Coroner Says Everyone Should Avoid Energy Drinks, Which Kill at Random
As usual, coverage of the latest scare ignores or misrepresents the relative potency of caffeinated beverages.
Last week a South Carolina coroner blamed a teenager's sudden death on caffeine-induced arrhythmia, prompting yet another burst of alarmist warnings about the dangers posed by energy drinks. As usual, the stories either glossed over or misrepresented the amount of caffeine these products contain compared to other, less controversial beverages.
Davis Cripe, a student at Spring Hill High School in Chapin, collapsed during art class on the afternoon of April 26 and was rushed to Palmetto Health Baptist Parkridge Hospital, where he was pronounced dead about an hour later. Cripe's friends reported that he had drunk a McDonald's latte, a large Mountain Dew, and an unspecified energy drink over the course of two hours. Richland County Coroner Gary Watts attributed Cripe's death to a "caffeine-induced cardiac event causing a probable arrhythmia."
Watts, who announced his findings at a news conference that also featured Cripe's grieving father, conceded that his conclusion was debatable. "I realize this is a controversial scenario," he said. "There are are obviously people that don't think this can happen—that you can have this arrhythmia caused by caffeine."
One reason to doubt Watts' determination is that Cripe does not seem to have consumed a very large dose of caffeine. According to the website Caffeine Informer, a McDonald's latte contains 142 milligrams of caffeine, a large (20-ounce) bottle of Mountain Dew has 90, and the most popular energy drinks contain 10 milligrams per fluid ounce, or 160 milligrams in a 16-ounce can. That's a total of less than 400 milligrams, which is the daily limit recommended by the Food and Drug Administration (FDA) for adults. A lethal dose of caffeine is estimated to be somewhere between 5 and 10 grams—i.e., between 5,000 and 10,000 milligrams—for an adult. Cripe was 16 and weighed about 200 pounds.
Watts acknowledged that Cripe did not consume very much caffeine. "This is not a caffeine overdose," he told Reuters. "We're not saying that it was the total amount of caffeine in the system. It was just the way that it was ingested over that short period of time, and the chugging of the energy drink at the end was what the issue was with the cardiac arrhythmia."
Millions of teenagers chug energy drinks, of course, but very few of them die afterward. So assuming Watts is right, Cripe must have been especially sensitive to caffeine. Yet Watts said Cripe seemed perfectly healthy and there was no evidence of previously undetected cardiovascular disease. The coroner suggested that energy drinks kill at random. "This is what's dangerous about this," he said. "You can have five people line up and all of them do the exact same thing with him that day, drink more, and it may not have any type of effect on them at all. It's not something that just because you drink one drink or three drinks [it] is necessarily going to have this effect."
The implication that energy drinks kill something like one out of six teenagers who consume them obviously has no basis in reality. Yet for some reason Watts wants people to think that energy drink consumers face Russian roulette odds. "Our purpose here today is to let people know, especially our young kids in school, that these drinks can be dangerous," he said. "Be very careful with how you use them, and how many you drink on a daily basis." But since Watts is saying even one can might be lethal, complete abstinence would seem to be the only prudent course.
That does appear to be Watts' message. "These drinks can be very dangerous," he said. "I'm telling my friends and family, 'Don't drink them.'" Yet he also claimed that "the purpose here today is not to slam Mountain Dew, not to slam cafe lattes, or energy drinks." It is hard to see how Watts is not slamming energy drinks when he describes them as so dangerous that no one should consume them.
Although Watts emphasized that Cripe did not die from a caffeine overdose, news outlets bent over backward to exaggerate the amount of the stimulant he ingested. Relying on Caffeine Informer's numbers, BBC News reported that "a McDonald's latte has 142mg of caffeine, a 570ml (20oz) Mountain Dew has 90mg, and a 450ml (16oz) energy drink can have as much as 240mg." That "as much as" is a bit of a giveaway. Since the type of energy drink is unknown, it seems more reasonable to cite the caffeine content of the leading brands, which generally contain 160 milligrams or less of caffeine in a 16-ounce can. But even adding another 80 milligrams brings the total to just 472, not far above the level the FDA deems safe for adults (a cutoff that seems to be excessively cautious).
To make that number seem more impressive, BBC News claims a cup of brewed coffee contains "roughly" 100 milligrams of caffeine, even though Caffeine Informer, the source it cites for the other beverages, says it's more like 163 milligrams for an eight-ounce cup. According to Caffeine Informer, brewed coffee typically contains about twice as much caffeine per ounce as those "very dangerous" energy drinks. Brewed coffee sold by some retailers is less potent but generally contains at least as much caffeine per ounce as energy drinks. Dunkin's Donuts brewed coffee, for instance, has 15 milligrams per ounce, while Peet's has about 17. At the low end, McDonald's coffee contains about nine milligrams of caffeine per ounce.
BBC News is suggesting that Cripe consumed the caffeine equivalent of more than four cups of coffee, which is true only if the coffee is unusually weak. The coffee served at other news organizations seems to be even less potent than the BBC brew. NBC News says 400 milligrams of caffeine is equivalent to "about five cups of coffee," while The Washington Post says "about four or five."
BBC News also reports that "most energy drinks contain a caffeine equivalent of three cups of coffee," relying on an estimate by the American Academy of Pediatrics. Even if we compare eight-ounce coffee cups to 16-ounce energy drink cans, that cannot possibly be true, since it implies a total caffeine content in the neighborhood of 480 milligrams. None of the energy drinks listed by Caffeine Informer contains anywhere near that amount in a container of any size.
The Post is slightly more cautious, saying "energy drinks may contain about 300 mg of caffeine." Although that is literally true, fewer than 10 of the 401 varieties listed by Caffeine Informer contain that much caffeine in a single container. Yet an earlier version of the Post story, later corrected, said that potency was typical.
"We're not trying to speak out totally against caffeine," Watts said. "We believe people need to pay attention to their caffeine intake and how they do it." But if that is the message, why did Watts single out energy drinks, which are about half as potent as coffee, urging people to eschew them entirely? And why are news organizations so keen to reinforce the same irrational distinction?