![]() 1, 4Īlarmingly, EB consumption has been shown to be positively associated with high-risk behavior, including marijuana use, sexual risk taking, fighting, failure to use seat belts, and taking risks on a dare, as well as with smoking, drinking, problems stemming from alcohol abuse, and illicit drug use. 4 This absence of oversight has resulted in aggressive marketing of EBs, targeted primarily toward young men and openly promoting psychoactive, performance-enhancing, and stimulatory effects. This is in stark contrast to countries in which some EBs have been banned, and companies are not allowed to outline the performance effects that their products may or may not provide. 2 For instance, no EBs are banned in the United States, and EB companies can say whatever they want regarding energy and performance effects. Regulation of EBs, including content labeling and health warnings, differs across countries, with some of the laxest requirements existing in the United States. 2 Consumption of EBs is most common among those aged 11 to 35 years, and 24% to 57% of this age group reported that they drank an EB within the past few months. 3 The United States is the world's largest consumer of EBs by volume, roughly 290 million gallons in 2007, or 3.8 qt per person per year. 2 In the United States, Red Bull enjoyed a 65% share of the $650-million energy/power drink market in 2005, and its sales are growing at about 35% per year. 1 Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle. Since then, the energy beverage (EB) market has grown exponentially. Red Bull was introduced in Austria in 1987 and in the United States in 1997. Evidence regarding the effects of EBs is summarized, and practical recommendations are made to help in answering the patient who asks, “Is it safe for me to drink an energy beverage when I exercise?”ĮB = energy beverage ECG = electrocardiogram SD = sport drink For this review, we searched the MEDLINE and EMBASE databases from 1976 through May 2010, using the following keywords: energy beverage, energy drink, power drink, exercise, caffeine, red bull, bitter orange, glucose, ginseng, guarana, and taurine. Long-term exposure to the various components of EBs may result in significant alterations in the cardiovascular system, and the safety of EBs has not been fully established. Subsequently, energy beverages (EBs) containing stimulants and additives have appeared in most gyms and grocery stores and are being used increasingly by “weekend warriors” and those seeking an edge in an endurance event. Initially, sports drinks were developed to provide electrolyte and carbohydrate replacement. This trend has spawned many supplements that purport to aid performance, muscle growth, and recovery. Exercise is making a resurgence in many countries, given its benefits for fitness as well as prevention of obesity.
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