Energy Drinks: An Assessment of the Potential Health Risks in the Canadian Context

Abstract

Abstract The purpose of this document is to develop a health risk assessment on energy drinks, based on health hazard and exposure assessments when consumed as a food in Canada. In this document, a typical energy drink is exemplified by the product known as Red Bull?, where a single can serving of 250 ml contains 80 mg of caffeine, 1000 mg of taurine, 600 mg of glucuronolactone and several B vitamins. Health hazard data on energy drinks were found to be limited and therefore the hazard assessment was based on individual ingredients. Caffeine was identified as the ingredient with the greatest potential for intakes of possible health concern. On this basis, excess consumption of energy drinks would be expected to result in health consequences similar to those from excess exposure to caffeine. The more mild and transient health consequences could include anxiety, headache and insomnia and these health consequences can become chronic conditions. More severe health consequences may include irregular heartbeat, heart attack and, very rarely, death. Currently, the potential for taurine and glucuronolactone to interact with caffeine is unknown and therefore they may or may not exacerbate the effects of caffeine. In addition, the health effects of excessive intake of taurine and glucuronolactone are also unknown. The health hazard assessment concluded that the general adult population could safely consume 2 servings of a typical energy drink per day, with no health consequences. This conclusion was based on the safety of the non‐caffeine ingredients of energy drinks at this level of consumption, and the fact that caffeine from other dietary sources in addition to that in 2 servings of energy drinks would not pose a health hazard to the general adult population. The consumption of energy drinks by subpopulations, such as children, adolescents, and pregnant women, should be limited to their respective recommended maximum daily intakes of caffeine, as recommended by Health Canada. Using exposure modelling, the potential health risk posed by energy drink consumption was examined. However, no Canadian intake data for energy drinks were available. Therefore, for the purpose of modelling intake, it was assumed that energy drinks are consumed in a manner similar to that of caffeinated carbonated soft drinks. In the worst case modelling exposure scenario, energy drinks were substituted for caffeinated carbonated soft drinks on a volume basis. The energy drink caffeine concentration was set to 320 ppm (80 mg of caffeine/250 ml serving) for modelling purposes. In the most conservative scenario, all caffeinated carbonated soft drinks were replaced by a typical energy drink for consumers who drink these beverages (eaters only). The results of this conservative estimate showed that slightly less than 30% of male and female adults, about 15% of pregnant woman and more than 50% of the children and adolescents, amongst consumers who drank caffeinated carbonated soft drinks, were above Health Canada’s recommended maximum daily caffeine intake. This extreme scenario only applies to that subset of the population that consumes caffeinated carbonated soft drinks, which does not exceed 8% of young children (1‐8 years old), 22% of older children (9‐14 years old), 32% of adolescents, 20% of the adult population and 13% of pregnant females. In critically reviewing the outcomes of this exposure modelling, it appeared that the corresponding health concerns for children and adults would be limited to remote, based on this scenario, in view of the parental control that should exist and would limit access of these products to children, as well as the ability of adults and pregnant women to monitor their own caffeine intake. This hypothetical scenario and its outcomes could not be as easily excluded for adolescents, given that energy drinks tend to be marketed to this subset of the population, which is less likely to adhere to consumption recommendations than adults. The existence of larger volume containers (e.g., 710 ml) increases the likelihood of exceeding caffeine recommended intakes in one consumption setting. Specific risk management measures to address potentially high caffeine levels in larger volume energy drink products would therefore be desirable. It is acknowledged that various data gaps would need to be addressed to improve the exposure assessment and the overall risk characterization. In particular, data related to the evolving consumption patterns of these products by the various subsets of the population, in Canada, needs to be gathered. Health Canada’s proposed risk management approach for energy drinks, announced in October 2011 and updated in 2012, limits the concentration and total amount of caffeine in these products and requires that caffeine and nutrition information be displayed on product labels. These measures support the mitigation of risks related to overconsumption of caffeine from this type of product that are within the possible areas of intervention available to a federal food regulator. A more concerted approach (e.g., education, awareness and regulation) and more research would be needed to ascertain the effectiveness of the various measures taken by regulators and other stakeholders.