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"contents": "<span style=\"font-weight: 400;\">Prime drinks have been heavily promoted in Australia (and now in South Africa too), leading to </span><a href=\"https://au.news.yahoo.com/woolworths-shoppers-in-frenzy-to-get-hands-on-cult-drink-prime-062849789.html\"><span style=\"font-weight: 400;\">frenzied sales</span></a><span style=\"font-weight: 400;\"> in supermarkets, as well as </span><a href=\"https://www.abc.net.au/news/2023-03-29/prime-logan-paul-ksi-drink-australian-schools-ban/102154550\"><span style=\"font-weight: 400;\">bans in schools</span></a><span style=\"font-weight: 400;\">.</span>\r\n\r\n<span style=\"font-weight: 400;\">Prime offers two products: one is marketed as a “hydration” drink, the other as an “energy” drink. The latter comes with a </span><a href=\"https://drinkprime.com/pages/faq\"><span style=\"font-weight: 400;\">warning</span></a><span style=\"font-weight: 400;\"> it’s not suitable for people under 18 years of age, or pregnant or lactating women and isn’t legally sold in stores in Australia.</span>\r\n\r\n<span style=\"font-weight: 400;\">But both drinks may pose problems to under-18s and women who are pregnant or lactating.</span>\r\n<blockquote class=\"twitter-tweet\">\r\n<p dir=\"ltr\" lang=\"en\">\"Their win may form something of a blueprint for other content creators as YouTubers become more professional and look to harness the platform’s algorithm for their commercial success.\" <a href=\"https://t.co/4NIZKwKtEB\">https://t.co/4NIZKwKtEB</a></p>\r\n— The Conversation (@ConversationUK) <a href=\"https://twitter.com/ConversationUK/status/1637195918595313665?ref_src=twsrc%5Etfw\">March 18, 2023</a></blockquote>\r\n<script async src=\"https://platform.twitter.com/widgets.js\" charset=\"utf-8\"></script>\r\n\r\n<strong>Read more in Daily Maverick:</strong> <a href=\"https://www.dailymaverick.co.za/article/2023-04-24-much-hyped-energy-drink-prime-is-coming-for-a-lot-cheaper/\">Much-hyped energy drink PRIME is now in a store near you – for a lot cheaper</a>\r\n<h4><b>What’s in Prime Energy?</b></h4>\r\n<span style=\"font-weight: 400;\">Prime Energy contains </span><a href=\"https://drinkprime.com/pages/faq\"><span style=\"font-weight: 400;\">200 milligrams</span></a><span style=\"font-weight: 400;\"> of caffeine per can, which is equivalent to about two to three instant coffees. This caffeine content is roughly double what is </span><a href=\"https://www.foodstandards.gov.au/consumer/generalissues/pages/caffeine.aspx\"><span style=\"font-weight: 400;\">legally allowed</span></a><span style=\"font-weight: 400;\"> for products sold in Australia.</span>\r\n\r\n<span style=\"font-weight: 400;\">Despite its name, Prime Energy drink contains only about 40 kilojoules from carbohydrates, which is one of our body’s key sources of energy. The “energy” in Prime Energy refers to the caffeine, which makes you feel more alert and lessens the perceived effort involved in any work you do.</span>\r\n\r\n<span style=\"font-weight: 400;\">Caffeine </span><a href=\"https://www.ais.gov.au/__data/assets/pdf_file/0003/1001379/Caffeine-Infographic-final.pdf\"><span style=\"font-weight: 400;\">does provide performance benefits</span></a><span style=\"font-weight: 400;\"> for athletes aged over 18. However, given the high quantities in the drinks, there may be better ways to get caffeine in more appropriate doses.</span>\r\n<h4><b>Caffeine is a concern during pregnancy</b></h4>\r\n<span style=\"font-weight: 400;\">Health guidelines recommend </span><a href=\"https://www.foodstandards.gov.au/consumer/generalissues/Pages/Caffeine.aspx\"><span style=\"font-weight: 400;\">limiting</span></a><span style=\"font-weight: 400;\"> caffeine intake during pregnancy and while breastfeeding to below 200mg a day.</span>\r\n\r\n<span style=\"font-weight: 400;\">Theoretically, this drink alone, with 200mg of caffeine per can, should be fine. But practically, diets include many other sources of caffeine including coffee, tea, chocolate and cola drinks. Consumption of these alongside energy drinks would increase the intake for pregnant women above this safety threshold.</span>\r\n<h4><b>Why is caffeine a problem for fetuses and babies?</b></h4>\r\n<span style=\"font-weight: 400;\">Caffeine can cross the placenta into the growing fetus’s bloodstream. Fetuses can’t break down the caffeine, so it remains in their circulation.</span>\r\n\r\n<span style=\"font-weight: 400;\">As the pregnancy proceeds, the mother becomes </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872737/\"><span style=\"font-weight: 400;\">slower at clearing caffeine</span></a><span style=\"font-weight: 400;\"> from her metabolism. This potentially exposes the fetus to caffeine for longer.</span>\r\n\r\n<span style=\"font-weight: 400;\">Studies have shown a high intake of caffeine is associated with </span><a href=\"https://link.springer.com/article/10.1007/s10654-014-9944-x\"><span style=\"font-weight: 400;\">growth restriction</span></a><span style=\"font-weight: 400;\">, </span><a href=\"https://pubmed.ncbi.nlm.nih.gov/26026343/\"><span style=\"font-weight: 400;\">reduced birth weight, preterm birth and stillbirth</span></a><span style=\"font-weight: 400;\">. Some experts argue there is </span><a href=\"https://ebm.bmj.com/content/26/3/114\"><span style=\"font-weight: 400;\">no safe limit of caffeine intake</span></a><span style=\"font-weight: 400;\"> during pregnancy.</span>\r\n\r\n<span style=\"font-weight: 400;\">With breastfeeding, </span><a href=\"https://adc.bmj.com/content/54/10/787.short\"><span style=\"font-weight: 400;\">caffeine passes into the breast milk</span></a><span style=\"font-weight: 400;\">. It remains in the baby’s circulation, as they’re unable to metabolise it. </span><a href=\"https://pubmed.ncbi.nlm.nih.gov/9849117/\"><span style=\"font-weight: 400;\">Evidence shows</span></a><span style=\"font-weight: 400;\"> that caffeine may make babies more colicky, irritable and less likely to sleep.</span>\r\n<h4><b>What about in kids?</b></h4>\r\n<span style=\"font-weight: 400;\">Children also have a limited ability to break down caffeine. Combined with their lighter body mass, a caffeine-based drink will have a more pronounced effect.</span>\r\n\r\n<span style=\"font-weight: 400;\">As such, safe caffeine levels are determined on a weight basis: </span><a href=\"https://www.foodstandards.gov.au/code/proposals/Documents/P1056%20SD1%201st%20CFS%20Safety%20Assessment.pdf\"><span style=\"font-weight: 400;\">3mg per kg of body weight per day</span></a><span style=\"font-weight: 400;\">. For example, children aged 9 to 13 years, who weigh no more than 40kg, should have no more than 120mg of caffeine per day. Those aged between 14 to 17 years who weigh less than 60kg should have no more than 180mg per day.</span>\r\n<blockquote class=\"twitter-tweet\">\r\n<p dir=\"ltr\" lang=\"en\">'Dangerous' super-caffeinated drink pushed by social media influencers banned from schools as students rush to buy it <a href=\"https://t.co/OCYCBRTPyy\">https://t.co/OCYCBRTPyy</a></p>\r\n— ABC News (@abcnews) <a href=\"https://twitter.com/abcnews/status/1640853762519728129?ref_src=twsrc%5Etfw\">March 28, 2023</a></blockquote>\r\n<script async src=\"https://platform.twitter.com/widgets.js\" charset=\"utf-8\"></script>\r\n\r\n<a href=\"https://www.internationaljournalofcardiology.com/article/S0167-5273(15)30918-9/fulltext\"><span style=\"font-weight: 400;\">Studies have shown</span></a><span style=\"font-weight: 400;\"> higher intakes increase the risk of heart problems, such as heart palpitations, chest pain, shortness of breath and fainting. This may reflect underlying heart rhythm problems, which have in some cases ended up with </span><a href=\"https://www.internationaljournalofcardiology.com/article/S0167-5273(15)30918-9/fulltext\"><span style=\"font-weight: 400;\">children and teenagers</span></a><span style=\"font-weight: 400;\"> presenting to hospital emergency departments.</span>\r\n<h4><b>What about Prime Hydrate, which doesn’t contain caffeine?</b></h4>\r\n<span style=\"font-weight: 400;\">This drink contains branch chain amino acids, or BCAA, which the supplements industry promotes as helping gain muscle bulk. There are three BCAA: valine, leucine and isoleucine.</span>\r\n\r\n<span style=\"font-weight: 400;\">However, there is no evidence they provide any benefit. As such, the </span><a href=\"https://www.ais.gov.au/nutrition/supplements/group_c\"><span style=\"font-weight: 400;\">Australian Institute of Sport</span></a><span style=\"font-weight: 400;\"> has concluded they are not an effective supplement for athletes.</span>\r\n\r\n<span style=\"font-weight: 400;\">Supplements in general are not recommended in </span><a href=\"https://www.nccih.nih.gov/health/dietary-and-herbal-supplements\"><span style=\"font-weight: 400;\">children or pregnant women</span></a><span style=\"font-weight: 400;\"> as they have not been tested in these groups.</span>\r\n\r\n<span style=\"font-weight: 400;\">There is also concern about the impact of BCAA and how they may impact the growth of the fetus. A </span><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178017/\"><span style=\"font-weight: 400;\">scientific animal study</span></a><span style=\"font-weight: 400;\"> has shown altered patterns of growth with foetal mice.</span>\r\n\r\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551332/\"><span style=\"font-weight: 400;\">No human studies</span></a><span style=\"font-weight: 400;\"> have examined BCAA and foetal growth, so that research needs to be done before recommendations can be given to pregnant women. They should avoid these ingredients in the absence of evidence.</span>\r\n\r\n<span style=\"font-weight: 400;\">Similarly, there has been no testing of these supplements in children under 18 years, so there is no guarantee of their safety.</span>\r\n\r\n<span style=\"font-weight: 400;\">Performance-enhancing sport supplements are </span><a href=\"https://journals.humankinetics.com/view/journals/ijsnem/24/5/article-p570.xml\"><span style=\"font-weight: 400;\">not recommended</span></a><span style=\"font-weight: 400;\"> for children and adolescents, as they are still developing physically as well as refining and improving their sporting skills.</span>\r\n<h4><b>What does the science say about BCAA?</b></h4>\r\n<span style=\"font-weight: 400;\">Scientists have been investigating how BCAA affect adults. Circulating BCAA can affect carbohydrate metabolism in the muscle and therefore can </span><a href=\"https://www.mdpi.com/2072-6643/14/7/1454\"><span style=\"font-weight: 400;\">change insulin sensitivity</span></a><span style=\"font-weight: 400;\">. BCAA are elevated in adults with diet-induced obesity and are associated with </span><a href=\"https://www.mdpi.com/2072-6643/14/7/1454\"><span style=\"font-weight: 400;\">increased future risk of type 2 diabetes</span></a><span style=\"font-weight: 400;\">, even when scientists account for other baseline risk factors.</span>\r\n\r\n<span style=\"font-weight: 400;\">Adults with obesity and insulin resistance have been found to have higher levels of BCAA. </span><a href=\"https://onlinelibrary.wiley.com/doi/full/10.1111/j.2047-6310.2012.00087.x\"><span style=\"font-weight: 400;\">Emerging evidence suggests</span></a><span style=\"font-weight: 400;\"> children and adolescents with obesity also have higher levels of BCAA, which may predict future insulin resistance, a risk factor for diabetes.</span>\r\n\r\n<span style=\"font-weight: 400;\">However, we don’t yet know if these elevated levels of BCAA in the blood are because people are overweight or obese, or if it plays a role in them becoming overweight or obese.</span>\r\n\r\n<span style=\"font-weight: 400;\">The bottom line is we have clear evidence that caffeine is problematic for children and women who are pregnant and lactating. And there is emerging evidence BCAA may be also problematic. </span><b>DM</b>\r\n\r\n<i><span style=\"font-weight: 400;\">First published by </span></i><a href=\"https://theconversation.com/prime-drinks-arent-suitable-for-children-and-pregnant-women-heres-why-202829\"><i><span style=\"font-weight: 400;\">The Conversation</span></i></a><i><span style=\"font-weight: 400;\">.</span></i>\r\n\r\n<i><span style=\"font-weight: 400;\">Evangeline Mantzioris is Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia.</span></i>",
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