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Drinking an energy drink may have the same artery-hardening effects as eating a porterhouse steak. A nutrient found in red meat and used in energy drinks and weight loss pills contributes to hardening of the arteries, according to researchers at the Cleveland Clinic.

According to the new findings, cholesterol levels alone might not be the only indicator of heart disease. The Cleveland Clinic group led by Dr. Stanley Hazen has been studying the link between the bacteria in the intestines and heart disease. When the bacteria digest food, certain byproducts are created.

One of these is called trimethylamine N-oxide (TMAO), a chemical that is a 10-fold stronger indicator of heart disease than cholesterol. High levels of this compound indicate a greater risk of heart disease.

The group’s latest findings suggest that TMAO interacts with carnitine, a nutrient found in large quantities in red meat such as beef, venison, lamb, duck and pork that is needed to produce energy. Carnitine is a necessary nutrient, but when it is digested it increases the levels of TMAO, which leads to plaque buildup in the arteries.

And carnitine isn’t just found in red meat.

Carnitine in Energy Drinks Equivalent to Eating a Porterhouse Steak

According to Hazen, the amount of carnitine in an energy drink is as much as the amount found in a porterhouse steak – or more.

Hazen told Cleveland.com:“It’s everywhere. Drinking these drinks is like eating steaks every day, and they’re getting it in a can and don’t even realize it.”

This latest findings add to the list of growing concerns regarding ill health effects of energy drinks. Last year, the Food and Drug Administration (FDA) began investigating brands such as 5-Hour Energy and Monster after the drinks caused a number of deaths. However, because the FDA cannot regulate the other ingredients in these drinks, it only concentrated on investigating caffeine.

The FDA limits the caffeine in soda to 71 mg per 12 ounces. In contrast, energy drinks contain as much as 500 mg per serving.

Cholesterol Not the Only Culprit in Heart Disease?

The study findings also raise new questions about using cholesterol alone as an indicator of heart disease risk.

Dr. Daniel Rader, a professor of medicine at the University of Pennsylvania who was not involved in the study, offered his opinion to Cleveland.com: “It leads to an interesting question that I don’t have the answer to: Is there evidence that red meat consumption in people taking statins is still associated with cardiovascular risk? I don’t know that yet.”

Millions of Americans take statins like Crestor, Lipitor and Zocor to keep their cholesterol under control to avoid heart disease. While these drugs are effective at controlling cholesterol, they also come with side effects like memory loss, type 2 diabetes, and kidney and muscle damage that may lead to death. The study indicates that eating too much red meat may still raise heart disease risk even if cholesterol levels are normal.

Hazen says that the information they learned may also help find ways to reduce the risk of heart disease, like taking a probiotic or eating yogurt as opposed to taking a drug. In the meantime, however, more studies are needed to truly understand how all of these elements interact with one another.