THE WASHINGTON POST – A second death linked to a caffeinated “Charged Lemonade” drink sold by the cafe-bakery chain Panera Bread has raised questions about the safety of ultra-caffeinated drinks and how much caffeine is too much.
On Monday, the family of a 46-year-old man in Florida filed a wrongful-death lawsuit against Panera, alleging that he died after drinking three caffeinated lemonade drinks. It’s the second lawsuit levied against Panera this year over its lemonade.
In October, the parents of a 21-year-old college student in Pennsylvania also filed a lawsuit after their daughter, who avoided energy drinks because of a cardiac condition, suffered fatal cardiac arrest after consuming the lemonade.
An estimated 85 per cent of Americans drink at least one caffeinated beverage a day. Energy drink sales are also on the rise, and so are their doses of caffeine.
But experts say that a person’s tolerance for caffeine – as well as its benefits or risks – can vary widely, depending on their habits, size, overall health and other factors.
Here’s what to know about caffeinated drinks.
How much caffeine is in Panera’s ‘Charged’ Lemonade?
Panera promotes a line of caffeinated cold lemonade beverages as “charged sips,” including flavours such as “mango yuzu citrus” and “fugu apple cranberry.” The drinks have been offered in self-service dispensers, with free refills for Panera Unlimited Sip Club members.
Both the Florida man and Pennsylvania student who died after drinking the lemonade were Unlimited Sip Club members, according to the lawsuits.
A 30-ounce, large-size Panera Charged Lemonade has about 390 milligrams of caffeine, about four times the amount found in a cup of coffee.
The caffeine content is “exceptional,” according to Jennifer Temple, director of the Nutrition and Health Research Laboratory at the University of Buffalo in New York. She said that the drink stands out in that it was sold with the potential for free refills in a self-dispenser, and in much higher volumes than most energy drinks.
Monster, one of the larger energy drinks on the market, is served in 16-ounce cans, with about 164 milligrams of caffeine.
“Even if the caffeine content per millilitre of liquid is similar, the amount that you’re getting when you’re pouring into these large cups is much more than you would get in a commercial energy drink,” Temple said, adding, “I can’t think of another example where you can kind of self-dispense an energy drink.”
A Panera spokesman said the company “expresses our deep sympathy for Mr Brown’s family” but disputed the merits of the lawsuit. “Based on our investigation, we believe his unfortunate passing was not caused by one of the company’s products,” the spokesman said.
“We view this lawsuit, which was filed by the same law firm as the previous claim, to be equally without merit. Panera stands firmly by the safety of our products.”
How much caffeine is too much?
For healthy adults, the Food and Drug Administration recommends no more than 400 milligrams of caffeine per day, an amount it says is generally not dangerous or associated with negative effects. That’s equivalent to about four cups of coffee, six shots of espresso or two cans of Prime energy drink. Black and green tea have even less caffeine per cup.
Who should limit caffeine intake?
People with certain medical conditions are advised to limit or avoid caffeine. Pregnant people are generally advised to limit caffeine to no more than 200 mg daily – about two cups of coffee a day. Caffeine passes through the placenta to the developing foetus and has been linked to miscarriage, preterm birth and low birth weight.
As with other stimulants, it’s possible to overdose on caffeine. Symptoms of a mild overdose include headache, fever, nausea, tinnitus, insomnia and anxiety.
In more severe cases, people may experience vomiting, chest pain, confusion and seizures – symptoms that would warrant a visit to the hospital, according to experts.
“Caffeine is a drug and does have addictive properties,” said David Ma, a professor of human health and nutritional sciences at the University of Guelph in Ontario.
“If it’s consumed in moderation, great. But people are not drinking small cups of coffee anymore,” he said. “And energy drinks are consumed fairly rapidly.”
Fatal caffeine overdoses are extremely rare, but they have been reported. Facebook groups have been created for people who say they “lost loved ones because of caffeine poisoning.”
For the average healthy adult, a lethal dose of caffeine would be about 10 grams, or 150 mg per kilogram of body weight, according to Temple. That amount – equal to about 60 Monster drinks – is incredibly difficult to consume through liquids but is more likely with caffeine powder or pill supplements, she said. For people with underlying heart problems, dangerous effects can happen at “much lower doses,” she added.
Are there benefits to drinking caffeine?
Caffeine can enhance a person’s energy, alertness, ability to concentrate and reaction time. Some research also suggests it can help with memory and decision-making, though results have been mixed.
But the vast majority of research involving caffeine has focused on coffee. While the beverage has several documented health benefits, it can be difficult to untangle which components of coffee play a role in its therapeutic properties.
“There are quite a number of different compounds in coffee that are attributed to its beneficial effects,” Ma said. “The question then is: Is it caffeine specifically that has all these beneficial properties?”
Coffee is known to contain Vitamin B2, magnesium, polyphenols and other compounds that have antioxidant properties. Research suggests it can be therapeutic for liver disease and can reduce risk for heart disease, diabetes and some cancers. Drinking three to five cups a day “has been consistently associated with a reduced risk of several chronic diseases,” according to Harvard University’s TH Chan School of Public Health.
Energy drinks have the potential to be a performance enhancer – or a treat that simply elevates mood – but most contain a high amount of sugar to offset caffeine’s bitterness, and some may have stimulants added to them.
“They’re not providing any nutritional value that support health and well-being. They’re providing a lot of empty calories,” Ma said. But “if you’re a student, sometimes you may feel like you need one for an exam coming up.”
How does caffeine affect children?
There’s limited research on how children are affected by caffeine, but most experts believe that it can be harmful.
Children under age 12 are advised not to consume it at all, according to the American Academy of Child and Adolescent Psychiatry, and those between ages 12 and 18 should limit their intake to 100 mg a day.
“A lot of times in research, we think of kids as tiny adults, and we don’t understand that their body and brains may operate differently,” Temple said. But “one of the things we know that caffeine does in everybody is it can disrupt sleep.”
US lawmakers have expressed concerns about the marketing of energy drinks to teens, and the American Medical Association has supported a ban on such marketing to minors. Some countries – such as Britain, Latvia, Lithuania and Turkey – have placed age restrictions on the sale of energy drinks.
Is caffeine regulated?
Naturally occurring caffeine, such as that found in coffee or tea, is generally not regulated. The U.S. government considers most energy drinks a dietary supplement. The agency requires that companies ensure their products contain an amount of caffeine that is “safe,” but explicit limits are placed only on carbonated drinks or “cola-type beverages.”
There are no clear guidelines for labelling a beverage an energy drink, which the FDA considers to be a marketing term. All non-drug products – whether they are considered a beverage or a supplement – are required to list added caffeine on the ingredients label, but the specific amount doesn’t have to be disclosed. Energy drink companies that are part of the American Beverage Association, however, do disclose the amount of added caffeine.
If you’re worried about your caffeine intake, experts recommend slowly tapering it down to avoid headaches or cutting intake in half each day. Most people take about three to seven days to completely withdraw from the stimulant, Temple said. Quitting cold turkey is also safe, she added.
“Caffeine withdrawal is not going to kill you,” she said. “It will be very unpleasant for a few days, but then you will be fine.”
