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Think twice before you take a sip from that cola bottle this summer. Experts are warning that excessive cola consumption can lead to anything from mild weakness to profound muscle paralysis.
This is because the cola drinks can cause blood potassium to drop dangerously low, they report in the International Journal of Clinical Practice.
They tell of the curious case of an Australian ostrich farmer who needed emergency care for lung paralysis after drinking 4-10 litres of cola a day.
He made a full recovery and was advised to curtail his cola intake, BBC News portal reported on Tuesday.
Another example included a pregnant woman who regularly consumed up to three litres a day for the last six years and complained of tiredness, appetite loss and persistent vomiting.
A heart trace revealed she had an irregular heartbeat, most likely caused by her low blood potassium levels.
Once she stopped drinking such quantity of cola, she made a full and uneventful recovery.
The investigators believe these cases are not atypical and that many people risk problems due to their intake. Manufacturers insist the products are safe when consumed in moderation.
In a commentary, Clifford Packer from the Louis Stokes Cleveland VA Medical Centre in Ohio said: "We have every reason to think that it is not rare. With aggressive mass marketing, super-sizing of soft drinks, and the effects of caffeine tolerance and dependence, there is very little doubt that tens of millions of people in industrialised countries drink at least 2-3 litres of cola per day. "It follows that the serum potassium levels of these heavy cola drinkers are dropping, in some cases, to dangerous low levels."
The author of the study, Moses Elisaf from the University of Ioannina in Greece, said it appeared that hypokalaemia can be caused by excessive consumption of three of the most common ingredients in cola drinks - glucose, fructose and caffeine. "The individual role of each of these ingredients in the pathophysiology of cola-induced hypokalaemia has not been determined and may vary in different patients. However in most of cases we looked at for our review, caffeine intoxication was thought to play the most important role.
"This has been borne out by case studies that focus on other products that contain high levels of caffeine but no glucose or fructose."
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