Stay away from energy drinks, doctors say

In a new report, a large group of American doctors urge kids and teens to avoid energy drinks and only consume sports drinks in limited amount.The recommendations come in the wake of a national debate over energy drinks, which experts fear may have side effects.
"Children never need energy drinks," said Dr. Holly Benjamin, of the American Academy of Pediatrics, who worked on the new report. "They contain caffeine and other stimulant substances that aren't nutritional, so you don't need them."
And kids might be more vulnerable to the contents of energy drinks than grownups.
"If you drink them on a regular basis, it stresses the body," Benjamin told Reuters Health. "You don't really want to stress the body of a person that's growing."
For the new recommendations, published in the journal Pediatrics, researchers went through earlier studies and reports on both energy drinks and sports drinks, which don't contain any stimulants.
They note that energy drinks contain a jumble of ingredients -- including vitamins and herbal extracts -- with possible side effects that aren't always well understood.
While there aren't many documented cases of harm directly linked to the beverages, stimulants can disturb the heart's rhythm and may lead to seizures in very rare cases, Benjamin said.
Recently, she saw a 15-year-old boy with attention deficit hyperactivity disorder who came into the hospital with a seizure after having drunk two 24-ounce bottles of Mountain Dew, a soft drink that contains caffeine.
The boy was already taking stimulant ADHD medication, and the extra caffeine in principle might have pushed him over the edge, according to Benjamin.
"You just never know," she said. "It's definitely a concern."
Earlier this year, Pediatrics published another review of the literature on energy drinks.
In it, Florida pediatricians described cases of seizures, delusions, heart problems and kidney or liver damage in people who had drunk one or more non-alcoholic energy drinks -- including brands like Red Bull, Spike Shooter and Redline.
While they acknowledged that such cases are very rare, and can't be conclusively linked to the drinks, they urged caution, especially in kids with medical conditions (see Reuters story of February 14, 2011).
U.S. sales of non-alcoholic energy drinks are expected to hit $9 billion this year, with children and young adults accounting for half the market.
Manufacturers claim their products will enhance both mental and physical performance, and were quick to downplay the February report.
"The effects of caffeine are well-known and as an 8.4 oz can of Red Bull contains about the same amount of caffeine as a cup of coffee (80 mg), it should be treated accordingly," Red Bull said in an emailed statement to Reuters Health.
Benjamin said that for most kids, water is the best thing to quench their thirst. If they happen to be young athletes training hard, a sports drink might be helpful, too, because it contains sugar.
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Vitamins won't prevent pregnancy complication

Alison McCook Reuters

NEW YORK (Reuters Health) - Despite hopes that high doses of vitamins C and E might lower a woman's risk of developing a pregnancy complication marked by high blood pressure, a new analysis of the evidence to date finds no benefit.

After reviewing nine studies including nearly 20,000 women, researchers found that women taking 1,000 milligrams of vitamin C and 400 IU of vitamin E - much higher doses than in most prenatal multivitamins - were no less likely to develop the potentially deadly pregnancy complication known as preeclampsia. Instead, they saw that women given extra doses of C and E had a higher risk of certain other pregnancy complications.

Most doctors do not suggest women concerned about their risk of preeclampsia take these vitamins, and with good reason, study author Dr. Sonia S. Hassan of Wayne State University told Reuters Health. "We are not routinely recommending the use of vitamin C and E, due to the findings of this systematic analysis," she said.

Indeed, this is not the first study to cast doubt on vitamins' ability to curb preeclampsia. Last year, a 4-1/2-year study of nearly 5,000 women found those taking very high doses of vitamins C and E were 10 percent more likely to develop high blood pressure during pregnancy than volunteers taking placebo pills.

Preeclampsia, which is characterized by high blood pressure, protein in the urine and swelling, occurs in about 5 percent of American pregnancies every year. If left untreated, it can lead to severe - and sometimes fatal - complications for the woman and baby.

Some past studies have found a connection between vitamin C deficiency and an elevated risk of preterm birth, including those caused by what's known as premature rupture of membranes -- where a woman's "water breaks" before the pregnancy has reached full-term and labor has begun.

Vitamin C has been thought to play a role in maintaining the placenta and the membranes that surround the fetus during pregnancy, possibly by limiting so-called oxidative stress -- vitamins C and E are both "antioxidants."

So researchers have been studying whether they might help lower the risk of not only preterm birth but also preeclampsia.

However, the current study - in which Hassan and her colleagues combined results from nine studies including 19,810 pregnant women - found that 9.6 percent of women overall developed preeclampsia, regardless of whether they received extra doses of C and E or a placebo drug.

It's not clear why taking antioxidants doesn't reduce women's risk, said Hassan, who is also based at the Perinatology Research Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, along with her co-authors Dr. Agustín Conde-Agudelo and Dr. Roberto Romero. "It is likely that although oxidative stress seems to play a major role in the disease of preeclampsia, it may not play a major role in the pathway that leads to preeclampsia."

In addition, those taking higher doses of vitamins C and E were more likely to develop high blood pressure without the protein in urine and other hallmarks of preeclampsia, and to experience a premature rupture of membranes.

Women given extra C and E did, however, have a lower risk of abruptio placentae, in which the placenta detaches from the uterine wall, the authors report in the American Journal of Obstetrics & Gynecology.

This is an interesting result, Hassan said in an email. "The finding of the decreased risk of abruptio placentae in women receiving vitamins C and E certainly may provide some insight into potential causes of abruptio placentae and can guide areas of future research."

More than 10 years ago, Dr. Lucy Chappell at King's College London co-authored a study suggesting extra vitamin C and E could help prevent preeclampsia, but large studies conducted since have convinced her otherwise, Chappell told Reuters Health. "These findings should persuade women that they should not take vitamins C and E at these high doses."

Chappell explained in an email that her study was small, and therefore the results may have been due to a "chance statistical finding." Since the results fit all the biological theories, however, they were "jumped on with gusto," she said. However, "many initial promising studies turn out to be less so when repeated in larger numbers."
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