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'Drinking cola can lead to paralysis and heart problems'

21 May, 2009

Drinking large amounts of cola can cause paralysis, reported The Daily Telegraph.

Brought to you by NHS Choices.

It said that doctors have warned that muscle problems, an irregular heartbeat and even paralysis can be caused by

drinking large amounts of cola. The newspaper said that chronic cola consumption can cause hypokalaemia, a condition in

which patients have low levels of potassium in the blood.

The news report is based on a review of six case reports featuring people who drank excessive amounts of cola and

developed hypokalaemia. More research is needed to establish whether drinking large amounts of cola can cause this

condition.

It should be emphasised that these people drank three to 10 litres of cola a day for an extended period of time. Drinking

such large amounts of sugar-rich soft drinks is known to raise the risk of diabetes, tooth erosion and obesity. At present,

these should be considered as more likely and worrying effects of drinking such large amounts of soft drinks.

Where did the story come from?

The research was carried out by Dr Vasilis Tsimihodimos and colleagues from the Department of Internal Medicine at the

University of Ioannina in Greece. The study was published in the peer-reviewed medical journal The International Journal

of Clinical Practice.

What kind of scientific study was this?

This review investigated the rare, but potentially dangerous, side effect of hypokalaemia (low blood levels of potassium)

caused by the consumption of large amounts of cola-based soft drinks. The authors searched for published case studies on

the subject, and discussed its clinical significance and how it might occur.

To find suitable case studies, the researchers searched the database PubMed for instances of cola, hypokalaemia,

potassium and caffeine.

They say that soft drink consumption has increased considerably over the last few decades and that cola-based soft drinks

are now possibly the refreshment with the most sales worldwide. Concerns have been raised about the effects of colas on

human health, including the softening of tooth enamel, the loss of bone minerals and diabetes mellitus. They say there is

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also some evidence that drinking large amounts of cola-based soft drinks over a long period of time may result in severe

symptoms from low blood potassium.

What were the results of the study?

The literature search found six case reports published between 1994 and 2008. The case reports feature six individuals

who developed problems after drinking three to 10 litres of cola a day for more than a month and a half (most cases

sustained this intake for one to three years).

The six individuals included two pregnant women and four non-pregnant individuals. The first pregnant woman reported

tiredness, a loss of appetite and recurrent vomiting. The 21-year-old woman had drunk more than three litres of cola a day

for the past six years. She was found to have severe hypokalaemia (she had potassium levels of 1.9mmol/L when the level

is usually above 3.5mmol/L) and a slow heartbeat. After stopping cola consumption and replacing the potassium in her

blood she made a full recovery. The other pregnant woman reportedly suffered from muscular weakness and very low

serum potassium levels.

The most common health complaints from the six case reports were muscular in origin and ranged from mild weakness to

serious paralysis. All the individuals had abnormally low levels of potassium in the blood, which the authors say could not

be attributed to other more common causes of hypokalaemia.

All six patients made a full recovery. The authors of the individual case reports mostly suggest caffeine intoxication to be

the probable cause.

What interpretations did the researchers draw from these results?

The researchers say that it is well known that caffeine may result in severe hypokalaemia because the chemical moves

potassium into cells and increases the excretion of potassium through the kidneys. They say that several other cases of

hypokalaemia have been described in individuals consuming large amounts of other caffeinated drinks such as tea and

coffee.

They say that there are important public health implications to their findings and, despite the full recovery of all patients so

far, they say that chronic hypokalaemia clearly predisposes individuals to the development of potentially fatal

complications such as cardiac arrhythmias (heart rhythm abnormalities). They propose that it may also be a cause of

increased fatigue, loss of productivity and muscular symptoms that could vary from mild weakness to profound paralysis.