(Not so) High Energy Drinks Mike LaFontaine, Ph.D. Associate Professor College of Osteopathic Medicine Marian University Why do We Care About Energy Drinks? 1. 2. Energy drinks are the fastest growing segment of the beverage industry.1 Energy drinks are a $12,500,000,000 per year industry. 1 There are over 300 brands of energy drinks currently on the market. Due to the high concentration of stimulants, potential hazards exist. 20,000 ER visits attributed to consumption. 2 US Market Trends 2013 Industry Report The Substance Abuse and Mental Health Services Administration FDA Regulations for Energy Drinks Energy drinks and shots are regulated as dietary supplements. Dietary Supplement Health and Education Act 1994 Removed supplements from the “food and drug umbrella” of the FDA. Does not require FDA approval to bring to market or imply activity. Disclaimer statement must be present: “This product has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent and disease.” Evaluation of Dietary Supplements Actual Biological role of supplement. What is the bioavailability of the supplement? Can it be absorbed and/or incorporated into the body to perform this role? Is there a need for supplementation? Does it match the claim? Is it readily available through the diet or endogenous synthesis in adequate amounts? Is there evidence-based research to support supplementation? What’s (not) in an Energy Drink? Energy content is variable. Ranges from 0-150 calories per serving (serving size 2-12 oz.) 12 oz. can of cola typically has 150-180 calories. Caffeine “Caffeine is known for its beneficial effects on mental and physical functions.” (Red Bull Website) Caffeine levels range from 280 mg/can (“Cocaine”) to 80 mg/can (“Red Bull”). Very tough to get exact amounts because of the use of guarana. By comparison, a can of Coke has about 40 mg/can. What is Caffeine? Caffeine is in a class of derivatives of the organic molecule purine called “xanthines”. Often mistaken for theophylline and theobromine. R2 N N N N R1 O O R3 R1, R2, R3 = H R1, R2, R3 = CH3 R1, R2 = CH3, R3 = H R1 = H, R2, R3 = CH3 Xanthine Caffeine Theobromine Theophylline What Does Caffeine Do? Inhibitor of adenosine receptors in the brain and cAMP phosphodiesterase in muscle. Inhibition of adenosine receptors lead to a release of epinephrine. Increased heart rate. Increased activity of liver glycogen phosphorylase. Interrupted wake/sleep cycles. Inhibition of phosphodiesterase leads to increased metabolic rate in muscle cells. HO OH HO H N O N NH N NH2 Adenosine O O P OO HO O N N H N NH NH2 cAMP Taurine “Taurine is the second most abundant amino acid in muscle fiber.” - Eric Serrano, M.D., bodybuilding.com. Typically around 500-1000 mg in drinks containing taurine. What is Taurine Taurine is NOT an amino acid, it is an amino sulfonate. While present in muscle cells, it is NOT a part of the proteins that make up the filaments. + O H3N + O S O Taurine H3N O- OSH Cysteine What Does Taurine Do? Conjugated with bile acids to make bile salts and account for the surfactant properties of bile salts. No evidence that taurine is involved in energy metabolism. No evidence that taurine is involved in muscle function. Creatine Claims include increased in muscle mass, boost “brain function”, reduce risk of “several diseases”, and protect skin from aging effects of the sun. –Muscle and Fitness Magazine Not extensively used in energy drinks, 5001000 mg/can typically. What is Creatine? Creatine is a water-soluble, phosphatetransfer aid. Creatine is synthesized in hepatic tissue from arginine and glycine. Highest concentrations are found in skeletal muscle. CH3 H2N N + NH2 O O- What Does Creatine Do? Creatine phosphate can serve as a source of rapid ATP regeneration. Exercise Cell With Creatine Phosphate Two ADP molecules can rapidly be converted back to ATP by creatine phosphate. Does Creatine Work? Creatine supplementation has limited effect on creatine levels. 1 Dietary intake is significant with a meat-heavy diet. Endogenous synthesis is adequate with typical dietary protein levels. No function of creatine has been found to be associated with muscle building. No immune function of creatine has been discovered. Since it is not lipid soluble, unlikely to be skin protectant. Brain function? 1. Greenhaff P: The Nutritional Biochemistry of Creatine J. Nutrit Biochem 1997, 11: 610-618 Carnitine Claims primarily center around being a “fat burner”. Typically less than 1000 mg/can where found in energy drinks. Usually found in “low carb” or “low calorie” energy drinks. What is Carnitine? Carnitine is a water-soluble non-standard amino acid. Carnitine is synthesized in the liver from lysine. O OH CH3 + - O N CH3 CH3 What Does Carnitine Do? Carnitine is a fatty acid transporter that delivers fatty acids to the mitochondria. Carnitine is NOT involved in the actual breakdown of fatty acids. Carnitine-based transport responds to fatty acid metabolism, not the other way around. Excess intake of carnitine linked to increase risk of heart disease.1 1. Koeth, et al Intestinal Microbiota Metabolism of L-carnitine, a Nutrient in Red Meat, Promotes Atherosclerosis Nature Medicine 2013 B-complex Vitamins B-complex vitamins are not chemically related to each other. All are water-soluble and play a role in energy metabolism. All are heavily fortified in foods in western cultures. Typically large amounts found in energy drinks. What are B-complex Vitamins? Thiamine Niacin Riboflavin Biotin Pantothenic Acid Pyridoxine (B6) Folic Acid Cobalamin (B12) What Do B-complex Vitamins Do? All B-complex vitamins have at least some role in energy metabolism. Typically as a co-enzyme or enzyme prosthetic group. Niacin, riboflavin, thiamine, and pyridoxine are the most prevalent. Biotin, folic acid and cobalamin are utilized only in the metabolism of a few types of fats and amino acids. Sample Energy Drink Chaser 5-hour Energy Claims “5 hours of Energy” “No Crash Later” “Sugar Free” “Does not rely on caffeine like other energy drinks.” “Packed with B-vitamins and enzymes!” “Five Hours of Energy” 15 calories! Walking at 3 mph burns .027 calories per pound per minute. A 200 pound man burns 324 calories per hour WALKING. “5-hour Energy” provides less than 3 minutes worth of calories! “Does Not Rely on Caffeine…” Caffeine levels is approximately equal to a cup of coffee. 5-hour energy is only 2 oz.! “…Packed With B-vitamins and Enzymes!” Most are pancreatic enzymes released into the small intestine. Cellulase is a fungal enzyme that is involved in breaking down cellulose. All of these enzymes would be denatured upon entry to the stomach. Conclusions Little if any energy associated with energy drinks. Energy drinks rely on heavy caffeine to provide a stimulant. Most other additives are water-soluble compounds with little, if any, benefit. Strongest attribute of energy drinks has been marketing.