The American College of Sports Medicine (ACSM) makes clear that energy drinks are “fundamentally different” than sports drinks like Gatorade or Powerade. 

But scrolling through social media or strolling through the grocery store aisle, and the lines start to blur a bit. When quarterback Justin Fields was a rookie, he inked an endorsement deal with C4 – an energy drink brand.

More recently, CELSIUS signed six Heisman Trophy “hopefuls” to NIL (name, image and likeness) deals. The company’s slogan is “live fit,” a motto many athletes can relate to.

Karan Rai, MD, is a sports medicine physician with OSF HealthCare who works in partnership with Illinois State University to see and treat ISU athletes. He says he’s having a lot of conversations with athletes about these types of drinks, and he always urges caution.

"Quite a few of them are not FDA approved," Dr. Rai says. “The reason that matters is that we often don't know the exact ingredients or mix of ingredients that are in the drinks. Depending on what's in the drink, that can affect your performance and your health. For example, caffeine is commonly involved in making these drinks.”

CELSIUS and C4, both have 200mg of caffeine content in a 16 ounce can. In contrast, a can of Pepsi has 38mg in a 12-ounce can, while an average 8-ounce cup of coffee has between 80-100mg of caffeine. Dr. Rai says higher levels of caffeine can have a negative effect on performance.

"It can cause excessive energy, anxiety and jitteriness, which depending on your sport or activity, can affect how you play,” Dr. Rai says. "The data is still a little bit mixed on the benefit things like green tea extract or guarana are providing, which are commonly marketed and used in sports drinks. 

In terms of what liquids athletes are putting into their bodies, Dr. Rai likes to break down hydration based on the activity.

"In activities that are generally 60 minutes or less, I recommend maximizing your water intake and timing that for at least 30-60 minutes before your activity," Dr. Rai says. “Then as you get into longer duration activities with more endurance, and you're pushing that 60-minute mark or longer, that's when you need to look into the type of electrolytes you're ingesting as well. Looking at drinks or gels out there that have a mix of sodium and potassium. Those typically help with performance during your activity.”

Another sign if you’re drinking enough water? The color of your pee.

"I often tell my patients and athletes to consider their urination. Typically, we have various scales we use based on your urine color, the amount you're urinating and how thirsty you feel. That can play a role in deciding if you need to hydrate with water alone or use a sports drink like Powerade or Gatorade. Or if you need to adjust your salt intake, things like that," Dr. Rai says.

If you have an underlying heart condition, are younger than 18 or are pregnant, Dr. Rai urges you to steer clear of these drinks.

“With quite a few of the sports performance drinks nowadays, which CELSIUS is one of them that's more publicized, the amount of caffeine in it, and ingredients like guarana, which has a caffeine component to it, can exacerbate underlying arrythmias,” Dr. Rai says. “This can put someone with a pre-existing risk at a higher risk.”

Sports drinks like Powerade and Gatorade have a sugar and electrolyte component that is "fairly safe," Dr. Rai says. But the effects of Celsius, Prime and other drinks out there aren't fully understood yet. So, proceed with caution. Talk with your primary care provider or sports medicine physician to get an individualized take on it. 

Video Interview Clips

Miami Dolphins quarterback Tua Tagovailoa recently suffered his third confirmed concussion in 25 months – just another reminder that football and other contact sports pose the threat of a traumatic brain injury.  Research indicates it’s important to accurately and immediately diagnose a concussion because the consequences of misdiagnosis or faulty management can lead to major disability or death.

Illinois State University senior Cyerra Hibbert knows about concussions. She’s had multiple ones while playing soccer in high school and at ISU, the most recent just a month ago. Hibbert is one of the first athletes to test a new FlightPath concussion app. The lead app developer is *Adam Cross, MD, a pediatric hospitalist and clinical informaticist for OSF HealthCare and director of the OSF Children’s Innovation Lab at Jump Simulation & Education Center in Peoria, Illinois. He is working with co-lead Inki Kim, of the Health Care Engineering Systems Center at the Grainger College of Engineering at the University of Illinois Urbana-Champaign.

The concussion assessment app is a grant-funded project through Jump ARCHES, a research collaborative that partners teams of clinicians and engineers working together to improve patient outcomes and reduce health care costs. The FlightPath app is being tested at Illinois State, Illinois Wesleyan and Bradley Universities as part of a clinical trial and research coalition.  Hibbert used the FlightPath app after receiving instructions from her athletic trainer six days after she received a blow to the head during a game.

Hibbert was able to finish the test. It only takes about two minutes to collect more than a million data points as a person tries to catch a hummingbird within a 3D space on a screen.

“After a while it did bring a little confusion or if I wasn’t aware of where the bird flew on or off the screen, that did trick a little bit of my memory and concentration skills, so I do think it’s definitely approachable," Hibbert explains. “It’s definitely doable. I think just based on your outcome will determine where you are in your concussion level.”

Dr. Cross says the single biggest risk factor for prolonged time to recovery is delayed diagnosis, so FlightPath is his answer with its ability to diagnose a concussion within minutes. His research team has done some internal testing.

“Regarding how well it detects differences in impairments with people – how well they can determine if someone is functioning, acting appropriately, or if there's if there's something else going on. The challenge has been really doing that with individuals that have true concussion,” says Dr. Cross.

Athletes with a suspected concussion are challenged by FlightPath to walk in their environment while trying to keep a hummingbird in a bubble on the screen.

“The players themselves are trying out this app while concussed after having been consented earlier on in the year so that we can get data around how they perform with this app while concussed versus not concussed, and comparing that to the normal, typical present-day evaluation techniques that the trainers perform.”

Dr. Cross stresses, right now, the clinical trial does not involve trainers using the app to help make decisions. He says the research is not that far along and data collection needs to happen first. But, Karan Rai, MD, a sports medicine physician with OSF HealthCare who also serves as the team doctor for ISU Athletics, says eventually, the data from FlightPath could help beyond diagnosis.

“It in turn can help us with making prognoses, coming up with recovery timelines, implementing certain vestibular therapy. Other than diagnostic purposes, we can extrapolate that data to help us come up with a better treatment plan as well.”

Takes the pressure off
Both Hibbert and Dr. Rai are excited to be part of what they consider ground-breaking research that has the potential for helping athletes in the future. Hibbert, who plans to go into medical sales, says it’s helpful to have an objective tool for an evaluation. She thinks it takes the pressure off athletes.

“Because as athletes, we’re always eager to be on the field or play the game and to have that mindset to be better and get back on your feet as quickly as you can. I think this app will allow you to really settle and to really take your time with your symptoms.”

The clinical trial is looking at whether FlightPath can do as good or better as traditional methods in diagnosing a concussion.  So far, Dr. Rai says nearly 15 athletes who have suffered a concussion have completed a FlightPath assessment and it’s been performing well.

“Results are early so far but in our sample size we found some associations at least where FlightPath has shown some abnormalities similar to what other examinations have found as well, whether that’s the SCAT test or the ImPACT test.”

There are other concussion applications commercially available, but Dr. Cross suggests none are as robust as FlightPath.

“There aren't any, as far as I've seen, that use this mixed reality approach to gather the kinds of data that we're gathering. This is very rich data in a very short time in our app. One of the things that makes it so unique and sets it apart is that we get so much data about so many different manifestations of concussion in such a short time.”

Testing is expected to take at least two years. After testing, the app will be submitted to the FDA for clinical approval.

Here is a video demonstrating how the app works.

*Dr. Adam Cross also holds these positions:
Assistant Professor, University of Illinois College of Medicine Peoria, Division of Pediatric Hospital Medicine
Adjunct Professor, University of Illinois at Urbana-Champaign, Health Care Engineering Systems Center (HCESC)
Clinical Research Informatician, OSF HealthCare | Jump Trading Simulation & Education Center (JTSEC) 

Dr. Adam Cross, ISU soccer player Cyerra Hibbert and Dr. Karan Rai

B-roll of ISU soccer player Cyerra Hibbert on soccer field

B-roll of FlightPath app demonstration

OSF HealthCare is turning to researchers for improved insights as it strives to make sure care teams know patients better to prevent health challenges and to manage their chronic diseases.

A recent Connected Communities Initiative (CCI) grant of up to $75,000 will support research to improve health care outcomes by incorporating social drivers of health (SDoH) data into predictive models. Social drivers of health are non-medical factors that have a big impact on a person’s health and wellness. Those can include a person’s financial constraints, housing, transportation, childcare and access to fresh food, among others.

Those needs can often be revealed by where a person lives. For example, the Robert Wood Johnson Foundation has tied ZIP codes to data showing a person’s life expectancy by neighborhood.

By integrating SDoH factors with information from traditional patient records, the project seeks to develop more accurate predictive models for 30-day hospital readmission and health care costs. Led by a collaborative team of data science experts and health care professionals, the research involves exploring SDoH data features, enriching already existing predictive models, and fine-tuning them for better accuracy.

Chris Franciskovich, vice president for Advanced Analytics, OSF Innovation, stressed, “The goal is to provide actionable insights and develop advanced predictive models to transform health care decision-making and resource allocation. Ultimately, this initiative should benefit patients, health care providers and insurance providers while contributing to advancements in health care technology and practices.”

Illinois State University co-lead researcher professor Maochao Xu, who directs the master’s program in the Mathematics Department, is excited to bring his expertise in statistical modeling to help patients and health systems. Graduate students will also contribute to the work, something Xu thinks is important as the role of artificial intelligence and predictive modeling will have growing applications in health care.

“We have three faculty members working on this who have great experience and can help students develop expertise in dating mining, statistical analysis and building and optimizing predictive models so they’ll help future generations better take care of patients.”

The CCI program is a partnership between OSF HealthCare and Illinois State University. The funding supports research involving clinicians, engineers and social scientists to rapidly develop technologies and devices that could revolutionize medical training and health care delivery.

As part of the five-year agreement, OSF HealthCare will provide Illinois State University athletes with access to athletic trainers, sports medicine providers, orthopedic surgeons and behavioral health professionals.

“We are excited to continue building our partnership with ISU and proud to be part of the Redbird fan club in an official capacity as the health care provider of Illinois State University Athletics. This new partnership reinforces our dedication to providing high quality health care to the Bloomington-Normal communities and extends that to the ISU athletes,” said Lynn Fulton, president, OSF HealthCare St. Joseph Medical Center.   

Robert Seidl, MD, will serve as the medical director of the ISU program and will work closely with Karan Rai, MD, a sports medicine physician with OSF HealthCare.

“Continuing to care for Illinois State Redbirds year after year is a passion of mine,” said Dr. Seidl. “I enjoy working with the athletes and supporting their ongoing health and wellness. The partnership with OSF HealthCare is a great addition and will elevate the breadth and depth of services for the student athletes.”

Illinois State University Interim President Dr. Aondover Tarhule is pleased that the partnership with OSF HealthCare continues to grow.

“Illinois State is proud of its student athletes and their remarkable achievements in the classroom and in competition. They put in long hours and great effort to excel in their studies and in their sports,” said Dr. Tarhule. “Supporting our student athletes in their pursuit of excellence is vitally important. This new partnership with OSF ensures that they have a team of dedicated and caring healthcare professionals in their corner as they study, train, and compete.”

OSF Healthcare and ISU both have a long history of being embedded in this area. ISU was founded in 1857, and the sisters of the Order of St. Francis opened what is now OSF St. Joseph Medical Center in 1880. Throughout the years, the two long-standing organizations have worked together for the good of the community. The two organizations in March launched a joint research partnership, the Connected Communities Initiative (CCI) to bring together clinicians, university faculty researchers and students to explore innovative ideas to improve health care with a focus on medical engineering, data science and cybersecurity.

“The health and safety of our student-athletes is the top priority for our department, and our partnership with OSF HealthCare will help us fulfill that mission,” said ISU Interim Director of Athletics Dr. Jeri Beggs. “OSF brings to the table a comprehensive, compassionate approach to physical and mental health care that aligns perfectly with our goals.  Also, it’s exciting for our athletics programs to join in on the collaboration of an academic partnership that the University announced with OSF HealthCare earlier this year.”

The athletic partnership launches with the first home football game when the ISU Redbirds take on Dayton on Saturday, September 2.                                               

Video clips with OSF Orthopedic Surgeon Dr. Robert Seidl and ISU Interim Athletic Director Jerri Beggs

Iowa was the only state where opioid-related deaths did not increase last year. The American Medical Association says more than 105,000 opioid overdose deaths were reported in the United States between December 2021 and December 2022.

Federal health officials blame the steep increase in opioid overdose deaths, in part, to the rapid growth of highly potent and often deadly fentanyl that can be added to look-alike opioid drugs. The surgeon general recommends more individuals, including family, friends and those personally at risk for opioid overdose, keep on hand and know how to use naloxone, a safe antidote to a suspected overdose.  When given in time, naloxone can save a life.

Scott Barrows, director of the OSF Innovation Design Lab at Jump Trading Simulation & Education Center, is working on an Illinois Innovation Network-funded education project called Virtual Reality Embedded Naloxone Training (VENT). It includes researchers at Illinois State University (ISU) in Normal and Southern Illinois University (SIU) in Carbondale, Illinois. The work centers around developing mixed-use or augmented reality education for an immersive, engaging approach to train people on how to give someone naloxone, often sold as a nasal spray under the name Narcan.

Barrows says the research will make use of cutting-edge technology, which blends the virtual and physical worlds.

“The mixed-reality portion of this being physical and virtual, will combine the actual spray device and a manikin so that people can practice the actual physical spraying with a manikin as well as having this virtual world that is valuable at the same time.”

The opioid epidemic is affecting all demographics, but Barrows points out underserved populations have the least access to resources for prevention, education and treatment. So, the training will be designed with input from a variety of stakeholders.

Keeping it simple and realistic

“It has to be simple. It has to be easy to use. It has to be intuitive, but it also needs to be sensitive to the community experience whether it's rural, urban, suburban, no matter what age, so that's going to be the trick of the design process," Barrows stresses.

The U.S. Food and Drug Administration made naloxone nasal spray available over the counter in March. It’s part of a strategy that includes harm reduction through innovation and education.

Joanna Willett, MSN, RN, a certified nurse educator who directs the nursing simulation lab at ISU’s Mennonite College of Nursing, believes research and development of innovative training can result in education that an average citizen, using a virtual reality headset, could use fairly easily.

“I've seen dozens of adults of all ages, parents, grandparents, sim lab visitors, etc. navigate our current nursing VR software without issue, and without nurses’ training, take lifesaving steps to save a patient with respiratory distress,” Willett says.  “I personally have no doubt that the intended audience of non-medical adults of all ages will benefit from this experience.”  

Virtual reality training has an advantage because it can be easily accessible and repeatable without significant setup or cost.  Willett believes once it is developed, the simulation training will be easy to maintain as an educational program. A prototype will be field-tested in community settings and at the Illinois State University simulation lab using 15 average citizens and five experts with diverse backgrounds.

Roy Magnuson, an assistant professor of Creative Technologies at ISU, will work with graduate students to design a prototype and make adjustments based on feedback. Magnuson has already developed music composition and conducting software for virtual reality. He’ll work with graduate students to create an immersive world, swapping out medical variables for ones he’s used for his other software development.

Magnuson is thrilled to take on the challenge.

Barrows believes the more immersive training will help people recall important best practices while in a high-stress, opioid overdose situation in real life.

“Providing as realistic a situation as possible, we think is more effective than certainly a classroom situation or watching a video or something that doesn’t really provide that as-close-to-reality experience that we think we’re doing.”

The second phase of research would seek additional funding to conduct a randomized, controlled trial to determine if VENT is more effective than traditional education approaches, in addition to examining whether the training is easier to use and accessible to the target audience.

But during the initial development phase, Wasantha Jayawardene, MD, PhD, will tap resources at the Social Perception Lab at SIU to assess the degree to which an individual’s subconscious bias against people with drug addiction influences how they would respond when someone suffers an overdose. Individuals trying the new education prototype will be given an evaluation called an Implicit Association Test (IAT) that can reveal their implicit bias before they test-drive the VENT prototype.

According to Jayawardene, “Based on the IAT results, the VENT will include a model that addresses implicit bias, which can help the layperson responders to become more conscious of their own biases and their potential impact on helping a victim in a real-life scenario.”

There is $54 billion available in lawsuit settlement money tied to companies for their role in fueling the opioid crisis through actions such as downplaying the risks of prescription opioids and promoting the use of the drugs. States are required to spend 85% of settlement funds on opioid remediation and Barrows hopes to explore the potential of tapping that source in the future to make training available using VENT. 

Video Interview Clips, Scott Barrows

The program is a formalization of the partnership between these two anchor institutions in Bloomington-Normal and the broader OSF HealthCare system. Illinois State and OSF HealthCare are lead hub members of the Illinois Innovation Network (IIN). The collaborative work in the Connected Communities Initiative has the potential to generate intellectual property that the two institutions can share and advance the IIN mission of driving inclusive and integrated research, innovation, and economic development across the state.

The agreement also provides a financial foundation for the work with both organizations providing $500,000 each, to contribute a total of $1 million annually for research and development of strategic solutions to improve health care delivery, and patient and provider experience.

“We believe expanding academic collaborations can help us create innovative solutions and new care models that provide more access, particularly to underserved populations,” said CEO of OSF HealthCare Bob Sehring.

“Working with OSF HealthCare on the CCI Program reflects Illinois State’s core values of Collaboration, Learning and Scholarship, and Civic Engagement,” said Illinois State Interim President Aondover Tarhule. “This partnership will provide many opportunities for Illinois State faculty and students to work with our partners at OSF on a wide range of innovative projects that address real-world needs. This is truly an exciting project that will have wide-ranging benefits for all involved.”

The partnership will initially build on Illinois State’s expertise in education, health, cybersecurity, biomedical science, visualization, and process improvement. There will be opportunities for Illinois State’s academic colleges to collaborate on projects with OSF Healthcare. The broad range of faculty expertise and the engagement from the student body will lead to exciting new solutions to complex problems facing society.

“There is a long tradition of partnership between OSF and Illinois State, perhaps most clearly with students in clinical placements and in clinical situations,” said Craig C. McLauchlan, PhD, Illinois State’s associate vice president for Research and Graduate Studies. “The CCI expands that relationship in the area of research and provides an institutional framework that will allow us to build on already existing collaborations more easily. The partnership will provide students and persons in our community opportunities to contribute to innovation and growth that will benefit many.”

OSF Healthcare and Illinois State University have a tradition of collaboration on research, including a recent project to improve low childhood vaccination rates. 

Joint projects can include testing solutions in clinical spaces, such as OSF HealthCare St. Joseph Medical Center and medical offices. The efforts will take place both virtually and in-person in a variety of settings including ISU labs and computer centers, along with Jump Trading Simulation & Education Center in Peoria, a world-class building with labs focused on advanced imaging and modeling, blockchain, children’s innovation, genomics and precision medicine, interprofessional education, neuro health, and STEAM.

“For OSF HealthCare, the expanded partnership will support the needs of researchers, medical educators, clinicians and most importantly, patients,” added John Vozenilek, MD, vice president and chief medical officer, OSF Innovation and Digital Health. “The brightest minds at Illinois State University can help us develop novel solutions with enhanced security and business processes to improve patient care and health outcomes, along with optimizing the use of resources using data.” Vozenilek adds, “That will become increasingly important as care continues to move from hospital settings to home and as we expand access to patients across all of the regions OSF serves.”

The CCI is built upon successful models that OSF Healthcare has developed and maintains with the University of Illinois Urbana-Champaign, University of Illinois-Chicago, and Bradley University.

Video clips with Bob Sehring, Dr. John Vozenilek, Lynn Fulton, Aondover Tarhule, and Craig McLauchlan

B-roll from OSF-ISU partnership announcement