Binge Drinking and Energy Drinks

As consumers’ thirst for carbonated beverages continues its decline, Pepsico, the maker of Pepsi and Mountain Dew, is moving to fortify its beverage portfolio with a major energy drink brand.

The food and beverage giant has announced the acquisition of Rockstar Energy Beverages for $3.85 billion. 

"As we work to be more consumer-centric and capitalize on rising demand in the functional beverage space, this highly strategic acquisition will enable us to leverage PepsiCo's capabilities to both accelerate Rockstar's performance and unlock our ability to expand in the category with existing brands such as Mountain Dew," said PepsiCo Chairman and CEO Ramon Laguarta. 

Pepsico already has a relationship with Rockstar because it distributes it to retailers along with the company’s other beverages. The acquisition improves Pepsico’s energy beverage position in relation to Coca-Cola, which owns a major stake in Monster Beverages.

"Over time, we expect to capture our fair share of this fast-growing, highly profitable category and create meaningful new partnerships in the energy space," Laguarta said.

Active lifestyle consumers

Rockstar has been around since its founding in 2001, marketing its product as a beverage for consumers who lead an active lifestyle, such as athletes. The company says its products come in over 30 flavors and are sold at convenience and grocery stores worldwide.

With the addition of Rockstar, PepsiCo's energy drink portfolio will include Mountain Dew's Kickstart, GameFuel, and AMP. Russ Weiner, Rockstar's founder, says the acquisition is the continuation of what he says has been a strong partnership since 2009.

"PepsiCo shares our competitive spirit and will invest in growing our brand even further,” he said. “I'm proud of what we built and how we've changed the game in the energy space." 

Energy beverages are formulated to increase mental alertness and physical performances for consumers by stepping up caffeine content, along with other additives like vitamins and herbal supplements. Energy drinks are especially popular among young consumers, making them attractive to legacy beverage manufacturers looking for long-term growth.

Health concerns

The products have been the subject of concern by health officials as they’ve grown in popularity. A 2019 study by researchers at the American Heart Association cautioned consumers to use the products in moderation.

The study found that drinking 32 ounces of an energy drink can affect the heart’s normal functioning and also dramatically shift consumers’ blood pressure.

“Energy drinks are readily accessible and commonly consumed by a large number of teens and young adults, including college students,” researcher Kate O’Dell said when the study was released. “Understanding how these drinks affect the heart is extremely important.”

A new study published in the Journal of Applied Psychology finds that college graduates who binge drink multiple times per month are less likely to be hired.

Researchers from Tel Aviv University and Cornell University say that applicants are 1.4 percent less likely to land a job for each instance of binge drinking throughout any given month. They define “binge drinking” as having four or more alcoholic drinks within two hours for women, or five or more alcoholic drinks within two hours for men.

"The manner in which students drink appears to be more influential than how much they drink when it comes to predicting the likelihood of getting a job upon graduation," said study co-author Professor Peter Bamberger.

The study analyzed 827 participants who graduated from Cornell, the University of Washington, the University of Florida, and the University of Michigan between 2014 and 2016. The researchers found that non-binge pattern drinking didn’t affect prospective employment, but the likelihood of negative outcomes built quickly as soon as drinking behaviors hit binge levels.

"A student who binge-drinks four times a month has a 6 percent lower probability of finding a job than a student who does not engage in similar drinking habits. Those students who drank heavily six times a month increased their unemployment probability to 10 percent," said Bamberger.

While the study results may be shocking to some, previous studies suggest that binge drinking among college students is actually declining overall. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) says that binge drinking declined every year from 2005 to 2014 among college students; however, excessive drinking was still found to be problematic among non-college students.

In a recent study, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that binge drinking is becoming a growing problem in the U.S., with 32 million Americans admitting to having more than four drinks on any one occasion in 2013.

While it’s bad enough that adults are engaging in these unhealthy behaviors, researchers from Oregon State University say that teens are reporting heavy drinking habits as well. In a recent mini review, assistant professor Anita Cservenka says that this is particularly dangerous because of the adverse effects that alcohol can have on brain health.

"Adolescence is a time when the brain still matures including not only biological development but also maturation of psychosocial behaviours,” she said. “Given the increase of binge and heavy drinking in young people, understanding the effects of consuming large quantities of alcohol on neural development and the impact on cognitive skills is very important.”

Alcohol use disorders

The review analyzed cross-sectional and longitudinal studies of young binge and heavy drinkers and how their habits affected their brain structure. In particular, the researchers examined six areas of brain development: response inhibition, working memory, verbal learning and memory, decision making and reward processing, alcohol cue reactivity, and socio-cogntive/socio-emotional processing.

MRI scans taken of patients’ brains showed that binge and heavy-drinking teens and young adults had brains that were physically different from teens who didn’t drink. Specifically, the researchers said that teens who drank had systematically thinner and lower volume in the prefrontal cortex and cerebellar regions of their brain, as well as reduced white matter development. This is crucial, they say, because these brain areas play a key role in memory, attention, language, awareness, and consciousness.

Additionally, the findings showed that young people who excessively drink alcohol can alter the neural structure of their brains over time, which could make them more susceptible to having alcohol dependence issues when they get older.

“[The] brain alterations, as a result of heavy alcohol use during adolescence and young adulthood, could result in increased risk of developing an alcohol use disorder later on in life,” said Cservenka. “It is therefore important to continue raising awareness of the risks of binge drinking and to promote future research in this area.”

The full study has been published in Frontiers of Psychology.

Americans love their caffeine. Whether it's in coffee, soft drinks, chocolate, or energy drinks, we seem to need a caffeine buzz to get through the day.

But does all that caffeine cause heart problems? According to the American Heart Association, the jury is still out.

“Many studies have been done to see if there's a direct link between caffeine, coffee drinking and coronary heart disease,” the association reports on its website. “The results are conflicting. This may be due to the way the studies were done and confounding dietary factors. However, moderate coffee drinking (1–2 cups per day) doesn't seem to be harmful.”

But how about energy drinks, which also contain caffeine and are consumed with the expressed purpose of gaining a physical or mental boost?

Case study

A case report in the Journal of Addiction Medicine concludes the high levels of caffeine in energy drinks “may lead to cardiac complications.” The report focused on a 28-year old man treated in the emergency room for heart arrhythmias. The man, who also suffered from obesity, said he routinely drank two Monster energy drinks per day containing a total of 320 milligrams of caffeine. He also drank alcohol on a daily basis.

Until 2010, many energy drinks also contained alcohol, but that combination was outlawed by the Food and Drug Administration (FDA). But how about energy drinks consumed without alcohol? Is the caffeine content alone enough to cause heart problems?

An international study last year concluded that consumption of energy drinks by otherwise healthy young people could aggravate underlying heart issues. It found these beverages' high amounts of caffeine and sugar could cause young people to develop dangerous heart arrhythmias.

Treatment resolved the issue

In the case of the 28-year old patient in the case report, researchers say medication resolved the atrial fibrillation after 48 hours. A one-year follow-up showed no signs of the arrhythmia.

"We believe that energy drink consumption played a key role," the authors write.

They stress that the 160 mg caffeine content of a Monster energy drink is about four times higher than in a caffeinated soft drink. However, it should be pointed out that heavy coffee consumption might include even higher levels of caffeine. But the researchers suggest the possibility that other ingredients in energy drinks might heighten caffeine's effects.

They conclude more research is this area is needed and that, in the meantime, health care providers should question patients about energy drink consumption when they treat them for heart problems.

A new study from Loyola Medicine and Loyola University Chicago shows that drinking excessive amounts of alcohol is not only bad for your liver – it can also have a severe impact on your lungs.

Researchers have found that those who drink alcohol have less nitric oxide in their lungs than those who do not. This is important because nitric oxide helps protect these vital organs from harmful bacteria that often cause infection.

Dr. Majid Afshar, lead author of the study, confirms the finding, saying that “alcohol appears to disrupt the healthy balance in the lung.” He and his colleagues believe that their findings could be important to those who abuse alcohol and those who are affected by asthma, since altered levels of nitric oxide could create complications with medication.

Increased risk of infection

The researchers came to their conclusions after studying over 12,000 adults who participated in the U.S. Centers for Disease Control and Prevention’s National Health and Examination Survey between 2007 and 2012. Those included in the study were asked about their level of alcohol consumption and were given physical examinations that measured levels of nitric oxide in their lungs.

Out of all the participants, the researchers found that 26.9% could be classified as excessive drinkers, defined as an individual who had more than one drink per day on average for women and two drinks per day for men. After controlling for several variables, the test results showed that these individuals exhaled lower levels of nitric oxide than those who did not drink. This correlation was proven to be pervasive; the more that participants reported drinking, the lower their levels of nitric oxide were.

These findings indicate that the likelihood of respiratory infections is much higher for those who drink excessively. Asthma patients need to be especially cautious, the researchers say. Measuring nitric oxide levels for these individuals is extremely common in order to see how well certain medications are working. Afshar and his colleagues believe that consuming alcohol may invalidate or obscure those results, which could lead to improper dosage recommendations.

The full study has been published the journal Chest. 

Results of a recent animal study funded by the National Institute on Alcohol Abuse and Alcoholism suggest that carrying a gene variant that affects the release of a specific brain protein may put one at greater risk of developing an alcohol use disorder.

Scientists led by Professor Dorit Ron, PhD, Endowed Chair of Cell Biology of Addiction, Department of Neurology, University of California, San Francisco, found that mice carrying the Met68BDNF gene variant, which reduces the release of brain-derived neurotrophic (BDNF) factor, would consume excessive amounts of alcohol, despite negative consequences.

BDNF plays a role in the survival of existing neurons and the growth of new neurons and synapses, the junctures through which cell-to-cell communication occurs. The human form of this gene variant, Met66BDNF, leads to a reduction in the normal function of BDNF in the brain and is associated with several psychiatric disorders, including schizophrenia and depression.

In an animal study reported earlier this year, NIAAA-supported scientists found that adolescent binge drinking was linked to lower levels of brain-derived neurotrophic factor, and these changes persisted into adulthood.

“Genetic factors play a role in determining who develops alcohol problems,” said Dr. George Koob, PhD, NIAAA Director. “By understanding the genetic underpinnings of alcohol use disorder, we will be better able to develop targeted treatment and prevention strategies.”

Alcohol addiction in mice

In the study, published in Biological Psychiatry, researchers tested the role of BDNF in alcohol addiction by creating a “knock-in” mouse carrying Met68BDNF. In this variant, the amino acid valine (Val) is replaced by methionine (Met) in a specific position within the protein sequence of BDNF, resulting in reduced activity-dependent BDNF release.

These “knock-in” mice drank more alcohol, even when the alcohol was treated with bitter-tasting quinine. This suggests Met68BDNF carriers compulsively drink alcohol despite aversive consequences.

The effect of the genetic mutation seemed to be specific to alcohol consumption since the mice did not differ in their consumption of other fluids, or exhibit differences in levels of anxiety or compulsive behaviors

Practical application

Significantly, researchers were able to reverse compulsive alcohol drinking in the mice using gene delivery and pharmacology. Increasing levels of BDNF in the ventromedial portion of the prefrontal cortex, a brain region involved in compulsive drug and alcohol seeking, returned the mice to moderate levels of alcohol intake.

In addition, by administering a pharmaceutical compound developed to mimic the action of BDNF, researchers were also able to put a stop to compulsive drinking behaviors. This compound (LM22A-4) may have potential as a therapeutic for humans. It appears to reduce compulsive alcohol drinking without a generalized effect on motivation.

Alcohol use disorder affects about 16.6 million U.S. adults. Knowing whether patients carry a gene that results in decreased BDNF function could help in tailoring alcohol prevention and treatment strategies in the future.

We once heard of a would-be scam artist who tried to market powdered water. "Just add water!" his ad proclaimed. It might have been a prank. No one is quite sure.

But powdered alcohol? It sounds like a prank as well but it's not. The Alcohol and Tobacco Tax and Trade Bureau -- a federal agency perhaps best known for approving viticultural, or wine-growing, regions -- has given its approval to a product called Palcohol.

But don't rush out to the corner liquor store just yet. For starters, the company says it has to gear up its production facility but hopes to have the powdery substance on the market by this summer.

The other hitch is that alcohol sales are regulated by the states as well as the feds and many states are less than enthused about the whole idea.

For their parts, the feds say their approval isn't based on whether powdered alcohol is a keen idea but simply on whether the label accurately describes the contents. By law, that's all it can consider.

Why would anybody think this is a good idea? Well, company founder Mark Phillips lists several reasons on the Palcohol website. 

• Outdoor Activity Applications: Palcohol is a boon to outdoors enthusiasts such as campers, hikers and others who wanted to enjoy adult beverages responsibly without having the undue burden of carrying heavy bottles of liquid.

• Travel Applications: Similarly, adult travelers journeying to destinations far from home could conveniently and lawfully carry their favorite cocktail in powder format. Moderate quantities of flavored Palcohol products carried in resealable pouches are a fraction of the weight and bulk associated with traditional liquor packaging.

• Hospitality Applications: Because powdered alcohol is so light, airlines can reduce the weight on an airplane by serving powdered vs. liquid alcohol and save millions on fuel costs. An ice cream manufacturer wants to add Palcohol to their ice cream to make an "adult" version. A hotel in Hawaii is interested in powdered alcohol because it would save them so much on shipping from the mainland. That savings in shipping costs would be attractive to many resorts who rely on imported alcohol.

In other words, Palcohol would make it easier and cheaper to drink. Whether this is a good thing isn't for us to say but Palcohol's opponents include the liquor industry and some state legislators, who say they fear an outbreak of abuse. 

Colorado, where marijuana is legal, last month passed a measure that temporarily outlaws powdered alcohol. Other states are considering similar easures.

"We moved to keep this potentially dangerous product out of Virginia because we knew that federal approval was pending and it would be difficult to address the problem after the fact," said Virginia Attorney General Mark Herring. "I'm glad the General Assembly agreed it was the right move to protect Virginians, especially young people, because the risk of abuse and misuse is just so high with this product."

“Everything in moderation,” the old saying goes. It particularly applies to alcohol consumption.

In recent years health officials have worried about the increasing tendency of some people to “binge” drink, consuming multiple alcoholic beverages in a short period of time. This pattern often develops during the college years.

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men in about 2 hours.

Many of the dangers of binge drinking are fairly obvious. Accidents are much more likely when you are intoxicated. Over time, binge drinking can bring on serious health effects.

Alcohol poisoning

One often-overlooked danger, health officials say, is binge drinkers might die of alcohol poisoning. A new report from the Centers for Disease Control and Prevention (CDC) reveals that more than 2,200 people in the U.S. die each year from alcohol poisoning – consuming too much alcohol in too short a period of time.

When this happens it often results in very high levels of alcohol in the body, which can shut down critical areas of the brain that control breathing, heart rate, and body temperature - resulting in death.

A lot of people are at risk, perhaps more than you might think. The CDC says more than 38 million U.S. adults report binge drinking an average of 4 times per month, consuming an average of 8 drinks per binge.

CDC scientists analyzed deaths from alcohol poisoning among people aged 15 and older, using multiple cause-of-death data from the National Vital Statistics System for 2010-2012. Alcohol showed up as a contributing factor in about 30% of the deaths.

While that's more than the researchers were expecting to find, they conclude that the actual number is probably higher.

"Alcohol poisoning deaths are a heartbreaking reminder of the dangers of excessive alcohol use, which is a leading cause of preventable deaths in the U.S.," said CDC Principal Deputy Director Ileana Arias. "We need to implement effective programs and policies to prevent binge drinking and the many health and social harms that are related to it, including deaths from alcohol poisoning."

Make it cost more

Researchers at Boston University who have studied binge drinking from a policy angle say higher taxes on alcoholic beverages may be the answer.

The study found that a 1% increase in alcohol beverage prices from taxes resulted in a 1.4% decrease in the proportion of adults who binge drink. Most previous studies have examined the effect of taxes on average consumption, while the effect of taxes on high-level drinking has been controversial.

"This is really significant for public health," said lead author Ziming Xuan.

Xuan says binge drinking causes more than half of nearly 90,000 alcohol-attributable deaths in the U.S. each year, and accounts for three-quarters of the $224 billion in annual economic costs.

The study shows that as combined alcohol taxes rise, binge drinking rates fall, with taxes accounting for some 20% of the difference in binge drinking prevalence rates across the states.

The state with the highest beer combined taxes - Tennessee--had the lowest binge drinking rate in 2010, the study found. Conversely, states with low alcohol taxes, such as Montana, Wisconsin and Delaware, had relatively high binge drinking rates.

Planning your New Year's Eve celebration? You may want to pause a moment to review a new study that finds binge drinking in young, healthy adults significantly disrupts the immune system.

In the study, led by a researcher now at Loyola University Chicago Stritch School of Medicine, study participants drank four or five shots of vodka, depending on their weight.

Twenty minutes after reaching peak intoxication, their immune systems revved up. But when measured again, at two hours and five hours after peak intoxication, their immune systems had become less active than when sober. The study included eight women and seven men with a median age of 27.

The study led by Majid Afshar, MD, illustrates a potentially harmful effect of binge drinking that is not widely recognized, unlike the falls, burns, gunshot wounds, car accidents and other traumatic injuries generally associated with heavy drinking. One-third of trauma patients have alcohol in their systems.

In addition to increasing the risk of traumatic injuries, binge drinking impairs the body's ability to recover from such injuries. Previous studies have found, for example, that binge drinking delays wound healing, increases blood loss and makes patients more prone to pneumonia and infections from catheters. Binge drinkers also are more likely to die from traumatic injuries.

Less awareness

Drinkers generally understand how binge drinking alters behavior. "But there is less awareness of alcohol's harmful effects in other areas, such as the immune system," said Elizabeth Kovacs, PhD, a co-author of the study and director of Loyola's Alcohol Research Program.

The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as drinking enough to reach or exceed a blood alcohol content of .08, the legal limit for driving.

This typically occurs after four drinks for women or five drinks for men, consumed in two hours. One in six U.S. adults binge drinks about four times a month, and binge drinking is more common in young adults aged 18 to 34, according to the Centers for Disease Control and Prevention.

Dr. Afshar is planning a follow-up study of burn unit patients. He will compare patients who had alcohol in their system when they arrived with patients who were alcohol-free. He will measure immune system markers from each group, and compare their outcomes, including lung injury, organ failure and death.

The study is published online ahead of print in Alcohol, an international, peer-reviewed journal.

Alcohol consumption in the U.S. has been steadily rising since the end of Prohibition in 1933, peaking in the early 1990s. Not surprisingly, more Americans over the years have been treated for alcoholism.

But where is the line between heavy drinking and clinical alcoholism? A study in the Centers for Disease Control and Prevention (CDC) journal Preventing Chronic Disease says it isn't where you think it is.

The researchers found a distinction between drinking too much and being alcohol dependent. They say 9 in 10 Americans who drink too much shouldn't be classified as alcoholics.

“This study shows that, contrary to popular opinion, most people who drink too much are not alcohol dependent or alcoholics,” said Dr. Robert Brewer, Alcohol Program Lead at CDC and one of the report’s authors. “It also emphasizes the importance of taking a comprehensive approach to reducing excessive drinking that includes evidence-based community strategies, screening and counseling in healthcare settings, and high-quality substance abuse treatment for those who need it.”

But heavy drinking is a problem

But just because someone isn't classified as “alcoholic” doesn't mean they aren't doing real damage physically and socially. In recent years binge drinking has been a growing concern, especially among young adults.

Binge drinking is defined as 4 or more drinks on an occasion for women, 5 or more drinks on an occasion for men. Consuming 8 or more drinks a week for women or 15 or more drinks a week for men also falls within the binge drinking definition.

And it turns out millions fall into that category. The study found that nearly 1 in 3 adults is an excessive drinker, and most of them binge drink, usually on multiple occasions. That, in itself, is a big problem.

Death toll

The researchers say excessive drinking is responsible for 88,000 deaths in the U.S. each year and only 3,700 of those deaths are linked to alcohol dependence. Putting a dollar figure on all this imbibing, the tab came to $223.5 billion in 2006.

The alcohol-related deaths tracked by the study were due to health effects from drinking too much over time, such as breast cancer, liver disease, and heart disease. The National Institutes of Health (NIH) reports that 48% of all cirrhosis deaths in 2009 were alcohol related.

There were also serious health effects from drinking too much in a short period of time, such as violence, alcohol poisoning, and car accidents.

What to do

This may be timely information, coming at the beginning of the holiday season when alcohol flows with abandon. To get through the next few weeks without over indulging, specialists at the University of California Davis Health Center offer these tips:

• Think about how much alcohol you will consume before arriving at a party, then stick to your budget
• Don't pressure anyone to have another drink
• If you're the host, offer a wide selection of non-alcohol beverages
• If someone is intoxicated, don't serve them another drink and, by all means, don't let them drive home

Are there ways to reduce the growing tendency to drink to excess? The Community Preventive Services Task Force has recommended increasing alcohol taxes, regulating alcohol outlet density, and holding alcohol retailers liable for harms resulting from illegal sales to minors or intoxicated patrons.  

Athletes who consume energy drinks to give them a competitive edge might in fact get a boost in energy, but could pay for it later.

Researchers at Camilo José Cela University (UCJC) say they found athletes who use energy beverages were more likely to report insomnia and nervousness in the hours after the competition.

In the 4-year study, athletes in a variety of vigorous sports consumed the equivalent of 3 cans of energy drink or an energy drink placebo before a sports competition. Sporting performance was measured with the use of GPS devices that determined the distance and the speed at which athletes moved.

The researchers also employed other sophisticated equipment to measure muscle performance. Published in the British Journal of Nutrition, the results show that athletes who used energy drinks increased their sporting performance by between 3% and 7%.

Juan Del Coso Garrigós, one of the study authors, says energy drinks do in fact make basketball players jump higher, increase muscle force and power for climbers and trained individuals, swimming speed for sprinter swimmers, hit force and accuracy for volleyball players and the number of points scored in tennis.

Insomnia and nervousness

That's the good news. But once the sport competition is over, it isn't exactly back to normal.

These studies asked athletes about their sensations after consuming the energy drink and measured the frequency of the side effects in comparison with the placebo drink.

"Athletes felt they had more strength, power and resistance with the energy drink than with the placebo drink," said Del Coso. "However, the energy drinks increased the frequency of insomnia, nervousness and the level of stimulation in the hours following the competition".

Maybe it shouldn't come as a surprise that the consumption of energy drinks produced an increase in the side effects typically found with other caffeinated drinks. The researchers said they found no significant differences between male and female athletes in the perception of positive sensations, nor in the apparition of side effects.

"Caffeinated energy drinks are a commercial product that can significantly increase sporting performance in many sports activities," said Del Coso. "The increase in their consumption is probably driven by the hard advertising campaigns of energy drink companies related to sports sponsorships."

Not that much energy

Energy drinks are made up of mostly carbohydrates, caffeine, taurine and B vitamins. From brand to brand, there is little difference in the quantities and ingredients.

Despite being labeled as energy drinks, the researchers say they don't really provide more energy than other soft drinks. Instead, they have an 'energizing' effect, due mainly to the caffeine they contain.

Del Coso maintains that none of the other ingredients in energy drinks actually produce a significant effect on physical or mental performance.

The average energy drink can contain from 75 to over 200 milligrams of caffeine per serving. Health experts at Brown University say this compares to 34 milligrams in Coke and 55 milligrams in Mountain Dew.

If the beverage is labeled “no caffeine,” the energy comes from guarana, which is the equivalent of caffeine. The Brown experts note that 5-hour energy advertises “no crash,” but says this claim is referring to no “sugar crash” because the drink has artificial sweetners.