Coca Cola causes depression

Why energy drinks are not sports drinks

History of energy drinks

The first "energy drink" in history is Vin Mariani, a drink made for the first time in 1863 by the chemist Angelo Mariani from Bordeaux wine and extracts of the coca bush, the chemical structure of which was very closely related to cocaine. In Germany, free sales were stopped by the Opium Act of 1920.

On May 8, 1886, the American pharmacist John Stith Pemberton, addicted to morphine, invented “Coca Cola” in search of a headache-relieving syrup that could make his withdrawal from morphine tolerable. He created a drink, which cocaine from the leaf of the coca

Contains plant and caffeine from the cola nut (Cocaine was not yet considered to be hazardous to health at the time). The first advertisement appeared in the Atlanta Journal on May 29, 1886, and on June 6, 1887, Pemberton patented his drink as "Coca Cola". Immediately thereafter, he sold 2/3 of his trademark rights to Griggs Candler to finance his morphine addiction and died in 1888 at the age of 57 of stomach cancer. His son Charlie, who held the last third of the Coca Cola Company, died 6 years later of an overdose of raw opium - before that he had also sold his stake in Candler in order to be able to pay for his opium consumption. "Coca Cola" is now the most valuable brand in the world and, after "O.K.", the second most famous word in the world. Stern magazine called Coca Cola the "mother's milk of capitalism". It was not until 1903 that the company had to remove cocaine from its drink due to changes in the law in the USA - although it still contains non-psychoactive extracts from the coca bush.

What is an energy drink made of?

In addition to 18 sugar cubes (55g) Many of the manufacturers use the maximum permitted dose of 80 mg caffeine per 250 ml can (320 mg per liter) and by adding L-carnitine, guarana, ginseng, ginkgo biloba, glucuronolactone, taurine, B vitamins and inositol, we create a cocktail of active ingredients that does not provide any scientifically proven benefits beyond the pure effect of caffeine and its incalculable risk potential for paediatricians and sports cardiologists warn for a long time.

What is the risk of consuming energy drinks?

Under the headline "RedBull gives you heart stumbling" Jakob Simmank pointed out the health risks, especially for athletes, children and young people, online on May 29, 2019.

The introduction of the “RedBull” brand in Austria in 1987 and in the USA in 1997 established the marketing of high-sugar and caffeinated lemonades as “energy drinks”, the sales of which have doubled every five years since 2008 without government regulation. Children, adolescents and young adults <30 years of age are the main target group for marketing that specifically targets energy drinks (extreme-) promotes a sporting context and tries to establish it as a "sports drink". Who does not remember Felix Baumgartner's impressive parachute jump from the stratosphere at a height of 40 km from his “RedBull Stratos capsule” on October 14, 2012?

The number of medical emergencies related to energy drink consumption rose just as rapidly as the sales figures in US hospitals (The number of cases doubled between 2007 [10 068 cases] and 2011 [20 783 cases]). Not least because of this, efforts are being made in the USA to withdraw the status of a “drink” from energy drinks and to downgrade them to “dietary supplements”.

Teens and energy drinks

With the onset of puberty around the age of 11, the hormonal rhythms that control the sleep rhythm of people change: With an average need for sleep of 9 hours per night, the natural time to fall asleep shifts (Release of the sleep hormone melatonin) the teenager getting late at night. The use of electronic media can further delay falling asleep. When the alarm clock rings at 6:40 a.m. every morning, fatigue, concentration disorders and mood swings are the result - obesity and depression are also favored.

68% of 10-18 year olds in the EU drink energy drinks regularly or occasionally; 12% thereof an average of 7 liters per month. 53% consume these with alcohol at parties; 68% drink energy drinks before or during exercise. Among the 3–10 year olds in Europe, 18% drink energy drinks, 16% of them an average of 4 liters per month. 60% of young people in Germany drink energy drinks occasionally or regularly, which in no way gives them superpowers or school success, but rather as a risk factor for obesity, diabetes and mental illness in longitudinal studies (especially depression and addictions) and an early start to regular alcohol and cigarette consumption. Analyzes of American poisoning databases show an increase in overdose and poisoning symptoms from energy drinks in children and adolescents. According to current studies, the regular consumption of energy drinks does not bring any health benefits, but is associated with a multitude of potential health risks for children and adolescents. France banned the sale of Red Bull in 2004 until the EU Commission determined in 2008 that there were no proven health risks and France had to lift the ban. In Germany, consumer advocates have been calling for a sales ban to minors since 2017; since 2018 there are many supermarket chains (Aldi, Lidl) In England and the Netherlands, after considerable public pressure, they no longer sell energy drinks to people under the age of 16 - in Germany the same discounters are refusing this voluntary age limit. A majority of the CDU parliamentary group prevented the introduction of a binding age limit for energy drinks in Germany in 2018. In May 2019, the Federal Institute for Risk Assessment issued a warning (BfR) Again against health risks for the cardiovascular system from "excessive" consumption in children and adolescents.

How does caffeine work?

The central ingredient of the energy drinks is caffeine - a methylxanthine, the effect of which is enhanced and influenced by sugar, taurine and other ingredients. caffeine (= 1,3,7-trimethylxanthine) is a natural alkaloid that gets into baked goods, confectionery or soft drinks via raw materials such as coffee beans, tea leaves, cocoa beans and kola nuts. It reaches its maximum concentration in the blood 30 - 60 minutes after ingestion and has a half-life of 2 - 10 hours. Caffeine leads to pronounced reactions in the heart muscle in two ways: The main effect of caffeine is to block the adenosine receptors, e.g. in the central nervous system and on the heart muscle: In the brain, the sleep-promoting and relaxing function of the adenosine receptors is inhibited. In the heart, the beat frequency and oxygen consumption can increase and at the same time the flow of current in the nerve tracts of the heart muscle - in the form of the so-called "QT time" in the ECG - slowed down. In addition, caffeine stimulates the release of the stress hormones adrenaline and noradrenaline, which also increase the work of the heart and the heart's oxygen consumption. Caffeine is established in endurance sports and has been proven to increase performance (ergogenic) Active substance, the consumption of which is not doping-relevant in any dosage according to the World Anti-Doping Code according to the NDA Prohibited List 2019.

How Much Caffeine is Too Much Caffeine?

The European Food Safety Authority EFSA has a maximum single dose of 3 mg per kg of body weight for adults - a maximum of 200 mg caffeine (corresponds to 2.5 250 ml doses of RedBull) and a daily upper limit of 400 mg (5 250 ml doses of RedBull) classified as harmless. For pregnant and breastfeeding women, 200 mg is the single and maximum daily dose. For children, 3 mg caffeine per kg body weight is classified as safe as the maximum individual and maximum daily dose. HEALTH CANADA has set the maximum daily dose for children and adolescents at 2.5 mg per kg body weight.

These critical quantities are reached quickly: During one cup (200 ml) Filter coffee contains 90 mg, a 250 ml can of a standard energy drink is 80 mg. An espresso (60 ml) contains an average of 70 mg of caffeine, one cup of black tea (200 ml) is 50 mg, green tea (200 ml) at 20 mg and a can of Coca Cola (335 ml) has 40 mg caffeine content. 100 g dark chocolate contains 88 mg caffeine, whereas 100 g milk chocolate contains 20 mg. Since people react very differently to caffeine depending on their individual predisposition and how they are used to caffeine, the upper limits proposed by EFSA are to be understood as guidelines for the general public. Listen to your body! While some contemporaries get palpitations and sweats after a cup of coffee, some coffee drinkers who are used to caffeine tolerate more than a pot without feeling such discomfort. The upper limit above which undesirable side effects occur is individual; it can be above or below the EFSA recommendations.

However, there is some evidence that the possible cardiac death risk does not come primarily from caffeine alone.

Energy drinks and cardiac death risk

The focus of the ongoing scientific discussion about energy drinks is the possible cardiac death risk. Among other things, discussed two possible mechanisms by which excessive energy drink consumption can endanger heart health:

1. Reduced blood flow to the heart muscle (Myocardial ischemia)

The observed systolic and diastolic blood pressure increased (approx. + 10%) as well as the increase in heart rate (+10 %) and heartbeat volume lead to a measurable additional load on the runner's heart with increased oxygen consumption (This additional consumption is added to other factors that increase oxygen consumption, such as cold or hot running environments). In addition, there are disorders of the inner wall of the blood vessels (Endothelial dysfunction) and increased platelet adhesion (+ 134% platelet aggregation) whereby acute vascular occlusions with the risk of a subsequent heart attack can be favored. The additives carnithine may play a central role in this (promotes the development of arteriosclerosis) and glucoronolactone (promotes platelet aggregation and endothelial dysfunction) to.

In 2016, Giuseppe Lippi from Parma and Fabian Sanchis-Gomar from Madrid published a compilation of eight case reports of serious heart attacks published in the scientific literature ("ST elevation myocardial infarction", STEMI) in heart-healthy 13-32 year old patients with high consumption of energy drinks (> 5 cans) without any physical exertion. Particularly tragic was the case of a 13-year-old boy with normal weight and healthy heart who suffered a heart attack with coronary vascular dissection less than 24 hours after first consuming energy drinks.

Because the exact relationships are still unclear, experts recommend that energy drinks and their possible cardiac infarction-causing effects be placed much more intensively in the focus of scientific research.

2. Fatal arrhythmias

In several studies, the consumption of energy drinks led to a measurable increase in the "QT time" in the athlete's EKG. A prolongation of the QT time is a risk factor for the occurrence of fatal cardiac arrhythmias during exercise. There are numerous case reports of cardiac deaths under various QT time-prolonging influences, including: through energy drinks.

This is relevant when athletes are additionally affected by a genetically caused QT time prolongation, as is the case e.g. B. is the case with the so-called "long QT syndrome" - a hereditary heart disease which, at 1: 2500, is not so rare in the normal population in Germany.

It also happens that exercisers take drugs without knowing that they can also prolong the QT time as an undesirable side effect. QT time extensions caused by drugs are also a risk factor for fatal cardiac arrhythmias. This affects over a hundred drugs approved in Germany. These include commonly used drugs such as:

· Antibiotics (Quinolones, azithromycin, clindamycin, clarithromycin, roxithromycin, erythromycin, cotrimoxazole, moxifloxacin etc.),

· Antidepressant drugs (Citalopram, Escitalopram, Maprotilin, Imipramine, Sertralin etc.),

· Psychiatric drugs (Levomepromazin, Haloperidol, Tiaprid, Venlafaxin etc.),

· Nausea inhibitor (Domperidone, Ondansetron),
Heart rhythm stabilizing drugs ((Ajmaline, Amiodarone, Flecanid, Sotaloletc.),

· Opiate pain relievers (Fentanyl, methadone, pethidine),

Antifungal medicines (fluconazole, ketoconazole)

Fat reducers (probucol),

Chemotherapeutic agents (tamoxifen etc.),

Immunosuppressants (tacrolism),

Allergy medication / antihistamines (clemastine,

Antimalarials (quinine, cholorquine, mefloquine, halofantrine),

Muscle relaxants (tizanidine),

· Anti-migraine drugs (Sumatriptan),

Parkinone medications (Amantadin, Budipin),

· Epilepsy therapeutics (Valproinate).

[The combination of a macrolide antibiotic with antihistamines (allergy medication) is particularly critical for athletes: If a sport-related electrolyte disorder and / or energy drink consumption are added, severe cardiac arrhythmias up to fatal ventricular fibrillation can result.]

»The above list does not claim to be complete! Please check all medicines you are taking for possible undesirable side effects and discuss the issue of QT prolongation with your doctor and pharmacist.

In addition to the two mechanisms of action listed here, vascular wall spasms (vasospasm), thrombosis and detachment of the vascular wall (coronary vascular dissection) are also discussed as possible causes of cardiac death after energy drink consumption. While there are a few double-blind studies on the assumed increase in performance, this investigation approach is understandably not feasible for possible cardiac death risk for ethical reasons. The statements made above are therefore based on case descriptions, recommendations by specialist organizations and authorities as well as experimental data on possible mechanisms of action.

Are comparable risks to heart health to be expected when drinking tea or coffee?

In a meta-analysis on the question of "caffeine and cardiac arrhythmias" from 2019, Aleksandr Voskoboinik and colleagues come to the conclusion that high tea or coffee consumption in healthy people does not usually lead to an increased rate of threatening cardiac arrhythmias. While most studies showed no increase or even a decrease in the risk of cardiac arrhythmias with regular tea and coffee consumption, few studies showed an increase above a critical limit of 9-10 cups of coffee per day. The authors of this work consider a daily intake of 300 mg caffeine for adults to be generally safe. They see no scientific basis for a general ban on coffee for heart patients and recommend that you only advise not to use coffee in justified individual cases.

With increasing evidence that tea and coffee consumption have no comparable cardiac death risk, the focus is increasingly being shifted from caffeine to the additives in energy drinks. The role that the various mixtures of sugar, caffeine with L-carnitine, guarana, ginseng, ginkgo biloba, glucuronolactone, taurine, vitamin B6 and inositol and their mutual interactions play in the risk of cardiac death is of central importance for a final assessment, but hardly so far explored.

From a scientific point of view, the uncontrolled constant consumption of energy drinks without any restriction by children and adults can be seen as a large experiment with an unclear outcome to the detriment of the consumer.