Wellness Wash of Energy Drinks

Energy drinks are increasingly styled not as edgy or dangerous but as wellness products. As STAT reports, Alani Nu, for example, is marketed 

“as the nectar that fuels today’s effortlessly high-achieving, hummingbird-like young woman,” 

replacing the extreme sports aesthetic of Red Bull and Monster with something much more palatable to wellness-savvy Gen Z consumers. These drinks now sit beside protein bars and kombucha, boasting ingredients like biotin or lion’s mane mushrooms, “promising benefits from hair growth to mental clarity.”

Though appearing like sparkling water or vitamin elixirs, they often contain 200 mg of caffeine, double the recommended daily intake for adolescents and comparable to a strong cup of coffee. 

“What we’ve learned over the years is that energy is a need state” for which there’s round-the-clock demand, said Michael Bellas, head of the research and consulting firm Beverage Marketing Corporation. Other than water, he said, energy is the No. 1 fuel that today’s anxious, hassled consumer relies upon.”  - STAT

Red Bull transformed energy drinks into one of the fastest-growing segments in the beverage industry, second only to water. Unlike sports drinks that replenish electrolytes lost through sweat, energy drinks are marketed to sharpen focus during a late-night study session or to power through a workout.

As energy drinks entered convenience stores and gym bags, their popularity among the young soared. Surveys in Europe and Canada suggest that two-thirds of adolescents have down energy drinks, and some ten percent consume as much as seven liters or more per month. The high prevalence of energy drink (ED) consumption among young people is largely driven by strategic marketing, particularly through sponsorships. ED brands frequently fund extreme sports, and of late, social influencers have recommended them for diet and study. 

So, if energy drinks are to be considered under the mantra of “food as medicine,” perhaps we should consider not just the marketing and influencers but our scientific knowledge. For that, we turn to a review article published in Nutrients. 

Ingredients

Energy drinks are mainly about caffeine but can contain sweeteners, amino acids, vitamins, and herbal supplements. Sometimes, additional ingredients, e.g., guarana or yerba mate, contribute to the caffeine. While the average ranges, energy drinks are comparable to a strong or exceedingly strong cup of coffee. 

Caffeine blocks the brain’s natural sleep-promoting signals, improving mood, alertness, and reaction time and delaying fatigue. In muscles, it enhances calcium release within cells, contributing to stronger and more efficient contractions. Add to that a spike in circulating adrenaline, cortisol, and beta-endorphins, and with 3–6 mg of caffeine per kilogram of body weight, you get a potent physiological shift: increased endurance, reduced pain perception, and a nudge toward fat over sugar for fuel: lower doses, 40 to 60 mg, sharpens attention and lift mood.

Tucked into the ingredient list of many energy drinks is taurine, an sort-of amino acid [1] found abundantly in meat, seafood, and fish. While the average adult diet provides between 40 and 400 mg of taurine daily, energy drinks deliver significantly more. Taurine wears many biochemical hats, contributing, like caffeine, to neurotransmission and muscle contractility. While taurine may not provide the immediate jolt of caffeine, it quietly enhances endurance and, by counteracting oxidative stress, protects muscles, “supporting” cellular health.

Caffeine and Taurine: Better Together—or Just Together?

Although both are staples of energy drinks and have independently shown performance-enhancing effects at proper doses, combining them has yielded mixed results. 

“The presented investigations suggest that the contribution of two primary ED ingredients [caffeine and taurine] possibly do not provide any additive or synergic effect.” 

In both in vitro and human trials, the caffeine-taurine duo performed no better than caffeine alone. Possibly, caffeine and taurine act through overlapping molecular pathways, leading to a plateau effect rather than synergy when combined. For now, the blend’s buzz may be more branding than biochemistry.

Energy Drinks and Physical Performance: Mixed, Modest, and Murky

Despite widespread interest, the evidence on energy drinks improving physical performance remains mixed, modest in effect, and scientifically unclear. While some users may experience small benefits, the overall impact on physical performance is inconsistent. A large meta-analysis found small but statistically significant improvements in endurance, strength, and jumping for some sport-specific tasks. However, study design, dosages, participant training levels, and performance measures complicate the picture. One study of sleep-deprived medical students who consumed caffeine or a combination of caffeine and taurine demonstrated faster reaction times and better motion economy in simulated laparoscopic tasks. Still, the improvement came without a reduction in errors. 

The Hidden Costs of Energy Drinks

Energy drinks have been dogged by concerns over their health impacts for several decades. 

“They increase heart rate, do all of these abnormal things — it can increase the likelihood of having a coronary event, a blockage of the artery, or a perforation of the artery,” she said. “Anybody who is more susceptible to these things is going to be more significantly affected, but a lot of people don’t know they’re at risk.” 

- Victoria Vetter, MD, Professor of Pediatric Cardiology, Children’s Hospital of Philadelphia

“The serious and detrimental impacts of energy drink consumption are well documented in the case report literature [2]. The ACSM writing group concurs that energy drink consumption, especially in vulnerable populations, can be potentially hazardous [2].”

 – American College of Sports Medicine

The immediate effects of energy drink consumption seem relatively benign: a boost in alertness, a surge of energy, perhaps a bit of jitteriness. However, for adolescents with lower body weight and, for some, heightened sensitivity, modest consumption can lead to headaches, insomnia, increased urination, digestive issues, and a racing heart – reactions more pronounced in the presence of greater adrenaline levels, e.g., physical exertion, stress, or sleep deprivation.

A 2021 meta-analysis found that among children and teens, the most commonly reported side effects were insomnia (35.4%), stress (35.4%), and depressed mood (23.1%). Among adults, restlessness or jitteriness (29.8%), insomnia (24.7%), and gastrointestinal upset (21.6%) topped the list. 

• Across age groups, tachycardia (rapid heartbeat) and headaches were the most commonly reported cardiovascular and neurological complaints. While cardiovascular effects are the most troubling, the literature consists of case reports suggesting the incidence, while real, is exceedingly low.
• Multiple studies have found an association between regular use of energy drinks and increased psychological distress, including higher rates of depression, anxiety, and suicidal ideation among adolescents. As with many studies, it is difficult to tell whether this is a cause or an effect.
• The metabolic picture is murkier with few studies and little data. Habitual energy drink users often exhibit unhealthy lifestyle behaviors, further confounding the little data that is available. 

In the end, the long-term cardiovascular, psychological, and metabolic impacts of energy drinks are ill-defined and unclear. 

A Road Paved With Good Intentions

What makes energy drinks a compelling example of “food as medicine” is not that they heal or sustain in a medical sense but that they are sold with that implication. Energy drinks demonstrate how the concept of "food as medicine" can be co-opted by industry and warped by corporate marketing and their digital shills, the influencers. 

They’re engineered to deliver performance-enhancing effects like a pharmaceutical but regulated like soda. And while they may contain food-based ingredients, their metabolic and cardiovascular impact is far from benign. Energy drinks illustrate the limitations of “food as medicine,” especially when dose-response relationships are ill-defined and short- and long-term adverse responses are understudied. 

Energy drinks walk and talk like wellness products, blurring the line between food, supplements, and medications, co-opting the language of health while sidestepping the responsibility. If we’re serious about “food as medicine,” then we need to demand science over spin, transparency over trend, and regulation as robust as the claims on the label. Whether the MAHA mamas will have the bureaucratic chops to ground changes in transparent regulatory science or just be happy altering a few chaffing dishes at the buffet remains to be seen. 

[1] My colleague, Dr. Bloom, who is a real chemist points out "Taurine is not an amino acid. It's an aminosulfonic acid, made in the body from cysteine, which is an amino acid."

[2] Based on evidence from uncontrolled, nonrandomized, or observational studies.

[3] A panel consensus was used when guidance was advisable, but compelling literature was insufficient.

Source: Effects of Energy Drink Consumption on Physical Performance and Potential Danger of Inordinate Usage Nutrients DOI: 10.3390/nu13082506