Bar-goers mix them with vodka to stay up and party longer. Students drink them to help pull all-night study sessions. And some athletes down them to boost performance.
So-called energy drinks -- a new breed of concoctions with stiff doses of caffeine, sugar and a mixture of herbs and other substances -- are fast becoming the younger generation's pick-me-up of choice.
That's raising the concern of some doctors and nutritionists, despite assurances from the drink-makers, who say the products are harmless so long as people who use them also stay hydrated. Water is an issue because caffeine, like alcohol, is a diuretic that promotes fluid loss.
"When it's all said and done, most energy drinks are caffeine and sugar, as are most soda pops," says Jim Heidenreich, vice president of marketing for Colorado-based EAS Inc., which began marketing Piranha brand energy drinks on the extreme sports and college scenes this year.
But some health experts aren't convinced energy drinks are safe. They say young people already consume unhealthy amounts of caffeine and don't need a product which raises that intake. They also believe the penchant for mixing a strong stimulant with alcohol -- a practice Piranha warns against on its label -- is a disaster waiting to happen.
"Any stimulant has the potential to cause some problems," said Dr. Basit Chaudhari, a Cape Girardeau neurologist. "These are the drinks we probably do not know the quantity of the stimulant."
Heart rate increase puts extra pressure on the heart, brain, blood vessels and other parts of the body.
"That can be dangerous," Chaudhari said. "I share their suspicion. I certainly would not kick the brain with some kind of stimulant and use something that is liable to cause some problems."
Officials in Canada, France, Norway and Denmark have yet to approve many energy drinks, including Austria's Red Bull, which accounts for more than half of booming energy drink sales in this country.
And last summer, Sweden's National Food Administration began advising people not to consume Red Bull with alcohol, or as a thirst-quencher. The recommendation came after a young woman who had consumed alcohol with the popular product died, apparently of dehydration. Two other deaths are also under investigation.
Emmy Cortes, a spokeswoman for Red Bull North America, says Swedish officials have yet to prove a link between the deaths and her company's drink. She also says Red Bull does not promote mixing its product with alcohol, though the company only warns against doing so in Austria, and commonly sells its product by the caseload to bars and nightclubs.
"We know it happens," she says, noting that few would question cola-makers about the popularity of mixing their product with rum. "What's going to happen is going to happen."
Dr. Michael Hirt, a California physician, is more worried about the smaller number of drinks that contain the drug ephedrine, a stimulant occasionally used in energy drinks that is also included in decongestants. Combined with caffeine, he says, ephedrine has been proven to cause deadly heart problems.
Athletic endurance
Scott Givens, assistant manager of Main Street Fitness Center in Cape Girardeau, said the "healthful" energy drinks aren't all that good for you.
Givens decides what food and drink supplements will be sold in the health club. He said he tries to steer his clients toward healthier protein and recovery drinks.
Most non-athletes don't use the drinks properly, he said, and he isn't so sure they're a good idea even for the elite athletes the drinks were originally developed for.
"They were designed to give heavy lifters an extra boost right before a workout, maybe give them some more endurance," Givens said.
Now, people are downing three or four a day just sitting down, he said. The result "speeds up their heart rate well past resting," he said. And frequently people are adding the energy drinks to a regular diet which already includes caffeinated soft drinks and other unhealthy products.
"It's just not safe for the body," Givens said. "It's another addiction."
Madison Lowrance, 14, is a Cape Girardeau Central Junior High School student.
"I've heard of people drinking them," she said. "But I don't find a reason to. I've heard that it might be bad for you, so I just don't."
Cape Girardeau Central High School senior Erica Kinnison, 18, doesn't use high-energy drinks either, but she understands why some do.
"I could see how somebody would want to use one of those with all the pressure and stress of school," she said. "But I wouldn't use it because it doesn't seem natural."
Kinnison said she doesn't know of anyone who drinks high-energy drinks.
"But if you use those, I don't guess you'd be going around telling everybody," she said.
A more common energy drink ingredient is taurine, an amino acid which occurs naturally in other foods, though in significantly smaller quantities.
Hirt estimates that one can of Red Bull has about as much taurine in it as 500 glasses of red wine -- a level he says is theoretically supposed to boost the effects of the drinks' stimulants but has not been studied for long-term effects.
Other caffeine sources
Many drinks also contain guarana or extract from its seeds, yet another source of caffeine.
"It just becomes more of a witches' brew. You're playing with things that we don't really understand and the long-term consequences are unclear," says Hirt, medical director at the Center for Integrative Medicine at the Encino-Tarzana Regional Medical Center in Encino, Calif.
Already, sales in this country have more than doubled since last year, according to the Beverage Marketing Corp. -- from $130 million in wholesale sales to a projected $275 million this year. Such figures helped entice such beverage giants as Coca-Cola and Anheuser-Busch to introduce their own products -- called KMX and 180.
Scott Moyers and Andrea L. Buchanan of the Southeast Missourian contributed to this report.
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