Caffeinated drinks not risky for most, experts say

With a 3:30 p.m. meeting for his group design project, a class from 6 to 9 p.m., and a mechanical-engineering exam the next day, Kevin Capps was feeling a workload crunch.

So the skateboard-toting Drexel University senior stopped by a Wawa store Wednesday morning to pick up some energy in a can: 12 ounces of Red Bull.

Was he risking his health?

Almost certainly not, say health experts. The amount of caffeine in one 12-ounce can of the popular beverage - 114 milligrams - is about the same as that in a typical cup of coffee.

Yet so-called energy drinks have come under increasing scrutiny this week after the Food and Drug Administration acknowledged that it was looking into reports that five people had died after drinking the Monster Energy brand of beverages. And on Thursday, Consumer Reports disclosed the results of lab tests showing that some of the drinks contain at least 20 percent more caffeine than advertised, while others do not list the amount on their labels.

Several brands contained about 200 milligrams per serving, even when the "serving" was little more than a mouthful, the magazine reported. Tops among 27 products tested was a 1.9-ounce energy "shot," called 5-hour Energy Extra Strength, containing 242 milligrams of caffeine.

In ordinary circumstances and in healthy people, a much larger amount of caffeine is needed to induce serious consequences such as death, said Adam Rowden, operations director for the emergency department at Einstein Medical Center in North Philadelphia. The danger zone is 5 grams, he said - equivalent to swilling 20 of the most caffeine-intense beverages.

But someone with an underlying health problem, such as a heart condition or a tendency to have seizures, could get in trouble with much less, said Rowden, who is also a consulting toxicologist for the poison control center at Children's Hospital of Philadelphia.

Those competing in strenuous sports also should take it in moderation, says the International Marathon Medical Directors Association. The group recommends no more than 200 milligrams on the day of a race of 10 kilometers or more.

Caffeine is a stimulant that increases heart rate and blood pressure. Monster, based in California, denied any suggestion that its products were unsafe.

In eastern Pennsylvania and Delaware, the area that Children's covers as a poison control center, at least two people have died from a caffeine overdose in the last several years, Rowden said. One case involved caffeine pills, while the other person had a mixture of pills and energy drinks, he said.

In 2009, the most recent year for which federal statistics are available, emergency departments reported more than 13,000 cases in which energy drinks played a role - half of them in combination with alcohol.

That combination is popular in young adults, and is thought to make them more likely to drive while drunk.

Capps, the Drexel senior, said he had heard the reports of possible health risks but was not concerned. He said he drinks a Red Bull two or three times a week, more than one a day, if needed.

"It really just depends on my energy level, and my wallet," Capps said.

The 12-ounce Red Bull cost him $2.99 at the Wawa, at 36th and Chestnut Streets. And a lot of people are joining him. According to Beverage Digest, a trade publication, energy drinks pulled in $8.9 billion in 2011, up more than 40 percent from 2007. In an interview, editor John Sicher projected that the total for 2012 would exceed $10 billion.

Makers of energy drinks questioned why they were the focus of attention, noting that coffee contains more caffeine than some energy drinks.

The American Beverage Association, which represents several energy-drink makers but not Monster, said its members have agreed to list total caffeine amounts on product labels. Many labels also carry a warning that energy drinks are not recommended for children or pregnant women.

Not good enough, said Christina Calamaro, a nurse practitioner at Drexel Hill Pediatrics and an assistant professor at the University of Maryland School of Nursing. The problem is that the drinks are marketed to younger people, she said - citing seductive names such as Rockstar and Full Throttle, and the ads that feature athletes from extreme sports.

"They make it seem very, very cool to drink these drinks," Calamaro said. "If they're not marketing to kids, then I'm a supermodel."

Some of the drinks contain vitamins and additives that can boost heart rate further, she said. Plus, they contain unhealthful amounts of sugar.

Even though caffeine does not often lead to grave illness, it plays havoc with sleep, which can lead to other issues such as attention problems and obesity, she said.

Calamaro was the lead author of a 2009 study in the journal Pediatrics, which found that out of a sample of 100 teenagers, 85 reported drinking caffeinated beverages, consuming an average of 215 milligrams a day. Eleven percent drank more than 400 milligrams a day - the equivalent of four espressos.

One-third of the teenagers reported falling asleep during school, and caffeine intake was 76 percent higher among those who fell asleep.

For some, it starts even earlier. In another study this year, Calamaro and colleagues reported that in a sample of 625 children age 6 to 10, close to 30 percent of children drank a caffeinated beverage every day.