co-author Dr. Gary Arendash.

The researchers believe higher blood caffeine levels indicate habitually higher caffeine intake, most probably through coffee. Caffeinated coffee appeared to be the main, if not exclusive, source of caffeine in the memory-protected MCI patients, because they had the same profile of blood immune markers as Alzheimer’s mice given caffeinated coffee. Alzheimer’s mice given caffeine alone or decaffeinated coffee had a very different immune marker profile.

Since 2006, USF’s Dr. Cao and Dr. Arendash have published several studies investigating the effects of caffeine/coffee administered to Alzheimer’s mice. Most recently, they reported that caffeine interacts with a yet unidentified component of coffee to boost blood levels of a critical growth factor that seems to fight off the Alzheimer’s disease process.

“We are not saying that moderate coffee consumption will completely protect people from Alzheimer’s disease,” Dr. Cao cautioned. “However, we firmly believe that moderate coffee consumption can appreciably reduce your risk of Alzheimer’s or delay its onset.”

Alzheimer’s pathology is a process in which plaques and tangles accumulate in the brain, killing nerve cells, destroying neural connections, and ultimately leading to progressive and irreversible memory loss. Since the neurodegenerative disease starts one or two decades before cognitive decline becomes apparent, the study authors point out, any intervention to cut the risk of Alzheimer’s should ideally begin that far in advance of symptoms.

“Moderate daily consumption of caffeinated coffee appears to be the best dietary option for long-term protection against Alzheimer’s memory loss,” Dr. Arendash said. “Coffee is inexpensive, readilyavailable, easily gets into the brain, and has few side-effects for most of us. Moreover, our studies show that caffeine and coffee appear to directly attack the Alzheimer’s disease process.”

In addition to Alzheimer’s disease, moderate caffeine/coffee intake appears to reduce the risk of several other diseases of aging, including Parkinson’s disease, stroke, Type II diabetes, and breast cancer. However, supporting studies for these benefits have all been observational (uncontrolled), and controlled clinical trials are needed to definitively demonstrate therapeutic value.

A study tracking the health and coffee consumption of more than 400,000 older adults for 13 years, and published earlier this year in the New England Journal of Medicine, found that coffee drinkers reduced their risk of dying from heart disease, lung disease, pneumonia, stroke, diabetes, infections, and even injuries and accidents.

With new Alzheimer’s diagnostic guidelines encompassing the full continuum of the disease, approximately 10 million Americans now fall within one of three developmental stages of Alzheimer’s disease — Alzheimer’s disease brain pathology only, MCI, or diagnosed Alzheimer’s disease. That number is expected to climb even higher as the baby-boomer generation continues to enter older age, unless an effective and proven preventive measure is identified.

“If we could conduct a large cohort study to look into the mechanisms of how and why coffee and caffeine can delay or prevent Alzheimer’s disease, it might result in billions of dollars in savings each year in addition to improved quality of life,” Dr. Cao said.

The USF-UM study was funded by the NIH-designated Florida Alzheimer’s Disease Research Center and the State of Florida.

Alcohol, Caffeine and Energy Drink Issues Detailed In JAMA Articles

CHICAGO—In commentaries published Dec. 19 online in JAMA, several medical doctors have discussed the science, research, health and regulatory status of energy drinks relative to caffeine and alcohol content. Overall, they discussed research and other evidence suggesting negative health effects from excessive consumption of caffeine, especially in conjunction with alcohol, but they noted much is not yet known about the exact roles these ingredients have played in deaths associated with energy consumption, due to the unique characteristics of each case, and to what extent government should or will regulate energy drinks containing these ingredients.

In one commentary, Jonathan Howland, PhD, MPH, from the Department of Emergency Medicine at Boston University, and Damaris J. Rohsenow, PhD, from both the Center for Alcohol and Addiction Studies at Brown University and VA Medical Center, Providence, R.I., detail the health effects of alcohol mixed with energy drinks (AMED), including premixed “alcopop” drinks such as Four Loko and self-mixing of highly caffeinated energy drinks with various types of alcohol.

Citing survey’s showing as much as 56 percent of college students reported mixing energy drinks with alcohol, the authors established the potential for public health consequences for this recreational use of energy drinks, which often contain herbal ingredients, including botanical sources of caffeine that contribute tot he overall average of 80 to 140 mg of total caffeine content.

Caffeine counters the sedating and intoxicating effects of alcohol, thereby impairing judgment relative to risky behavior

At issue are concerns the caffeine counters the sedating and intoxicating effects of alcohol, thereby impairing judgment relative to risky behavior. They concluded the scientific evidence on AMED’s effects “on perceived intoxication and sedation has been inconsistent,” but noted AMED use has been correlated to “increased risk for negative consequences of drinking.” They summarize and cite several studies to support their findings.

In some of the evidence, they found sources of potential confounding factors that make it difficult to definitively link AMED use to riskier behavior. For instance, cross-sectional studies connecting AMED use with increased risk taking most often compared AMED users to people drinking alcohol without energy drinks/caffeine. “This study design leaves open the possibility that those who choose to use AMED are inherently more prone to risk-taking behaviors, and thus the relationship between AMED and risk taking could be spurious,” they suggested, adding it is possible personality traits such as impulsivity and thrill-seeking lead to AMED consumption, not vice versa. In fact, they cited a study showing heavy energy drink users were more likely to be heavy alcohol drinkers than were people who infrequently consumed energy drinks. They suggested a future approach to this subject might be the study of drinking and risk taking within the same group of people who consume alcohol with or without caffeine.

Caffeine allowed moderately intoxicated individuals to respond as quickly as if not intoxicated.

To further highlight the effects of caffeine paired with alcohol, Howland and Rohsenow pointed to experimental studies showing caffeine can reverse certain impairment—reaction time, psychomotor speed and simulated driving performance—due to moderate alcohol consumption, but there is no such effect on error rate. “Thus, caffeine allowed moderately intoxicated individuals to respond as quickly as if not intoxicated, but their performance remained impaired,” they noted. To this end, they argued marketing that suggests AMEDs can reduce impairment and sedation is misleading, and social drinkers who think caffeine will counteract alcohol impairment have actually shown greater impairment.

The authors acknowledge actions by state and federal officials against energy drinks containing alcohol and high levels of caffeine help increase awareness and improve the marketing of these products, but most young people will continue to mix energy drinks and alcohol. “Thus, it is important that policy makers, parents, university administrators, health care professionals, and consumers of AMED have accurate information regarding AMED as a public health danger,” they advised. They also recommended stakeholders address gaps in knowledge on the exact effects of AMED use on behavior through targeted research and assessment of evidence by experts from relevant government, research and trade groups.

In another commentary, Kent Sepkowitz, M.D., from Memorial Sloan-Kettering Cancer Center and Weill-Cornell Medical College, New York, discusses the distant and recent histories of caffeine scrutiny, including recent action and involvement by FDA in cases involving marketers of certain caffeinated alcoholic energy drinks. He also provided an overview of data on energy drink usage, as well as information on how energy drinks are often marketed as dietary supplements when containing various botanical and other nutraceutical ingredients, some of which are additional sources of caffeine.

The article explores the situation of caffeine poisoning, highlighting research on caffeine levels in forensic autopsies and discussing caffeine metabolism relative to achieving toxic levels. In a Swedish study, one percent of 5,000 autopsies had Caffeine levels higher than 10 mcg/mL—the equivalent of five to seven cups of standard coffee—and 20 cases out of 16 year’s worth of autopsies featured caffeine levels higher than 80 mcg/mL, which is considered a lethal dose. Of these cases, 12 of the deaths were attributed to caffeine intoxication, with the most common cause of death being arrhythmias.

Sepkowitz noted caffeine is well-absorbed and reaches maximum blood level in about 15 to 45 minutes, and alcohol can extend the life of caffeine in the body, possibly increasing the stimulant’s toxic effects. He advised, consuming 3 to 10 g of caffeine in a short period of time might be lethal, but to reach such a dosage would require consumption of about 12 typical energy drinks—about 100 mg of caffeine per serving—within a few hours.

“It is not known how many energy drinks were ingested by patients thought to have energy drink–related deaths,” he noted, adding a number of confounding factors could be involved such as drug-drug interactions, multiple drugs and compounds being metabolized in the same pathway, underlying cardiac or liver disease, and the influence of other ingredients in the energy drinks.

The Top 10 Energy Drink Logos

In light of the evidence, both research and public records, he recommended energy drink consumers, especially young men (the heaviest users), should talk to their physicians about energy drink use. He further suggested having caffeine content clearly listed on product labels could help users keep their intake of the stimulant below the safe level of 500 mg per day for people without heart or liver disease. In fact, he said while the role of regulators in energy drink oversight is undefined, requiring labeling of caffeine content on these drinks would be a good start. “In Sweden, restriction of caffeine tablet sales from 250 to 30 pills per customer appeared to decrease the rate of fatal caffeine overdoses, suggesting that deliberately restricting the sale of preparations with a high dose of caffeine might be an effective approach,” he said.

In addition to the commentaries, JAMA also published a Patient Page containing information on the energy drink market, including common ingredients, caffeine content of various known energy drink brands, and some health risks associated with energy drink use—increased heart rate, palpitations blood pressure, sleep disturbances, urine production and blood sugar.

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