Fogger, McGuinness - 2011 - Update on Energy Drinks and Youth. - Journal of Psychosocial Nursing and Mental Health Services

March 21, 2018 | Author: OngJoonFaii | Category: Caffeine, Alcohol Intoxication, Sleep, Science, Drink


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Addressing psychiatric and psychosocial issues related to children and adolescentsTeena M. McGuinness, PhD, CRNP, FAAN, Section Editor Youth in Mind ABSTRACT Energy drinks are attractive and readily available in every grocery store and gas station. While most youth verbalize an understanding that too much caffeine is bad for one’s health, at an age of multiple demands, an over-the-counter offer of increased energy and alertness is hard to ignore. What makes energy drinks different from regular coffee? Although the heavily caffeinated drinks promise increased energy and stamina and are loaded with healthy natural ingredients, excessive consumption is of concern on many levels. This article will discuss some of the effects of excessive caffeine, as well as risks associated with energy drinks mixed with alcohol. W ith names like Rock Star® and Red Bull®, adolescents cannot help but take notice of energy drinks. Attractively packaged and heavily marketed to youth, energy drinks promise high get-up-and-go and stamina. Further, they are loaded with purportedly healthy substances such as B vitamins and other “natural ingredients.” But energy drinks are also laden with large amounts of caffeine. Most adolescents and young adults can verbalize that too much caffeine is unhealthy, but the advertising hype offering increased energy and alertness is hard for them to ignore. What is it then that makes energy drinks different from coffee? In this article, we will cover the effects of energy drinks as well as risks associ- ated with the dangerous trend of mixing energy drinks and alcohol. Young people comprise more than half of the market for energy drinks (Babu, Church, & Lewander, 2008; Seifert, Schaechter, Hershorin, & Lipshultz, 2011). Energy drinks are different from ordinary soft drinks because although the U.S. Food and Drug Administration (FDA) classifies traditional soft drinks as foods, energy drinks fall into a separate classification for dietary supplements and thus are not subject to the same rules. For example, a 12-ounce can of soda is allowed by the FDA to contain a maximum of 65 mg of caffeine; however, an energy drink such as Red Bull contains 80 mg of caffeine in a 8.4-ounce can; a larger-volume drink such as Full Throttle® (original) has 144 mg in a 16-ounce can Susanne Fogger, DNP, CRNP; and Teena M. McGuinness, PhD, CRNP, FAAN Journal of Psychosocial nursing • Vol. 49, no. 12, 2011 © 2011 iStockphoto.com/NoDerog 17 increasing risk for caffeine poisoning. Energy drinks are not the same as sports drinks. 2010). sweating. Adenosine blockade via caffeine produces a less sleepy and more focused person through enhanced dopamine and decreased adenosine availability.. but the primary constituents of energy drinks are caffeine and sugars. an amino acid naturally found in the body. Tuttle. However.. the excess is unnecessary. similar to drugs of abuse such as cocaine (Robinson & Berridge. and endocrine disorders should definitely avoid them (Seifert et al. as the body is unable to absorb more than 2 grams (Higgins et al. which contain caffeine yet are not included in the caffeine totals (Higgins et al. 2011).. which may be three to four times higher than a soft drink. Supplementing the diet with L-carnitine has demonstrated a beneficial effect on athletes. they replace needed electrolytes and provide carbohydrates. caffeine is the most commonly used legal psychoactive substance. The blockade of adenosine enhances available dopamine. It is thought to trigger the formation of increased protein within the body. These stimulating effects are contraindicated for those who are ac18 tive and thirsty. it often varies substantially. guarana. Seifert et al. Sensitive people may notice side effects of caffeine at lower levels. anxiety. the label listing the caffeine content of the beverage is not entirely accurate. decreases sensitivity to D2. L-arginine. liver. Drinking several cans quickly can result in a rapid rise in caffeine levels. In caffeinehabituated individuals. most adults drink coffee in the morning to wake up or to reenergize when taking a break. PHYSIOLOGICAL EFFECTS OF CAFFEINE Essentially. Although most adolescents can tolerate the added stimulation. & Higgins. flushed face. Caffeine is an adenosine antagonist and blocks the adenosine receptor. OVERVIEW OF “NATURAL” INGREDIENTS IN ENERGY DRINKS Energy drinks are touted as containing natural ingredients.Youth in Mind (Babu et al. as caffeine levels decline. thereby increasing the effect of dopamine on the D2 receptor.. Worldwide. and consumption of 5 to 10 grams can be deadly because of cardiac arrhythmias. theobromine. caffeine activates dopaminergic reward circuits. teenagers are happy to pay the higher cost for the “buzz” these drinks can induce. Despite their expense. While an intake of less than 400 mg per day is safe for healthy adults. 2011). However. as . and taurine... 2011). an intake of 1 gram or more causes significant symptoms such as anxiety. It plays a role in the prevention of cellular damage and recovery from exercise stress (Higgins et al. but generally. such as guarana. However. These caffeine-withdrawal symptoms peak in approximately 48 hours but may last up to 1 week. an amino acid. under normal conditions. caffeine-laden energy drinks are often placed in retail displays adjacent to sports drinks. potentially confusing children and their parents about their use. as some of the caffeine may be hidden in other substances. renal. 2011). Caffeine also increases attention and speeds response times. a particular problem ensues when children and adolescents confuse energy drinks with sports drinks. yawning. acute toxicity can occur with 1 gram. but the primary constituents of energy drinks are caffeine and sugars. Interestingly. Guarana contains high amounts of caffeine. a healthy body manufactures enough. L-arginine is a semi-essential amino acid.. 2010). Sports drinks are designed for rehydration. Of additional concern is the metabolism and elimination of caffeine. 2000). withdrawal symptoms occur within 12 to 24 hours of last consumption (Heatherley. so supplementation is unnecessary (Higgins et al. resulting in an immediate increase in blood pressure and peripheral vascular resistance related to sympathetic stimulation (Higgins. they may contain other ingredients such as L-carnitine. Recall that adenosine is a sleep-inducing neurochemical. It enables one to focus on tasks longer despite fatigue and keeps one awake when one might otherwise fall asleep. One of the most common ingredients is L-carnitine. 2010). is suggested to increase blood flow as well as exercise tolerance. youth with histories of cardiovascular. such as in protein malnutrition or severe burns. 2000). However. and theophyline and is derived from a South American plant that increases energy as well as aids in weight loss. it stimulates increased Copyright © SLACK Incorporated Energy drinks are touted as containing natural ingredients. caffeine is not harmless. L-arginine. 2008. Consequently. if an energy drink contains more than 2 grams (and some contain up to 6 grams). and helps promote sleep. 2010). Symptoms include fatigue. The danger is that energy drinks can worsen dehydration and increase the workload on the cardiovascular system (Seifert et al. Caffeine is an integral part of the American diet. and headache. thus creating a stimulating effect (Stahl. when the system is severely stressed. 2010). and cardiac arrhythmias (American Psychiatric Association. 2008).. R.3122/ jabfm. early school hours.P.. (2010). Energy beverages: Content and safety. Several retrospective case studies on individuals with mental illness found that those who consumed large amounts taurinecontaining beverages (4 or more per day) for a number of days experienced a worsening of their underlying illness.2009-3592 Stahl.. AL 352941210. Heatherley. The person became hypervigilant.. School of Nursing. 85. 95(Suppl. adolescents. they contribute to caffeine dependence and poor sleep hygiene.L. doi:10. (2000). 2011). Taurine is an abundant amino acid found in the central nervous system. 23. S. Tuttle. The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. Poor sleep hygiene. 2011 19 . Babu. teens engaging in this underage drinking practice will binge and consume three or more drinks at a time. In addition. doi:10. S. However. J. Clinical Pediatric Emergency Medicine. Birmingham. NURSING IMPLICATIONS Nurses must have the knowledge and ability to communicate these concerns so adolescents. including research support. and full schedules can play havoc on sleep cycles. FAAN. and parents can be aware of the risks of energy drinks.04.0381 Robinson. more is not better. J.090261 Dr. T. Hershorin. Often. S.E. and young adults. The psychobiology and neurobiology of addiction: An incentive-sensitization view. Seifert et al. 89-95. (2011). C.L. Church. W. Address correspondence to Teena M. & Lewander. they returned to baseline function (Seifert et al.2010. 9. a review and analysis of the literature revealed that caffeine and other substances contained in energy drinks have no legitimate place in the diets of children or adolescents (Seifert et al. or having undesirable sexual encounters. Seifert. American Psychiatric Association.3928/02793695-20111102-03 REFERENCES Journal of Psychosocial nursing • Vol. carbonation of energy drinks increases alcohol absorption. antioxidant properties. Weldy. text rev. can be fatal. Diagnostic and statistical manual of mental disorders (4th ed.R. (2011). & Higgins. This binge- drinking behavior increases the risks of injury related to impaired judgment. 555-558. Journal of the American Board of Family Medicine. D. (2008).D. 2011 doi:10..M. 12. Overriding the sedating effects of the alcohol allows the person to drink more but further clouds judgment concerning the degree of impairment from alcohol (Higgins et al. and urea. Risks of alcoholic energy drinks for youth. 14(3). (2010). (2011) reported that adolescents who are dependent on marijuana consumed significantly more caffeine than non-marijuana-dependent control participants. 2011). 1033-1041. young adults. such as driving while intoxicated.. Side effects include increased levels of potassium. Acute alcohol poisoning. University of Alabama at Birmingham. New York: Cambridge University Press. Thus.. It is an antioxidant and acts on neuronal growth (Seifert et al. Professor. K. Adolescents with cardiac and renal disorders need to be aware that more than one energy drink can be considered excessive and should be avoided. energy drinks increase the likelihood of alcohol poisoning. doi:10. 2011).V. (2008). The stimulating effects of caffeine override the sedating effects of alcohol and permit greater alcohol consumption—a potentially fatal situation. 2010). Individuals with renal or hepatic disease should avoid this supplement. increasing the chances of caffeine toxicity as well as becoming intoxicated. Washington. even psychotic. 2010. Weldy. 35-42. Further. S91-S117. Mixing energy drinks with alcohol increases the likelihood of such a fatal event (Weldy. Mayo Clinic Proceedings. K. Assessment of energy drink consumption should be a routine part of mental health evaluation by psychiatric nurses. McGuinness is Professor. no. indeed... Schaechter. 127. Screening for consumption of energy drinks can begin the dialogue concerning harmful effects and risks of these products. Birmingham. e-mail: [email protected] (2000). each of the additives suggests a combined benefit to tissue. increased protein production. University of Alabama at Birmingham. screening questions about energy drinks can be a lead-in for discussion of other chemical dependencies. as well as verbally and physically aggressive. Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (3rd ed. CRNP. and Dr. & Berridge. Higgins. Interestingly. sleepiness. Alabama. S. Pediatrics. puts both adolescents and their companions at risk for accidental injury. the value of L-arginine to a healthy adult has not been confirmed. added to not getting enough sleep.L. Fogger is Assistant Professor. School of Nursing.. no current evidence supports the anticipated claims of energy drinks on athletic performance.. Individually. as well as improved circulation. 511-528.1542/ peds.. SUMMARY Energy drinks may represent a significant health risk to youth because they are not rehydration products. Health effects of energy drinks on children.E. Excessive use of caffeine to remain awake. Energy drinks: The new eye-opener for adolescents. McGuinness. A common complaint for adolescents is fatigue from lack of sleep. A DANGEROUS TREND: MIXING ALCOHOL WITH ENERGY DRINKS One unfortunate and dangerous trend is mixing energy drinks with alcohol to avoid excessive sedation. thereby escalating the likelihood that the person would consume a toxic quantity of alcohol (Weldy.).4065/ mcp. & Lipshultz. Caffeine withdrawal. However. creatinine. 2010). In any case. NB 205. 2).). PhD. 1530 3rd Avenue South. When mixed with alcohol. When hospitalized and no longer able to consume the energy drinks. 49. T.2010. 2010). DC: Author. if not treated immediately.. and driving performance: What does the research really tell us? Nutritional Neuroscience. riding with an intoxicated driver.Youth in Mind production of muscle mass.. with taurine. E. Discussion concerning caffeine overdose symptoms and use of energy drinks with alcohol may dispel attractive myths about excessive use.M. Addiction. 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