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Energy drinks are everywhere. How dangerous are they?

If you believe the ads, energy drinks turn ordinary schnooks like you and me into lean, mean, git-her-done machines. They promise to give you wings, unleash the beast, make you the boss of time, and enable the crushing of your enemies. No wonder sales have bo…

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If you believe the ads, energy drinks turn ordinary schnooks like you and me into lean, mean, git-her-done machines. They promise to give you wings, unleash the beast, make you the boss of time, and enable the crushing of your enemies. No wonder sales have boomed in recent years, growing by 73 percent from 2018 to 2023. Nearly half of consumers drink them multiple times a week. In addition to the offerings at retail and convenience stores, chains like Starbucks, Dunkin, and Caribou Coffee are adding energy drinks to their menus. In the next five years, energy drink sales are on track to reach $30 billion in the US. The vast majority of the people who drink energy drinks — mostly teens and men aged 18 to 34 — don’t die as a result. Occasionally, though, some do. The Center for Science in the Public Interest counted 34 deaths linked to these products between 2004 and 2014. More recently, the families of a female college student and a 46-year-old man sued Panera over the deaths of their loved ones following consumption of its highly caffeinated Charged Lemonade drinks. A far larger chunk of people who consume energy drinks experience other unpleasant side effects as a result, ranging from sleeplessness to twitchiness to anxiety to gastrointestinal distress. Still, demand for these products is mounting, even outside of their sweaty core constituency. That’s not an accident: As the current male market has neared energy drink saturation, manufacturers have set their sights on adults beyond college age — especially women, according to a recent report from market analysis firm Mintel. They’re reaching these new mouths by capitalizing on a growing and somewhat whimsical demand that the liquids we drink not only quench our thirst, but also reduce our stress, focus our minds, and improve our physical performance. That’s why, despite the persistent drip-drip of deaths that trails the industry, energy drink manufacturers are bullish (sorry) about their future. Energy drinks contain a variety of stimulants, some of which we understand better than others Energy drinks’ wakefulness-boosting qualities come by virtue of their ability to get stimulants into your bloodstream with cold, sweet efficiency and only an occasional metallic aftertaste. In addition to lots of added sugar, almost all energy drinks add caffeine to their formulations. Many also include guarana, an Amazonian plant that contains high levels of naturally occurring caffeine and other stimulants. Another common ingredient is taurine, a building block of proteins that occurs naturally in the human body and actually has the effect of tamping down the activity of certain nerve cells. In moderate amounts, caffeine makes people feel more alert, attentive, and energetic. However, in larger amounts, its negative effects — including jitteriness, nausea, and tremor — may overwhelm the positive. Scientists know surprisingly little about taurine’s and guarana’s toxicities in humans — most of the safety data for these products comes from animal studies — but they know a lot more about caffeine’s effects on various human organ systems. Many of those effects depend on how often and how much of it you consume: Although a big cup of coffee won’t meaningfully affect blood pressure or heart rate in people who are daily coffee drinkers, it could spike both in non-coffee drinkers, and large quantities can lead to serious side effects, including severe recurrent vomiting, seizures, and muscle breakdown. There’s also enormous variation in the amount of caffeine energy drinks contain. A typical 8-ounce cup of coffee has around 100 to 150 milligrams of caffeine. Filling the same cup with Monster Energy gives you only 80 milligrams, while filling it with 5-Hour Energy (four shot-sized bottles’ worth, something I implore you not to do) would give you 800 milligrams. (The Food and Drug Administration recommends a daily maximum of 400 milligrams of caffeine for most adults, a guideline based on recommendations issued by Canadian public health authorities.) Meanwhile, a large cup of the now-discontinued Panera Charged Lemonade, without ice, could contain 390 milligrams of caffeine. Because they were initially sold in self-serve dispensers, customers could easily free-refill their way to several days’ allowance of caffeine in one sitting. (The largest size of Starbucks’s Iced Energy tops out at 205 milligrams, and refills are not free.) How energy drink ingredients can lead to medical emergencies Although energy drinks have been linked with a range of worrisome health effects, some of the biggest concerns are related to their effects on the cardiovascular system and the heart’s rhythm in particular. Several studies have shown energy drinks raise heart rate and blood pressure, which in extreme cases can lead to spasms, rips, or clotting in blood vessels. They have also been linked to disruptions to the heart’s wiring that in certain higher-risk people could lead to cardiac arrest — when the heart stops beating entirely. One out of every 200 people have a genetic heart condition of some kind that puts them in that high-risk category, says Michael Ackerman, a cardiologist at the Mayo Clinic in Rochester, Minnesota. The most common circuitry problem in that group is called long QT syndrome, which affects one out of every 2,000 or so people. Ackerman counsels people with this syndrome to avoid medications, foods, and beverages (like energy drinks) that irritate the heart’s wiring, and occasionally prescribes medication to reduce their risk of having a rhythm problem. However, the condition is often asymptomatic and therefore may go undiagnosed until someone has symptoms. It’s not clear exactly which ingredients in energy drinks are responsible for throwing a wrench in the heart’s circuitry. Caffeine seems as though it would be the most likely culprit — in pure and highly concentrated forms, the drug can be lethal — but in clinical studies of smaller amounts of caffeine on its own, it doesn’t seem to cause heart wiring changes or rhythm problems. (However, outside of closely monitored study settings, people are probably drinking larger quantities of energy drinks at a much faster clip; it may be that researchers have simply never studied the caffeine-related effects of real-world levels of energy drink consumption.) The effects of energy drinks’ other ingredients on heart rhythms are an even bigger question mark, although some studies suggest interactions between multiple ingredients may disrupt heart rhythms. Ackerman has been asking his patients about energy drink consumption since 2000 and recently conducted a small study looking back at the medical records of the 144 patients he evaluated after they survived a cardiac arrest. Seven of them — 5 percent — had consumed an energy drink shortly before their hearts stopped beating. Only one of those seven had a previous diagnosis of a heart condition known to make energy drink consumption more risky. One detail of the study was particularly eye-catching to me: Six of the seven patients with post-energy-drink cardiac arrest were women. Ackerman said that’s likely related to estrogen’s propensity to induce heart rhythm fritziness in people with long QT syndrome. Still, the finding seems deeply ironic given that women have historically consumed far fewer energy drinks than men. This is a tiny study, and Ackerman cautions against overreacting to its findings. “Consumption is at all-time-high levels, and people aren’t dropping like flies left and right,” he says. “The absolute risk, if your heart is healthy, is super, super, super low.” Still, many energy drinks are marketed as supplements and can therefore claim to do all kinds of things without proof, says Jensen Jose, who works on regulation issues related to food additives, food chemicals, and dietary supplements at the Center for Science in the Public Interest. They can do so without giving you the information you need to moderate your intake of caffeine or other proven or potential compounds that stimulate or irritate the cardiovascular system. Although a product label may list caffeine and guarana extract, says Jose, “You have no idea how much caffeine you’re getting from either one of those ingredients.” An FDA loophole means there aren’t legal limits on the amount of caffeine in any of these products, nor does the agency require manufacturers to tell you how much caffeine is in them. How should consumers who like energy drinks keep themselves safe? “There’s no answer to your question,” says Jose, in large part because so little is known about what’s in a lot of these beverages and what intake levels make the most sense. Still, consuming only drinks that list their caffeine content — and consuming those in moderation, ensuring you’re staying under the FDA’s recommended daily limit — is, he says, better than mindlessly pounding one can after another. Although Ackerman doesn’t think the drinks’ sale should be restricted, the risk-benefit equation doesn’t at all tilt toward consuming them. “They don’t have much redeeming health value anyways,” he says. The Centers for Disease Control and Prevention recommends kids and teens avoid energy drinks entirely. Energy drinks began as a product marketed toward men, but that’s changing The modern energy drinks’ closest ancestor is probably the Japanese Lipovitan D, which first rolled out in 1962. Powered by a combination of taurine, caffeine, and other ingredients, these drinks were marketed with an emphasis on a hegemonic fight/burn/roar sleep-is-for-the-weak type of masculinity. In the 1980s, an Austrian businessman’s encounter with a Thai beverage containing taurine and caffeine led to the creation of Red Bull, the first entry into the modern Western energy drink canon. The market has only grown since, spurred by partnerships with the growing extreme sports and video gaming industries, which already attracted hordes of teen boys extremely receptive to messaging aimed squarely at their desire to prove their masculinity. In 2015, psychologist Ronald Levant found that among white college-aged men, energy drink consumption was driven by an embrace of traditional masculine ideology, which defines “real men” as tough, dominant, horny, handy, homophobic, and unemotional (unless mad or triumphant). Much of this effect was about boys seeking ways to be more manly, he tells Vox: “They're looking for ways to enhance their masculinity, and they saw energy drinks as a way to do that.” The aspiration to that kind of manliness is still alive and well on what commentator Max Read has called the Zynternet, the “fratty, horndog, boorishly provocative” corners online. The people occupying those corners and the men in their social networks still comprise a big part of the target audience for many energy drink brands. Because energy drinks have leaned so hard into their associations with traditional masculine norms, you might imagine they’d have a hard time finding audiences among groups less interested in beating their chests and peeing on things. Several years ago, however, manufacturers began a concerted effort to change that and started targeting tired, distracted women and post-college adults looking for solutions to their droopiness. Enter Alani’s saturated tropical swirls, Celsius’ fruit-forward flavors and packaging, Red Bull’s curuba elderflower “Summer Edition,” and the no-longer-in-production Go Girl. Russell Zwanka, who directs the food marketing program at Western Michigan University, says the pivot to young adults and women was unambiguous and long overdue. The trend that’s enabling this more expansive view of the energy drink audience is the consumer itch for beverages that do things, says Zwanka. “All marketing is now geared toward, ‘What is the function of the beverage?’” he says. In food marketing parlance, functional beverages contain biologically active compounds that give them specific health benefits. Currently, the most highly sought-after benefit is one you’d think would be a slam-dunk for something you slurp from a can: “Hydration has been by far the trend for the last year and a half. It is off the charts,” says Zwanka. To take energy drinks at their word, you’d have to forget they’re actually unlikely to provide better hydration than Gatorade or milk, especially because at higher doses, caffeine functions as a diuretic — that is, it actually drives water loss through increased urination. Energy drinks are promising it anyway, and so much more, because there’s simply not that much regulatory oversight on what’s in them or how they're marketed. That’s doing a great disservice to Americans, says Jose. “We want transparency in our food system,” says, “and we think that’s a pretty obvious first step.”
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Jones-Aspinall? Gaethje-Chandler? The MMA fights we want most the rest of 2024

Dream fights. Superstar debuts. Trash-talk-filled matchups. Here's a wish list of most desirable fights for the rest of the year.

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2024 is already shaping up as one of the most dramatic years in MMA history, and it's only just halfway over. Alex Pereira has saved not one but two major UFC events. Max Holloway delivered arguably the greatest knockout in MMA history. Conor McGregor is still teasing the biggest comeback in MMA history, much to the frustration of Michael Chandler.

And the year's second half might be better than the first. The McGregor speculation will continue, of course. Jon Jones is expected to return. Sean O'Malley is potentially looking at a career year, if he beats Merab Dvalishvili. Israel Adesanya is searching for retribution in a grudge match with Dricus Du Plessis. The UFC is headed to the Sphere in Las Vegas, a megaevent based on the venue alone.

There's plenty to look forward to outside of the UFC, including the tease of Francis Ngannou's PFL debut and Bellator title fights featuring champions Usman Nurmagomedov and Johnny Eblen.

Here are 10 fights I'd love to see in the next six months.

In January, this was the No. 11 matchup I most wanted to see in 2024. It's now up to No. 1, based on what Topuria and Holloway did in the first half of the year.

Holloway's BMF knockout against Justin Gaethje was an all-time performance. What Topuria did to Alexander Volkanovski in February was equally impressive. There's a growing personal rift between these two, which is extremely rare for a Holloway fight. Historically, it's been impossible to draw Holloway into pre-fight trash talk, but Topuria might be the exception. If I can only watch one fight the rest of the year, this is it.

The UFC is not going to book this fight. UFC CEO Dana White has adamantly maintained that Jones vs. Stipe Miocic will be next. I'm not a fan of that matchup. Miocic is the greatest heavyweight of all time, but booking him a championship bout when it's been over four years since his last win is silly. Maybe if Aspinall knocks out Curtis Blaydes at UFC 304 in the most spectacular fashion of all time and cuts the greatest promo the sport has ever seen, White would pivot. But probably not. I'm going down with this ship, though. The heavyweight fight to make in the UFC is Jones vs. Aspinall.

If the UFC doesn't make Jones vs. Aspinall, I'd like to see it make Aspinall vs. Pereira. White has made it clear he's not in favor of Pereira going up too quickly, but Pereira has countered that he is 37 years old and wants a third belt, so it needs to happen sooner rather than later. If we're being honest, Aspinall should be fighting Jones. That's the fight for Aspinall. So, if we're not going to make the fight that makes the most sense, let's do the next most exciting thing -- give Pereira a chance to make history with a third belt by fighting Aspinall.

The sport is very down on Chimaev, which is understandable. In the last two years, he badly missed weight against Nate Diaz, didn't look great in a three-rounder against Kamaru Usman and pulled out of the biggest fight of his career against Robert Whittaker.

Costa is not exactly peaking, either. He's lost four of five and was timid against Sean Strickland. However, if these two made it to fight week against each other, the buildup would be outstanding and highly anticipated. If it happened, fans would love it despite the millions of eye rolls that would occur when the UFC announced it.

We still don't know what's happening with McGregor, but Chandler seems ready to move on if the right opportunity comes. This matchup would make so much sense on so many levels. Gaethje did the UFC a solid by fighting Holloway in April, even though he was waiting in line for a lightweight title shot. Chandler has done everything the UFC has asked to stay the course on a potential McGregor fight, including filming "The Ultimate Fighter." Islam Makhachev wants new opponents, preferably with name value. The first fight between Gaethje and Chandler was entertaining. Book the rematch and call it a No. 1 contender fight.

All signs point to a Pennington versus Peña title bout in the fall, potentially in October. Depending on what happens there, it would be great to see the winner turn around quickly and fight Harrison by the end of the year. If it doesn't happen this year, it's perfectly understandable. It just feels like it's a long time coming to see Harrison in a UFC title fight, and it'd be nice to see her compete more than once in 2024, as she only fought once in 2023 as well.

In some ways, it still feels like Pico has never recaptured the hype he came into the sport with, after going 4-3 in his first seven pro appearances. Since then, however, he is 9-1 with seven finishes -- with the only loss coming to Jeremy Kennedy when he suffered a shoulder injury in the first round.

Pico, 27, is realizing the potential he came into the sport with, and it's fun to watch right now. Pitbull is one of the best featherweights -- and arguably one of the best fighters -- of the last decade. This might be a passing of the torch moment, or Pitbull will show Pico's not at a championship level. It's a fight that's worthy of your attention.

This is the most anticipated fight that PFL could put on at the moment, and it only became bigger when Ferreira knocked out Ryan Bader in 21 seconds in February. There was already so much intrigue around Ngannou, from how he might respond to a knockout loss to Anthony Joshua in boxing to his first MMA appearance outside of the UFC. The African champion has endured a personal tragedy this year, with the death of his young son, Kobe. Ngannou is already one of the most inspirational figures the sport of mixed martial arts has ever seen. If he chooses to come back and take on a challenge like Ferreira, it will be impossible not to root for him.

The PFL has something in Ditcheva. She is charismatic, authentic, supremely confident and ready for the spotlight, which is huge considering her quick rise. She's still relatively untested, but the skill set looks very legit. Ditcheva moves and throws strikes in a way that jumps off the screen. If Ditcheva remains the real deal, she has true star power. Next month, Ditcheva faces Jena Bishop in the PFL semifinals, which is an intriguing matchup. Bishop figures to test her on the ground in ways she has not been yet. If Ditcheva wins, throwing her in with either Carmouche or Santos would be the final step to see if she is a world-class talent at age 26.

It's a fight that makes too much sense now. A win would buy Covington back some goodwill with the fans and the UFC that he lost in a lackluster performance against Leon Edwards last year. If he beats a young, hungry, surging contender such as Machado Garry, it reaffirms his place near the top of the 170-pound division and gives any of his callouts more validity. For Machado Garry, it's a chance to add the biggest name to his résumé yet and earn a good share of the spotlight. I'd love to see it as a main event, preferably in Ireland. Covington in Ireland would be a scene. Tell me you wouldn't get up for that fight week.
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5 causes — and accelerants — of political violence

Information is still emerging about the shooting at former President Donald Trump’s campaign rally in Pennsylvania on Saturday. However, even though the complete picture isn’t available, there are ways to think about the political and social moment we’re livi…

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Information is still emerging about the shooting at former President Donald Trump’s campaign rally in Pennsylvania on Saturday. However, even though the complete picture isn’t available, there are ways to think about the political and social moment we’re living in and how it may have contributed to the violence. We do know the shooter, Thomas Matthew Crooks, was a 20-year-old from Bethel Park, Pennsylvania, about a 75-minute drive from Butler, where the rally was being held. He was a registered Republican (though he also made a $15 donation to a progressive group), perpetrated the shooting with an AR-15 style rifle purchased by his father, and had at least two explosive devices with him. And he was killed by a Secret Service agent after he killed 50-year-old Corey Comperatore and injured Trump as well as two others. It’s entirely possible the shooting won’t be deemed “political” at all — we simply don’t know enough about the motive. But it’s fair to say that the attempted assassination has raised the political temperature in an already volatile country. Since Trump’s 2016 election, the US has seen the Charlottesville protests, the 2018 Tree of Life shooting, the 2022 Buffalo shooting, and the January 6, 2021, Capitol riot, among other events; now, the specter of political violence looms over our future, too. To better understand the anxious and destabilized moment we’re living in, Vox spoke to four experts to help explain how political polarization, state violence, online radicalization, and feelings of disenfranchisement can drive political violence. Based on our conversations, here are five ways we should think about political violence in this historic moment — why it breaks out and why violent periods often get worse before they get better. Extreme polarization can make political violence more likely Violence of this nature is unpredictable; that’s part of what makes it terrifying. Mass shootings, terror attacks, and political violence like Saturday’s shooting are profoundly destabilizing, especially in a profoundly violent time, with multiple wars and civil conflicts ongoing. But we do know that there are social, political, and interpersonal factors that contribute to public, politically motivated violence. Lilliana Mason, associate professor of political science at Johns Hopkins University: Political violence is more likely to emerge when a society is politically divided along identity-based lines. When parties are on opposite sides of racial, ethnic, or religious divides (like our parties are in the US), it becomes easier for people to think of their political opponents as enemies. In the US, we’re also geographically divided, so partisans have little exposure to regular people from the other party. This creates what we call “moral disengagement,” which consists of vilifying and dehumanizing attitudes toward our political opponents. These attitudes allow us to harm our fellow citizens without feeling like bad people ourselves. Erik Nisbet, professor of policy analysis and communication at Northwestern University: We’re incredibly tribal and our political identities have become almost mega identities. They supersede all other social or cultural identities that we have. For some people, this is combined with these perceptions and rhetoric of dehumanizing the other side: “The other side is immoral — and an existential threat to our group, to our identity …” And if the other side is immoral, not human and a threat, then violence becomes almost morally justified. “I still can be a good person and engage in violence.” And that’s how many of those around January 6, for example, viewed themselves: They were good people. They were righting a wrong. And violence was justified in that case. Political violence is more American than we’d like to admit Violence has always been a part of our politics. As Today, Explained host Sean Rameswaram put it recently, “Joe Biden has spoken about three times in about 24 hours about this assassination attempt on his opponent … The first time he said, ‘This isn’t us.’ The second time he said, ‘This isn’t us.’ The third time he said, ‘This isn’t us.’ But I think students of history might recall that this is kind of ‘us.’” Nisbet: Unfortunately, it’s us, but there is something different in this historical moment. What’s different over the last 10 years is that political violence is no longer just political violence — it’s partisan violence. It’s violence that’s focused on and centered around our political identities as Democrat and Republican. Previously, political violence was actually pretty symmetrical on the left and the right; it was focused around more general ideologies. Focused on maybe single issues. Now, political violence, the trends in recent years, are focused on more, “I am a Democrat, and thus I support violence against Republicans” or vice versa. And at least in terms of the number of violent acts tracked by the FBI and domestic terrorism databases, it has been more right-leaning in recent years than left. [Media: https://megaphone.link/VMP3197633622] Today’s extremism didn’t appear out of nowhere Politically motivated public violence doesn’t happen in a vacuum; people don’t simply plan an assassination attempt or bombing for no reason. Political radicalization, personal grievance, and psychological illness all interact with social forces like political polarization — as well as the bare fact of widely available deadly weapons — to make political violence more likely. Kurt Braddock, assistant professor of public communications at American University: We’re finding that extremists are motivated often by the way that they engage with content online, whether that content be a social network, or content that they’re absorbing. It never occurs in a black box and never occurs in isolation. There’s always some kind of way that the attacker perceives that their action is part of a greater movement they learned about and are motivated by, in the context of their interactions, usually with people online. There is some social upheaval when assassination attempts occur. It often has to do with the shooters’ perceptions of that social upheaval. Oftentimes, they feel as though they’ve been personally victimized, or that they perceive that there has been a threat by the target on them, or their own safety, which is why I think there’s a connection between state repression and actual violence against politicians. Violence can come from a perception that people are losing their rights The loss of privileges and rights — whether real or perceived — is another motivator of political violence. That’s a fairly easy pattern to recognize throughout the 20th and 21st centuries in American history. Violence perpetrated by the state against citizens also plays a part in acts of violence against the state or its representatives. When the state visits its disproportionate capacity for violence on people — whether that is via repressive legislation or police brutality — violence against the state becomes a more logical response. Braddock: There’s pretty significant literature that shows that one of the things that increases violence generally — not just terrorism, but also insurrection and riot and things like that — is state repression and the idea that people are losing their rights, that people have a perception that they’ve been victimized in a way. That’s been in the literature for quite some time. There’s a theory of radicalization that argues that when one “side” starts to become more and more radical, the other side feels the need to engage in defense — they get radicalized themselves to engage in defense. Nathan Kalmoe, executive director of the Center for Communication and Civil Renewal at the University of Wisconsin-Madison: Many political scientists define the state as an entity that holds a monopoly on the legitimate use of force within its territory. In other words, the state can do violence, and no other person or group can do so toward the state or each other without punishment. That puts the threat of state violence against its citizens at the center of our understanding of government, even for good governments. State violence and political violence by citizens are often mutually supportive. For example, the violent white supremacist response to the Civil Rights Movement often combined Klan violence alongside police violence against activists and ordinary citizens. Sometimes they coordinated or even worked together, while other times they merely worked toward the same broad goals of maintaining white supremacy. Research by Professor Christian Davenport at the University of Michigan and his colleagues shows that people tend to view the appropriateness of violence by the state and violence by citizens as proportional to each other in ways that parallel proportionate/disproportionate violence in wars. So, police acting with disproportionate violence against protesters makes people more willing to endorse proportionate violence against police in response. Violence begets violence The US body politic is already highly polarized, and an apparent attempt on a presidential candidate’s life is not going to change that. In fact, there is some reason to be concerned about the possibility that more violence of this nature is in store in the coming months. Nisbet: One of the drivers of political violence is what we call meta perceptions. If a Democrat thinks Republicans are violent, they’re more likely to engage in violence themselves and vice versa. It’s “If they pull a knife, we pull a gun.” And so acts of political violence actually will beget violence because it makes each group more willing to engage in violence as sort of a self-protective function. And that becomes like a self-reinforcing spiral. Kalmoe: I’m very worried about the potential for subsequent political violence. What we learn about motives may have a big impact on that. The vast majority of Americans are opposed to political violence, but that shifts substantially if the other side is seen as acting violently first. The most inflammatory situation would be an ideologically motivated killer from the political left, though it helps that Democratic leaders have uniformly denounced the violence. Braddock: I’m glad to see that people on both sides, whether politically motivated or not, are coming out against political violence. And I’m hoping that that’s a trend that continues. I wouldn’t say I’m confident, but I am hoping for it. I worry, though, that we are going to see more violence coming from this. Peter Balonon-Rosen and Sean Rameswaram contributed reporting to this article.
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