Caffeine and Energy Drinks: Bend Bulletin

From a recent article in the Bend Bulletin in Bend, Oregon. Eat2Win Dietitian Bill Nadeau, MS, RD is quoted extensively:

A few years ago, Bend ultramarathoner Jeff Browning had heard so much buzz about energy drinks, he decided to try one in his next race. About a third of the way into the 50-mile race, he grabbed the drink he had stashed away in a drop bag and quickly downed it.

“It just made my stomach squirrelly,” he said. “Normally my stomach is solid. I’ve done over 40 ultramarathons and I’ve never thrown up. That was definitely one of the worst races as far as stomach issues that I’ve ever had.”

Browning, 38, said he suffered through another 10 to 15 miles of stomach troubles before it finally eased up. And he’s never touched another energy drink again, to avoid what he calls the pit-stop factor.

“Basically, what it does is make you hit the bushes quite a few times,” he said. “In a race like that, it’s definitely not something you want to do.”

Still, thousands of competitive and recreational athletes are lured by energy drinks such as Red Bull, Monster or Rockstar that promise to give an extra kick, an additional edge or metaphorical wings on race or game day. While research suggests there can be some performance benefit from an energy drink, experts warn there can be considerable downsides as well. And with better alternatives providing the same gains, energy drinks might not be worth the risk of ruining your event.

“Unfortunately, in so many of the products, people don’t want to look beyond the label,” said Leslie Bonci, a registered dietitian with the University of Pittsburgh Medical Center and nutritionist for the Pittsburgh Steelers professional football team. “The assumption is that because it says ‘energy’ it will provide energy to me.”

/ Caffeine /

Most of the performance benefits attributed to energy drinks are thought to come from its caffeine content. A number of studies have shown that caffeine at a dose of about 2.5 mg per pound of body weight can improve performance in aerobic events — such as running, cycling or swimming — lasting more than five minutes.

Competitors using caffeine in those studies showed an average of 3 percent improvement over their non-caffeine race times.

That means a 125-pound athlete should consume about 300 mg of caffeine per day.

“Keep in mind that a grande Starbucks contains more than that amount,” said Bill Nadeau, a dietitian with, an Internet-based triathlon coaching and sports nutrition service. A 160-pound athlete could go as high as 400 mg per day. Some energy drinks on the market exceed that amount in a single can.

Researchers aren’t sure exactly how caffeine helps with endurance. The prevailing theory is that caffeine helps the body tap into its fat stores earlier, sparing more of the carbohydrates in muscles for use later on. Studies that measured how long athletes could go before reaching exhaustion support that notion.

It’s why many endurance athletes have turned to caffeine. A survey of 140 athletes competing in the 2005 Hawaiian Ironman Triathlon World Championships found that 89 percent intended to use caffeine on race day. Many drink flat colas before or during the race to get their caffeine dose.

Colas, however, have half the caffeine per ounce of energy drinks, minimizing the chance that the athletes will exceed the 2.5 mg per pound recommended intake.

“There’s no performance-enhancing benefit from consuming more than that amount of caffeine, but it can be detrimental to your health,” Nadeau said. “The problem with caffeine is that the same things that enhance it can also tip the scale and send you in the other direction.”

Indeed, there have been several reported cases of caffeine overdose, where healthy individuals with no underlying heart problems died as a result of ingesting too much caffeine.

“Don’t get me wrong, this is not common,” Nadeau said. “But it has happened.”

And at higher levels of competition, excessive caffeine can be a violation of the rules on performance-enhancing drugs. The World Anti-Doping Agency, which oversees the drug-testing policy for the International Olympic Committee, considers athletes to be doping if they exceed a certain level of caffeine in their urine. Authorities estimate this to be the equivalent of drinking 8 cups of coffee containing 100 mg of caffeine each.

Many people also believe that caffeine is a diuretic and can lead to dehydration. Studies suggest caffeine will not necessarily increase the volume of urine excreted but can make you want to go earlier. Energy drinks may not interfere with hydration levels, but they don’t seem to help much either.

Bonci said there is no evidence showing that caffeine will help with shorter duration events, such as a sprint, or stop-and-go sports like football or soccer.

“It’s a different utilization of fuel sources, so it’s of pretty limited use,” she said.

/ Other ingredients /

Many athletes associate the high sugar content in energy drinks with energy as well. After all, muscles rely on glucose, a form of sugar, for fuel. Most energy drinks contain at least 18 grams of sugar per 8-ounce serving, and many contain more than 25 grams per serving. Sports drinks such as Gatorade, on the other hand, contain about 14 grams per serving. That’s because a high sugar concentration can slow the absorption rate.

“The more concentrated something is, the longer it takes to empty from the stomach, so you don’t even get that available energy,” Bonci said. “It’s not in the muscles, so it will not optimize performance.”

It may be that the sugar adds little to the performance benefit attributed to energy drinks. Tests comparing sugar-free energy drinks with full-sugar versions, for example, showed no difference in performance.

Energy drinks also pack in plenty of other ingredients. Their contents are considered dietary supplements, and as such aren’t regulated by the Food and Drug Administration as long as they don’t claim a medicinal benefit. As a result, there is scant evidence whether those other ingredients add much to the mix.

“Speaking generally, there’s a lot of stuff in there, and we don’t know a lot about it,” Nadeau said. “That’s why we have to proceed with caution.”

One of the more common of the other ingredients is taurine, an amino acid found naturally in meat and fish. Some studies have suggested that taurine can boost performance, while others conclude it is effective only in combination with caffeine. Neither finding is considered definitive.

Many drinks add B vitamins or herbs, such as ginseng or ginkgo biloba. Neither has been proven to affect performance.

“Vitamins are a critical component in getting the maximum out of the food that the body ingests,” Bonci said. “But by itself, it doesn’t do anything. It’s more there to drive the cost up and as a marketing ploy.”

When it comes to athletic performance, “it doesn’t make a difference,” she said.

/ Alternatives /

Neither Nadeau nor Bonci routinely recommend energy drinks to athletes.

“The only time I might recommend Red Bull to clients during a race is at the very end of the race,” Nadeau said. “The last three miles of a marathon, if they’re really hurting and they need something quick, the sugar and caffeine might be appropriate for them.”

But Nadeau, who also runs competitively, said he relies on caffeinated energy gels instead. They provide both carbohydrates and caffeine and should be washed down with water.

“They provide that boost you need,” he said.

Otherwise, he advises clients to continue their normal daily intake of caffeine on race day as well. If you don’t normally consume caffeine, adding some on race day could prove disastrous. But if you do have coffee every day, there’s no need to cut back on the day of the event either.

Bonci suggests making sure you get liquids along with your caffeine, without too much sugar. That could mean an espresso followed by a sports drink. Or if that combination doesn’t sit well with athletes, an iced coffee before the race.

“They could do something like a latte, with a relatively small amount of milk and a little bit of sugar. You get the volume of liquid you need, the caffeine would be there, and maybe two packets of sugar at most, would give somebody the carbohydrates,” she said. “Chances are, it’s not going to be at the start line, so you need to bring your barista with you.”

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