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

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Energy Drinks: an Assessment of the Potential Health Risks in the Canadian Context ! ARTICLE International Food Risk Analysis Journal Energy Drinks: An Assessment of the Potential Health Risks in the Canadian Context Regular Paper Joel Rotstein1, Jennifer Barber1, Carl Strowbridge1, Stephen Hayward1, Rong Huang1 and Samuel Benrejeb Godefroy1,* 1 Food Directorate, Health Products and Food Branch, Health Canada, Canada * Corresponding author E-mail: [email protected] ȱ Received 12 February 2013; Accepted 3 June 2013 DOI: 10.5772/56723 © 2013 Rotstein et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstractȱ Theȱ purposeȱ ofȱ thisȱ documentȱ isȱ toȱ developȱ aȱ caffeine.ȱInȱaddition,ȱtheȱhealthȱeffectsȱofȱexcessiveȱintakeȱ healthȱriskȱassessmentȱonȱenergyȱdrinks,ȱbasedȱonȱhealthȱ ofȱ taurineȱ andȱ glucuronolactoneȱ areȱ alsoȱ unknown.ȱ Theȱ hazardȱ andȱ exposureȱ assessmentsȱ whenȱ consumedȱ asȱ aȱ healthȱhazardȱassessmentȱconcludedȱthatȱtheȱgeneralȱadultȱ foodȱinȱCanada.ȱInȱthisȱdocument,ȱaȱtypicalȱenergyȱdrinkȱ populationȱ couldȱ safelyȱ consumeȱ 2ȱ servingsȱ ofȱ aȱ typicalȱ isȱ exemplifiedȱ byȱ theȱ productȱ knownȱ asȱ Redȱ Bull,ȱ energyȱ drinkȱ perȱ day,ȱ withȱ noȱ healthȱ consequences.ȱ Thisȱ whereȱ aȱ singleȱ canȱ servingȱ ofȱ 250ȱ mlȱ containsȱ 80ȱ mgȱ ofȱ conclusionȱ wasȱ basedȱ onȱ theȱ safetyȱ ofȱ theȱ nonȬcaffeineȱ caffeine,ȱ1000ȱmgȱofȱtaurine,ȱ600ȱmgȱofȱglucuronolactoneȱ ingredientsȱofȱenergyȱdrinksȱatȱthisȱlevelȱofȱconsumption,ȱ andȱseveralȱBȱvitamins.ȱȱ andȱ theȱ factȱ thatȱ caffeineȱ fromȱ otherȱ dietaryȱ sourcesȱ inȱ Healthȱ hazardȱ dataȱ onȱ energyȱ drinksȱ wereȱ foundȱ toȱ beȱ additionȱtoȱthatȱinȱ2ȱservingsȱofȱenergyȱdrinksȱwouldȱnotȱ limitedȱandȱthereforeȱtheȱhazardȱassessmentȱwasȱbasedȱonȱ poseȱaȱhealthȱhazardȱtoȱtheȱgeneralȱadultȱpopulation.ȱTheȱ individualȱ ingredients.ȱ Caffeineȱ wasȱ identifiedȱ asȱ theȱ consumptionȱofȱenergyȱdrinksȱbyȱsubpopulations,ȱsuchȱasȱ ingredientȱ withȱ theȱ greatestȱ potentialȱ forȱ intakesȱ ofȱ children,ȱ adolescents,ȱ andȱ pregnantȱ women,ȱ shouldȱ beȱ possibleȱ healthȱ concern.ȱ Onȱ thisȱ basis,ȱ excessȱ limitedȱ toȱ theirȱ respectiveȱ recommendedȱ maximumȱ dailyȱ consumptionȱ ofȱ energyȱ drinksȱ wouldȱ beȱ expectedȱ toȱ intakesȱofȱcaffeine,ȱasȱrecommendedȱbyȱHealthȱCanada.ȱȱ resultȱinȱhealthȱconsequencesȱsimilarȱtoȱthoseȱfromȱexcessȱ Usingȱexposureȱmodelling,ȱtheȱpotentialȱhealthȱriskȱposedȱ exposureȱtoȱcaffeine.ȱTheȱmoreȱmildȱandȱtransientȱhealthȱ byȱ energyȱ drinkȱ consumptionȱ wasȱ examined.ȱ However,ȱ consequencesȱ couldȱ includeȱ anxiety,ȱ headacheȱ andȱ noȱCanadianȱintakeȱdataȱforȱenergyȱdrinksȱwereȱavailable.ȱ insomniaȱ andȱ theseȱ healthȱ consequencesȱ canȱ becomeȱ Therefore,ȱ forȱ theȱ purposeȱ ofȱ modellingȱ intake,ȱ itȱ wasȱ chronicȱconditions.ȱMoreȱsevereȱhealthȱconsequencesȱmayȱ assumedȱ thatȱ energyȱ drinksȱ areȱ consumedȱ inȱ aȱ mannerȱ includeȱ irregularȱ heartbeat,ȱ heartȱ attackȱ and,ȱ veryȱ rarely,ȱ similarȱtoȱthatȱofȱcaffeinatedȱcarbonatedȱsoftȱdrinks.ȱInȱtheȱ death.ȱ Currently,ȱ theȱ potentialȱ forȱ taurineȱ andȱ worstȱ caseȱ modellingȱ exposureȱ scenario,ȱ energyȱ drinksȱ glucuronolactoneȱtoȱinteractȱwithȱcaffeineȱisȱunknownȱandȱ wereȱsubstitutedȱforȱcaffeinatedȱcarbonatedȱsoftȱdrinksȱonȱ thereforeȱ theyȱ mayȱ orȱ mayȱ notȱ exacerbateȱ theȱ effectsȱ ofȱ aȱvolumeȱbasis.ȱ www.intechopen.com Joel Rotstein, Jennifer Barber, Carl Strowbridge, Stephen Hayward, RongInt. Huang food risk and anal. Samuel j., 2013, Benrejeb Vol. Godefroy:3, 4:2013 1 Energy Drinks: An Assessment of the Potential Health Risks in the Canadian Context ! Theȱ energyȱ drinkȱ caffeineȱ concentrationȱ wasȱ setȱ toȱ 320ȱ Disclaimer:ȱȱ ppmȱ (80ȱ mgȱ ofȱ caffeine/250ȱ mlȱ serving)ȱ forȱ modellingȱ ȱ purposes.ȱInȱtheȱmostȱconservativeȱscenario,ȱallȱcaffeinatedȱ Thisȱ documentȱ wasȱ developedȱ asȱ aȱ reviewȱ ofȱ theȱ carbonatedȱ softȱ drinksȱ wereȱ replacedȱ byȱ aȱ typicalȱ energyȱ scientificȱinformationȱavailableȱpertainingȱtoȱtheȱsafetyȱofȱ drinkȱ forȱ consumersȱ whoȱ drinkȱ theseȱ beveragesȱ (eatersȱ ingredientsȱ thatȱ mayȱ beȱ partȱ ofȱ theȱ compositionȱ ofȱ theȱ only).ȱTheȱresultsȱofȱthisȱconservativeȱestimateȱshowedȱthatȱ beveragesȱ knownȱ asȱ Caffeinatedȱ Energyȱ Drinksȱ (Energyȱ slightlyȱlessȱthanȱ30%ȱofȱmaleȱandȱfemaleȱadults,ȱaboutȱ15%ȱ Drinks).ȱ Theȱ documentȱ wasȱ developedȱ duringȱ aȱ periodȱ ofȱpregnantȱwomanȱandȱmoreȱthanȱ50%ȱofȱtheȱchildrenȱandȱ spanningȱfromȱ2010ȱtoȱlateȱ2011.ȱAȱnumberȱofȱreferencesȱ adolescents,ȱ amongstȱ consumersȱ whoȱ drankȱ caffeinatedȱ andȱnewȱstudiesȱhaveȱbeenȱmadeȱavailableȱsinceȱthenȱandȱ carbonatedȱ softȱ drinks,ȱ wereȱ aboveȱ Healthȱ Canadasȱ areȱnotȱreferencedȱinȱtheȱpresentȱdocument.ȱAnȱupdateȱofȱ recommendedȱmaximumȱdailyȱcaffeineȱintake.ȱȱ theȱpresentȱHealthȱRiskȱAssessmentȱisȱenvisagedȱinȱ2014Ȭ Thisȱ extremeȱ scenarioȱ onlyȱ appliesȱ toȱ thatȱ subsetȱ ofȱ theȱ 15,ȱuponȱreviewȱofȱinformationȱcurrentlyȱbeingȱcollectedȱ populationȱ thatȱ consumesȱ caffeinatedȱ carbonatedȱ softȱ byȱHealthȱCanadasȱFoodȱDirectorateȱsinceȱtheȱregulatoryȱ drinks,ȱwhichȱdoesȱnotȱexceedȱ8%ȱofȱyoungȱchildrenȱ(1Ȭ8ȱ decisionȱmadeȱinȱOctoberȱ2011,ȱtoȱregulateȱEnergyȱDrinksȱ yearsȱold),ȱ22%ȱofȱolderȱchildrenȱ(9Ȭ14ȱyearsȱold),ȱ32%ȱofȱ asȱ beveragesȱ (i.e.ȱ food)ȱ asȱ opposedȱ toȱ theirȱ formerȱ adolescents,ȱ 20%ȱ ofȱ theȱ adultȱ populationȱ andȱ 13%ȱ ofȱ classificationȱasȱNaturalȱHealthȱProducts.ȱȱ pregnantȱfemales.ȱ ȱ Inȱ criticallyȱ reviewingȱ theȱ outcomesȱ ofȱ thisȱ exposureȱ 1.ȱIntroductionȱ modelling,ȱ itȱ appearedȱ thatȱ theȱ correspondingȱ healthȱ concernsȱ forȱ childrenȱ andȱ adultsȱ wouldȱ beȱ limitedȱ toȱ 1.1ȱȱ Purposeȱ remote,ȱ basedȱ onȱ thisȱ scenario,ȱ inȱ viewȱ ofȱ theȱ parentalȱ Theȱpurposeȱofȱthisȱdocumentȱisȱtoȱprovideȱaȱhealthȱriskȱ controlȱthatȱshouldȱexistȱandȱwouldȱlimitȱaccessȱofȱtheseȱ assessmentȱ ofȱ energyȱ drinkȱ productsȱ basedȱ onȱ theirȱ productsȱtoȱchildren,ȱasȱwellȱasȱtheȱabilityȱofȱadultsȱandȱ consumptionȱ asȱ beveragesȱ inȱ Canada.ȱ Theȱ documentȱ pregnantȱwomenȱtoȱmonitorȱtheirȱownȱcaffeineȱintake.ȱ attemptsȱ toȱ provideȱ aȱ scientificȱ analysisȱ basedȱ onȱ theȱ Thisȱhypotheticalȱscenarioȱandȱitsȱoutcomesȱcouldȱnotȱbeȱasȱ informationȱavailableȱ toȱdate,ȱ whichȱcouldȱ thenȱ beȱ usedȱ easilyȱ excludedȱ forȱ adolescents,ȱ givenȱ thatȱ energyȱ drinksȱ toȱsupportȱtheȱdevelopmentȱofȱsuitableȱriskȱmanagementȱ tendȱtoȱbeȱmarketedȱtoȱthisȱsubsetȱofȱtheȱpopulation,ȱwhichȱ measuresȱforȱtheseȱproductsȱwhenȱconsumedȱasȱfoods.ȱȱ isȱ lessȱ likelyȱ toȱ adhereȱ toȱ consumptionȱ recommendationsȱ thanȱadults.ȱTheȱexistenceȱofȱlargerȱvolumeȱcontainersȱ(e.g.,ȱ 2.ȱDefiningȱaȱtypicalȱenergyȱdrinkȱȱ 710ȱ ml)ȱ increasesȱ theȱ likelihoodȱ ofȱ exceedingȱ caffeineȱ recommendedȱintakesȱinȱoneȱconsumptionȱsetting.ȱ 2.1ȱDefiningȱproductsȱknownȱasȱenergyȱdrinksȱ Specificȱriskȱmanagementȱmeasuresȱtoȱaddressȱpotentiallyȱ highȱ caffeineȱ levelsȱ inȱ largerȱ volumeȱ energyȱ drinkȱ Forȱtheȱpurposeȱofȱthisȱdocument,ȱaȱtypicalȱenergyȱdrinkȱ productsȱwouldȱthereforeȱbeȱdesirable.ȱ isȱ characterisedȱ byȱ theȱ ingredientsȱ andȱ ingredientȱ levelsȱ Itȱisȱacknowledgedȱthatȱvariousȱdataȱgapsȱwouldȱneedȱtoȱ shownȱ inȱ Tableȱ 1.ȱ Ingredientsȱ includeȱ caffeine,ȱ taurine,ȱ beȱaddressedȱtoȱimproveȱtheȱexposureȱassessmentȱandȱtheȱ glucuronolactone,ȱ inositolȱ andȱ aȱ varietyȱ ofȱ Bȱ vitamins.ȱ overallȱriskȱcharacterization.ȱInȱparticular,ȱdataȱrelatedȱtoȱ Theȱ basisȱ forȱ thisȱ characterisationȱ isȱ theȱ formulationȱ ofȱ theȱ evolvingȱ consumptionȱ patternsȱ ofȱ theseȱ productsȱ byȱ theȱ mostȱ commonlyȱ soldȱ productsȱ ofȱ thisȱ categoryȱ ofȱ theȱvariousȱsubsetsȱofȱtheȱpopulation,ȱinȱCanada,ȱneedsȱtoȱ beverages,ȱ suchȱ asȱ theȱ productȱ knownȱ asȱ Redȱ Bull,ȱ beȱgathered.ȱ whichȱwasȱtheȱfirstȱenergyȱdrinkȱapprovedȱforȱtheȱmarketȱ Healthȱ Canadasȱ proposedȱ riskȱ managementȱ approachȱ forȱ inȱ Canada.ȱ Basedȱ onȱ 2009ȱ marketȱ dataȱ ofȱ theȱ globalȱ energyȱdrinks,ȱannouncedȱinȱOctoberȱ2011ȱandȱupdatedȱinȱ marketingȱ researchȱ firmȱ ACNielsen,ȱ Redȱ Bullȱ 2012,ȱlimitsȱtheȱconcentrationȱandȱtotalȱamountȱofȱcaffeineȱinȱ comprisedȱ approximatelyȱ 37%ȱ ofȱ theȱ salesȱ ofȱ energyȱ theseȱ productsȱ andȱ requiresȱ thatȱ caffeineȱ andȱ nutritionȱ drinksȱ inȱ Canadaȱ and,ȱ asȱ such,ȱ hadȱ theȱ largestȱ marketȱ informationȱbeȱdisplayedȱonȱproductȱlabels.ȱTheseȱmeasuresȱ share.ȱThisȱisȱconsistentȱwithȱaȱmoreȱrecentȱreportȱ(AAFC,ȱ supportȱtheȱmitigationȱofȱrisksȱrelatedȱtoȱoverconsumptionȱ 2011)ȱ thatȱ statesȱ thatȱ Redȱ Bullȱ constitutesȱ 43%ȱ ofȱ theȱ ofȱ caffeineȱ fromȱ thisȱ typeȱ ofȱ productȱ thatȱ areȱ withinȱ theȱ salesȱofȱenergyȱdrinksȱinȱNorthȱAmerica.ȱ possibleȱ areasȱ ofȱ interventionȱ availableȱ toȱ aȱ federalȱ foodȱ ȱ regulator.ȱ Aȱ moreȱ concertedȱ approachȱ (e.g.,ȱ education,ȱ Althoughȱ Healthȱ Canadaȱ doesȱ notȱ haveȱ aȱ definitionȱ orȱ awarenessȱ andȱ regulation)ȱ andȱ moreȱ researchȱ wouldȱ beȱ standardȱ forȱ productsȱ knownȱ asȱ energyȱ drinks,ȱ otherȱ neededȱtoȱascertainȱtheȱeffectivenessȱofȱtheȱvariousȱmeasuresȱ foodȱregulatorsȱhaveȱreachedȱaȱdecisionȱonȱthisȱaspectȱofȱ takenȱbyȱregulatorsȱandȱotherȱstakeholders.ȱ theseȱproducts.ȱForȱexample,ȱAustraliaȱandȱNewȱZealandȱ ȱ categorizesȱ energyȱ drinksȱ asȱ formulatedȱ caffeinatedȱ Keywordsȱ Energyȱ drink,ȱ Caffeine,ȱ Taurine,ȱ beveragesȱ whichȱ areȱ definedȱ underȱ theȱ Australiaȱ Newȱ Glucuronolactone,ȱInositol,ȱBȱvitaminȱ Zealandȱ Foodȱ Standardsȱ Codeȱ asȱ aȱ nonȬalcoholicȱ waterȬ basedȱ flavouredȱ beverageȱ whichȱ containsȱ caffeineȱ andȱ ȱ 2 Int. food
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