Energy drinks: a narrative review of their physiological and pathological effects

Abstract

The consumption of energy drinks (Edks) has increased significantly in past years, with a growing market that is estimated to reach $61 billion by 2021 worldwide. Several studies demonstrated the physiological and pathological effects of these substances contained in Edks. The most common ingredient contained in Edks is caffeine, which is commonly mixed with taurine, and B-group vitamins. Scientific evidence of potentially serious adverse health effects are known, but it would be better to acquire more information regarding these beverages. We systematically checked Medical literature on MEDLINE-Pubmed from inception to January 2020 to find studies and reports on Edks and adverse events. Edks consumption is specially related to cardiovascular effects as malignant arrhythmias. We found a significant focus on arrhythmogenic risk in patients affected by long QT syndrome or other predisposing conditions for QT elongation. Other pathological effects are known as gastrointestinal, vascular and neurological disorders. Edks, as well as all caffeinated beverages, should be taken with caution or avoided in select populations, such as patients suffering from cardiovascular or neurological illnesses; their use can unmask a sleepy life-threatening disease. MethodsWe checked the medical literature on MEDLINE-Pubmed from inception to January 2020. The search strings were:

Effects of Energy Drink Consumption on Physical Performance and Potential Danger of Inordinate Usage

“…According to various reports, EDs can cause all kinds of arrhythmias, with occurring atrial fibrillation (AF) the most often [ 61 ]. QT prolongation, aortic dissection, myocardial infarctions, acute coronary vasospasm, and sudden death have been also observed in healthy subjects with structurally normal hearts or high-risk cardiovascular patients due to massive quantities of EDs consumption [ 62 , 63 , 64 ]. As a long-term effect, EDs are able to induce morphological changes in the heart muscle.…”

“…In addition, a recent study on 129,809 Korean adolescents presented that frequent ED consumption was associated with allergic diseases, such as asthma, allergic rhinitis, and atopic dermatitis [ 73 ]. The last finding also demonstrated that EDs containing caffeine can stimulate gastrin and gastric acid secretion and may reduce the competence of the lower esophageal sphincter, which eventually leads to gastroesophageal reflux disease (GERD) [ 64 , 73 ]. Interestingly, a case study revealed that atrophic gastritis and the gastric intestinal metaplasia can be limited with the withdrawal of EDs [ 74 ].…”

“…Beyond the previously mentioned alarming effects of ED consumption, there are extra concerns for athletes. EDs induce diuresis and slow fluid absorption, which may exert a negative influence in particularly during hot weather and during ultra-resistance sports competitions like marathons [ 28 , 51 , 64 ]. In addition, dehydration was pointed out as a patomechanism of exercise-induced asthma because a reduced airway surface protects against further liquid loss [ 73 ].…”

“…Unclear pharmacology and interactions between various ingredients found in these drinks put children at risk of dangerous consequences [ 64 ]. Considering that adolescence is an important stage of physical and psychological development, health care providers and teaching staff should inform both parents and adolescents that EDs have no therapeutic benefit at a young age and may lead to serious health events, including sudden death.…”

Energy Drink-Associated Electrophysiological and Ischemic Abnormalities: A Narrative Review

“…To our knowledge, this is the most comprehensive review as other reviews are only driven by case reports or have not captured the totality of available literature ( 69 , 70 ). However, several limitations should be noted when interpreting our findings in this review.…”