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Concept: Coca-Cola


BACKGROUND: Cola is an extremely popular caffeinated soft drink. The media have recently cited a poll in which 16% of the respondents considered themselves to be addicted to cola soft drinks. We find the contrast between the apparent prevalence of cola addiction and the lack of scientific literature on the subject remarkable. To our knowledge, this is the first case of cola dependency described in the scientific literature. CASE PRESENTATION: The patient is a 40-year-old woman, who when feeling down used cola to give her an energy boost and feel better about herself. During the past seven years her symptoms increased, and she was prescribed antidepressant medication by her family doctor. Due to worsening of symptoms she was hospitalised and later referred to a specialised outpatient clinic for affective disorders. At entry to the clinic she suffered from constant tiredness, lack of energy, failing concentration, problems falling asleep as well as interrupted sleep. She drank about three litres of cola daily, and she had developed a metabolic syndrome.The patient fulfilled the ICD-10 criteria for dependency, and on the Yale Food Addiction Scale (YFAS) she scored 40 points. Her clinical mental status was at baseline assessed by the Major Depression Inventory (MDI) = 41, Hamilton Depression - 17 item Scale (HAMD-17) = 14, Young Mania Rating Scale (YMRS) = 2 and the Global Assessment of Functioning (GAF) Scale = 45.During cognitive therapy sessions she was guided to stop drinking cola and was able to moderate her use to an average daily consumption of 200 ml of cola Her concentration improved and she felt mentally and physically better. At discharge one year after entry her YFAS was zero. She was mentally stable (MDI =1, HAMD-17 = 0, YMRS = 0 and GAF = 85) and without antidepressant medication. She had lost 7.2 kg, her waistline was reduced by 13 cm and the metabolic syndrome disappeared. CONCLUSION: This case serves as an example of how the overconsumption of a caffeinated soft drink likely was causing or accentuating the patient’s symptoms of mental disorder. When diagnosing and treating depression, health professionals should pay attention to potential overuse of cola or other caffeinated beverages.

Concepts: Coffee, Addiction, Caffeine, Bipolar disorder, Major depressive disorder, Soft drink, Energy drink, Coca-Cola


Consumption of soft drinks is declining in many countries, yet energy drink sales continue to increase, particularly amongst young consumers. Little is currently known about the drivers behind these trends. Energy drinks are high in sugar and caffeine, and evidence indicates that regular or heavy use by under 18s is likely to be detrimental to health. This study aimed to explore children and young people’s attitudes and perceptions in relation to energy drinks in a UK context.

Concepts: United Kingdom, Caffeine, Soft drink, Energy drink, Coca-Cola


The number of highly caffeinated products has increased dramatically in the past few years. Among these products, highly caffeinated energy drinks are the most heavily advertised and purchased, which has resulted in increased incidences of co-consumption of energy drinks with alcohol. Despite the growing number of adolescents and young adults reporting caffeine-mixed alcohol use, knowledge of the potential consequences associated with co-consumption has been limited to survey-based results and in-laboratory human behavioral testing. Here, we investigate the effect of repeated adolescent (post-natal days P35-61) exposure to caffeine-mixed alcohol in C57BL/6 mice on common drug-related behaviors such as locomotor sensitivity, drug reward and cross-sensitivity, and natural reward. To determine changes in neurological activity resulting from adolescent exposure, we monitored changes in expression of the transcription factor ΔFosB in the dopaminergic reward pathway as a sign of long-term increases in neuronal activity. Repeated adolescent exposure to caffeine-mixed alcohol exposure induced significant locomotor sensitization, desensitized cocaine conditioned place preference, decreased cocaine locomotor cross-sensitivity, and increased natural reward consumption. We also observed increased accumulation of ΔFosB in the nucleus accumbens following repeated adolescent caffeine-mixed alcohol exposure compared to alcohol or caffeine alone. Using our exposure model, we found that repeated exposure to caffeine-mixed alcohol during adolescence causes unique behavioral and neurochemical effects not observed in mice exposed to caffeine or alcohol alone. Based on similar findings for different substances of abuse, it is possible that repeated exposure to caffeine-mixed alcohol during adolescence could potentially alter or escalate future substance abuse as means to compensate for these behavioral and neurochemical alterations.

Concepts: Coffee, Drug addiction, Addiction, Adolescence, Caffeine, Dopamine, Mesolimbic pathway, Coca-Cola


Critics have long accused food and beverage companies of trying to exonerate their products from blame for obesity by funding organisations that highlight alternative causes. Yet, conclusions about the intentions of food and beverage companies in funding scientific organisations have been prevented by limited access to industry’s internal documents. Here we allow the words of Coca-Cola employees to speak about how the corporation intended to advance its interests by funding the Global Energy Balance Network (GEBN). The documents reveal that Coca-Cola funded and supported the GEBN because it would serve as a ‘weapon’ to ‘change the conversation’ about obesity amidst a ‘growing war between the public health community and private industry’. Despite its close links to the Coca-Cola company, the GEBN was to be portrayed as an ‘honest broker’ in this ‘war’. The GEBN’s message was to be promoted via an extensive advocacy campaign linking researchers, policy-makers, health professionals, journalists and the general public. Ultimately, these activities were intended to advance Coca-Cola’s corporate interests: as they note, their purpose was to ‘promote practices that are effective in terms of both policy and profit’. Coca-Cola’s proposal for establishing the GEBN corroborates concerns about food and beverage corporations' involvement in scientific organisations and their similarities with Big Tobacco.

Concepts: Corporation, Coca-Cola, Thums Up, The Coca-Cola Company, Diet Coke, Sprite, Minute Maid


We have analyzed the loss of enamel and dentine after exposure to different non-alcoholic drinks with a simple new method using bovine teeth. 100 enamel and 100 dentine specimens from freshly extracted bovine incisors were randomly attributed to 10 groups (n=10 for enamel and dentine each). Prior to the start of the experiment all specimens were weighed using a precision balance. The mean initial masses (SD) were 35.8 mg (7.2) for enamel and 24.7 mg (7.0) for dentine. No statistically significant differences were found between groups for initial masses (p>0.05, ANOVA with Bonferroni post hoc test). Thereafter, all specimens of one group were simultaneously placed in 200 ml of the following fluids: Coca-Cola, Coca-Cola light, Sprite, apple juice, Red Bull, orange juice, Bonaqua Fruits (Mango-Acai), tap water, chlorinated swimming pool water, and lemon juice. Fluids were continuously ventilated at 37° C for 7 days. Thereafter the specimens were weighed again and the mean mass loss was calculated.

Concepts: Statistics, Statistical significance, Citrus, Teeth, Orange, Swimming pool, Coca-Cola, The Coca-Cola Company


There has been recent interest in the ergogenic effects of caffeine delivered in low doses (~ 200 mg or ~ 3 mg/kg body mass) and administered in forms other than capsules, coffee and sports drinks, including chewing gum, bars, gels, mouth rinses, energy drinks and aerosols. Caffeinated chewing gum is absorbed quicker through the buccal mucosa compared with capsule delivery and absorption in the gut, although total caffeine absorption over time is not different. Rapid absorption may be important in many sporting situations. Caffeinated chewing gum improved endurance cycling performance, and there is limited evidence that repeated sprint cycling and power production may also be improved. Mouth rinsing with caffeine may stimulate nerves with direct links to the brain, in addition to caffeine absorption in the mouth. However, caffeine mouth rinsing has not been shown to have significant effects on cognitive performance. Delivering caffeine with mouth rinsing improved short-duration, high-intensity, repeated sprinting in normal and depleted glycogen states, while the majority of the literature indicates no ergogenic effect on aerobic exercise performance, and resistance exercise has not been adequately studied. Studies with caffeinated energy drinks have generally not examined the individual effects of caffeine on performance, making conclusions about this form of caffeine delivery impossible. Caffeinated aerosol mouth and nasal sprays may stimulate nerves with direct brain connections and enter the blood via mucosal and pulmonary absorption, although little support exists for caffeine delivered in this manner. Overall, more research is needed examining alternate forms of caffeine delivery including direct measures of brain activation and entry of caffeine into the blood, as well as more studies examining trained athletes and female subjects.

Concepts: Coffee, Strength training, Caffeine, Tea, Energy drink, Red Bull, Coca-Cola, Guarana


Externally decorated glassware used for the consumption of beverages, purchased new or sourced second-hand, and including tumblers, beer glasses, shot glasses, wine glasses and jars, has been analysed for Pb and Cd by portable x-ray fluorescence (XRF) spectrometry. Out of 197 analyses performed on distinctly different colours and regions of enamelling on 72 products, Pb was detected in 139 cases and among all colours tested, with concentrations ranging from about 40 to 400,000μgg(-1) (median=63,000μgg(-1)); Cd was detected in 134 cases and among all colours apart from gold leaf, with concentrations ranging from about 300 to 70,000μgg(-1) (median=8460μgg(-1)). The frequent occurrence of these metals is attributed to their use in both the oxidic fluxes and coloured pigments of decorative enamels employed by the glass industry. A standard test involving extraction of the external surface to within 20mm of the rim (lip area) by 4% acetic acid and subsequent analysis by ICP was applied to selected positive samples (n=14). Lead concentrations normalised to internal volume exceeded limit values of 0.5mgL(-1) in all but one case, with concentrations over 100mgL(-1) returned by three products. Cadmium concentrations exceeded limit values of 4mgL(-1) in five cases, with a maximum concentration of about 40mgL(-1). Repeating the experiment on five positive samples using a carbonated drink (Coca Cola Classic) resulted in lower extractable concentrations but non-compliance for Pb in all cases. The presence of high concentrations of total and extractable Pb and Cd in the decorated lip areas of a wide range of products manufactured in both China and Europe is cause for concern from a health and safety perspective.

Concepts: Caffeine, Pigment, Occupational safety and health, Carbonation, Drink, Coca-Cola, Cola, The Coca-Cola Company


Highly caffeinated energy drinks (EDs) are popular with adolescents and young adults, but longitudinal consumption patterns are poorly understood especially in relation to other substance use.

Concepts: Coffee, Caffeine, Soft drink, Energy drink, Red Bull, Coca-Cola, Guarana, Jolt Cola


Brands surround us everywhere in daily life. Here we investigate the influences of brand cues on gustatory processing of the same beverage. Participants were led to believe that the brand that announced the administration of a Cola mixture provided correct information about the drink to come. We found stronger fMRI signal in right mOFC during weak compared to strong brand cues in a contrast of parametric modulation with subjective liking. When directly comparing the two strong brands cues, more activation in the right amygdala was found for Coca Cola cues compared with Pepsi Cola cues. During the taste phase the same beverage elicited stronger activation in left ventral striatum when it was previously announced by a strong compared with a weak brand. This effect was stronger in participants who drink Cola infrequently and might therefore point to a stronger reliance on brand cues in less experienced consumers. The present results reveal strong effects of brand labels on neural responses signalling reward.

Concepts: Left-wing politics, Caffeine, Advertising, Coca-Cola, Cola, Pepsi, PepsiCo, Logo


Previous research suggests that effects of caffeine on behaviour are positive unless one is investigating sensitive groups or ingestion of large amounts. Children are a potentially sensitive subgroup, and especially so considering the high levels of caffeine currently found in energy drinks. The present study used data from the Cornish Academies Project to investigate associations between caffeine (both its total consumption, and that derived separately from energy drinks, cola, tea, and coffee) and single-item measures of stress, anxiety, and depression, in a large cohort of secondary school children from the South West of England. After adjusting for additional dietary, demographic, and lifestyle covariates, positive associations between total weekly caffeine intake and anxiety and depression remained significant, and the effects differed between males and females. Initially, effects were also observed in relation to caffeine consumed specifically from coffee. However, coffee was found to be the major contributor to high overall caffeine intake, providing explanation as to why effects relating to this source were also apparent. Findings from the current study increase our knowledge regarding associations between caffeine intake and stress, anxiety, and depression in secondary school children, though the cross-sectional nature of the research made it impossible to infer causality.

Concepts: Anxiety, Coffee, High school, Caffeine, England, Tea, College, Coca-Cola