Sports and Energy Drinks

PRODUCT UPDATE Column Editor: Maria Karalis, MBA, RD, LDN

Sports and Energy Drinks Kelly Kotke, RD, and Kim Gehrke, RD

T

HE NUMBER OF SPORTS AND energy drinks on the market today is creating quite a stir. It can be a challenge for renal dietitians to stay informed of the abundance of products and to guide chronic kidney disease (CKD) patients appropriately. By law, manufacturers do not have to provide amounts of certain ingredients that may be important to the CKD patient. This issue focuses on the vast array of sports and energy drinks that are enhanced with vitamins, minerals, caffeine, and unique herbal ingredients. Table 1 provides the reader with nutritional information on the most popular drinks. Sports and energy drinks are different from a nutritional standpoint. A sports drink is defined as a beverage designed to help athletes rehydrate and replenish sugar and other nutrients that can be depleted after strenuous training or competition. An energy drink is a beverage designed to give the consumer a burst of energy through a combination of ingredients including caffeine, vitamins, minerals, and exotic herbal ingredients. Some CKD patients may need a sports drink if they are training for or performing in a strenuous sports-related event that depletes their electrolytes and sugar. Energy drinks, if approved by the renal dietitian, may be appropriate for patients who can tolerate them. An endless number of different energy and sports drinks are available today. This Product Update focuses on the most popular beverages found in most retail stores in the Northern California area. In the course of our research, most companies were willing to share the nutritional information requested. However, some compa-

Renal Advantage, Inc., Elk Grove, California. Address reprint requests to Kelly Kotke, RD, Renal Advantage, Inc., 8139 Elk Grove Blvd., Suite 200, Elk Grove, CA 95742.

E-mail: [email protected] 2008 by the National Kidney Foundation, Inc. 1051-2276/08/1802-0014$34.00/0 doi:10.1053/j.jrn.2007.10.034

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Journal of Renal Nutrition, Vol 18, No 2 (March), 2008: pp e1–e8

nies did not have a telephone number listed on their website, e-mails were not returned, or the more detailed information simply was not available. Most energy drinks contain herbal supplements such as guarana, yerba mate leaves, Pannax ginseng, gingko biloba, and milk thistle. When determining if an energy drink is appropriate, it is important to remember that herbal supplements often claim to provide health benefits with minimal scientific evidentiary support. Some herbs may interact with prescription medications and alter their effectiveness or interact in a harmful way. Some patients may be allergic to particular herbal compounds. Please note that the Food and Drug Administration does not regulate these compounds, and the potential for drug/nutrient interactions may be increased with the unique combinations of ingredients in these drinks. Caffeine is also an ingredient meriting special attention. Caffeine is a central nervous system stimulant, causing potential side effects such as heart palpitations, feelings of anxiousness, irritability, restless sleep, and gastrointestinal upset. In comparing energy drinks to caffeinated soda or coffee, soda contains approximately 35 to 55 g of caffeine per 12 ounces, and 1 cup of coffee (6 ounces) contains anywhere from 50 to 200 mg of caffeine. Some energy drinks contain slightly more caffeine, insofar as the serving size listed is based on approximately 8 ounces. Table 1 provides valuable information to the renal dietitian for better educating the CKD patient of the potential consequences of consuming sports and energy drinks, and ultimately for preventing possible toxicity after an excessive intake of vitamins, minerals, or other additives. You will find an ‘‘N/A’’ (not available) in Table 1 for the following reasons: companies were unable to provide all of the information requested; we were unable to find all of the information on their respective websites; or we were unable to reach anyone in the company. This does not imply e1

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Table 1. Nutritional Content of Sports and Energy Drinks Energy Drinks: 8 Ounces

Carbohydrate Sugars Protein Calories (g) (g) (g)

Phosphorus (mg) ND (not detected) ND (not detected) 5.6

Potassium (mg)

1.5

33.7

25

85

0

0

0

0

Vitamins B6, B12, and C

1.2

34.2

90

85

0

0

0

0

Vitamins B6, B12, and C

3.9

38.1

15

84

0

0

0

0

Vitamins B6, B12, and C Vitamins B6, B12, and C Vitamins B1, B2, B6, and E, goji berry juice, guarana, lychee natural flavor Taurine, ginseng, guarana, calcium disodium EDTA, potassium benzoate, orange juice concentrate, ascorbic acid, niacinamide, calcium pantothenate, riboflavin, vitamin B12, pyridoxine, hydrochloride Taurine, ginseng, guarana, calcium disodium EDTA, potassium benzoate, niacinamide, calcium pantothenate, riboflavin, vitamin B12, pyridoxine, hydrochloride Vitamin C, taurine, ginseng, inositol, guarana, milk thistle Vitamin C, taurine, ginseng, inositol, guarana, milk thistle

Sodium Caffeine Vitamin Vitamin Vitamin Vitamin (mg) (mg) A D E K

180 Energy Orange Citrus Blast (8.2 ounces) 180 Orange Sugar Free

120

33

30

0

5

1

0

0

180 Blue Acai

120

31

28

0

180 Blue Acai Low Calorie 180 Red Goji

15

4

1

0

4.4

3.4

39.5

55

85

0

0

0

0

130

31

27

0

4.8

2.18

48.8

25

84

0

0

0

0

AMP Energy Drink

110

29

29

0

34

0

5

65

71

0

0

0

0

AMP Energy Overdrive

110

29

29

0

34

0

1

70

N/A

0

0

0

0

Arizona Green Tea Energy Drink

100

26

25

0

N/A

0

N/A

10

100

0

0

0

0

Arizona Green Tea Low Carb

10

3

3

0

0

0

0

10

100

0

0

0

0

Additional Additives

Manufacturer and Contact Information Anheuser Busch, St. Louis, MO, 800-DIAL-BUD

Pepsi Cola, Purchase, NY, 914-253-2000, www.pepsicola.com

Arizona Beverage Co., Lake Success, NY, 800-832-3775

KOTKE AND GEHRKE

Calcium (mg)

Table 1. Nutritional Content of Sports and Energy Drinks (Continued) Energy Drinks: 8 Ounces

Carbohydrate Sugars Protein (g) (g) (g) Calories

Phosphorus (mg)

Calcium (mg)

Potassium (mg)

Sodium Caffeine Vitamin Vitamin Vitamin Vitamin (mg) (mg) A D E K

Additional Additives

32

32

0

N/A

N/A

N/A

30

100

N/A

N/A

N/A

N/A Guarana

Bawls Guarana Cherry Bawls Guaranex Sugar Free Full Throttle

90

25

25

0

N/A

N/A

N/A

30

100

N/A

N/A

N/A

N/A Guarana

0

0

0

0

N/A

N/A

N/A

35

100

N/A

N/A

N/A

N/A Guarana

110

29

29

0

N/A

N/A

N/A

85

N/A

N/A

N/A

N/A

5

0

0

0

N/A

N/A

N/A

85

N/A

N/A

N/A

N/A

110

29

29

N/A

N/A

N/A

85

N/A

N/A

N/A

N/A

5

0

0

0

N/A

N/A

N/A

85

N/A

N/A

N/A

N/A

0

0

0

0

65

N/A

40

N/A

150

0

0

0

Go Fast Energy Drink

130 (11.9 33 ounces)

30

0

0

0

0

100

120

0

0

0

Go Fast Energy Drink Light

30 (11.9 ounces)

1

0

0

0

0

0

100

120

0

0

0

120

32

32

0

N/A

25

N/A

N/A

N/A

N/A

N/A Taurine, ginseng extract, acacia, glycerol ester of wood rosin, guarana extract N/A Taurine, ginseng extact, acacia, sucralose, glycerol ester of wood rosin, carnitine, guarana extract N/A Taurine, ginseng extract, carnitine fumarate, guarana extract N/A Taurine, ginseng extract, sucralose, guarana extract 0 Super Citrimax, taurine, glucuronolactone, bitamins B2, B3, B5, B6, and B12 0 Australian honey, taurine, ginseng, guarana, milk thistle herb, sucrose 0 Australian honey, taurine, ginseng, milk thistle Herb, sucralose N/A Taurine, Pannax ginseng, glucose, ginkgo biloba, natural caffeine, maltodextrin

Full Throttle Sugar Free

Full Throttle Fury Full Throttle Fury Sugar Free Go Girl Energy Drink

Hansen’s Energy Pro

N/A Not tested for

Bawls, Miami, FL, www.bawls.com (no telephone number)

Coca Cola Co., Atlanta, GA, 800-439-2653

Go Girl, West Sacramento, CA, 800-331-2059

Go Fast Sports, Denver, CO, 800-895-7290

Hanson’s Energy Drinks, St. Corona, CA, 800-HANSENS

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90

PRODUCT UPDATE

Bawls Guarana Drink

Manufacturer and Contact Information

Energy Drinks: 8 Ounces

Carbohydrate Sugars Protein (g) (g) (g) Calories

Phosphorus (mg)

Calcium (mg)

28

28

N/A Not tested for

100

27

27

N/A

N/A

N/A

Monster Lo Carb Energy

10

3

3

N/A

N/A

N/A

Monster Khaos

90

21

21

1

N/A

30

Monster Assault

90

23

23

N/A

N/A

50

Monster M-80

90

23

23

N/A

N/A

50

140

31

31

N/A

N/A

Rockstar (not recommended for children, pregnant or nursing women, or those sensitive to caffeine)

40

N/A

320

Sodium Caffeine Vitamin Vitamin Vitamin Vitamin (mg) (mg) A D E K

Additional Additives

5

N/A

8%

N/A

N/A

N/A Taurine, Pannax ginseng

N/A

180

80

N/A

N/A

N/A

N/A

180

68

N/A

N/A

N/A

N/A

15

80

2,590 IU

N/A

N/A

215

15

80

N/A

N/A

N/A

215

15

80

N/A

N/A

N/A

40

80

N/A

N/A

N/A

N/A Taurine, Pannax ginseng, energy blend (L-carnitine, glucose, caffeine, guarana, inositol, glucuronolactone, maltodextrin) N/A Taurine, Pannax ginseng, energy blend (L-carnitine, glucose, caffeine, guarana, inositol, glucuronolactone, maltodextrin) N/A Taurine, Pannax ginseng, energy blend (L-carnitine, glucose, caffeine, guarana, inositol, glucuronolactone, maltodextrin) N/A Taurine, Pannax ginseng, energy blend (L-carnitine, glucose, caffeine, guarana, inositol, glucuronolactone, maltodextrin) N/A Taurine, Pannax Ginseng, Energy Blend (L-carnitine, glucose, caffeine, guarana, inositol, glucuronolactone, maltodextrin) N/A Energy blend 1.35 g (taurine, ginkgo biloba leaf extract, guarana seed extract, inositol, L-carnitine, Pannax ginseng, milk thistle extract)

N/A

Manufacturer and Contact Information

Monster Beverages, Corona, CA, 866-322-4466

KOTKE AND GEHRKE

120

Rumba Energy Juice (Hansen’s Naturals) Monster Energy

Potassium (mg)

e4

Table 1. Nutritional Content of Sports and Energy Drinks (Continued)

Rockstar, Inc., Las Vegas, NV, 702-939-5535

Table 1. Nutritional Content of Sports and Energy Drinks (Continued) Energy Drinks: 8 Ounces

Carbohydrate Sugars Protein (g) (g) (g) Calories

Phosphorus (mg)

Calcium (mg)

Potassium (mg)

Sodium Caffeine Vitamin Vitamin Vitamin Vitamin (mg) (mg) A D E K

10

0

0

N/A

N/A

N/A

N/A

125

80

N/A

N/A

N/A

Rockstar Zero Carb (not recommended for children, pregnant or nursing women, or those sensitive to caffeine) Rockstar Juiced Energy Guava (not recommended for children, pregnant or nursing women, or those sensitive to caffeine)

10

0

0

N/A

N/A

N/A

N/A

110

120

N/A

N/A

N/A

90

21

20

N/A

N/A

N/A

N/A

30

80

N/A

N/A

N/A

Rockstar Juiced Energy Pommegranite (not recommended for children, pregnant or nursing women, or those sensitive to caffeine) Rockstar Juiced (not recommended for children, pregnant or nursing women, or those sensitive to caffeine)

100

24

23

N/A

N/A

N/A

N/A

25

80

N/A

N/A

N/A

100

23

22

N/A

N/A

N/A

N/A

40

80

N/A

N/A

N/A

Manufacturer and Contact Information

N/A Energy blend 1.35 g (taurine, ginkgo biloba leaf extract, guarana seed extract, inositol, L-carnitine, Pannax ginseng, milk thistle extract) N/A Energy blend 1.27 g (taurine, caffeine, green tea extract, L-carnitine, yerba mate leaf extract)

e5

N/A Energy blend 1.35 g (taurine, ginkgo biloba leaf extract, guarana seed extract, inositol, L-carnitine, Pannax ginseng, milk thistle extract) N/A Energy blend 1.35 g (taurine, ginkgo biloba leaf extract, guarana seed extract, inositol, L-carnitine, Pannax ginseng, milk thistle extract) N/A Energy blend 1.35 g (taurine, ginkgo biloba leaf extract, guarana seed extract, inositol, L-carnitine, Pannax ginseng, milk thistle extract)

PRODUCT UPDATE

Rockstar SF (not recommended for children, pregnant or nursing women, or those sensitive to caffeine)

Additional Additives

Energy Drinks: 8 Ounces

Carbohydrate Sugars Protein (g) (g) (g) Calories

Phosphorus (mg)

Calcium (mg)

Potassium (mg)

e6

Table 1. Nutritional Content of Sports and Energy Drinks (Continued) Sodium Caffeine Vitamin Vitamin Vitamin Vitamin (mg) (mg) A D E K

130

34

33

0

N/A

0

20

95

78

N/A

N/A

N/A

SoBe Adrenaline Rush SF

20

2

0

0

N/A

0

50

240

78

N/A

N/A

N/A

SoBe Essential Energy Orange

120

29

28

0

N/A

0

N/A

15

48

N/A

SoBe Essential Energy Berry Pommegranite

120

29

28

0

N/A

0

N/A

15

48

N/A Not a significant source N/A N/A

SoBe No Fear

130

36

33

1

N/A

0

25

115

87

N/A

N/A

N/A

SoBe No Fear Gold

130

34

33

1

N/A

0

20

110

87

N/A

N/A

N/A

10

1

0

1

N/A

0

30

100

87

N/A

N/A

N/A

0.1

0

Trace

7

85

72

N/A

N/A

10

120

Not a N/A significant source N/A N/A

200

80

SoBe No Fear SF

Tab Energy

Vamp Energy Drink (8.3 ounces) Red Bull Energy Drink (8.3 ounces)

6

0

110

28

27

N/A

N/A

110

28

27

,1

,1

Not a significant source N/A

0

1.2

N/A

N/A

N/A

N/A Taurine, D-ribose, L-carnitine, inositol, guarana, Pannax ginseng N/A Taurine, D-ribose, L-carnitine, inositol, guarana, Pannax ginseng N/A Pannax ginseng root extract, guarana, yerba mate leaf extract N/A Pannax ginseng root extract, guarana, yerba mate leaf extract N/A Taurine, inositol, Pannax ginseng extract, guarana extract, grape seed extract, L-carnitine, L-arginine N/A Taurine, inositol, Pannax ginseng extract, guarana extract, grape seed extract, L-carnitine, L-arginine N/A Taurine, inositol, Pannax ginseng extract, guarana extract, grape seed extract, L-carnitine, L-arginine N/A Taurine, ginseng extract, guarana extract, carnitine

N/A

N/A Taurine, inositol, guarana, ginseng

N/A

N/A Taurine, glucuronolactone, B-group vitamins

Manufacturer and Contact Information Southbeach Beverage Co., Norwalk, CT, 800-588-0548

KOTKE AND GEHRKE

SoBe Adrenaline Rush

Additional Additives

Coca Cola Co., Atlanta, GA, 800-439-2653 TI Beverage Co., Beverly Hills, CA, 310-274-6600 Redbull North America, Inc., Santa Monica, CA, 310-393-4647

Table 1. Nutritional Content of Sports and Energy Drinks (Continued) Energy Drinks: 8 Ounces

Carbohydrate Sugars Protein (g) (g) (g) Calories

Phosphorus (mg)

Calcium (mg)

3

0

,1

50

14

14

0

N/A

Gatorade Thirst Quencher

50

14

14

0

N/A

PowerAde

65

17

15

0

N/A

PowerAde Option

10

2

2

0

N/A

N/A

PowerAde Advance

66

17

15

0

2

N/A

,1

0

,2% of daily value Not a significant source N/A

Sodium Caffeine Vitamin Vitamin Vitamin Vitamin (mg) (mg) A D E K

Additional Additives

10.8

200

80

N/A

N/A

N/A

90

200

N/A

N/A

N/A

N/A

N/A Taurine, glucuronolactone, B-group vitamins N/A

30

110

N/A

N/A

N/A

N/A

N/A

32

53

0

N/A

N/A

N/A

N/A Niacin, B6, and B12

52

0

N/A

N/A

N/A

N/A Niacin, B6, and B12

53

47

N/A

N/A

N/A

N/A Taurine, carnitine, niacin, B6, and B12

33 (contains 6 mg of acesulfame-K) 32

Manufacturer and Contact Information

Gatorade Co., Chicago, IL, 800-884-2864

Coca Cola Co., Atlanta, GA, 800-439-2653

PRODUCT UPDATE

10

Red Bull Energy Drink SF (8.3 ounces) Gatorade Endurance

Potassium (mg)

N/A, not available; EDTA, ethylenediaminetetraacetic acid; IU, International Units; SF, sugar free.

e7

e8

KOTKE AND GEHRKE

that CKD patients should or should not drink these products; it simply means the information was not available, and therefore the authors do not recommend these products until further in-

formation is available. As a case in point, some products contain guarana, an herbal supplement containing caffeine, but the caffeine amount is not listed.