By: Sarah Galzerano, Jefferson Health – New Jersey
While a tempting caffeine boost may be helpful when it comes to keeping you alert and focused on a busy day, just like anything else we consume, too much of a “good” thing isn’t always good for us.
Over the past few years, more and more reports have shown that the consumption of energy drinks – of which there are more than 500 brands to choose from – can have adverse effects on the heart. We spoke with cardiologists Dr. Reginald Ho, with expertise in electrophysiology, and Dr. David Fischman, with expertise in interventional cardiology, to understand what makes energy drinks particularly harmful, what the risks are and who should steer clear of them.
Overstimulating the Heart
Caffeine is a stimulant, meaning it can speed up your sympathetic nervous system increasing your heart rate and blood pressure. Unlike coffee, energy drinks don’t just contain caffeine; they’re full of additives that act as stimulants – such as guarana, taurine and L-carnitine – which intensify the effects of caffeine, explains Dr. Fischman.
There’s also typically more caffeine concentrated into one canned energy drink versus an 8-ounce mug of coffee, says Dr. Ho. The FDA generally considers it ok to consume, at most, 400 milligrams of caffeine a day when you have no underlying cardiovascular health issues.
The difference in caffeine between the two isn’t huge, notes Dr. Fischman, however, nutrition labels can be deceiving. A cup of coffee contains around 90 mg of caffeine, while an energy drink may contain anywhere between 100 to 350 mg. What’s worrisome is when cans contain more than one serving. It’s important to be mindful of nutrition labels and how many servings you’re actually consuming.
An Abnormal Heart Rate and More
When caffeine is consumed in excess, it can do more than temporarily raise your heart rate. It may also increase your blood pressure, trigger anxiety, and, overtime, you may develop a physical and psychological dependence, explains Dr. Ho.
Studies have looked at how energy drinks affect the electrical activity of the heart. “Some data suggest that quick ingestion over a short period of time might result in QT prolongation on an electrocardiogram (EKG); this shows us that the heart is taking longer than usual to recharge between beats, posing a risk of developing a lethal (or deadly) arrhythmia, or a heart rate or rhythm irregularity,” explains Dr. Ho.
You can often feel an arrhythmia as it causes a sudden pounding (palpitations) or fluttering sensation in the chest, sometimes along with fatigue, lightheadedness or shortness of breath. While arrhythmias are typically short-lived, they can become chronic, such as with atrial fibrillation (aFib).
“Some people already predisposed to cardiovascular complications – often without knowing it – can trigger significant problems with regular consumption of energy drinks,” adds Dr. Fischman. If you’re feeling potential symptoms of aFib or noticing something else feels “off,” it’s important to have it addressed and managed by your healthcare provider to reduce your risk for stroke, heart attack, heart failure, sudden cardiac arrest and even dementia.
Excess Calories on Heart Health
Energy drinks – as well as handcrafted coffees that are full of syrups, sweeteners and heavy dairy products – can also cause harm to our heart health due to the amount of added sugars and calories they contain.
If you consume high-calorie drinks frequently, you are increasing your risk for weight gain, obesity and type 2 diabetes – all of which are detrimental for cardiovascular health, says Dr. Ho, leading to long-term hypertension (high blood pressure), rapid heart rate, cardiovascular disease and more.
Dangers of Mixing Energy Drinks with Alcohol
This has become a growing concern in the last few years, especially among young adults and teens who are mixing energy drinks (a stimulant) with alcohol (a depressant). Depressants affect the central nervous system the opposite of how a stimulant does; they slow brain activity, lower blood pressure and decrease overall concentration and energy levels.
“When you mix a stimulant with a depressant, it is likely to mask the effects of intoxication, leading you to poor judgement and drinking more,” notes Dr. Ho. And both caffeine and alcohol pose risks to the heart, making it somewhat of a “double-whammy.”
Energy Drinks & Exercise
Some people turn to energy drinks to give them a boost before exercising, but it’s not recommended to consume any caffeine directly before a workout, notes Dr. Ho. “Exercise itself stimulates your heart and functionality; it can be dangerous to have something exaggerate that effect.”
If you feel too fatigued to work out – or simply go about your day – the answer shouldn’t be caffeine, adds Dr. Ho. It could indicate there’s another basic health need of yours being neglected. Try asking yourself, “Am I sleeping well,” “Am I hydrated,” or “Have I been eating the right foods?”
On the other hand, sport beverages – or electrolyte beverages – are a healthier alternative to keep yourself well-hydrated during a higher intensity workout; but, like everything, they should be consumed in moderation.
What You Should Do
If you’re a self-proclaimed fan of energy drinks, Dr. Fischman urges you to remember that there’s no evidence that they enhance your cognitive function, awareness or physical performance. There’s also no nutritional value. “You’re better off with a cup of coffee,” he says.
If you have no underlying cardiovascular issues, you may follow the FDA’s standard recommendations for caffeine, while being mindful of extra calories and listening to your body.
If you have a heart condition, it’s highly recommended you limit or avoid caffeine, adds Dr. Fischman. Depending on your condition, your cardiologist may say it’s safe to drink one or two cups of coffee per day.
If you experience any troublesome cardiac symptoms, alert your primary care provider or cardiologist as soon as possible. Feelings of chest pain or squeezing, shortness of breath, nausea, fatigue and arm or neck pain could be signs of a heart attack or more serious complication, and you should call 911 or go to your local emergency room for care.
To stay up-to-date on health and wellness tips and advancements in treatment from our experts, please visit JeffersonHealth.org.
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