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Affiliation
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Infectious Disease Service, Department of Medicine, Infection Control, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA. sepkowik@mskcc.org |
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Abstract
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In 1911, under authority granted by the recently enacted Food and Drug Act, US agents seized 40 kegs and 20 barrels of Coca-Cola syrup in Chattanooga, Tennessee. The group, led by chief chemist Harvey Wiley, considered the caffeine in Coca-Cola to be a significant public health hazard (both cocaine and alcohol had been removed from the recipe in the previous decade). The case continued for years. Eventually Coca-Cola decreased the caffeine content in this product and legal action was dropped.
In 2012, the Food and Drug Administration (FDA) is again investigating a caffeine-containing product, the “energy drink,” because of safety concerns. Several types of these caffeinated drinks are linked to unexpected deaths in apparently healthy persons, raising calls for closer scrutiny and possible regulation. Drinks containing both caffeine and alcohol were considered unsafe by the FDA in 2010 because the caffeine obscured “some of the sensory cues individuals might normally rely on to determine their level of intoxication.”
The swift change in public perception of energy drinks from harmless mild stimulant to lethal, unregulated drug is unprecedented. Energy drinks were introduced in the United States in 1997. Since then their popularity has increased: US residents consumed an estimated 2.3 billion energy drinks in 2005 and 6 billion in 2010. About 6% of young men in the United States report consuming a daily energy drink. In a recent survey of US overseas troops, 45% reported daily use.6 Sales of energy drinks in the United States increased 16% in a single year to almost $9 billion in 2011.
Product labels for most energy drinks do not list their caffeine content. Many energy drinks contain “natural” ingredients, such as ginkgo or milk thistle, allowing these drinks to be regulated as “dietary supplements” rather than as medications. The 1994 Dietary Supplement and Education Act classifies products containing herbs and other natural ingredients as supplements rather than drugs, allowing manufacturers to side-step disclosure of caffeine dose, even though some brands do provide the information. In contrast, caffeine-containing products such as No-Doz and Caffedrine, marketed as over-the-counter drugs, are required to provide dose.
The millions of persons consuming energy drinks seek more energy, alertness, or stamina yet may be unaware of the amount of caffeine they are ingesting. Consequently, unintentional caffeine overdoses have resulted in serious illness and rare deaths from caffeine poisoning....
Language: en |