Should Energy Drinks Carry a Health Warning?

James LaValle, R.Ph, ND, CCN

The US has become a "caffeine-dependent nation". As if the traditional coffee, tea, and soft drinks were not enough, we have added caffeine to mints, gum, and a variety of "energy drinks." These drinks happen to be enjoying tremendous sales not only in the US, but in other countries as well. So it caught my eye when Australian researchers recently reported that the energy drink, Red Bull, has the potential to increase the risk of heart attack or stroke.¹

The study conducted on college age adults found that Red Bull not only increased blood pressure, it increased the stickiness of blood cells -- after consuming only one can of the drink. It is known that increasing the stickiness of blood cells means our blood will be more prone to forming clots, which can cause a heart attack or stroke. The authors of the study concluded that drinking Red Bull could be dangerous, especially for anyone who may already be predisposed to heart disease.

After the study was published, a spokesperson for Red Bull stated that these effects are similar to the changes found with drinking a cup of coffee, and so the long-term risks of energy drinks could not be determined from these results alone.²

It's true that each can of Red Bull contains about 80 mg of caffeine, the amount typically found in one cup of brewed coffee. Caffeine is a stimulant, and in moderation it has been shown to have some benefits. For instance, it slightly increases the body's rate of metabolism and enhances mental focus and clarity. However, in comparing coffee to energy drinks, are we really comparing apple to apples?

Both drinks contain caffeine. Stimulants in general increase the production of the stress hormones, adrenaline, nor-adrenaline, and cortisol. (Remember, anything that increases the production of stress hormones in the long run has potential for harm, as they are known to interfere with sleep, increase waist to hip ratio, and increase one's risk of heart disease and stroke.)

Nor-adrenaline causes blood vessels to constrict, and that increases blood pressure. One study found that in rats, caffeine and other stimulants increased the production of renin, a hormone made in the kidneys, which also increases blood pressure.³ But the difference between coffee and energy drinks is that coffee is coming from a plant and contains other natural substances that may be moderating its effects.

For instance, while some studies have found that coffee increases blood pressure in occasional drinkers, in habitual coffee drinkers, that effect seems to wear off.⁴ Longer term studies would need to be conducted on energy drinks to see if this effect would the same.

But what about the blood stickiness? So far there are no studies showing that coffee increases blood platelet stickiness. In fact, it has been found to have the opposite effect. Italian researchers have found that coffee makes blood platelets less sticky, and they have narrowed that effect down to the phenolic compounds contained in coffee.⁵

Phenolic compounds are the natural antioxidants found in many plant foods -- and coffee is very high in these antioxidants. So this may be part of the reason coffee is not as harmful. (But that does not mean you should drink more than a moderate amount.)

Obviously, the combination of ingredients in Red Bull is somehow exerting an effect resulting in increased blood stickiness -- and this is enough reason to avoid it, even if the blood pressure raising effects are only temporary. The manufacturers of Red Bull even warn consumers not to drink more than two cans a day. I think we would all do well to heed that advice.

However, I must say the negative results of the Red Bull study surprised me. Red Bull does not contain excessive caffeine and even contains some B vitamins and taurine, which should help counteract any of the effects of the caffeine. So when asked if these drinks are OK, I have considered them to be like any other stimulant.

Since they promote the increased production of stress hormones, they should be used with moderation and individual tolerance should be assessed and used as a guideline. For instance, some people don't clear the caffeine as well through their liver, and can't sleep at night with any caffeine at all.

In the meantime, I think we all need to consider why these drinks have become so popular in the first place. People are stressed out, burned out, and are not getting enough sleep. The use of these energy drinks will not remedy that. In fact, another study found that in people who were sleep deprived, the energy drinks were not effective in counteracting feelings of sleepiness, and even slowed reaction times compared to a placebo.⁶

This may explain why some people keep trying with more and more of these drinks. I see many people consuming ungodly amounts of caffeinated drinks -- 3 pots of coffee or 20 Mountain Dews daily. Even worse, I have seen patients drinking anywhere from 5 to 15 Red Bulls or other energy drinks per day.

Unfortunately, the attempt to get more energy in this way is very short-sighted and it can end up contributing to adrenal fatigue or exhaustion. And I must add that none of this discussion includes consideration of the long term effects of stimulants on our neurotransmitters. In general, we need to remember that too much constant stimulation over time will deplete vitamins and minerals and increase anxiety. It can also contribute to adrenal exhaustion, while increasing other health risks.

So, what should you do if you need more energy?

Consider using the adaptogenic herb, Rhodiola. It has been well-studied and found to increase energy by supporting adrenal function. An added benefit is that at the same time, it reduces the effects of stress on the body.

Finally, if you desire a little caffeine, so far the safest and most beneficial way to get it, seems to be with tea. Tea contains caffeine, but is balanced by the naturally occurring and calming substance, theanine. In addition, tea is very high in health-promoting antioxidants. And that's no bull!

References

1. http://www.medscape.com/viewarticle/579188?sssdmh=dm1.378116&src=nldne.
2. http://www.reuters.com/article/healthNews/idUSSYD584612008081.
3. Tofovic SP, J Pharmacol Exp Ther. 1991 Mar;256(3):850-60.
4. Science Daily. New Buzz On Coffee: It's Not The Caffeine That Raises Blood Pressure. American Heart Association, 2002, November 19.
5. Natella, F et al. British Journal of Nutrition. 28 Apr 2008.
6. Anderson C. and Horne J. Human Psychopharmacology: Clinical and Experimental. July 2006, 21 (5): 299.

[Ed. Note: James LaValle, R.Ph, ND, CCN, is the founding Director of the LaValle Metabolic Institute, one of the largest integrative medicine practices in the country. He was named as one of the 50 most influential pharmacists in the US by American Druggist magazine. Dr. LaValle is the Executive Editor of THB's The Healing Prescription and the author of more than a dozen books including the bestseller, Cracking the Metabolic Code: 9 Keys to Optimal Health.]

Cutting Edge Fitness: 3 Exercises to Improve Low Back Strength By Carlo Alvarez

It has been said that up to 80% of the U.S. population will suffer from some type of low back problems throughout their lifetime. And there are many causes -- including instability, strains, injuries, and accidents. Among adults, low back pain is often caused by overuse and muscle strain or injury. Proper treatment can help you stay as active as possible and enable you to understand that some continued or repeated back pain is not surprising or dangerous.¹

Specific exercises have also been shown to reduce low back pain and speed up recovery from a strain or injury.² I have outlined below, an effective program for the low back that includes a series of strengthening exercises.

The purpose of this exercise program is to improve the flexibility and strength of your trunk musculature, which is essential for the care of your low back. A strong trunk is the source of many movements and synchronizes the upper with the lower body. Therefore, all sides of the trunk must be trained -- the abdominal muscles for flexion, the lower back muscles for extension, obliques for rotation, and all of them together for stabilization and proper posture.³

By following this program on a regular basis, you will see improvements in your posture, work endurance, and athletic performance. Perform each exercise at a slow pace at least once a day, everyday.

Hip Bridge
Lie on your back on a flat surface. Your feet are flat on the surface and your knees are bent. Keep your legs together and cross your arms over your chest. Tilt your pelvis and push your low back to the floor, then slowly lift your buttocks off the floor as far as possible without straining. Maintain this position for 5 seconds. Lower your buttocks to the floor.

Kneeling Opposites
Start on the floor, on your hands and knees. Tighten your stomach muscles. Raise one leg off the floor and hold it straight out behind you. Be careful not to let your hip drop down, because that will twist your trunk. Hold for 5 seconds, then lower your leg and switch to the other leg. Work up to holding the position for 10 to 30 seconds each time. If you feel stable and secure with your leg raised, try raising the opposite arm straight out in front of you at the same time. Try to keep your body straight at all times, and don't let one hip drop lower than the other.

Cable Rotations
This exercise should be performed on a cable machine or with resistance tubing. Stand with good posture and feet slighter wider than shoulder width distance apart. Grip handle firmly with both hands, extend your arms in front of you and bend your knees slightly. Begin movement by rotating your trunk, and immediately pull the cable or tubing away from the machine. Pivot your back foot as you rotate your torso. Return to start position. Make sure you pivot your rear foot to allow for a full hip and torso rotation.

References

1. Carragee EJ. New England Journal of Medicine, 2005; 352(18): 1891-1898.
2. Koes B and Van Tulder M. Low back pain (acute), search date November 2004. Online version of Clinical Evidence (15).
3. Roetert EP. High-Performance Sports Conditioning, 2001, 119-137.

[Ed. note: Carlo X. Alvarez is a noted authority in the customized fitness and sports performance field. He is recognized for his integrated and systematic approach to training, based on a foundation of safe and proven methodology that has direct and measurable benefits to performance.]

Healthy Living: Caffeine -- Are You Addicted? By Laura LaValle, RD, LD

If you have an addiction to caffeine, you usually know it fairly quickly -- especially if you ever miss your regular fix. Not only can caffeine withdrawal make you feel very sluggish and cranky, it can give you severe headaches.

Caffeine is a central nervous system stimulant. And usually we get started on it because we enjoy the energy boost and the increased alertness it can give us. But there can be downsides. Caffeine increases acid production in the stomach and can lead to gastric reflux. It is also associated with fibrocystic breast disease.

But the biggest problem for many people is that over time you need more caffeine to feel as awake and stimulated, which can lead to the jitters or anxiousness -- and can eventually keep you from sleeping well at night. If your caffeine kick comes from a soft drink, it can cause other potential side effects like increased risk of diabetes and osteoporosis.

How much caffeine is too much? Some estimates are that you don't start to experience the negative effects of caffeine until you meet or exceed 500 mg per day. However, I have seen people get jittery and have sleep interference on less than that amount --so tolerance is very individualized.

For example, one cup of brewed coffee contains 95 mg of caffeine, typical colas contain 35 to 40 mg, energy drinks can contain anywhere from 80 to 170 mg per bottle, and chocolate bars contain 10 to 20 mg per serving.

If you know it's time to cut back or quit that caffeine for good, here are some pointers:

1. First and foremost, never quit cold turkey. A sudden drop in caffeine intake can lead to severe headaches. Cut back gradually by reducing your usual intake by just one serving per day. Hold at that level for a week until you are finally down to no more than one serving per day. For instance, if you normally drink 5 energy drinks per day, cut down to 4 a day for one week, then 3 a day, etc.

2. Find a replacement for your caffeinated drink. If you were used to coffee, switching to decaf first can help. One cup of decaf contains only 2 mg of caffeine; so replacing one regular coffee for a decaf is still a significant reduction in caffeine. If your caffeine source was a soft drink, switching to other non-caffeinated soft drinks only takes care of the caffeine problem, not the diabetes and osteoporosis risk. It can be a start, but for a healthier alternative, try mixing a carbonated water like club soda or a sparkling mineral water with a little fruit juice. You still have a cold bubbly drink but minus the phosphoric acids that rob the bones of minerals, and the refined sugars or artificial sweeteners that influence blood sugar control. You can also try different herbal teas until you find one or two that you really like.

3. Find other ways to increase your energy. Two of the best natural energy boosters I have found are drinking water and eating lots of raw fruits and vegetables. Drinking plenty of water during caffeine withdrawal not only improves your energy, it helps to flush the caffeine out of your body. And eating raw vegetables and fruits increases the body's alkalinity and provides enzymes that can be a real picker upper. If you start craving sugar, eat fruit and nuts instead, or enjoy a sugar-free mint; peppermint oil in particular is known to stimulate the brain and increase alertness.

4. Try to sleep more. As you are decreasing your caffeine, you should find it easier to sleep at night -- and that's good because at first you may feel like you need more sleep. Try to indulge yourself in that needed rest as much as possible.

5. Take a high-quality multi-vitamin. The adrenal glands use vitamin C, pantothenic acid and other B vitamins, and magnesium to make their hormones. Over time, your adrenal glands will start to recuperate with those additional vitamins you are taking in and you should find that you don't need as much sleep.

By following these tips, you'll avoid unpleasant withdrawal symptoms and begin to replace artificial stimulation with a healthier metabolism and more natural energy.

[Ed. Note: Laura B. LaValle, RD, LD is presently the director of dietetics nutrition at LaValle Metabolic Institute (formerly part of Living Longer Institute). She offers personal nutritional counseling at LMI for clients who need help with their diet in relation to illness or disease. Laura also provides educational services in the areas of health promotion, wellness, and disease prevention. To learn more, click here.]

Healthy Recipes: White Bean and Tomato Salad By Laura LaValle, RD, LD

At the end of summer, I love finding farmer's markets or roadside stands selling their bounty of fresh tomatoes. Recently, I have been into trying different types of course salts -- black and pink Hawaiian and Himalayan salts for example. They are great on sliced fresh tomatoes with fresh ground pepper. If you need more ideas for using up your fresh tomatoes, here's a great tasting salad that makes up really quickly.

Time to table: 5 minutes

Serves: 4

Healing Nutrient Spotlight

Excellent source of vitamin C and fiber
Good source of vitamin A and iron

Ingredients*

1 can (14 oz.) cannellini beans, rinsed and drained
1 pint grape tomatoes, halved; or 3 to 4 medium tomatoes, cut into chunks
4 scallions or 6 green onions thinly sliced
2 tbsp olive oil
1 tbsp fresh lemon juice
Coarse salt and ground pepper

*Choose organic ingredients for optimal nutrition.

Preparation

In a medium-sized bowl, lightly toss the first five ingredients together to mix and disperse the oil and lemon juice thoroughly with the other ingredients. Then, season with salt and pepper to taste.

This is an extremely easy salad to prepare and it is great for adding other ingredients as you have them for a different twist on the taste. For instance, add fresh minced garlic, or if you have any fresh jalapeno or banana pepper, chop them up and add an amount that is to your liking. Sprinkle with a little chili powder if desired. The flavors in this salad get even better after sitting awhile, so it is great to make it up a day ahead of time.

Nutrition

150 calories, 8 g total fat, 1 g saturated fat, 5 g monounsaturated fat, 1 g polyunsaturated fat, 17 g carbohydrate, 5 g fiber, 3 g sugar, 4 g protein, 620 IU vitamin A, .7 mg niacin, 23 mcg folate, 0 mg vitamin C, 40 mg calcium, 250 mg potassium, 2 mg iron, 330 mg sodium

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These articles appear courtesy of Early to Rise’s Total Health Breakthroughs [Issue 09-12-08] which offers alternative solutions for mind, body and soul. For a complimentary subscription, visit http://www.totalhealthbreakthroughs.com/