Vanyiam


 * 5-Hour Energy: Is it Worth Taking?**

The use of caffeinated beverages has increased significantly throughout the years. Of these energy drinks, 5-Hour Energy has arguably gotten the most amount of attention along with Monster. What makes 5 -Hour Energy unique is the amount of caffeine (compound 5) that is contained inside despite its very small stature. 5-Hour Energy bottles are only 1.93 ounces, yet the "regular" bottles contain over 200 mg of caffeine (compound 5). A recent study was conducted on 5-Hour energy which showed that it can improve important aspects of cognitive function for up to 6 hours. The main issues regarding 5-Hour Energy however, is where the energy actually comes from. 5-Hour Energy doesn't contain any carbs, and to have the energy that the beverage provides last for that length of time, the drink has to have carbs [Cohen, “Is 5-Hour Energy bad for you?”]. That leads one to consider whether the B-vitamins in these energy drinks contribute in providing energy. However, there is no evidence that suggests B-vitamins specifically provide energy despite the large percentage of them that are contained in 5-Hour Energy. Rather, they are primarily used to help the body to produce energy by breaking down food within the body. That leaves caffeine (compound 5) as the primary source of energy and most other energy drinks obtain their energy boosting properties primarily from sugar and caffeine. 5-Hour Energy however, contains no sugar at all and has slightly over 200 mg of caffeine and that by itself is not enough to help the average human get through an entire day [Cohen, “Is 5-Hour Energy bad for you?”]. However, it is still unclear as to which ingredients specifically produce energy for this length of time. The amount of evidence that is lacking for some of the ingredients and B-vitamins listed in 5-Hour Energy, as well as detail on where the "5 hours of energy" actually comes from, brings up the question of whether it is even worth taking.
 * Abstract**

Since the introduction of Red Bull in Austria in 1987 and the United States in 1997, the energy drink market has grown exponentially [Reissig 2009]. Energy drinks are beverages that contain large doses of caffeine and other legal stimulants such as taurine, carbohydrates, glucuronolactone, inositol, niacin, panthenol, and B-complex vitamins [Atilla and Cakir 2011]. Energy drinks have been found to improve attention and/or reaction times and indices of alertness in some studies [Atilla and Cakir 2011].
 * Introduction**

5 hour energy is a flavored energy drink which is typically sold in small 2 oz bottles or “shots” as most people call it. The brand was made by Living Essentials in Wabash, Indiana and was introduced to the public in 2004 [“5-Hour Energy,” Wikipedia]. The company does not disclose the amount of caffeine in each bottle, but a recent article published by Consumer Reports placed that level at about 6 to 242 milligrams per serving. It is usually taken by people who intend to negate the effect of sleepiness and increase alertness and energy. It is sold in three different types of bottles: original, decaf, and extra strength. The original 5-hour energy shot comes in various flavors including raspberry, grape, pink lemonade, berry, orange, and many more. The original energy shot Contains caffeine (compound 5) comparable to a cup of the leading premium coffee [“5-Hour Energy,” product directions]. The original also contains various types of B-vitamins along with other ingredients. The Decaf 5-Hour energy shot was made for people who don’t like caffeine (compound 5) but are still looking for a boost in energy. The Decaf contains 6 mg of caffeine which is about as much as a half cup of decaffeinated coffee [“5-Hour Energy,” product directions]. The Decaf is similar to the original containing the same ingredients and B-vitamins with the exception of Niacin (compound 4). The Extra Strength is for people who are really looking to get a major boost of energy. The Extra Strength energy shot Contains caffeine (compound 5) comparable to 12 ounces of the leading premium coffee [“5-Hour Energy,” product directions]. This also contains the same ingredients and B-vitamins as the original with the only exception being an additional amount of Niacin (compound 4).



An analysis that was done in 2010 by ConsumerLab.com also supports this info. as it found that 5-Hour Energy contains about 207 milligrams of caffeine [ConsumerReports.org]. The main selling points for 5-Hour Energy are that it immediately provides five hours of energy with no sugar crash after, that it has no sugar, and that it has zero net carbs. The most important selling point that all 5 Hour-Energy ads seem to include is that there is no energy crash that typically occurs after the effects of an energy drink wears off [Cohen, “Is 5-Hour Energy bad for you?”]. 5-Hour Energy doesn’t come with any crash because it doesn't contain any sugar. Sugar is a major source of energy for the brain, muscles, red blood cells, and other cells of the body. It is also an essential component of normal functioning of the Central Nervous System [Rath 2010]. The claims of 5-Hour Energy are very unrealistic considering these facts. With no carbs or sugar, it makes one wonder if the “energy” in this shot is coming primarily from the other ingredients.

Young men are the most likely to consume energy drinks and shots but the range among adults between the ages of 25-45 is growing. Young people ages 12-17 consume about 5 cans of energy drinks every month. According to a recent US survey, the primary target for the marketing of energy drinks is young adults and teens. This survey shows that 34 % of young adults aged 18–24 and 31 % of adolescents aged 12–17 consumed these drinks, as opposed to only 22 % of adults aged 25–34 and a mere 3 % of people aged 65 or more [Gallimberti 2013]. Although energy drinks are mainly targeted to young adult consumers, there has been little research regarding effects of energy-drink consumption by college students and the potential for related health hazards [Atilla and Cakir 2011]. Observations have suggested that young adults can easily access energy drinks and use energy drinks frequently, but there is barely any evidence on the reasons why they consume energy drinks and whether they are aware of the potential health hazards [Atilla and Cakir 2011].
 * Demographic**

Figure 1 shows how regularly energy drinks are consumed according to age and sex. Among the males, roughly 50% of kids in eighth grade consumed energy drinks less than once per week compared to the 18.6% of sixth graders and 34% of seventh graders who drank less than once per week [Gallimberti 2013]. The numbers of kids who drank at least once per week was much lower than those who drank less than once per week. However, the trend remained the same as the amount of people who drank increased as they got older.



It's clear that energy drinks have indeed become popular among younger kids. Thanks to clever marketing strategies, energy drinks represent a rapidly expanding segment of the beverage industry, and 31% of people between the ages of 12-17 have been reported to be regular consumers of these drinks [Gallimberti 2013]. Other studies have shown that 30.6% of individuals between the ages of 17-29 consume energy drinks regularly [Gallimberti 2013]. One interesting factor associated with the use of energy drinks among adolescents is that a majority of them also consume alcohol and smoke cigarettes [Gallimberti 2013]. The combined use of caffeine (compound 5) and alcohol is increasing sharply, and studies suggest that such combined use may increase the rate of alcohol-related injury [Reissig 2009].

A recent study was done which was designed to evaluate the effects of an energy shot [5-Hour Energy] compared to placebo on major aspects of cognitive function, alertness and mood in volunteers that were fatigued due to partial sleep deprivation. The placebo contained a mixture of water, Berry flavour, Sucralose (Splenda), Citric acid, Potassium sorbate, and Sodium benzoate as shown in Table 1. The study assessed whether 5-Hour energy would affect these aspects of cognitive function and mood despite the fact that it does not contain any carbs. This study was conducted over a 6 hour time period and the volunteers were requested to limit their sleep to between three and six hours the night before each testing day. 94 volunteers (54 male and 40 female) between the ages of 18 and 55 were selected.
 * 5-Hour Energy Study**



The CDR System (which is an integrated set of computerized cognitive tests designed for use in clinical trials) was selected as the instrument to assess cognitive function in this study [Wesnes 2013]. Five factors that were tested were //Power of Attention//, //Continuity of Attention//, //Quality of Working Memory//, //Quality of Episodic Secondary Memory//, and //Speed of Memory//. The following terms are defined in the paper. [|doi]. The effect sizes of the differences between the energy shot and placebo are presented in figure 2. The largest effect sizes were seen for Power of Attention and Continuity of Attention. The overall effect size of the benefit for Power of Attention was 0.37, a small to medium effect, and for Continuity, was 0.51, a medium sized effect [Wesnes 2013]. The peak benefit for Power of Attention occurred at 1 hour, the effect size being medium at that time; while for Continuity, the peak occurred at 6 hour, being a medium to large effect size [Wesnes 2013]. For Reaction Time Variability, Quality of Working Memory and Quality of Episodic Memory, the effect sizes were in the small to medium range [Wesnes 2013]. Speed of Memory displayed the smallest effect sized benefits.



A questionnaire that focuses on Self-ratings of alertness, calmness and contentment, were measured through The Bond-Lader Visual Analogue Scales (VAS). Each score had a significant main effect of treatment, but for Alertness and Contentment there were also significant interactions with time [Wesnes 2013]. The effect sizes of these changes are displayed in figure 3. For Alertness this interaction can be seen to reflect an increase in feelings of alertness over placebo and baseline for the first 4 hours after dosing, after which the effects were not statistically different to placebo [Wesnes 2013]. For Contentment, a similar pattern can be seen, significant increases in this measure occurring over the first 4 hours [Wesnes 2013]. Calmness showed a small overall decline with energy shot compared to placebo.



The results from this study indicate that the 5-Hour Energy shot helped maintain attentional focus, concentration, information processing and vigilance over the 6 hour period [Wesnes 2013]. This indicates 5-Hour Energy will facilitate performance on a range of everyday tasks in partially sleep deprived volunteers.

5-Hour Energy contains a mixture of B-vitamins including vitamin B6 (compound 3), vitamin B12 (compound 1), vitamin B3 (compound 4), and vitamin B9 (compound 2). It also contains a blend of other ingredients such as citicoline, tyrosine, phenylalanine, taurine, and caffeine which is the most important ingredient. Energy drinks containing caffeine, taurine, and glucose may improve mood and cognitive performance. However, there are no studies assessing the individual and interactive effects of these ingredients [Giles 2012]. The ingredients which I would like to focus on primarily are caffeine and B-vitamins since those are the most significant ingredients contained in 5-Hour Energy.
 * Ingredients**

The B-complex vitamins, including B3 (compound 4), B6 (compound 3), and B12 (compound 1), are obtained from the diet and are required for optimal brain functioning and the production of neurotransmitters [Herbison 2012]. The vitamins contained within 5-Hour Energy are Vitamins B3 (compound 4), B6(compound 3), B9 (compound 2), and B12 (compound 1) as shown in the compounds above. The B vitamins regulate energy metabolism by modulating the synthesis and degradation of carbohydrate, fat, protein, and bio-active compounds [Lukaski 2004]. The TV ads for 5-Hour Energy claim that the combination of the B-vitamins will provide energy to help you get through your day. The only problem with this statement however, is that there is no evidence that actually proves B-vitamins can increase energy levels. B-vitamins assist the body in using energy but no evidence has shown them to be able to use energy. B vitamins are often called the energy vitamins, but they are more like keys that unlock it [Lawson, “Vitamin B: A Key to Energy]. In other words, the B-vitamins help the body convert food into fuel which is used to produce energy.
 * B-Vitamins**

The B vitamins play essential roles in the complex biochemical machinery that breaks glucose into ATP, releasing energy from the food we eat [Dennett, “Vitamin B for energy? Not so fast”]. In adults, low B-vitamin status (in particular folate and vitamins B6 and B12) has been associated with internalizing behavioral problems such as depression [Herbison 2004]. If you have an adequate amount of B-vitamins however, then your body will simply secrete the excess in your urine [Dennett, “Vitamin B for energy? Not so fast”]. A low intake of B-vitamins could be associated with increased mental health and behavioral problems in adolescence [Herbison 2004]. B-vitamins are water soluble which means they will leave the body through the urine. B-vitamins aren't typically toxic but consuming large amounts can cause nerve damage. Consuming a lot of B-vitamins will not provide a boost in energy unless the individual is deficient in B-vitamins. Most individuals get the B-vitamins they need through a varied diet. Foods typically rich in B-vitamins include fish, meat, eggs, and dairy products. They can also be found in leafy green vegetables, beans, and whole grains.

Vitamin B12 (compound 1) is a water-soluble vitamin that helps in the production of DNA and RNA. It is naturally present in some foods such as fish, meat, eggs, and milk products and is also available as a dietary supplement. Vitamin B12 has the highest concentration in the drink containing 8,333% of a persons daily recommended amount. This number might seem alarming and unsafe to most people but since there is barely any toxicity from high doses of B12 and is easily passed out of the body, it is safe to consume. Advertisements often promote vitamin B12 supplements as a way to increase energy or endurance. Except in people with a vitamin B12 deficiency, no evidence shows that vitamin B12 supplements increase energy or improve athletic performance ["Vitamin B12,"]. A randomized placebo controlled study including 140 individuals with an increased plasma methylmalonic acid, was done to assess the cognitive function and symptoms of depression to evaluate the effect of vitamin B12 [Anne-Mette 2004]. The result was that a high prevalence of cognition impairment among individuals was found with biochemical signs of vitamin B12 deficiancy. However, vitamin B12 treatment did not improve cognitive function or symptoms of depression [Anne-Mette 2004]. No studies have shown that B12 produces a significant increase in energy.
 * Vitamin B12**

Vitamin B9 (compound 2),also known as Folic Acid, is another vitamin that plays a role in synthesizing DNA and RNA. Foods that are rich in Folic Acid include leafy green vegetables (spinach, broccoli, and lettuce), beans, and fruits. It can also reduce blood levels, and also helps in preventing heart disease and stroke. The results to these experiments were based on studies of individuals without dementia to determine if there would be any prevention on cognitive decline. In one trial, out of 128 patients who were given folic acid and B12 or placebo, there was no change in cognitive function after 12 weeks of treatment [Wald 2010]. Another trial that was conducted involved 340 patients with Alzheimer’s disease. There was also no effect of B vitamins (folic acid, B6, and B12 combined) in slowing cognitive decline after 18 months of treatment [Wald 2010]. Folic acid may have other health benefits however, such as the treatment of folate deficiency anemia or the prevention of stroke. Although Folic acid cannot be recommended for the prevention of cognitive decline, clinicians can confidently use folic acid supplementation for other health reasons without expectation that this would cause harm [Wald 2010].
 * Vitamin B9**

Vitamin B6 (compound 3) is important in helping to produce amino acids. Amino acids are used in synthesizing DNA and are also very useful elements that helps in building protein blocks needed by the human body. A study was conducted on male Wistar rats to determine the effects of vitamin B6 on memory retrieval. The rats were divided into three groups. The first group received Saline while the other two groups received either 50 or 100 mg/kg of vitamin B6 every other day for one month prior to the actual trials. The results, as shown in figure 2 below, the rats who were administered vitamin B6 had a greater increase of memory. The memory enhancing effect of vitamin B6 was found to be dose dependent [Marjan 2012]. The administration of a pre-treatment with vitamin B6 at 100 mg/kg every other day for 1 month prior to training induced a significant increase in the memory retrieval of the rats compared with the control group in the first retention test [Marjan 2012]. Vitamin B6 50 mg/kg also increased memory retrieval compared with the control group but the effect was not significant [Marjan 2012]. Vitamin B6 at 100 mg/kg significantly increased memory retrieval in the second and third retention tests of the passive avoidance paradigm, compared with the control [Marjan 2012].
 * Vitamin B6**



Vitamin B3 (compound 4), also known as Niacin, which converts fats, carbs, and proteins into useful energy that our body needs. Foods rich in niacin include mixed dishes rich in meat, fish or poultry, whole or enriched grain cereal and bread products, and most fresh foods [Flore 2006]. Niacin exists mostly as NAD+ and NADP+ in the diet [Flore 2006]. NAD+ deficiency leads to a decrease in DNA repair, decreased mitochondrial membrane potential, decreased ATP synthesis, decreased glycolysis and increased inflammation signaling [Flore 2006]. The company warns that some users who are sensitive to vitamin B3 may experience a "Niacin Flush," which can cause skin redness. A study examined whether dietary intake of niacin was associated with development of Alzheimer's disease and cognitive decline. The results showed that energy adjusted niacin intake had a protective effect on development of AD and cognitive decline [Morris 2004].
 * Vitamin B3**


 * Caffeine**

In energy drinks caffeine (compound 5) is regulated as a food additive but its drug status is complicated by the fact that it occurs naturally in foods such as coffee and chocolate [Kroll 2012]. Caffeine is an easily obtainable drug with which there is little knowledge by individuals for the potential effects it can have on student health, academic performance, and overall well-being [Rath 2012]. Caffeine enhances alertness and performance in studies with explicit sleep deprivation, restriction, or circadian sleep schedule reversals. But, under conditions of habitual sleep the evidence indicates that caffeine, rather than enhancing performance, is merely restoring performance degraded by sleepiness [Roehrs and Roth 2008]. Caffeine is arguably the most important ingredient that 5-Hour Energy contains primarily because it’s where the bulk of the energy comes from. Caffeine is the world’s most psychoactive drug, which acts as a central nervous system stimulant, temporarily warding off drowsiness and restoring alertness [“Caffeine,” Wikipedia]. Caffeine mainly comes from dietary sources such as coffee or tea and common sources for young teens and adolescents comes from chocolate bars and soft drinks.

Many studies have shown that consuming caffeine (compound 5) can increase alertness, ability to concentrate, problem-solving ability, and help you stay awake. As mentioned earlier in this paper, each type of 5-Hour energy shot; Original, Decaf, and Extra Strength each contain their own relative amounts of caffeine in each shot. Original contains caffeine similar to a cup or premium coffee, Decaf contains caffeine similar to half a cup of decaffeinated coffee, and Extra Strength contains caffeine similar to 12 ounces of premium coffee. Caffeine helps to increase time-to-exhaustion, promote a greater work capacity, and reduce perceived exertion [Volk and Creighton 2013]. Studies have shown that caffeine dependence develops at relatively low daily doses and after short periods of regular daily use [Roehrs and Roth 2008]. The blood also hits its peak with caffeine consumption after 30-75 minutes. As most things do, Caffeine weakens over time so it’s recommended that athletes who want to use it to maximize their performance should stay away from it at least 7 days prior to the athletic event [Volk and Creighton 2013].

Caffeine (compound 5) is a drug, capable of providing us with mental alertness but at higher doses can make us anxious, shaky, and have gastrointestinal problems such as diarrhea [Kroll 2012]. In addition to benefiting physical performance and endurance, caffeine directly supports the central nervous system [Glade 2010]. The popularity of beverages containing caffeine is widely attributed to the fact that it improves alertness and the general sense of well-being.
 * Positive and Negative effects of Caffeine**

Alertness is often reduced by minor illnesses such as the common cold along with sedative drugs such as alcohol. Recent research has shown that caffeine (compound 5) can remove the impaired performance and negative mood associated with these illnesses [Smith 2002]. Considering the effects of caffeine on attention it can be carefully concluded that caffeine seems to have a general, positive effect. The information processing system seems to be modified to process relevant stimulus characteristics more effectively [Lorist and Tops 2003]. The most noticeable effects of caffeine has arguably been that it would be expected in situations of lowered arousal or fatigue, or in tasks placing high demands on controlled processing, or conditions with explicit attentional demands [Lorist and Tops 2003].

However, the consequences of chronic consumption also include complex effects on the central nervous system that predispose to headache and substance dependency [Shapiro 2007]. The health effects of caffeine (compound 5) have both short term side effects and long term. The short term side effects experienced from mild caffeine consumption include headache, nausea, and anxiety [“Health effects of caffeine,” Wikipedia]. Fatigue and depression could often occur after discontinuation of having caffeine. The long term side effects associated with moderate caffeine consumption include development of Parkinson’s disease, type 2 diabetes, hepatic diseases, and cardiovascular disease [“Health effects of caffeine,” Wikipedia]. Too much caffeine can also cause nervousness, trouble with falling asleep, and increase in blood pressure. Caffeine toxicity is another occurrence that is also a possibility. Common features that are noticed with caffeine intoxication include nervousness, anxiety, restlessness, and in rare cases, even death [Rath 2012].

The label warns against drinking more than two bottles daily. It also advises to avoid it if you're pregnant or nursing, and don’t give it to kids [ConsumerReports.org]. It is recommended to drink a 5-Hour Energy right before eating a meal. The caffeine and B Vitamins help to convert proteins, carbs, starches, and fats from the meal into energy which is why the added food element can help produce a better energy boost and extend its effectiveness [Cohen, “Is 5-Hour Energy bad for you?”]. Another thing that is dangerous in these drinks is that they also contain various combinations of vitamins and amino acids, with some vitamins far exceeding recommended daily values [Kroll 2012]. One has to be careful when it comes to the B-vitamins in 5-Hour Energy because even though they are water-soluble and easily passed out of the body through the urine, it is still possible to overdose on B-vitamins. What they forget to state is that you must consume a mega-dose amount of water to fully allow your body to get rid of the excess B Vitamins [Cohen, “Is 5-Hour Energy bad for you?”]. The symptoms from overdosing on B Vitamins include headaches, dizziness, fainting, and temporary nerve/brain damage [Cohen, “Is 5-Hour Energy bad for you?”].
 * Safety**

5-Hour energy has gotten some reports of symptoms such as dizziness, anxiety, nausea, and seizures dating back to 2005. Since 2009, 5-Hour Energy has been mentioned in some 90 filings with the F.D.A., including more than 30 that involved serious or life-threatening injuries like heart attacks [Meier 2012]. As shown in Table 1 below, 5-Hour Energy has reported systems of dizziness, headache, dehydration, and death. However, just because these deaths were reportedly people who used 5-Hour Energy doesn’t necessarily mean that it was the drink that caused the reported deaths and hospitalizations. The major problem is that these reports don’t list other very important information such as weight, age, pre-existing conditions such as heart disease, or any indication of drugs or dietary supplements that might have contributed to these adverse reactions [Kroll 2012].



While Food Products such as bread, milk and cereal and Dietary Supplements (such as 5-hour Energy or your daily multivitamin] do not require FDA “approval” both are regulated and monitored by the FDA [Myths about 5-Hour Energy]. 5-hour ENERGY is regulated by the FDA per the Dietary Supplement Health and Education Act (DSHEA) of 1994 (Myths about 5-Hour Energy). The 2007 FDA rules require that dietary supplements follow standards called Good Manufacturing Practices (GMPs) with which 5-hour Energy complies fully [Myths about 5-Hour Energy]. So even though the FDA does not technically "approve" of 5-Hour Energy, it is still strictly regulated by them.

The primary reason that most people would choose to take 5-Hour Energy is because it’s a source of caffeine that's easily accessible and very easy to carry. The concentrated versions of the shots also make it easier for one to take large doses of caffeine without the bulk of all the other liquid found within the energy drinks [Kroll 2012]. The fact that it doesn’t contain much calories or sugar is also appealing to most people who consume it. When taken alone, 5-Hour Energy provides very little benefits and can result in overdosing on B Vitamins. The excess in B vitamins doesn't cause significant harm unless it's drank often in a short period of time. But when consumed right before or after a meal and while drinking lots of water 5-Hour Energy can be extremely beneficial. [Cohen, “Is 5-Hour Energy bad for you?”].
 * Conclusion**

However, there is barely any information explaining exactly how 5-Hour Energy chose the mixture of the ingredients contained in the energy shots so it’s generally safer to avoid such things if there’s a better alternative. Any substance that contains a lot of caffeine combined with other processed chemicals can trigger unpredictable reactions or changes in the body. The F.D.A. has even stated that it does not have sufficient scientific evidence to justify changing how it regulates caffeine or other ingredients in energy products [Meier 2012]. The recommendation however, would be to take a nap or exercise if one is feeling tired. Even though the majority of the ingredients have not been proven to be very harmful, it’s still risky having to resort to a drink loaded with caffeine, B-vitamins, and other mixtures of ingredients that hasn't been adequately tested. Other suggestions that can help build energy levels naturally are eating several small meals throughout the day rather than three large ones, avoid large amounts of fat and sugar, exercise regularly, and make sure you are getting enough sleep each day.

"5-hour Energy." Wikipedia. Wikimedia Foundation, 21 Nov. 2013. Web. 26 Nov. 2013. [|link]
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