Caffeine

Energy Drinks: Safe As Coffee But Somehow Lethal

An alarmist Washington Post story conflates Red Bull with pure caffeine powder.

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Red Bull

The Food and Drug Administration (FDA) recently warned manufacturers of caffeine powder that it considers their products, which are sold as dietary supplements, to be "adulterated" because they pose "a significant or unreasonable risk of illness or injury under the conditions of use recommended or suggested in the labeling." That conclusion, while arguable, was not completely far-fetched, since measurement errors involving pure caffeine, which is meant to be mixed into beverages, can easily lead to uncomfortable and even life-threatening overdoses. "The difference between a safe amount and a toxic dose of caffeine in these pure powdered products is very small," the FDA notes. "Safe quantities of these products can be nearly impossible to measure accurately with common kitchen measuring tools."

But Washington Post reporter Ariana Eunjung Cha latched onto the FDA's warning letters as an excuse to attack products that are not only much less potent than caffeine powder but in most cases contain less of the stimulant than coffee does. Under the headline "How America's Love Affair With Caffeine Sparked a Crisis of Overdoses—and What the FDA Is Trying to Do About It," Cha writes:

There was a time when getting your daily dose of caffeine meant a simple cup of coffee or tea.

Poured into a ceramic mug, the steaming liquid tended to be enough to give most people that extra burst of energy to get out the door. Back then, you'd have to drink a heck of a lot—81 cups of brewed coffee, or 317 cups of black tea, for the average 195-pound U.S. male—to reach a lethal dose. So while you might still get the occasional shakiness, nausea and fast heartbeat associated with ingesting too much caffeine, you were highly unlikely to die from it.

But somewhere along the way, caffeine became an obsession, a need for many Americans; and an entire industry sprang up to try to make caffeine ingesting more efficient. 

The clear implication is that the products Cha is about to discuss are in some important way more dangerous than coffee, which is true of caffeine powder but not of the energy drinks and caffeinated gum that she lumps together with it. Cha specifically mentions Red Bull and Monster Energy, which contain, respectively, 9.5 milligrams and 10 milligrams of caffeine per fluid ounce. Starbucks coffee contains twice as much caffeine per fluid ounce. Cha also mentions Jolt gum, which contains 45 milligrams of caffeine per piece, compared to about 165 milligrams in a "short" (eight-ounce) Starbucks coffee.

For some reason Cha's list of new, worse-than-coffee products also includes Stay Awake, which is Walmart's version of  NoDoz, a product that has been around for more than half a century. Both contain 200 milligrams of caffeine per tablet, making them as potent as a 16-ounce Starbucks iced coffee. Fun fact: NoDoz's slogan used to be "Safe As Coffee." 5 Hour Energy, which Cha also mentions, likewise contains 200 milligrams of caffeine per serving.

Cha claims "the new products have led to an alarming public health development in recent years that was unheard of in the many previous decades that people enjoyed caffeine: a rash of thousands of overdoses and reports of addiction and withdrawal." Cha apparently has in mind calls to poison control centers, because later she mentions that "poison centers across the country logged 1,675 reports involving energy drinks" in the first half of this year. To put that in perspective, poison control centers receive more than 46,000 exposure calls a year involving plants and more than 66,000 involving vitamins.

Another indicator of problems with caffeinated products is "adverse event" reports to the FDA. In November 2012 the FDA said it had received a total of 60 "adverse event" reports related to Monster and Rockstar energy drinks (two of the leading brands) since 2004—an average of six or seven a year. By comparison, the FDA receives thousands of such reports about aspirin each year and hundreds about coffee.

It's true that not every bad experience with caffeinated products is reported to the FDA, but it's also true that such a report does not prove causation. It simply means someone experienced symptoms after consuming the product; it does not necessarily mean the product caused the symptoms—a point that is especially important to keep in mind when people die after consuming a particular product.

Cha mentions "a 14-year-old with a heart condition" who "died after going into cardiac arrest shortly after she drank two caffeinated energy drinks in 24 hours" in the same paragraph as "a 19-year-old Connecticut resident who took a dozen caffeine pills" and "a healthy Ohio teen" who "died after consuming powdered caffeine." Lumping these cases together is misleading because they involve different products and dramatically different caffeine doses.

The 14-year-old, Anais Fournier, drank one 24-ounce can of Monster Energy, then another one a full day later. The total amount of caffeine was 480 milligrams over two days, nowhere near a lethal dose, which is something like 10,000 milligrams for an adult. Fournier would have gotten more caffeine from two 16-ounce Starbucks coffees.

By contrast, the Connecticut teenager, James Stone, consumed something like 2,400 milligrams in one sitting, still less than a fatal dose but five times Fournier's two-day dose, while a postmortem test of blood from the Ohio teenager, Logan Stiner, found that it contained 70 micrograms of caffeine per milliliter—above the lethal level. Yet Cha, following in the footsteps of alarmists like New York Times business reporter Barry Meier, presents these three examples of caffeine consumption as if they were equally risky, implying that you are taking your life into your hands every time you consume an energy drink.

The biological absurdity of that fear is apparent from a 2013 meta-analyses of 23 studies that looked at the association between coffee consumption and cardiovascular health. It found that the lowest cardiovascular risk was associated with drinking three to five cups of coffee a day.  An eight-ounce cup of coffee (the usual definition in these studies) typically contains between 100 and 200 milligrams of caffeine. Assuming an average of about 150, three to five cups contain 450 to 750 milligrams of caffeine.

In other words, the upper limit of the healthiest consumption range in these studies is equivalent to more than three 24-ounce cans of Monster energy drink per day. Lower limits may be appropriate for teenagers or for people with pre-existing cardiovascular problems. But it is nothing but cheap scaremongering to suggest that energy drinks pose a potentially lethal threat to the average consumer.

Addendum: Cha's article was republished by The Independent on Tuesday, under the puzzling headline "Thousands Overdosing on Caffeine As Coffee Crisis Sparks Call for Urgent Action." In addition to implying that every call to a poison control center represents a life-threatening event (when in fact most calls involve minor incidents that do not require medical attention), the headline suggests that the article is all about the danger posed by coffee, which of course it isn't—although Cha's lack of concern about coffee makes no sense if the issue is too much caffeine.

[cross-posted at Forbes.com]

NEXT: Leash Law

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  1. Sullum, if you’re going to investigate thoroughly and bring perspective to every fake crisis that springs up, hacks like Ariana aren’t going to be able to gin up public fear about anything. Then what will they write about?

    1. They could always try their hand at productive work.

      1. Maybe writing is the better portion for all of us. Could you imagine this woman in the adjacent cubicle, peeking over your shoulder at the food you’ve brought or contacting HR about your unhealthy weekend habits and how they affect the company health premiums?

        1. portions, options, whatever.

          Posting before coffee may be hazardous to your sandwiches.

      2. The world needs ditch diggers too.

  2. “Newspapers are unable … to discriminate between a bicycle accident and the collapse of civilization.”
    – George Bernard Shaw

    “If you don’t read the newspaper you are uninformed; if you do read the newspaper you are misinformed.”
    – Mark Twain

    1. I knew it! Falling off your bike causes global warming.

      1. Headline: “Caffeine-Caused Cycle Crash Creates Countless Causalities and Climatic Chaos.”

        1. You forgot to preface it with the adjective ‘Calamitous’

          1. This is Unprecedented

            1. Hey, Al… time for another Hockey-Stick Graph?
              I bet this wasn’t a problem before oil was discovered in Pennsylvania and changed the Civilized World!

  3. The FDA apparently has a different definition of adulterated than I do.

    1. If it involves salad tongs, a stepladder and a large map of Belgium than it’s close to mine.

      1. *notes this fact for future reference*

    2. “Adulterated”

      Adulteration is an addition of another substance to a food item in order to increase the quantity of the food item in raw form or prepared form, which may result in the loss of actual quality of food item.

      Such as substituting pea for eggs, mixing it with rapeseed and calling it “mayo”.

      1. Oy….

      2. I can’t believe it’s not butter.

    3. Yeah, pretty funny to call a pure chemical “adulterated”.

    4. Yes. It’s a statutory definition adopted by Congress & state legislatures?a term of art meant to conveniently cover for a long phrase they would’ve otherwise had to repeat in many places. It happens to match a real-world word whose meaning it subsumes. It might be better if made-up words were used in legal documents for such cases, but there are certain advantages to picking an existing word whose meaning the technical term will match some of the time.

  4. cheap scaremongering

    Nice energy drink name.

  5. All of these so-called “drinks” are marketed as new poroducts, unlike anything we’ve ever seen before. And we all know that anything new can kill you. That’s why we have government: so no one ever dies.

    BTW, if you’d like to try acupuncture, homeopathic, or some other alternative medicine, the government is ready to recommend a certified and licensed practitioner near you.

    1. “… the government is ready to recommend a certified and licensed practitioner near you.”

      Is she from Antwerp and favor salad tongs?

      1. Does she use ample amounts of Mazola?

  6. The feds comes up with something to talk about which gives the WaPo something to talk about which gives Reason something to talk about which gives us something to talk about which gives the feds something to talk about – it’s the circle of life. That’s a lot of mileage out of one shot of caffeine. I think I’ll just go back to heroin – you don’t see any articles in the WaPo about how dangerous heroin is, do you?

    1. Jerryskids,

      Remember recently when Nick posted an article’s title without posting an article below it?
      Some of us (myself included) had quite a bit of fun discussing the article’s non-existence, among other things.
      It was wonderfully on topic in that as much as some of us tried to go off topic, or couldn’t help but try to go off topic because it seems to be in our natures, none of us could actually go off topic in a thread whih had no article to comment upon.

      Perhaps the writers at WaPo could try an article like that. I’d be interested to read their comments section for once.

      1. I’m willing to bet it break down into KOCHTOPUS!!!!!!!!!!!!!!!!! pretty damn quick.

        1. Guaranteed… but what if WaPo printed a provocative headline with no article after it?
          Would the FDA get involved?

  7. “These statements have not been evaluated by the Food and Drug Administration.”

    1. “It tastes like chicken”

      1. “It tastes like ‘chicken’.”

        1. It’s an easy to play card game: http://www.boardgames.ca/taste…..dgame.aspx

  8. When I first heard noise about the FDA regulating pure caffeine I went and bought a kg of pure caffeine, just in case and just because I can. It’s incredibly cheap in bulk.

    I also bought a mg scale for $20, which is adequate to avoid ODing on caffeine. But of course we all have to be restricted so idiots don’t injure themselves.

    1. Only 1 kg? Some day I will be raided on my many kilos of caffeine powder.

      BTW: The Stupid, It Burns Coffee Mug: I nor reason make any money on this, but I find it required for reading Hit and Run in the mornings.

    2. I have a jar of caffeine a chemical supply house was getting rid of, for when I was pursuing an idea at the behest of my father of marketing caffeinated water.

    3. You’d better keep it locked securely in your gun safe and not in your pantry where children could get their hands on it and start reselling it in school…..

  9. In the interest of good health, everyone will be issued vitamin supplements, and required to exist only on (very little) bread, and water – Bloomberg Approved.

  10. “adulterated” because they pose “a significant or unreasonable risk of illness or injury under the conditions of use recommended or suggested in the labeling.”

    THAT IS NOT WHAT THAT WORD MEANS!!! /English teacher

    “Adulterated” means, “impure or debased; cheapened in quality or purity”, derived from adulturate, “to debase or make impure by adding inferior materials or elements”. Are they trying to say that there’s something other than caffeine in the caffeine powder?

    I am sick of these motherfuckin’ leftists, in this motherfuckin’ language! /SL Jackson imitation

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