00:03
Welcome, hi, I'm Mikki and this is Mikkipedia where I sit down and chat to doctors, professors, athletes, practitioners and experts in their fields related to health, nutrition, fitness and wellbeing and I'm delighted that you're here.

00:26
Hey everyone, it's Mikki here, you're listening to Mikkipedia and this week on the podcast I speak to Dr Andrew Jagim about the value of energy drinks. There are literally hundreds of different choices available and while they may seem like the domain of the sleep deprived or of the adolescent gamer, there's more to them than just leaving you wired. So today on the podcast we do a deep dive into the ins and outs.

00:56
of energy drinks based on a position statement released by the International Sports Science and Nutrition Group as to what the science says is worth considering when it comes to the different types of energy drinks. So we discuss the ingredients that have a real sports performance benefit, the timing of consumption in order to optimize their benefits, what athletes should look for in their ideal multi ingredient drink.

01:24
what the potential risks are and for whom, and the appropriateness of them for an adolescent population. And we discuss so much more than that as well. It's a super interesting conversation actually. So Dr. Andrew Jagim is currently the Director of Sports Medicine Research for the Mayo Clinic Health System in La Crosse, Wisconsin, and an Associate Professor of Family Medicine.

01:51
Dr. Jagim completed his PhD in Kinesiology with an emphasis in Exercise Physiology at Texas A&M University. Dr. Jagim is also a Certified Strength and Conditioning Specialist with distinction through the National Strength and Conditioning Association and a Certified Sports Nutritionist through the International Society of Sports Nutrition. His primary research area focuses on nutritional requirements.

02:17
knowledge and dietary intake of athletes and how these factors influence performance in health. Dr. Jagam also studies the physiological demands of various sports and how they pertain to injury, recovery status and performance. He also has a focused interest on the safety and efficacy of dietary supplements, which obviously is the topic of conversation today. So this work has led to several publications in peer-reviewed journals and presentations at national conference events.

02:46
and in the show notes I will put a link to the position statement that this conversation is based around and also of course Dr Andrew Jagim's biography from the Mayo Clinic. So I think actually or not most people are going to find this a super interesting conversation and certainly if you know of people who enjoy energy drinks or might have one too many energy drinks this would be definitely one to share with them.

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Just a reminder though that the best way to support this podcast is to hit the subscribe button on your favourite podcast listening platform because that increases the visibility of the podcast out there in amongst literally thousands of other podcasts. So more people get the opportunity to learn from the guest that I have on the show like Dr. Jagan. Alright team, enjoy this conversation.

03:39
so much for your time this morning I'm really looking forward to chatting to you and funny story actually I had one of my clients email me this morning and said that her son had she was concerned about the number of energy drinks that he was consuming in part because the gym that he goes to were like commenting on the fact that he was having like two energy drinks in a day before

04:07
Yeah, before hitting his workout. There's an issue with that, isn't there? Yeah, that's not my favorite thing to see. And we have the same issue around here. Those drinks are really popular among adolescents and high school age athletes. And it's not my favorite thing to see. It's just, it's a bad habit to get into at that age. So yeah. Yeah. And

04:30
It's interesting here in New Zealand as well. I think there is a restriction on the age with which you can purchase them. Is that the same for you over in the States? You can still purchase them if you're under the age of 18. They do have a warning label, you know, that says caution for those under the age of 18, but they could still walk into a convenience store and purchase it. Yeah. Yeah. OK. Well, before we sort of kick on into the topic for today, energy drinks and energy shots.

04:58
Can you just give us a little bit of your background with your research and just sort of where you're based and things like that? Yeah, absolutely. So I have a PhD in kinesiology, was the official title of the degree, with very much an emphasis in exercise, physiology, and sports nutrition. Excuse me. So that's kind of always been my interest is revolving around how the body responds to exercise and then how nutrition fits into that. So how can we improve?

05:28
you know, performance in acute type settings or over time, how can we use various nutritional strategies to kind of enhance training adaptations. Usually kind of a focus more on athletic populations, but some of that work is, has kind of been extended into either tactical athlete populations or even, you know, taking what we know works with athletes and applying it to some clinical populations. So individuals who, you know, are recovering from a surgery or

05:57
on bed rest from some type of illness. I think there's a lot of crossover in terms of how we can maybe recommend certain nutrients and supplement strategies for those individuals. And so I've worked in a variety of different settings. I've worked for a few different academic institutions as a faculty, doing kind of teaching and research. And then now the last five years, I've worked for Mayo Clinic in their sports medicine department. So now I'm in more of a clinical type setting.

06:27
but yet still trying to do a lot of the same kind of athlete focused research that I've done throughout my career. Yeah, nice. And it makes sense to me that you would try to apply what you learn in an athlete population to sort of more maybe that sort of specialized or even general population, given that the it's almost like the athlete is like this perfect sort of model of almost the extreme. And then I don't know, I can I can see how that's

06:55
I can see why you would want to sort of see how it works in sort of general population, I suppose. Yeah. And I think it's actually kind of an understudied area that really has a lot of potential. Because again, if you think a lot of the goals with some athletes, you know, we're always trying to get them bigger or increase lean body mass or maybe get them more stronger or improving performance where as in certain clinical populations, there is still a need to either maintain lean body mass, you know, if they're recovering from some of these invasive surgeries.

07:23
or if they have some type of catabolic condition where they're losing muscle, losing strength, losing functionality. It's like we can still take a lot of these principles, obviously you scale them down a little bit for clinical or general populations. But again, I think there's a lot of potential there for some of those strategies to be really beneficial and could make the difference of changing the quality of their life, helping them recover quicker or better managing whatever condition they may have.

07:51
Yeah, yeah, no, it makes perfect sense. Andrew, and how is it that you came to sort of be interested in the energy drinks, energy shots, sort of area? It kind of stems from some of the earlier work that I did with pre-workout supplements. And so I've always kind of had a fascination with really any dietary supplement. That was kind of what drew me into that field way back in grad school. I was always just kind of interested in

08:21
maybe manipulate some of the metabolic pathways or physiological responses in a way that could ultimately improve performance. And so even just myself through my training that I was doing, I was a fan of caffeine. I liked it. I liked coffee or other caffeinated type supplements or products. And so I had some self-serving interests there of, are the things that I'm taking actually making a difference? Are they safe?

08:48
And so early on it was a lot of, you know, again, studying different pre-workout supplement type products and then again evaluating, did they work kind of quote unquote? You know, what kind of a response did they have? How did they influence different aspects of performance? And so there's a lot of crossover and overlap between pre-workout supplements and energy drinks and people kind of use them.

09:13
almost interchangeably in some settings, or for some kind of athletes or regular gym goers. I see people use energy drinks as a pre-workout or I'll see people take pre-workout before they're going on a long car ride or they just need to stay awake and alert. So maybe we can get into the overlap of ingredients later on. But that was kind of how I became interested in this particular topic when we pursued that position stand with kind of focusing on energy drinks.

09:43
Yeah. And so you're seeing it as more like, is it emerging more and more that people are not relying, isn't the right word, but they're using them now compared to say what they once were with this sort of explosion of more energy drinks on the market? Yeah, absolutely. Certainly within the United States, that energy drink market as a whole has just skyrocketed in the last even just five years.

10:09
I don't know offhand the number of products available on the market, but I've got to imagine it's increased probably tenfold. You go into any grocery store, convenience store, and they have multiple shelves of different types of energy drink products. The other thing that's interesting here at Stateside is we start to see caffeine pop up in a lot of other types of beverages as well. Caffeinated water, caffeinated sparkling water.

10:38
some of these things that historically haven't really had caffeine in them, now all of a sudden there's added caffeine to it. So it's, even when we wrote this position stand, it was kind of hard of where do we draw the line between what is an energy drink and what isn't, because so many of these products are now having caffeine added to them. Yeah. And so what actually does define an energy drink? We try to set kind of our own criteria.

11:05
We did it in the position stand, but actually a couple years prior to that, we were kind of pursuing a study that would queue up this position stand. So we tried to establish our own kind of standard definition, if you will, of what an energy drink was, and then similarly with an energy shot. And so what we did is we kind of surveyed the market of some of these different types of products that were available and kind of informally just reviewed.

11:32
the nutrition facts labels on these different products and tried to, again, establish what could be a set definition here. There's a paper that I can pass along where we link. It's a mouthful of what our definition was, but more or less it was a product that was a ready-to-drink beverage, so it comes in various serving sizes of 8, 12, or 16 ounces in terms of beverage formulation.

12:01
typically has caffeine in it, is marketed in a way where it's supposed to provide increased energy or focus, alertness. And then we listed some common ingredients that needed to be there before we would designate it as an energy drink. And so really what we were trying to do is eliminate some of those products that I just mentioned where it's a sparkling water, where it has fluid, it has some kind of carbonation, it has caffeine, but that would be it.

12:32
of active ingredients in those types of products. So we were trying to exclude those from, you know, the position standard, this other review article that we kind of summarized the ingredient profile of these beverages. Yeah. Okay. And then, you know, if I think about some of the common ingredients like caffeine, obviously is one, and carbohydrate. I mean, you have, you know, you have a class that has

12:58
the sugar contained, but there are a ton of sort of zero calorie ones now on the market. Like outside of those two, which we know have an ergogenic aid, is there much research to support the use of B vitamins or vitamin A or E in that performance enhancement space?

13:21
I would say not enough evidence where we have a clear sense of, yes, there's an ergogenic benefit, here's the dose that you need to ingest, and here's the magnitude of benefit that you're likely to see. There's a handful of studies that have maybe shown mild improvements in exercise performance, whether it's from taurine or carnitine or some of those other popular ingredients that were in there.

13:49
not that I've seen where it's again convincing evidence that yeah, there's a definite benefit that you're going to get from adjusting these, even though they're in all kinds of products that claim that they are supposed to improve performance. I think a lot of it, or even those ingredients as a whole, is kind of a good example where there's really sound mechanistic reasoning as to why they would improve performance.

14:13
various cofactors in different pathways in terms of metabolism and energy systems. You look through it and you're like, yeah, I could see we're taking more of this, would increase that metabolic pathway or metabolic production of energy. Yet, when we translate it to human research and apply that same dosing recommendation, we just don't see that result that maybe people think there should be or would be, just based on that physiological rationale.

14:42
That's kind of why we do human subjects research, right? To see what we see in a cell line or petri dish or on paper. You know, does that translate to actual kind of meaningful performance improvements? And again, I'm not really convinced of the evidence where we have kind of a clear answer there with a lot of those other ingredients. Totally. And I and as you were talking about that, that just makes perfect sense to me because a lot of what I see in the nutrition literature is if you have insufficient

15:11
or inadequate sort of levels, then of course, having more of these is going to help optimize that pathway. But it's not like having these super physiological amounts is then going to result in that performance enhancement, I suppose. Yep. And I think that's a great point, is identifying whether or not that person does have a deficiency. So if they don't get any B vitamins in their diet, yeah, adding more to it.

15:37
might make a difference. It might not be enough to really move the needle in terms of a huge performance improvement, but maybe over time, just more ingestion of those vitamins or other ingredients that they may be deficient in, that could make more of a difference longer term. It's just hard to really kind of identify that within different research type projects.

16:01
What about the amounts that are in some of these drinks, Andrew? Like I'm thinking of carnitine, for example. Like I know, like I've, I've chatted to Dom Dagostino before who I'm sure you're familiar with, um, and he talks about carnitine, um, as a, as a supplement that helps shuttle, you know, um, uh, fat to be used as an energy source, but the amounts that you often see in things like.

16:29
energy drinks and other products are quite small compared to what you would actually need to see that appreciable difference. Is that the same sort of with what you're finding in this area? Yeah, for a select number of some of those active ingredients, I would say yes, that's certainly the case. And we saw the same thing with, we actually did the exact same kind of analysis with pre-workout supplements and again found that a lot of those were kind of under dosed.

16:56
to what you would need to ingest to see more of a meaningful increase in performance. However, it's not consistent across the board because in terms of the vitamin B content, the values that they include in some of these are off the charts, well above the recommended daily allowance. It seems like they just said if some is good, more is better and then just kept adding it, adding it, adding it to the point where some of the amounts were...

17:24
2000% above what's recommended for a daily intake. And so it's, I don't know why they went to that extreme or how they came to settle on that number. Good news is with a lot of those B vitamins, they're water soluble, so the risk of toxicity is lower compared to some of the fat soluble ones. But so again, some ingredients might be underdosed, whereas others have the other problem and they're extremely high dosed.

17:53
And still, I don't think it's enough, or I just don't think that ingredient is one that you're going to get kind of a dose response, you know, benefit if you just keep adding more and more to it. Yeah. And I guess it's sort of almost in the human psyche, isn't it? More is better. More is always going to be more. And I think that that idea that you're getting X like, you know, hundreds of times more of some particular thing sort of appeals to this requirement that if we have more, we'll do more and we'll be better.

18:23
I think some of them are chasing some of the acute responses, like niacin. If you take a high amount of that, you might get the niacin flush. A person might perceive that as, oh, this drink is kicking in, it's working, I can feel something. Then maybe they run faster or longer or something. There's not really anything from a physiological standpoint that is making them perform better. Again, just mentally, they may perceive it as, quote-unquote, working for them.

18:52
Am I right in thinking beta-alanine has that sort of pins and needles feeling? Am I certainly? Yeah. So, peristhesia is that side effect. And I think the exact same thing is some people will feel that and say, okay, I can feel the beta-alanine kicking in. It's doing something now. I can get that sensation. And so mentally, again, they may think it's kind of working or now they're going to perform better.

19:17
I do hear some people hate that effect and some people, you know, it drives them crazy and they're going to jump out of their skin and they just, they don't like it. So it kind of, I guess, depends on how you respond and how you tolerate some of those kind of acute responses to ingesting those ingredients. Yeah, sure. And also, of course, the placebo effect is a real effect too, right? So if I'm taking an energy drink or having an energy shot, then, and I think it's going to work for me, then potentially that is going to actually help.

19:47
help me excel at whatever I'm about to do next, right? Yep, absolutely. I think that's actually one of the more kind of contributing factors to why they can work kind of the way they do. But then, you know, on the flip side of that, like we said, with some of the younger athletes taking it, I think it kind of becomes habit forming where it's just part of your routine now. It's like, well, I gotta have my energy drink before I go work out, or my workouts not gonna go well, I'm not gonna perform good. So...

20:15
They just get into this habit of I need it now to go work out or perform at the level that I've done in the past where if they didn't take it, again, from a physiological standpoint, I don't think it would be enough to really kind of hinder their performance for the day. But mentally, they might just kind of check out for the day and say, oh, it's not going to go very well. I didn't get my energy drink or, again, same thing with pre-workout. I didn't get my pre-workout in. I didn't get my...

20:43
normal routine in for the day. So I'm just going to be slow and sluggish now. Yeah, yeah, sure. And Andrew, is it like, before we sort of get onto some of the potential negative impacts of some of the things in energy drinks, like if people are using energy drinks, what, what kind of, well, first, did you like when you were looking into it either in the sort of position stand I'm thinking of or any of your other research, like

21:10
Are there preferred drinks for brands? Are you able to like give us a couple of like preferred brands that you would go, yeah, actually this has a good profile of XYZ. We'll sort of do what it purports to do, or is there nothing really sort of that stand out in the market? Yeah, I think it really depends on a lot of factors and a lot of it.

21:32
is going to be body weight related, believe it or not, just because a lot of our dosing recommendations for caffeine of kind of what we know in terms of an optimal dose is usually body weight dependent. You know, bigger people may need a larger dose. And so if we look at the caffeine content of energy drinks, you could kind of make that decision based on how big that athlete is. If they're

21:54
know, 100 plus kilos, they may need the energy drinks that have 300 milligrams of caffeine in them to kind of put them in that recommended, you know, dosing range. Whereas if you have a 40 or 50 kilo athlete, maybe that would be way too much caffeine. They wouldn't tolerate that very well. And so maybe looking for a drink that has a smaller caffeine content to it to just to kind of avoid, you know, maybe overdosing them.

22:20
Because I think that's really the ingredient that's going to make the biggest difference one way or the other, if we're talking kind of performance benefits. So you could almost make that decision just based off of caffeine content alone. And then, you know, a lot of it's going to come down to just personal preference and taste or maybe what type of sweetener are in these, or if you're looking for a sugar or sugar-free version.

22:46
So you could kind of maybe go down a checklist of what's your priorities here? Do you want the caffeine or do you want a sugar one or do you need one that has a better electrolyte profile? Is that what you're looking for in a drink? So I think it kind of depends on what's most important to the user or the consumer of that drink. Yeah, sure. And so is it then... Well, I mean is it hard to...

23:12
think about it, is it hard to study, for example, the impact of this multi ingredient drink and what's having the most benefit because as I'm hearing you talk and of course what I know about performance enhancing aids, caffeine is the real standout from a lot of the ingredients that you're going to find outside of a course of course carbohydrates. So are there are the challenges in sort of studying the multiple ingredient drink?

23:40
Kind of twofold there. So one, it's not necessarily challenging to just give them the drink and then look how they perform. But B, it's challenging to determine, well, what made the difference in performance? And when you go look at the ingredient profiles, it's like, geez, it could be three or five different active ingredients that was conferring some type of ergogenic benefit. So it's the back end of that that is the challenging part of how do I explain.

24:05
what drove the performance improvement here. And then again, just kind of based on the literature of caffeine related research and kind of what we know about that ingredient, oftentimes that gets kind of moved to the top of the list of it's probably the caffeine here that's making the biggest difference in terms of performance improvements one way or the other, just because as we said earlier, there's not a lot of other ingredients in here that have the level of evidence and support behind them.

24:35
like caffeine does. And so the only way to really answer that question is if we get manufacturers to kind of specially formulate drinks where you do a head-to-head trial, this is an energy drink as normally formulated. The other one is an energy drink without caffeine in it or without taurine in it, where you almost kind of isolate single ingredients and pull them out and then just kind of compare them head-to-head.

25:04
which is a very tedious process. And I don't know if anyone's got the patience to really see that through just because there's 15 ingredients in some of these different beverages. But that's ultimately what you would need to do to kind of determine which is the most powerful or kind of biggest contributing factor to whatever you're seeing in terms of an ingredient. Yeah, and I guess as well as from a personal perspective, if someone is like,

25:31
I want to try this energy shot or this energy drink and compare how I feel taking this one versus this one. I guess at the end of the day, it doesn't really matter which one is going to help them perform better. If they know that one does, then they're just going to probably choose that. Yeah, absolutely. So yeah, so there's definitely kind of a pragmatic way to do it on an individual level of, and that's just the way the consumer market is driven anyway. You know, if people like the taste, like the way it makes them feel.

26:01
vice versa, someone drank an energy drink and they had a lot of GI upset and just didn't feel well after a while, they're probably not going to purchase that product again. Regardless, if I tell them it has a perfect ingredient profile and this is the one you want. So everyone kind of has to do their own case study on some of these different things. And I'll always tell athletes that, you know, make sure you try this out on practice or a non-training day, so, or a training day, a non-competition day so that you don't figure out the hard way.

26:30
you know, this pre-workout or this energy drink just doesn't sit well with you because it can have adverse effects and you don't want to learn that out on game day. No, for sure. And what about optimal timing for energy drink consumption? Andrew, what do we know about that? Usually it's recommended to aim for about 30 to 60 minutes kind of prior to the start of training or competition game match, kind of whatever you have upcoming.

27:00
And you kind of want to, you know, somewhat align it with when you want it the most within that competition, I guess. So the reason why we aim for 30 to 60 minutes is that's kind of the timeframe that's needed for just some of the absorption of the fluid and then probably more importantly, the caffeine to kind of get into the bloodstream and reach peak concentrations within the blood. So we're kind of stealing what we know from the caffeine literature.

27:27
and then applying it to some of the timing recommendations for these drinks. So if you're, if you have a long race, you know, something like a triathlon, you may want to maybe move that a little bit closer to the start of the race. Or I know some athletes that will even, you know, try to take something mid race or somewhat kind of in between events just to get that another kind of dose of that caffeine or even fluid electrolytes, some of those other things that will probably help them. Yeah.

27:56
And if an athlete is used to consuming the beverage and have tried it in training, is there any detrimental potential impact of having something like this mid event, like mid triathlon or Ironman or something like that? Do we know anything around that? I don't know if I've seen any evidence that would indicate that. Just again, from a pragmatic approach, drinking carbonated beverages mid-race just might not be well tolerated.

28:25
But I know some athletes will just kind of leave it open. Yep. And just get the carbonation out and you're drinking it flat. So that would be one approach or opting for more of kind of the powdered versions of an energy drink, which again, kind of might fit more of the definition of a pre-workout. But you know, something that you could easily just pour into a water bottle and kind of continue to drink while you're on the bike or whatever you're doing.

28:51
And I know even now there's there's caffeine gum and other ways to get caffeine. If that's truly what they're chasing is just the caffeine. I think you just got to go with whatever is logistically most feasible during that type of competition. And then again, what's the most well tolerated? Yeah. Well, it is interesting that if I'm thinking about Iron Man, they do have they have and actually a lot of ultra runs now as well. They have flipped.

29:17
Coke out on the course in the marathon and people are chasing caffeine. But like in my understanding, there's actually not a ton of caffeine that you're going to find there. So potentially it's a sugar actually that's helped those small amounts of sugar despite the fact that it's quite high concentration. Yeah I think a lot of

29:35
kind of general public are shocked when they hear about that strategy. But just like you said, it's got fluid, it has sugar, it has some sodium in it, and then some caffeine and all of those things are known to improve performance. So it's just kind of an easy way to get some of those things in there. And, but again, there's nothing necessarily magical about the Coke. It's just, you could get that from a variety of different products. So whatever works best for that athlete, you know, could be interchanged there. Yeah, for sure.

30:04
And what about, you know, athletes, obviously they expend a lot of energy, they burn a lot of calories and you've got your no sugar energy drink versus the one that does have sort of carbohydrate. Now, if we were just talking about a general not that active population, you might just go to the gym. To my mind, I would probably suggest, hey, you know, forgo the calories from carbohydrate. And if you really want it, just go the zero cal. Is there any

30:33
sort of contraindication for like a particularly active person, like a triathlete, to be consuming energy drinks with the sugar in it? Like, do we know what that sort of combo is like? I haven't seen a lot with, you know, a study like that using energy drinks. But again, if we combine what we know about caffeine and what we know about sports drinks and kind of, you know, extrapolate.

30:59
by combining those two, I don't see any reason why it wouldn't be helpful to an athlete. Because again, you're getting the carbohydrates, you're getting the fluids and then caffeine on top of it. So it very well likely could have a performance benefit by including all of those together. Yeah. And are there any, what are the potential pitfalls or downsides that you got that your sort of research group sort of listed out of having energy drinks or energy shots?

31:28
Some of them is just the concerns about over consumption of caffeine. So very similar to other kind of caffeinated products where there's always that risk for adverse effects where people get irritable, kind of feel anxious, GI distress, sometimes a frequent one, nauseous, those types of symptoms. Sometimes to the extreme, they'll feel like rapid heart rates.

31:55
and almost more of a cardiac related issues or adverse effects. But it's really no different than what we see from other caffeinated products in terms of kind of the risk profile, in my opinion. In the studies that have reported more kind of case series or case reports from adverse effects associated with energy drinks, usually you find out that that person was consuming two liters of energy drinks throughout the day and had some kind of adverse event.

32:25
If you consume four or five times the recommended serving size for a lot of different things, you may not tolerate it very well. So that's probably more the concern is kind of the abuse of those types of drinks, over consumption of them, or combining them with other types of products that may have overlapping ingredient profile. So if someone drinks a cup of coffee in the morning,

32:49
They take an energy shot throughout the day. They also take a pre-workout and then maybe an energy drink later. It's like that tends to be a lot of caffeine or a lot of B vitamins or some of these other overlapping ingredients in these different products that probably are increasing your risk for side effects throughout the day. Yeah. And Andrew, if someone's interested in energy drinks and caffeine is, I feel like caffeine is a thing that we should consider.

33:19
more than anything. Is there a particular amount of caffeine that we should be aiming for if we're wanting to maximize the potential ergogenic aid in an energy drink? I know more isn't better, but are there any recommendations around that? Yep. It's usually three to six milligrams per kilogram of body weight is the recommended.

33:41
dosing amount for the caffeine content. The challenge is kind of applying that to energy drinks and their formulations. You don't always have the luxury of getting exactly in that range that aligns with however much you weigh. The average caffeine content, if we combine most of the drinks on the market, is actually only about 174 milligrams. So it's not an excessive amount.

34:07
And so what that equates to in terms of a relative dose is obviously dependent on how big of an individual that we're talking about. And so sometimes people may have to combine different products to kind of fall within that recommended range. I don't know if the best solution would just be keep drinking more energy drinks until you're within that window just because there's all their ingredients in there, you know, other than caffeine. So.

34:32
that's usually not the way to go in my opinion. So there may be other strategies that you could use to kind of fall within that recommended range. Yeah. And what about guarana? Is that counted in terms of caffeine? Like in my head, I'm thinking people often talk about it as some sort of substitute for the buzz that you get from coffee. Am I, am I like, is that right? Am I wrong? Well, usually, usually in terms of total caffeine content, they'll, they should kind of provide

35:01
where that caffeine is coming from. Was it sourced from Guana or was it other extracts that contributed to that total caffeine content? So it can, I guess, be included in that. It just depends on how that manufacturer, how the label is treating it or viewing it when they report their total caffeine content. Yeah. Yeah. Nice. And are there any energy drinks that don't have caffeine? Like when you were looking at all of the ones out there?

35:31
There were. We didn't include them in our review of these ingredient profiles of the drinks on the market, just because when we set our definition, including caffeine was one of them that we had in there. It was a biased selection, I guess, depending on how you view all the energy drinks out there. But there are caffeine-free versions of some of the energy drinks where they're looking for, maybe they have more nootropic-focused ingredients in there.

36:00
And again, still trying to appease people looking for the cognitive benefit or increases in alertness, reaction time, using just maybe slightly different ingredients than obviously caffeine or some of the more traditional ones that you'll see in an energy drink. Yeah. Did you trial these out in interest, like when you were sort of doing the review or having a look at it going, oh, I might just see how I feel day to day on these different drinks?

36:27
Yeah, I really haven't. I haven't much for the caffeine-free one. Same thing with pre-workouts. There's caffeine-free pre-workouts available on the market as well. And from what I can tell, they're kind of marketed in a way for people who may work out at night where they still want the kind of benefit from a pre-workout, but they don't want a high caffeine content because they may be trying to go to bed two hours later. So.

36:52
again, trying to provide something to those types of consumers where they can still get some of the benefits but yet not stay up all night because they just ingested a high amount of caffeine. Yeah. And Andrew, with, I'm thinking about the market of drinks out there and, and since you're, you know, you're really familiar with the pre-workout sort of range as well, like what should we be looking for in either an energy drink, energy shot or pre-workout that

37:20
that may be most efficacious? I think it again, kind of depends on what is the reason for use or what sport or type of training are we talking about. Because a lot of the energy drinks and the ingredients in them and again, kind of how they're marketed are more geared towards that mental kind of energy of increasing alertness and reaction time, yet also kind of improving maybe various aspects of metabolism. So they're...

37:50
you know, purported to increase fat metabolism or glucose availability or something along those lines where they're just trying to get more energy, whether we're talking at the cellular level or just more mental type of energy. Whereas pre-workouts tend to include ingredients that offer more kind of performance or training related benefits. So they'll have ingredients like beta-alanine, creatine, nitrates.

38:16
some of those other active ingredients that have, I would say more of a profound impact on physical performance abilities, whether it's strength-related, endurance-related, or just kind of the adaptive response. So, by taking creatine over time, you tend to get better improvements in strength or power development, et cetera. And so, again, kind of depending on how you're defining works or makes a difference, I think it kind of, again,

38:43
goes back to what's your core reason for using it, what type of exercise are you trying to improve or enhance, or are you just taking it for more of the cognitive benefits where you're trying to study for an exam and you really need to focus, there I don't think you would need a pre-workout in that type of situation. Something that has more of the cognitive related benefits or active ingredients would probably be sufficient in that situation.

39:13
Yeah. And so if I was an endurance athlete, then I would probably benefit more from looking at that pre-workout range rather than an energy drink. Yeah. Again, if you weren't, the other advantage of the pre-workout is it's all of those ingredients combined into a single product. So for some athletes, they may be already taking some of those ingredients and other types of products or single ingredient.

39:41
type of supplements that they're taking. So again, it kind of depends on what else are we taking throughout the day and why are you using it. If you're just taking something for the caffeine, there's a lot of different options available. You could just do a cup of coffee, if you wanna just keep it simple with that. There's caffeine tablets that athletes often use because it's really convenient to just swallow a capsule and get your 200 milligrams of caffeine. As I said, there's gum, there's mouth rinse.

40:08
There's drinks, there's powder mixes. So again, it kind of depends if you just want the caffeine from it, or if you're trying to also benefit from some of our other kind of performance enhancing ingredients like creatine, beta-alanine, nitrates, and some of those. Yeah, no, awesome. And what about the health risks associated, Andrew? Like what are some of the things that you're a little bit, if you are concerned about with the...

40:35
burgeoning market of these energy drinks that are out there and shots. Yeah, usually a lot of the health risks are associated with some of the kind of adverse cardiovascular effects. So they can increase blood pressure, they can increase heart rate just because it's again, largely influenced by the caffeine content, which is a sympathomimetic drug. So you're increasing the sympathetic nervous system activity. And if you're already someone who is susceptible to

41:04
some of those effects if you have high blood pressure or again, risk factors for cardiovascular disease, it probably wouldn't be a good idea to be consuming these types of products or any product that has a high caffeine content just because of those risks. And so that's usually where I think the biggest concern is. However, when we again, look at the caffeine content of these beverages, they're really not that high.

41:31
If you look at regular coffee consumers, most people consume more caffeine on a regular basis just from their regular coffee habit than they would from energy drinks. But if you're that person who consumes three energy drinks throughout the day, that's a different story. And those, again, are...

41:51
I don't think we really know the risks of multiple servings of some of these beverages and then certainly the long-term implications of doing that. What happens if you consume a high amount of these every day for several days, weeks, or months, or years? I don't think we'll ever get those definitive answers and probably just have to rely on cross-sectional studies or epidemiological work.

42:18
to kind of look at some of those potential risks. And then the other kind of concern that I have, and I haven't really seen it well studied yet, is some of the more nervous system related side effects. Again, if we just think of young athlete who may already be stressed from training, from school, just life in general, and then you keep adding these boluses of caffeine and stimulating them repeatedly throughout the day.

42:47
you know, multiple days on end, what is that doing kind of to their nervous system? Are they going to be chronically in this kind of fight or flight, stressed out state where we see maybe chronic elevations in cortisol or some of these other kind of adverse hormonal responses from doing that and it could disrupt sleep? And so I think there's still a lot of unknowns associated with some of these beverages and maybe some of the more long-term health risks.

43:15
And I don't think it's unique to energy drinks. I think we could apply that same concern to, again, throw pre-workouts in there, throw energy shots in there. And as we've already alluded to, there's just a lot of caffeine and a lot of different things on the market nowadays. So what is that doing to all of us if we're just constantly consuming this stimulatory ingredient throughout the day? Yeah. And do we know much, Andrew, about

43:42
Adolescence and caffeine and I'm because I was just thinking as you were talking obviously there we know That we have that body weight recommendation Which I'm not sure if it's just adult related, you know, three to six milligrams per kg body weight from a performance perspective But does caffeine affect a young brain differently to say an adult brain? Do we know that?

44:04
I'm not familiar with that research. To be honest, I'm not sure if that has been studied in younger children. I would say probably not, just because of the ethical concerns that we often face when we try to do research on younger age individuals. To be honest, I'm not sure. I would certainly have my own hesitations. I wouldn't be thrilled if my nine-year-old daughter came home with a big energy drink and it was drinking that.

44:33
But again, I don't know from a research standpoint, how well investigated that has been. Yeah, yeah, that's interesting. And what you say about the nervous system thing is, I completely agree. And I think of thinking of like a number of people who from a health perspective, they shift from full sugar energy drink to a sugar free variety, which I think for the people I'm thinking about, because there is this large population of sedentary people who drink energy drinks.

45:02
for the energy buzz, if you like. And so whilst of course, to my mind, it's more healthful to go the sugar-free route, if we're thinking about that, but still getting that central nervous system impact of the caffeine that, as you say, is related, could also sort of impact negatively on metabolic health and blood pressure and your nervous system too. Yeah, and we'll see.

45:28
You know, where things go in the future, I can't see this market slowing down anytime soon, unfortunately. So I think we'll probably get some answers to these questions in the next, you know, five, 10 years as more just kind of population, you know, level research is being done to look at, you know, how are the consumption of these products, you know, again, whichever one you're talking about, but just how is that impacting?

45:53
all kinds of different health parameters. Like you said, the cardiovascular ones or a nervous system or just natural growth and development in kids if they're consuming these types of products. And again, within the States, maybe we will see a ban on certain ages at some point where they restrict it, like they do with alcohol sales or something at some point. So it's hard to tell what's coming.

46:22
teenager walk to school with this like huge, huge can of like Monster or I don't know what I mean, actually I don't know any other than I mean, I would Rockstar or I don't know just these these horrible looking energy drinks and they're just like sculling it back like it's water like that's the other thing I think about too is like think about all the water they're not drinking when they're drinking these things. Yeah, exactly.

46:49
The fact that they can drink it and tolerate it means they've probably been doing it for a while because I think when I was that age, if I were to drink something that had 300 milligrams of caffeine, I would have been off the walls. That would have just hit you really hard, but these kids must do it on a regular basis if they're able to do it and seem to tolerate it okay. And some of the other challenges too, I don't know if you have these drinks where you're located. But now...

47:16
Gatorade came out with a caffeinated kind of Gatorade type drink where it's a little bit lower in sugar content but then it has 200 milligrams of caffeine which For you know select athletes. I think it's a great beverage that they now have available, but it looks just like a little Gatorade drink So I just I hope there's not a kid out there that grabs this thinking that hey, this is a small Gatorade drink It's perfect for me. I'm a child and then they unknowingly

47:42
just ingest 200 milligrams of caffeine. So even when I have those in my fridge at home, I try to put them on the higher shelf so that, again, my girls don't accidentally grab them. I mean, I think, again, just goes to show that a lot of people probably drink a lot of caffeine, maybe not even knowing that there's caffeine in some of these types of products on the market. Yeah, yeah, sure. So Andrew, on that note,

48:07
Do you have energy drinks or energy shots? I mean, you just talked about the Gatorade one that you might have occasionally. Like, do you use them for your performance in, in, in gym work or sport or whatever it is that you do? I do. Yep. And all I'm really not partial to anyone. So sometimes I'll do coffee. Sometimes I'll do just like I mentioned, those kind of Gatorade type products. Some of them are more of the traditional kind of energy drink. Um, and sometimes it is for more performance type.

48:35
applications, you know, before I go workout or something like that, or it's sitting in the computer and, you know, writing away on a research manuscript and just kind of need that caffeine type pick me up. So it's, it's more of the caffeine that I'm kind of chasing with some of those products that I use. And again, I'll, I'll kind of switched up and get it from a variety of different sources.

48:59
So like right now when it's hot out, a nice hot cup of coffee doesn't really sound very refreshing when it's already this warm. So maybe an energy drink is more of my go-to during the summer and then winter is a complete opposite. Nice warm cup of coffee just kind of feels better when it's cold out. Yeah, nice. I love a coffee before a run, but I've just seemed to have discovered these

49:27
drink these Musashi drinks. I don't know if you guys have Musashi as a brand over there. I haven't seen it actually when I've been there. I don't think so. Yeah, it's got like 160 milligrams of caffeine in it and it's delicious apple and grape and it's slightly carbonated and it just really sort of hits a spot before you like, you know, go hit the bench press or whatever. I actually recently discovered, they're almost like a little caffeine chew. I saw them online.

49:57
And so it's again just a tiny little almost kind of like a gummy bear type thing that has has 200 milligrams You know per serving so just you know taking one of those is Kind of sufficient for what I'd be looking for but it's it's nice again for the convenience factor So I think athletes who are traveling Or even mid-race if they really need that bowl of caffine. It's a really convenient way to get it without

50:22
again, powders or, you know, obviously riding the bike, drinking an energy drink isn't very realistic. So it's, I think it's a good option for some of those individuals. So what's the brand? I think I even got it right here. Okay, it's fun. It's interesting where they can fit like, what does it say? Caffeine, caffeine nuts? Caffeine melts is the brand of it. Caffeine melts.

50:46
Brilliant. I'm going to pop that in the show notes because that I think for my endurance athletes, I think that that would be a really interesting one to trial when they're out practicing because of course you get the gels have the sort of 50 milligrams of caffeine as a higher amount of caffeine. But that's like, like when I run, I keep the last time I did a marathon, I kept my two caffeinated gels for the last couple of gels that I had during my marathon.

51:15
And most of me just thought this is placebo more than anything to give me a lift because I'm not sure that 50 milligrams is really going to sort of cut it in terms of performance. But you know what, like 200 milligrams, if you can stomach it in terms of your gut, that might actually, you might actually appreciably notice. Like how long do you notice after taking one of them that you get a bit of a hit? I would say it's probably similar to like drinking coffee, you know, so within 30 minutes, I would say I can kind of.

51:43
notice that the caffeine must have been absorbed and kind of circulating in bloodstream. The only thing I'll say about this, I hope the company doesn't come after me, but they taste terrible. I don't know if you've ever had caffeine and hydrous, you know, just a pure powder, but it is very bitter and very hard to mask that taste. And so my guess is hopefully they're still working on their masking and flavoring because I think it's a newer brand.

52:12
So I usually have to eat it and then immediately drink water and try to wash the taste down a little bit. But again, it's so convenient that I'm willing to do that if I kind of need it in a pinch. So the last time I actually took these was on a conference trip. So when I was traveling, you're not always around coffee shops or maybe I can't find the types of drinks that I like getting. So this again is a great option for people who are traveling and still kind of want that.

52:42
morning caffeine or whenever they get it. Oh, that's perfect. I don't know if you've ever tried ketone esters as in terms of like this is like, I mean, I know apparently they've improved the palatability of it and it's still horrendous. Yeah. You still have to like take it and then like quickly wash it down with something else. Similar. The things we do for a performance edge.

53:09
Totally. Andrew, thank you so much for your time this morning. And I will pop in the show notes, definitely link to those caffeine melts and of course the position stand that sort of sparked my interest in this area. Where can people find more of the work that you and your research team are doing? So we have kind of a departmental website, so Mayo Clinic, Health System, Sports Medicine, and if you kind of add my name to that you'd find...

53:37
some of the different research projects that we have ongoing and kind of a list of, you know, previous studies that we've published. And then I try to post a lot of updates that we do on Twitter or on Instagram to kind of highlight, you know, some of the different research projects, again, that we've done or, again, just other interesting studies that I come across. That's probably where I find a lot of my ideas or, you know, kind of helpful current literature is on Twitter. It's a really kind of helpful resource for some of those types of tools. So that's kind of where

54:06
People can follow some of that work if they're interested in it. Nice. Thank you. And finally, what are you working on right now? We have a couple of projects in the works with our local firefighters. So we've kind of shifted our focus recently with some more tactical populations and again, just kind of looking at how their performance changes throughout the year. And we'll probably start getting some nutritional interventions or different strategies that we can implement to help them sleep better, to help them recover.

54:35
in some of those types of tools. And then kind of going back to what I was saying earlier with the clinical populations, we have a couple of studies that we're about ready to start where we're providing patients with ingredients like protein, creatine, H and B before they go into surgery and then have them supplementing after surgery to see if it can help them better retain lean body mass and strength and kind of overall function. So.

55:02
Those are a couple of projects that are keeping us busy here in the next couple months. Yeah, oh that sounds really awesome. I'm really looking forward to hearing the outcomes of particularly that last study. That sounds really useful. Andrew, thank you so much for your time. I've really appreciated it this morning. Yeah, absolutely. Thanks for having me on.

55:31
Hopefully you got a little bit of sort of knowledge and information from what Dr. Jagim and I discussed today and of course as I mentioned I've popped a link to the position statement in the show notes. Next week on the podcast I speak to RD Dikekman, Richard Dikeman all about low-carb diets for type 1 diabetes. You are gonna want to listen to this it is great stuff so that is next week on

56:00
Until then though you can catch me over on Instagram, threads and Twitter @mikkiwilliden, over on Facebook @MikkiWillidenNutrition or head to my website mikkiwilliden.com. Alright team you have the best week see you later.