Red Bull

Red Bull is an energy drink sold by Austrian company Red Bull GmbH, created in 1987. In terms of market share, Red Bull is the most popular energy drink in the world, with 5.2 billion cans sold in 2012. The energy drink market has grown exponentially. Hundreds of different brands are now marketed, with caffeine content ranging from a modest 50 mg to an alarming 505 mg per can or bottle.

Health effects

Caffeine, taurine and glucuronolactone have been assessed by health authorities for their safety. Health Canada conducted a review of the scientific literature on caffeine, concluding that the general population of healthy adults is not at risk for potential adverse effects from caffeine if they limit their consumption to 400 mg per day.

Taurine and glucuronolactone are human body constituents and present in the human diet from foods such as scallops, fish, poultry and grains.

Ingredients

• Water
• Sucrose
• Glucose
• Acidity regulators (Sodium Citrates, Magnesium Carbonate)
• Carbon Dioxide
• Citric Acid
• Taurine (0.430%) equal to 430 mg/100mL
• Caffeine (0.032%) of 32 mg/100mL
• Glucuronolactone
• Inositol
• Alcohol (0.001%)
• Vitamins (Niacin, Pantothenic Acid, B6, B12)
• Aromas
• Dyes (Caramel, Riboflavin)

Nutritional Information per 100mL: Energy 45 kcal (192 kJ), Protein 0 g, Carbohydrates 11 g (of which sugar 11 g), Fat 0 g (of which saturates 0 g), Fibre 0 g, Sodium 0.04 g, Niacin 8 mg (44% RDA), Pantothenic Acid 2 mg (33% RDA), Vitamin B6 2 mg (100% RDA), Vitamin B12 2 mg (200% RDA).

RDA = Recommended Daily Allowance

Taurine

Amino acid produced from sulfur amino acids such as methionine and cysteine.

In part, it is synthesized by the body, but to cover the daily requirement of taurine is necessary to supplement the endogenous dose with that present in food. This particular amino acid is found only in foods of animal origin, that is why in people who follow a vegetarian or vegan diet can be useful to resort to the use of supplements.

Taurine is particularly concentrated in the muscles, heart and brain, and falls in numerous biological functions, in fact it:

• participates in the digestion and assimilation of nutrients: helps to synthesize bile salts that are used for the digestion of fats and fat-soluble vitamins;
• promotes weight loss: it improves tissue oxygenation (more oxygen in the tissues means much greater chance of burning fatty acids)
• acts as an inhibitory neurotransmitter in the nervous system and has beneficial effects against:
  • epilepsy
  • depression
  • insomnia
• improves functionality of the cardiovascular system:
  • helps fight hypertension
  • reduces bad cholesterol and triglyceride levels, thus decreasing the risk of heart attack for lipid accumulation in the arteries
  • improves the contractility of the heart, regulating calcium homeostasis
  • is an antiarrhythmic
• has an important role in hydrosaline cellular homeostasis;
• reduces the sense of fatigue and tiredness;
• has a beneficial effect on hair loss: it accumulates at the bulb's level and strengthens it, reducing its tendency to fall;
• acts for cellular and tissue protection (mainly cardiac) and has a detoxifying action;
• has antioxidant (it inhibits the production of nitrous oxide and ROS, free radicals that cause damage to the cells of the epidermis) and anti-inflammatory properties;
• modulates the immune response (it strengthens the immune system, enhances the action of Natural Killer cells and also acts on macrophages, favoring the release of molecules that are important during the inflammatory process, such as interleukin 1);
• has effects on the visual system: taurine is important to maintain the health of the retina and of the eyes, as it has been demonstrated that a deficiency can even lead to blindness causing loss of visual pigments in the retina;
• in sport, taurine has been used with success in the reduction of oxidative damage induced by intense physical activity, effectively protecting the muscular structures, already at doses of 1.5 g.

Glucuronolactone

Sugar produced in the liver during carbohydrate metabolism. Can be introduced through the diet (present in the fruit cluster, apples, oranges and in cruciferous vegetable), and then oxidized in the liver in glucaric acid and other metabolites. It has a detoxifying action and a possible cytoprotective and anti-tumor action (still experimental).

Caffeine

Methylxanthine is commonly introduced through coffee, in fact a cup of coffee can contain up to 100 mg. The caffeine content of a single can of Red Bull is 80 mg/250mL (32 mg/100mL). Adverse effects typically manifest with ingestion higher than 200 mg of caffeine.

Once ingested, caffeine is rapidly absorbed through the gastrointestinal tract and reaches the highest level in the blood after about 45 minutes since the consumption, and it is rapidly used by various tissues:

• Stomach: promotes acid secretion;
• Heart: caffeine binds to the adenosine class of G protein-coupled receptors on the surface of heart muscle cells, which begins a second messenger system with cyclic adenosine monophosphate (cAMP) inside the cells and mimics the effects of epinephrine. The rate of glycolysis increases, which increases the amount of adenosine triphoshate available for muscle contraction and relaxation. This can result in a positive inotropy and chronotropy, ie, an increased heart rate and force of myocardial contraction. Caffeine immediately increases blood pressure and peripheral vascular resistance, in part because of sympathetic stimulation;
• Brain: increases the capacity of attention (caffeine is able to reach the central nervous system; the ergogenic effect is primarily mediated by the action of "antagonism" with adenosine, neurotransmitter connected with the sense of fatigue at both nervous and muscular);
• Respiratory system: promotes the release of the involuntary bronchial muscles, improving ventilatory capacity;
• Muscles: facilitates the process of muscle contraction also improving the hemodynamic properties;
• Kidneys: facilitates diuresis.

In sport, caffeine contributes to:

• Improve the performance in terms of endurance and strength. This capacity is surely due to muscle vasodilatory effect, probably to a better influx of calcium in skeletal muscle (resulting in a facilitated contraction), and to the savings of glycogen in favor of lipid oxidation in muscle. The critical period in glycogen sparing appears to occur during the first 15 minutes of exercise, when caffeine has been shown to decrease glycogen utilization by as much as 50%; thus, glycogen saved at the beginning is available during the later stages of exercise, in such a way that this effect is obviously particularly useful in sports where the long-term savings of muscle glycogen is essential;
• Reduce the feeling of fatigue: thanks to the improvement of oxidative metabolism on the one hand and on the other to the analgesic effect.

The maximum safe dose used in the studies is 300-400 mg, beyond which you record tremor, anxiety, arrhythmia, insomnia and excitement. Prolonged use, however, is an important risk factor for diseases of the gastrointestinal tract, cardiovascular and nervous system (Migraine).

Moderate caffeine intake (less than 400 mg per day) does not adversely affect cardiovascular health.

B Vitamins

The B Vitamins are water-soluble vitamins required as coenzymes for proper cell function, especially mitochondrial function and energy production.

B vitamins in Red Bull energy drink include: niacinamide, pantothenic acid, vitamin B6 and vitamin B12.

Glucose and sucrose

Sugars are the basic currency for energy in the body, with glucose being the key carbohydrate that can readily be oxidized by skeletal muscle for energy production.

Administration of glucose or other carbohydrates before, during, and after prolonged exercise (>1 hour) has been shown to postpone fatigue, conserve muscle glycogen, and improve performance.
Ingestion of moderately concentrated carbohydrate solutions (4%-8%), with the aim of achieving a carbohydrate intake of 60 to 70 g/h, enhances exercise performance and is appropriate for optimizing energy and fluid delivery without causing adverse effects.

The amount of sugar provided in one can of an EB is typically about 54 g. A teaspoon of sugar weighs about 4 g, so a typical EB contains about 13 teaspoons of sugar!

Long-term exposure of the body to excesses of simple sugar is associated with the development of obesity and insulin resistance. Pancreatic beta cells increase insulin secretion in response to this reduction in insulin sensitivity. Over time, in many individuals, beta cells become unable to secrete sufficient insulin to maintain normal blood glucose levels, leading to the development of diabetes.

Other functional ingredients of Red Bull

Inositol: synthesized by the liver and derived from foods, it is very important for the function of the liver (hepatoprotective action), brain (mild sedative) and plasma membranes.

Citric Acid: corrector of acidity, promotes iron absorption and prevents the formation of kidney stones.

Contraindications

Energy drinks should be consumed in moderation: there are guys who drink 5-6 cans a day, a real abuse! (Energy Beverages: Content and Safety. 2010)

It is advisable to limit the consumption of Red Bull under the age of 16 (Risks of energy drinks in youths. 2010), pregnant, breastfeeding, presence of diabetes mellitus, hypertension, nervousness, hyperthyroidism, insomnia, high cardiovascular risk and dehydration (Red Bull is not a rehydration drink, but favors the loss of fluids because of the caffeine content).

Caffeine has been clearly associated with adverse health effects in susceptible individuals. Among adolescents, caffeine consumption has been linked to elevated blood pressure (one group of investigators showed a significant effect of drinking caffeinated cup on arterial tone and function, suggesting that caffeine immediately increases arterial stiffness) and sleep disturbances. Among pregnant women, high caffeine intake is associated with risk for late miscarriages, stillbirths, and small-for-gestational-age infants. Anxiety or panic attacks, caused by ingesting excessive amounts of caffeine is seen more often in consumers with panic disorders.

Caffeinism is a condition caused by ingesting a great amount of caffeine that shows a constellation of symptoms including insomnia, restlessness, excitement, diuresis (Diuretic potential of energy drinks. 2006), nervousness, headache, tachycardia, arrhythmia, nausea and tremors.

Excessive adrenergic stimulation from caffeine may also result in hyperglycaemia, hypokalaemia, leucocytosis and metabolic acidosis: in fact, the presence of catecholamines, beta-adrenoreceptor stimulation results in the hydrolysis of ATP and augments cyclic AMP activity within cells, which stimulates Na-K-ATPase and causes K+ ions to shift intracellularly; excess of catecholamines also stimulate glycogenolysis and the breakdown of fatty acids resulting in hyperglycaemia and metabolic acidosis, respectively.

Also, if it is true that the site of Red Bull advise to drink the can before doing physical activity (Caffeine and other sympathomimetic stimulants: modes of action and effects on sports performance. 2008), it is also true that suggest drinking lots of water during your workout. In fact, containing a lot of caffeine, it may cause dehydration and put strain on the heart.

In a recent study, Willoughby showed that energy drink consumption acutely increases platelet aggregation and decreases endothelial function in healthy young adults; thus, raising the risk of myocardial infarction. Many other studies have highlighted the risk of high blood pressure if taken daily.

Energy drinks can actually give the illusion of effectively combating the sedative effects of alcohol (Intake of energy drinks in association with alcoholic beverages in a cohort of students of the School of Medicine of the University of Messina. 2007; The effects of energy drinks alone and with alcohol on neuropsychological functioning. 2009), but the state of intoxication is rather masked, while signals as fatigue and sleepiness are only attenuated and remain in wait, as the blood concentration of alcohol is not changed.

The unwanted side effects of taurine are not well studied by scientific researches, but they mainly concern the genesis of anxiety, memory deficits and excessive depression of the immune system. An overdose of taurine can lead to kidney failure, gastrointestinal problems, such as ulcers and diarrhea, and can worsen certain skin diseases such as psoriasis, contributing to the genesis of itching and to the spread of the disease over the entire skin surface. For the lack of information on the possible effects on the fetus, it is not recommended during pregnancy.

Cardio-and cerebrovascular responses to the energy drink Red Bull in young adults: a randomized cross-over study.

PURPOSE:

Energy drinks are beverages containing vasoactive metabolites, usually a combination of caffeine, taurine, gluguronolactone and sugars. There are concerns about the safety of energy drinks with some countries banning their sales. We determined the acute effects of a popular energy drink, Red Bull, on cardiovascular and hemodynamic variables, cerebrovascular parameters and microvascular endothelial function. (Effect of “energy drink” consumption on hemodynamic and electrocardiographic parameters in healthy young adults. 2009)

METHODS:

25 young non-obese and healthy subjects attended two experimental sessions on separate days according to a randomized crossover study design. During each session, primary measurements included beat-to-beat blood pressure measurements, impedance cardiography and transcranial Doppler measurements for at least 20 min baseline and for 2 h following the ingestion of either 355 mL of the energy drink or 355 mL of tap water; the endothelial function test was performed before and two hours after either drink.

RESULTS:

Unlike the water control load, Red Bull consumption led to increases in both systolic and diastolic blood pressure (p<0.005), associated with increased heart rate and cardiac output (p<0.05), with no significant changes in total peripheral resistance and without diminished endothelial response to acetylcholine; consequently, double product (reflecting myocardial load) was increased (p<0.005). Double product is used as an estimate of myocardial work and is proportional to myocardial oxygen consumption. Strength training reduces the resting double product, indicating a decrease in myocardial oxygen consumption at rest. Red Bull consumption also led to increases in cerebrovascular resistance and breathing frequency (p<0.005), as well as to decreases in cerebral blood flow velocity (p<0.005) and end-tidal carbon dioxide (p<0.005).

CONCLUSION:

Our results show an overall negative hemodynamic profile in response to ingestion of the energy drink Red Bull, in particular an elevated blood pressure and double product and a lower cerebral blood flow velocity.

Research Issues

Many people consume more than the recommended daily allowance of EBs (one can).

• Short-term Effects

Physiologic effect occur immediately after drinking the first dose.
In one study, 15 healthy persons aged 18 to 40 years consumed 2 cans (500 mL) of a commercially available EB containing 1000 mg of taurine and 100 mg of caffeine, daily for 1 week; effects of the EB on their blood pressure, pulse, and electrocardiogram (ECG) were measured.
Within 4 hours of EB consumption, the maximum systolic blood pressure increased by 8% on day 1 and 10% on day 7. Within 2 hours of EB consumption, the maximum diastolic blood pressure increased by 7% on day 1 and 8% on day 7. Heart rate increased by 8% on day 1 and 11% on day 7.
Throughout the study, heart rates increased between 5 and 7 beats/min, and systolic blood pressure increased by 10 mmHg after EB consumption.
Although no clinically important ECG changes occurred, there were significant increases in heart rate and blood pressure, and thus patients with hypertension should not consume this type of drink.

In a double-blind crossover study, 13 endurance-trained participants performed an exhaustive bout of endurance exercise at 3 different times. Before the exercise, they ingested Red Bull drink and a placebo drink without caffeine or taurine. Echocardiography was performed before ingestion of the drinks, before exercise, minutes after ingestion, and in the recovery period after exercise. Stroke volume was significantly influenced only in the Red Bull (80±21 mL before ingestion vs 98±26 mL in the recovery period), mainly because of reduced end-systolic volume. Thus, this study shows that Red Bull increases cardiac contractility.

• Long-term Effects

There are no long-term studies of the effects of caffeine, taurine, and glucuronolactone on the body; but energy beverages may exacerbate risk factors for heart disease.