No good evidence for numerous claims about energy drinks

A Facebook reel shared over 4,000 times makes numerous health claims about the effects of some ingredients in popular energy drinks.

It makes the unevidenced claim that consuming more than one Prime Energy drink per day increases the risk of Alzheimer’s by 78.4% in later life. It also incorrectly claims that sugar free Monster contains dangerous levels of caffeine which increases the risks of stroke and heart disease, and also that sugar free Red Bull contains a sweetener called aspartame, which is harmful to both the kidneys and the liver.

However, sugar free Red Bull no longer contains aspartame and several scientific reviews have found that aspartame is safe to use within recommended amounts. The levels of caffeine in sugar free Monster are within the recommended daily amounts of caffeine that is considered safe. Prime products were first released in 2022 and thus long term data on its potential to cause Alzheimer’s in later life cannot exist.

Misleading information on social media, particularly about health, can cause unnecessary distress to those who see it.

Alzheimer’s and diet

Alzheimer’s disease is the most common type of dementia affecting adults in the UK. There are various risk factors for the development of dementia and these include increasing age, smoking, obesity, lack of physical activity and diabetes. Maintaining a healthy lifestyle is recommended as it reduces the likelihood of developing some of these established risk factors. 

Some studies have shown an association between high cholesterol and dementia, however this is thought to be due to cholesterol being a risk factor for some of the accepted causes mentioned above. Foods that promote obesity and diabetes may be associated with dementia, which is not the same as saying a particular food substance causes it.

Having a healthy balanced diet is recommended as part of reducing the risk of dementia but the exact cause of Alzheimer’s is unknown. Although many studies have looked at specific foods, there is currently not enough evidence to advise for or against a particular food to prevent Alzheimer’s.

What does it have to do with Prime Energy?

Prime Energy is a popular energy drink that contains coconut water, filtered water, caffeine, taurine, electrolytes, sweeteners and various B vitamins, amongst other ingredients. Since its first release in 2022, Prime products do not appear to have been subject to any scientific studies related to dementia. 

A review of the effects of energy drinks generally found that dizziness and headaches were the most commonly reported neurological side effects. There were also psychological effects such as stress and depressed mood reported.

Another review in 2023 looked at the available evidence for the effects for some common ingredients in energy drinks. They found that effects on the neurological system were variable and most likely due to caffeine. Lower doses of caffeine were associated with increased alertness and reduced fatigue, whereas higher doses were associated with anxiety, tremors and insomnia.

According to the Alzheimer’s Society, there is no strong evidence that caffeine increases the risk of developing dementia. They go on to point out that whilst some studies have shown tea and coffee slightly reduce the risk of dementia, other studies have shown no effect or even a slight increase in the risk.

There have also been reviews looking at specific ingredients (taurine and glucuronate) that are present in many energy drinks, like Prime, that have found no reason for concern with the levels currently used. The European Food Safety Authority published a risk assessment of these same ingredients and concluded that whilst further data may be needed, outstanding concerns about the effects on the brain (and kidneys) had been resolved. Others have highlighted the need to improve monitoring of both single and combination ingredients in energy drinks going forward, as well as setting maximum limits on amounts, volumes and improving labelling for consumers.

It is unclear where the quoted figure of 78.4% increased risk of Alzheimer’s has come from in this claim. Although there has been some research into individual substances present in Prime Energy, scientific data about the long term effects of this specific combination of ingredients is not yet available.

Some researchers have highlighted the need for improving the monitoring of combinations of ingredients in energy drinks and ensuring maximum safe limits are set going forward.

Sugar Free Red Bull and aspartame

Sugar free Red Bull contains caffeine, taurine, vitamins, water and sweeteners. Aspartame was previously listed as an ingredient, however this appears to no longer be the case.

Aspartame is a common artificial sweetener that has been scrutinised recently over concerns regarding its safety. It was given 2B classification by the WHO’s International Agency for Research on Cancer (IARC) in 2023. This classification means that there is limited evidence of an association with cancer in humans, and in particular liver cancer as some studies had suggested. This classification also means that there is insufficient evidence for cancer in animal studies. 

Although some studies have shown an association between artificial sweeteners and cancers, the evidence has been inconsistent. The US Food and Drug Administration has disagreed with the IARC classification of aspartame as a possible carcinogen citing flaws in the evidence that IARC considered.

The WHO Joint Expert Committee on Food Additives (JECFA) has reviewed aspartame safety on three occasions and has repeatedly found that aspartame consumed within the recommended limits does not pose a health concern. These findings are also supported by the European Food Safety Authority.

Sugar Free Monster and caffeine

Like many energy drinks, sugar free Monster has higher levels of caffeine than standard cups of tea or coffee. However, the levels are within the recommended guidelines and overall safety will depend on the number of energy drinks consumed per day as well as other background risk factors that a person might have.

Sugar free Monster contains 160mg of caffeine per can. For context, one standard cup of tea has approximately 75mg of caffeine in it and one mug of coffee contains approximately 100mg of caffeine, but both of these may vary depending on the size and type of tea or coffee consumed. Both the European Food Safety Authority and UK Food Standards Agency advise that there are no safety concerns with adults consuming up to 400mg of caffeine per day (unless they are pregnant). They also agree that single doses of up to 200mg are safe, provided the total daily limit is not exceeded.

Caffeine has several effects on the body including temporarily increasing blood pressure and heart rate. These effects depend on how much is consumed and the effects also depend on an individual’s tolerance. It is also important to note that there are different recommendations for pregnant women and children.

The British Heart Foundation advises that having a moderate intake of caffeine (between four to five cups of tea or coffee per day) should not be damaging for heart health. They also recommend that people who are sensitive to caffeine should consider decaffeinated alternatives or limit their intake of caffeinated products.

The evidence for increased stroke risk is less clear with some studies suggesting a protective effect for certain types of stroke with moderate coffee intake. Further research is needed to determine which components of coffee may be beneficial in stroke prevention.

Image courtesy of James Yarema