A family is suing Panera Bread for improperly marketing their caffeinated lemonade drink, which may have caused their 21-year-old daughter to go into cardiac arrest.
Doctors advise against energy drink consumption for children and teens, as well as those with heart conditions.
Food retailers continue to market highly caffeinated energy drinks despite their dangers.
Following the death of their 21-year-old daughter, Sarah Katza, a family is suing Panera Bread after the company allegedly improperly marketed a dangerous energy drink. Hours after consuming a large Panera Charged Lemonade, Katz went into cardiac arrest and died, according to a lawsuit obtained by NBC News.
The lawsuit alleges that the beverage was dangerous and “‘defective in design.’” Furthermore, it suggests that Panera Bread improperly marketed the product, stating that it had “‘no warning of any potentially dangerous effects, even the life-threatening effects on blood pressure, heart rate, and/or brain function.’”
Caffeine and health risks
Drinking too much caffeine in any form can have undesirable health effects, particularly for young people and children, says Tracy Zaslow, MD, a board-certified pediatrician and Primary Care Sports Medicine Specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA.
“Caffeine acts as a stimulant on the central nervous system,” which can impact various organ systems and cause “increases in heart rate, blood pressure, speech rate, motor activity, attentiveness, gastric secretion, diuresis, and temperature,” Dr. Zaslow says. She adds that drinking too much caffeine can bring about a range of symptoms, including:
Frequent urination or inability to control urination
Caffeine’s impact on the heart
Prior to her death, Katz was diagnosed with the heart condition long QT syndrome type 1. This is an often-inherited, rare condition that impacts the potassium ion channels in the heart, disrupting the heart’s electrical activity and increasing the risk of an abnormal heartbeat. According to Stanford Medicine, people with the condition may be advised to be cautious when performing activities that impact the trigger, including physical exercise like swimming.
As caffeine can impact heartbeat—increasing risks for sped-up or irregular patterns—it should not be consumed by some with heart conditions. According to the lawsuit obtained by NBC News, Katz was medically advised to avoid energy drinks due to her condition. Family and friends stated that they believed Katz would never have consumed Panera’s Charged Lemonade had she been aware of its dangers.
“High doses of caffeine have a direct effect on the rhythm of the heart,” says Ilan Shapiro, MD, a pediatrician and Chief Health Correspondent and Medical Affairs Officer at AltaMed Health Services in Los Angeles, CA. “If we have an underlying problem with the muscle or the electricity of the heart, this can produce problems like a heart attack or an arrhythmia.”
Caffeine and lethal limits
According to the United States Food and Drug Administration (FDA), up to 400 milligrams of caffeine—or about four or five cups of coffee—per day appears safe for adults without certain conditions. Studies say that “[l]ethal doses of caffeine have been reported at blood concentrations of 80 to 100 micrograms/ml, which can be reached with ingestion of approximately 10 grams or greater.”
Caffeine and legal limits
Despite these risks, the FDA only loosely regulates caffeine in food and beverage products.
The agency asks that products with added caffeine present caffeine as an ingredient on the label. However, products that inherently contain caffeine, such as coffee, tea, or guarana, do not have to explicitly list caffeine as an ingredient on the label. Where labeling is relevant, the FDA does not require manufacturers to list exact caffeine levels, nor does it specify a limit for caffeine in food or beverage products.
Caffeine and medical limits
Some health organizations have taken a firmer stance on regulating caffeine, particularly for young people, with some parents and pediatricians calling for age-based restrictions on caffeinated energy drinks.
Currently, the American Academy of Child and Adolescent Psychiatry recommends that children ages 12 to 18 limit caffeine consumption to a maximum of 100 milligrams per day (about one cup of coffee or two 12-ounce cans of cola). The agency also advises that children under 12 avoid caffeine altogether. Furthermore, it recommends against consuming energy drinks, like Panera’s Charged Lemonade, for all children and teens.
Energy drinks versus sports drinks
Some people mistake energy drinks for sports drinks, but the two categories should not be viewed as interchangeable, Dr. Zaslow says. Using proper language around energy drinks might help communicate risk.
Sports drinks include (often-flavored) beverages that contain carbohydrates, minerals, electrolytes, and/or vitamins or other nutrients, whereas “energy drinks are beverages that typically contain stimulants, such as caffeine and guarana, with varying amounts of carbohydrates, protein, amino acids, vitamins, sodium, and other minerals,” Dr. Zaslow explains.
Energy drinks can be dangerous due to their high caffeine content, and for those who rely on them for substances that should be provided through food, she adds.
“Although the term ‘energy’ can be perceived to imply calories, ‘energy drink’ is a misnomer,” Dr. Zaslow says. “Energy drinks often contain little fuel (i.e. carbohydrates) but provide an ‘energized’ sensation when the energy drink is consumed due to the stimulants.”
Staying safe in an unregulated environment
When it comes to reducing risks from caffeine consumption, it is important to be mindful of intake and to avoid extreme consumption, Dr. Shapiro says. Staying away from highly caffeinated energy drinks can be a healthy choice for many people, particularly young people and anyone with a heart condition.
“Having one cup or two cups of coffee a day will not make a difference,” Dr. Shapiro says. “But adding a lot of caffeine to our diet, [particularly for people with heart conditions], could produce problems with [heart] rhythm or the muscle itself.”
What this means for you
Doctors warn of the risk of consuming highly caffeinated energy drinks and encourage young people and those with heart conditions to limit their caffeine consumption.