A lawsuit in the US over the death of a youngster has renewed long-standing questions about the safety of energy drinks. The 21-year-old with a heart ailment died last year after drinking a highly caffeinated lemonade from Panera Bread, a chain of bakery-cafes headquartered in the US.

The woman’s parents, who filed the lawsuit in October, said that she was likely unaware of just how much caffeine was in the drink called a charged lemonade, which they claimed was not labelled an energy drink. A large size of the drink contains nearly the same amount of caffeine as five 236ml cans of Red Bull.

Such deaths are “exceedingly rare”, said Jennifer Temple, a professor of exercise and nutrition sciences at the University at Buffalo in the US, and usually occur only in people with underlying cardiac ailments. But highly caffeinated drinks can carry health risks for others too.

Here’s what to know about the drinks and how to stay safe if you choose to drink them.

At risk

Energy drinks typically contain high levels of caffeine, added sugars and stimulants; caffeine levels in some of the beverages have also crept up over recent years. For most people, the occasional energy drink will most likely not be harmful, said Bethany Doerfler, a dietitian at Northwestern Medicine in the US. But such drinks pose significant risks to people with heart ailments, who should avoid these beverages.

Their high caffeine content can stress the heart. Energy drinks also contain other stimulating ingredients, like taurine, which may make the heart pump harder when combined with caffeine, said Dr John Higgins, a sports cardiologist with UT Health Houston, US, who has studied energy drinks. Heart problems are undiagnosed in some people who have them, Dr Higgins pointed out.

Even if you do not have heart disease, high amounts of caffeine can strain your cardiac system. When you’re consuming an energy drink, watch out for warning signs: if you have palpitations, develop a bad headache, become out of breath, start sweating, feel chest pain or experience sudden fatigue, stop drinking it. Seek medical attention if your symptoms get worse.

Children under 18, pregnant and breastfeeding women, and those who are “caffeine naive” — or rarely consume caffeine — should preferably steer clear of energy drinks. People who take a stimulant medication, such as Adderall, may also want to avoid energy drinks, Doerfler said.

Caffeine limit

Most healthy adults can consume up to 400 milligrams of caffeine a day, according to the US Food and Drug Administration. Caffeine is not recommended for children younger than 12, and those 12 to 18 should consume no more than 100mg per day, according to the American Academy of Child and Adolescent Psychiatry.

Sensitivity to caffeine varies widely, Temple said, and it matters how quickly you consume it. Concentrated energy drinks, especially those sold as small shots, can allow a person to take in a lot of caffeine in a very short amount of time, before they can begin feel the effects on their bodies, she said.

If you feel jittery, anxious or nauseous or as if your heart is racing, that’s a sign you’ve had too much caffeine, Temple said. If you don’t usually consume caffeine, you can expect to be more sensitive to its effects, she explained.

The beverage at the centre of the lawsuit, the so-called charged lemonade, contains 390mg of caffeine in a large, 30-ounce (887ml) serving, according to Panera’s website. Packaged energy drinks usually contain smaller doses of caffeine: a 16-ounce (473ml) can of Monster Energy, for example, contains 160mg.

Most energy drinks are labelled with how much caffeine they contain, although this is not required by the FDA, Temple said. There is no legal limit on how much caffeine can be in energy drinks. Energy drinks can also contain many other ingredients, including other stimulants, which could also interact with caffeine to
enhance its effects,
she said.

Safety measures

If you’ve had too much caffeine, there isn’t much you can do except give it time to break down in your body. Drinking water, for example, won’t help to clear it, Temple said.

You should avoid strenuous exercise after consuming an energy drink, Dr Higgins said, so as to not tax your cardiovascular system. And don’t mix energy drinks with alcohol, which can strain the heart, Doerfler cautioned.

And you may want to limit how frequently you consume these beverages, if you choose to drink them at all. We don’t know much about the long-term effects of regularly drinking them, Dr Higgins said, noting “they have not been thoroughly researched”.

NYTNS