Young Girl Dies From Caffeine Overdose

Just last December, Anais Fournier, a 14-year-old girl from Maryland, died after drinking only two Monster energy drinks over the course of 24 hours. This incident has parents and researchers questioning whether energy drinks are safe for children.

Anais Fournier had a heart condition called mitral valve prolapse. In other words, one of her heart valves was malfunctioning. The National Institutes of Health reports that the condition is usually harmless under normal conditions. However, Anais went into cardiac arrest only a day after consuming two Monster energy drinks containing about 480 mg of caffeine. She died that same day from cardiac arrhythmia due to caffeine toxicity.

Fournier’s mother, Wendy Crossland, told the Record Herald “She was at the mall with her friends the night before and had a 24-ounce energy drink . . . She drank another one less than 24 hours later, even though she knew I do not allow them because I know they are bad for you. She went into cardiac arrest three hours later at home.”

According to The Huffington Post, the amount of caffeine that Fournier drank is equivalent to that found in 14 cans of Coca Cola and is almost five times the recommended caffeine limit announced by the American Academy of Pediatrics.

Caffeine poisoning is not uncommon here in the United States. TODAY reported that cases of caffeine poisoning have increased over the last few years, from 1,128 in 2005 to 13,114 in 2009.

A recent study in the journal Pediatrics showed that anywhere from 30 percent to 50 percent of teens and young adults consume energy drinks daily. Nearly half of the 5,448 reported caffeine overdoses in 2007 were in people younger than 19.

Does Citicoline Provide Energy?

Energy drink companies all promise the same thing: increased focus and vitality, but what is really the main provider of energy in these drinks? Energy drink manufacturers have revealed citicoline, a stimulant added to popular drinks on the market today, including 5-Hour Energy Shots. The Washington Post reported that citocoline is now being added to more energy drinks and supplements.

One of the latest drinks to come to market, Nawgen (pronounced “noggin”), promises that one can a day can “sharpen your mind.” The site even urges users to track their mental performance using an online memory and focus test.

“It helps with alertness and concentration by providing nutrients the brain needs for alertness,” said Jim von der Hoyt, CEO of Nawgen, which is based in St. Louis, MO.

According to a study on Nawgen’s website, the stimulant citicoline has been proven to increase focus and mental energy, as well as manage symptoms of ADD. However, many experts warn consumers to watch out for such claims. In fact, several studies regarding citicoline, better known as Cognizin, present overwhelming evidence that suggest that the stimulant is no more than a placebo. “If you need energy, you might need more sleep, not a drink,” said Keith Avoob, associate clinical professor of pediatrics at the Albert Einstein College of Medicine.

Ayoob suggests that more research is needed before citocoline should be considered the go-to solution for focus or energy. “One study is never enough to build a drink on or change your entire diet,” he said.

According to the Council for Responsible Nutrition, Americans spent about $9 billion on energy drinks just last year. Drinks containing citocoline make up only a fraction of all energy drink sales. The main provider of “energy” is most likely high levels of caffeine and sugar.

Beverage manufacturers and supplement makers in the U.S. are not required to prove certain health claims. But the U.S. Food and Drug Administration does require companies to ensure their products are safe before going to market. And once on shelves, the agency can review any product for safety.

Varying Caffeine Levels May Endanger Pregnant Women

A study by Glasgow University, led senior researcher Alan Crozier, showed espressos bought from different coffee shops contain vastly different amounts of caffeine. The discrepancy in caffeine levels could pose a risk to pregnant women and others who need to monitor their caffeine intake.

Analysis of espresso coffee from 20 different coffee houses indicates that one was six times stronger than the others. Imagine if one consumed six times more coffee than anticipated.

The Food Standards Agency (FSA) reports that too much caffeine during pregnancy may result in miscarriage or a low birth weight. As a result, the FSA advises that pregnant women limit their caffeine intake to no more than 200 mg a day, based on the assumption that an espresso contains about 50 mg of caffeine. The average caffeine intake for a healthy person is 300 mg per day.

The FSA currently advises pregnant women to consume no more than 200mg of caffeine a day, based on an assumption that an espresso contains about 50mg of caffeine. The guideline for an average healthy person is 300mg a day.

Crozier says “You metabolize caffeine much more slowly when you're pregnant.” Additionally, people with liver diseases do not have the enzymes to process caffeine. These people need to be careful how much caffeine they are consuming, which can be hard to do when coffee houses vary.

"The analysis that we did showed the amount of caffeine ranged from 50 mg per cup from Starbucks, up to over 300mg per cup from another coffee house, Patisserie Francoise," he said. "I was very surprised by this."

Drinking just one of the strongest cups of coffee would more than exceed the "safe" level for pregnant women.

"If you go to different coffee houses you can tell that some are much stronger than others," Crozier said. "The problem comes with people who should have a limited caffeine intake.”

FDA Issues Warning to AeroShot Manufacturers

According to an article by in the Huffington Post, the FDA announced today that it had issued a warning letter to Breathable Foods, the manufacturers of the caffeine inhaler known as Aeroshot, for "false or misleading statements" in the advertising for its controversial new product.
The FDA took questioned several of AeroShot's claims, especially the idea that the caffeine inhaler delivers "breathable energy" but is "intended to be ingested by swallowing." The FDA's press release notes that, "A product cannot be intended for both inhalation and ingestion.” These are two separate bodily functions.

The FDA was also worried about the possibility that AeroShot was marketing its product to teens as a fun complement to alcoholic beverages.  Due to prior incidents, the FDA has little patience for dangerous caffeine-alcohol mash-ups.
Breathable Foods indicated that it would cooperate with the terms of the FDA's warning letter. “We plan to work closely with the FDA to meet their requests for information and labeling changes to ensure compliance with dietary supplement requirements," Breathable Foods CEO Tom Hadfield said in a statement. "AeroShot delivers a mix of B vitamins and caffeine to the mouth for ingestion and is not 'inhaled' into the lungs. AeroShot is not recommended or marketed to persons under 18 or for use with alcohol."

So far, all this controversy seems to have actually boosted sales of AeroShot. Breathable Foods says that AeroShots remain available on store shelves in Boston and New York but are completely sold out on the company's website.

Caffeine vs Amphetamines

A recent study shows that stimulants, such as caffeine and amphetamines, can affect different people in different ways, especially regarding work ethic. There are two kinds of people: self-motivated hard workers and those who do just enough to get by. Hard workers focus on the reward that awaits at the end of a task while others focus only on the effort required to accomplish something.

However, the research, which was conducted on rats, reveals a twist: stimulants like caffeine seem to flip those approaches. "The workers are choosing fewer of the hard trials, and the slackers are choosing more of the hard trials," said study researcher Jay Hosking, a graduate student at the University of British Columbia.

Hosking and his colleagues trained and tested how motivated 20  different rats were. They were put in boxes with two levers and five holes. During the task, one of the holes lit up. By sticking its nose in that hole, the rat received a treat of sugar pellets. Using the levers, the rats could then choose between a hard task, in which the hole lit up for a fifth of a second — about how long it takes to blink — and an easier one, where the hole lit for a whole second.

"Even the rats have extreme slackers and extreme workers," Hosking told LiveScience. "Just like with human beings, there is a continuum of activity levels." As in humans, some rats frequently chose the bare-minimum task, and others went with the hard ones for the bigger payoff.

When the rats were given stimulants like caffeine or amphetamines, they were more impulsive and responded quicker, but they were just as accurate at nosing the lit-up hole. However, the two personalities of rat had opposite reactions when made to choose between tasks. On either of the drugs, the hardworking rats became lazy, preferring the easy tasks in trials.

Meanwhile, when the lazy rats were given amphetamines, they became hard workers. Oddly, the same effect was not seen for the caffeine.

"The good news is that caffeine doesn't make the lazy rats any worse, but it definitely decreases the workers' willingness to put in the work," Hosking said.

Why the difference between the two stimulants? "Both end up stimulating, both create arousal, but they have different specific effects on the brain," he said.

The results may explain why amphetamine-based stimulants such as Adderall can help calm someone who has attention deficit hyperactivity disorder (ADHD). Perhaps the drug works to turn those distracted people into focused workers.

Adderall has lots of "off-label" uses, too, Hosking noted. Everyone from overworked college students to long-haul truck drivers may take amphetamines.

"One treatment doesn't fit all individuals," Hosking said.

"In truck drivers, amphetamine is a common stimulant which helps keep drivers alert … but a quarter of truck accidents are related to that amphetamine use as well," he said. "Some people might do really well on the amphetamines, and some might be taking it and thinking it's helping and actually harming themselves."