NUT 11 UC Davis Energy Drinks and Their Impact on Cardiovascular System Paper 1. Copy and paste the URL for your news article into the comments section. 2

NUT 11 UC Davis Energy Drinks and Their Impact on Cardiovascular System Paper 1. Copy and paste the URL for your news article into the comments section.

2. Upload a PDF of your entire news article named “News.pdf”. Note: To capture a webpage, right-click and select print. Then under your printer options, choose “Save as PDF”.

3. Upload a PDF of your original research article named “ORA.pdf”.

4. Upload a PDF of your review article named “Review.pdf”.

5. If you used any additional articles, be sure to upload them as well.

6. Upload your final paper with reference list as a Word file. Name the file by your last name (for example: “Ruiz.docx”). NitN: Final Paper Guidelines NUT11
Nutrition research is frequently presented in the news. Sometimes the information presented is vague
or contradictory to other articles, so how do you know what to believe? The overarching purpose of
this group of assignments is for you to investigate and think critically about how the news interprets
and reports nutrition science. You may find that the news correctly reports the outcomes of a
scientific article; however, you may also find that the news either misinterprets or drastically
overemphasizes the size or importance of the reported results.
Note: In order to ensure that all university grade submission deadlines are met, we can only accept
final papers up to 24 hours late unless there is a valid and documented reason for late submission.
For this assignment, you will be writing your final paper based on your outline. Don’t forget to look
at any comments your TA has given you for improvement! The paper must be in your own words.
General Notes:
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750 ± 100 words (about 3 pages). Don’t forget to put the word count in the header.
Double spaced, 12pt font, 1 inch margins.
In-text citations and a reference list using the AMA style guidelines.
Sources (at minimum):
o News article
o Original research article
o Review article
You are not required to have a certain number of technical terms; however, if you use a
technical term remember to define it.
Upload PDFs of all of your articles.
Upload your paper as a Word document to Canvas.
Title: Give your paper a creative and catchy title.
Introduction: State the overall claim being made by the news article. Introduce the health or
performance issue and the influencing factor that are being addressed in the news article. Provide
information on why the health or performance issue is important, as well as some information on
how the influencing factor may be linked to the health or performance issue.
Body Paragraphs: The body of your paper should first summarize and describe the stance of the
news article. Then introduce and describe the original study presented in the research article. As
with your other written assignments, you do not need to describe every detail of the study. Consider
the important aspects of study design (intervention, dosage, duration, and important subject
characteristics), variables and how they were measured, and the main results. Critically evaluate how
the media reported the science. Are the results correct? Is the significance of the results stated in the
NitN: Final Paper Guidelines NUT11
media reflective of the actual results? Are there other results that the news article did not mention
that they should have? Are there methodological flaws in the study that the news failed to consider?
Finally, discuss the broader context for the results you have presented. There are several different
avenues that you could pursue in discussing the broader context; pick one that flows logically from
the information presented in your previous paragraphs. Do the results align with the prevailing
opinion in the scientific community? The news may have accurately reported a single paper, but
several other papers may have opposing results. Other researchers may have alternative
interpretations of the results or be able to point out methodological flaws in the original research.
The original research may also discuss important interpretations or limitations that the news failed to
report, and a review could help you to develop a better understanding of that discussion. Is the story
over? Are there other avenues of related research worth exploring?
Conclusion: Give the overall conclusion about the claim presented in the news taking the scientific
evidence into account. Also provide your personal opinion on how well the media did in reporting
the science. You should refer to the findings from your original research article and the review
article and draw a logical conclusion from the evidence. Does this assignment change how you will
evaluate nutrition science reported in the media?
References: You should include both in-text citations and an associated reference list at the end of
the paper using AMA style guidelines. Please look at the FAQ on AMA guidelines and refer back to
the Nutrition in the News lecture for full details.
NitN: Sample Final Paper
NUT11
Word count: 792
Anemic? An Iron Fish Might Be What All You Need
Approximately 30% of the world’s population suffers from anemia.1 Anemia is a condition
where the body does not have enough of the protein called hemoglobin,2 which is the part of red
blood cells that carries oxygen to the tissues in our body.1 As a result, individuals with anemia often
experience tiredness, headaches, decreased cognitive abilities, impaired immunity, and poor
pregnancy outcomes.2 Iron deficiency is the most common cause of anemia1—referred to as irondeficiency anemia (IDA)—and most commonly affects women and children.2 Typically anemia is
treated with iron tablets; however, getting tablets to poor and remote villages is difficult and costs
money. Furthermore, many women find that they feel nauseated when taking iron pills, which may
discourage them from taking the supplement.
Almost 50% of the women in rural Cambodian villages experience anemia, but treatment
with iron supplements was unsuccessful.1 In the 1980s, researchers showed that cooking in iron pots
would increase the amount of iron in the food that was consumed,2 which could help prevent IDA.
As reported in the news recently, a Canadian scientist had the idea to use a lump of iron in place of
iron cookware. After many iterations of the iron-ingot, scientists finally settled on the shape of a fish
because it is a symbol of luck in Cambodian culture, and the Lucky Iron Fish project was born.1
They claim that the Lucky Iron Fish can be used to treat anemia in these Cambodian villages. When
the ingot is boiled in water or soup for at least 10 minutes some iron leaches into the liquid. Then the
iron fish is removed and lemon juice is to the food to help the body absorb the iron when the food is
consumed. They claim that using the Lucky Iron Fish every day would provide enough iron to meet
75% of the iron that a woman should consume. The news reports that several hundred Cambodian
NitN: Sample Final Paper
NUT11
women tested the ingot for a year, and at the end half of the women who used the ingot weren’t
anemic anymore. They further claim that the ingot is better than supplements.
In the original research that tested the effectiveness of the Lucky Iron Fish, the researchers
actually had three different groups for their year-long study: iron-ingot, iron-ingot with basic
nutrition education, or a control that received neither.2 Ultimately, the researchers grouped both of
the iron-ingot groups together because they found that the nutrition lessons didn’t have an effect,
likely because the women that received the nutrition education couldn’t afford to purchase the foods
that the lessons encouraged them to eat. One critical piece of information that the news failed to
mention is that the women needed to add an acidifier, such as a teaspoon of citrus juice, while
boiling the ingot in plain water in order for water to make the ingot leach iron. Many Cambodian
soups contain acidic fruits, so additional juice isn’t needed in this case. Even though the Lucky Iron
Fish was tested in a smaller group that the news article reported, it actually seems to work better than
the news suggested. In the control group, the prevalence of anemia and IDA, which was measured
using blood tests, remained similar from the start to the end of the study. In the groups that received
the iron-ingot, the prevalence of anemia dropped from 57% to 11% and the prevalence of IDA
dropped from 13% to 2%. The original study didn’t directly compare to supplements, so we don’t
know if the iron-ingot works better than supplements for alleviating deficiency. Nevertheless, the
researchers didn’t notice any negative side effects, which is a benefit over supplements.
The prevalence of anemia in women in developing nations ranges from 11% in Nicaragua to
50% in Côte d’Ivoire.3 However, anemia can also be caused by other micronutrient deficiencies,
such as vitamins A and B12 or folate, repeated infections, or malaria.1 Additionally, the
inflammation that results from infection inhibits the absorption of iron,3 which may increase iron
requirements of individuals living in regions with a high burden of infection. Thus, before deciding
NitN: Sample Final Paper
NUT11
whether to use the Lucky Iron Fish, health officials need to consider both the amount of anemia that
can be attributed to iron deficiency and the level of exposure to inflammation in a given region. In
countries with a high prevalence of IDA and low to moderate infection rates, the Lucky Iron Fish
could be a cost effective and successful method of treating IDA. However, the Iron Fish may not be
as effective in countries with high infection rates or multiple micronutrient deficiencies. In my
opinion, the news reporter could have added a bit more about the limitations of the Lucky Iron Fish;
however, the rest of the information provided in the news article was accurate.
References
1. Roxby P. Why an iron fish can make you stronger. BBC News.
http://www.bbc.com/news/health-32749629. Published May 17, 2015. Accessed July 29,
2017.
2. Charles CV, Dewey CE, Hall A, Hak C, Channary S, Summerlee AJS. A Randomized
Control Trial Using a Fish-Shaped Iron Ingot for the Amelioration of Iron Deficiency
Anemia in Rural Cambodian Women. Tropical Medicine & Surgery. 2015; 3(3): 195. DOI:
10.4172/2329-9088.1000195.
3. Petry N, Olofin I, Hurrell RF, et al. The Proportion of Anemia Associated with Iron
Deficiency in Low, Medium, and High Human Development Index Countries: A Systematic
Analysis of National Surveys. Nutrients. 2016; 8: 693. DOI: 10.3390/nu8110693.
REVIEW
Energy Drinks and Their Impact on the
Cardiovascular System: Potential Mechanisms1,2
Erik Konrad Grasser,* Jennifer Lynn Miles-Chan, Nathalie Charrière, Cathríona R Loonam, Abdul G Dulloo,
and Jean-Pierre Montani
Department of Medicine/Physiology, University of Fribourg, Fribourg, Switzerland
ABSTRACT
Globally, the popularity of energy drinks is steadily increasing. Scientific interest in their effects on cardiovascular and cerebrovascular systems in
humans is also expanding and with it comes a growing number of case reports of adverse events associated with energy drinks. The vast
majority of studies carried out in the general population report effects on blood pressure and heart rate. However, inconsistencies in the current
literature render it difficult to draw firm conclusions with regard to the effects of energy drinks on cardiovascular and cerebrovascular
variables. These inconsistencies are due, in part, to differences in methodologies, volume of drink ingested, and duration of postconsumption
measurements, as well as subject variables during the test. Recent well-controlled, randomized crossover studies that used continuous beat-to-beat
measurements provide evidence that cardiovascular responses to the ingestion of energy drinks are best explained by the actions of caffeine
and sugar, with little influence from other ingredients. However, a role for other active constituents, such as taurine and glucuronolactone, cannot
be ruled out. This article reviews the potentially adverse hemodynamic effects of energy drinks, particularly on blood pressure and heart rate,
and discusses the mechanisms by which their active ingredients may interact to adversely affect the cardiovascular system. Research areas and gaps
in the literature are discussed with particular reference to the use of energy drinks among high-risk individuals. Adv Nutr 2016;7:950–60.
Keywords:
blood pressure, sugar, caffeine, heart rate, public health
Introduction
The authors reported no funding received for this study.
Author disclosures: EK Grasser, JL Miles-Chan, N Charrière, CR Loonam, AG Dulloo, and J-P
Montani, no conflicts of interest.
*To whom correspondence should be addressed. E-mail: erikkonrad.grasser@unifr.ch.
of EDs because they had been linked to cardiovascular complications (8), which led to sales restrictions and even bans
in some European countries (9). Although these restrictions
have since been lifted (10), Lithuania was the first European
country to ban ED sales for minors (11) and, currently, the
European Union is considering a sales ban of EDs for persons 50% of
their included case reports were related to the cardiovascular
system, followed by neurological issues (13). Moreover,
there are 8 case reports in which large intakes of EDs were
found to be associated with myocardial ischemia, with no
additional triggers in the majority of cases (14). Increasing
evidence of negative cardiovascular effects in response to
ED consumption was recently highlighted by SanchisGomar et al. (15), thereby providing specific recommendations for adolescents to prevent cardiac arrhythmias (16).
Furthermore, with the use of beat-to-beat hemodynamic
measurements in young healthy humans, work from our
laboratory previously showed that blood pressure and other
cardiovascular variables increased acutely in response to the
950
ã2016 American Society for Nutrition. Adv Nutr 2016;7:950–60; doi:10.3945/an.116.012526.
One substantial subcategory of soft drinks that is considered
to be one of the most popular is represented by energy
drinks (EDs). Indeed, the popularity of EDs has substantially
increased since their introduction around 1960 (1), and this
subcategory been found to be one of the fastest growing segments in the beverage industry (2). The majority of EDs are
targeted toward young adults aged between 18 and 34 y, with
a reported consumption frequency of 1–4 EDs/mo (3); and
approximately half of college student “ED users” consumed
EDs while studying or working on a major project (3). To
date, there exists an abundance and variety of EDs on the
market, with >200 brands in the United States alone (4).
However, only a few dominate the market, and there is
not much difference in caffeine and sugar content when
comparing the market leaders (Table 1). At the beginning
of the 21st century, early concerns arose about the safety
1
2
TABLE 1
Red Bull
Monster
Rockstar
NOS
Amp
Mean 6 SD
1
ED market leaders in the United States including their caffeine and sugar contents1
Market size in the
United States (5), %
Caffeine (6),
mg/100 g
43
39
10
3
3
NA
29
33
33
34
31
32 6 2
Sugars (7), g/100 g
Total
10.22
10.93
12.26
11.25
12.08
11.35 6 0.84
Fructose
Glucose
Sucrose
1.63
2.39
3.59
—
—
2.54 6 0.99
3.40
4.11
6.03
—
—
4.51 6 1.36
5.19
4.43
2.65
—
—
4.09 6 1.30
Red Bull, Red Bull GmbH; Monster, Monster Beverage; Rockstar, Rockstar, Inc.; NOS, Monster Beverage; Amp, PepsiCoA. ED, energy drink; NA, not applicable; —, content unknown, but ingredients include high-fructose corn syrup.
ingestion of 1 can (355 mL) of a sugar-sweetened ED (17).
This observation, which was confirmed by subsequent studies from our laboratory (18, 19), provided evidence that ED
consumption negatively affected the hemodynamic system
(Figure 1). The extent to which the various ingredients present in EDs contribute to their acute cardiovascular effects
are reviewed and discussed in the following sections.
EDs and Hemodynamics: Overall Effects
A number of studies investigating the cardio- and cerebrovascular impact of EDs in young healthy subjects primarily showed
myocardial effects, particularly on blood pressure and heart
rate. Recent studies that used beat-to-beat measurements (17)
showed that the ingestion of 1 can of a sugar-sweetened ED
(355-mL drink volume) resulted in an augmented workload
to the heart as evidenced by elevated blood pressure, heart
rate, cardiac output, and double product values (17); the ingestion of the ED did not lead to a deterioration of microvascular
endothelial function in response to acetylcholine, which
suggests that impaired endothelial function, at least in the microvasculature, is unlikely to account for the blood pressure–
elevating effect of the ED (17). An interesting and seemingly
novel finding of this study was that the ED diminished cerebral
blood flow velocity and increased the cerebrovascular resistance
index, which could at least partly be explained by an increase in
breathing frequency and the secondary reduction in end-tidal
carbon dioxide (17). In a follow-up study, which also used
beat-to-beat measurement techniques, it was found that the ingestion of the ED during a mental challenge imposed a cumulative cardiovascular load and reduced cerebral blood flow
velocity (18). Moreover, under resting conditions, we confirmed
our previous findings with regard to an overall adverse hemodynamic profile in response to the ingestion of an ED (18).
In agreement with the findings of our study (19) on the
predominantly myocardial effects of sugar-sweetened EDs
are the following: 1) a report that the consumption of a sugarsweetened Monster ED (Monster Beverage; 2.0 mg caffeine/kg
and 0.65 g sugar/kg) significantly elevated heart rate after 60
min compared with the placebo control (20), 2) a study in
which blood pressure and heart rate responses to a sugarsweetened ED (Rockstar, Rockstar, Inc.; 240 mg caffeine
and ;62 g sugar) resulted in significantly elevated blood
pressure values (systolic blood pressure: +6.6 mm Hg; diastolic blood pressure: +4.2 mm Hg) compared with a sugarmatched placebo (21), and 3) findings from current studies
evaluating the impact of sugar-free caffeinated energy shots
[5-h Energy; 200 mg and 215 mg caffeine] on cardiovascular
variables that showed that blood pressure variables significantly increased whereas heart rate did not change (22, 23).
Moreover, repeated intakes of an ED [8.3 oz of a Red Bull
ED (Red Bull GmbH) 4 times over 24 h; 1 oz = 30 mL] increased blood pressure variables when compared with a water
drink with equivalent amounts of caffeine (8 oz water with
80 mg caffeine) (24). On the basis of the aforementioned literature, it seems evident that EDs adversely affect the hemodynamic system, the magnitude and side effects of which
depend largely on their caffeine and sugar content.
EDs and Hemodynamics: Discrepancies
between Studies
The effects of EDs on changes in blood pressure and heart
rate are not always consistent, however (Table 2). A number
FIGURE 1 Hemodynamic
consequences of consumption of
a commercially available, sugared
energy drink. Y, diminished; [,
elevated; +, enhancing.
Cardiovascular impact of energy drinks 951
952 Grasser et al.
Energy shot vs. decaffeinated
shot (both sugar-free)
Energy shot (sugar-free) vs.
placebo control vs. no drink
RB (355 mL) vs. water control
RB (355 mL) vs. water control
RB (355 mL) vs. RB sugar-free
vs. water control
RB vs. RB light vs. Suso Orange
control (750 mL)
Marczinski et al. (22)
Grasser et al. (18)
Miles-Chan et al. (19)
Olateju et al. (34)
Grasser et al. (17)
39 g sugar;
1420 mg
taurine
39 g sugar;
1420 mg
taurine
39 g sugar;
1420 mg
taurine
—
;114 mg
;114 mg
—
;114 mg
—
—
—
200 mg
215 mg
1.25 or 2.5 mg/kg
Phan and Shah (23)
An et al. (33)
—
2 mg/kg
“Monster” standardized vs. flavor-matched placebo
“Hot6” vs. water control
Nelson et al. (20)
Worthley et al. (32)
—
RB original (250 mL) vs. lowcalorie
Ragsdale et al. (31)
;80 mg
500-mL drink; type not
specified
Steinke et al. (30)
—
1000 mg
taurine
—
250-mL sugar-free
“Meltdown RTD” (140 mL)
Rashti et al. (29)
100 mg
—
—
Caffeine pill
Bichler et al. (28)
1.2 mg/kg

—
—
—
“V” (New Zealand)
Rush et al. (27)
—
—
—
RB (500 mL)
Baum and …
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