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French Agency for Food, Environmental and Occupational Health & Safety

Energy drinks: health professionals asked by ANSES to declare the adverse effects brought to their attention

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News of 06/06/2012

6 June 2012

ANSES has been monitoring the issue surrounding the safety of energy drinks for many years. To this end, and within the framework of the nutritional vigilance scheme, the Agency has been gathering information on adverse effects that are suspected to be linked to consumption of these products. Several cases were recently reported to ANSES in which energy drinks were consumed along with alcohol. The Agency invites individuals who have noticed adverse effects following consumption of these beverages to contact a health professional who should declare the cases brought to their attention to ANSES via the nutritional vigilance scheme.

No regulatory framework exists for the term "energy drink". It includes beverages claimed to "boost energy" by stimulating the nervous system and which usually contain ingredients considered to be "energising" such as taurine, caffeine, guarana, ginseng, vitamins, etc.

ANSES, which has received several formal requests in the past to assess the safety and the nutritional soundness of one of these beverages, wishes to emphasise the fact that some of the contexts in which energy drinks are commonly consumed - in conjunction with sporting activities or alcohol, in particular - may be linked to cardiovascular risks due to their use during intense physical exercise or to lowered perception of alcohol-related effects.

A study by ANSES currently being conducted and scheduled for release next autumn shows that there has been a rise in consumption of these products in conjunction with sporting activities, and that 27% of consumers under 35 consume energy drinks in conjunction with alcohol at least occasionally.

In addition, the Agency recently received several reports through its nutritional vigilance scheme (see Find out more) concerning adverse effects with a suspected link to consumption of energy drinks, including two fatal cases.

In order to more closely investigate the possible risks of consuming energy drinks (especially in conjunction with alcohol or sporting activities), the Agency invites consumers to inform a health professional of any adverse effects they suspect may be linked to energy drink consumption. The Agency is asking health professionals to report to ANSES the cases brought to their attention via the nutritional vigilance declaration form available at this address:

More generally, ANSES wishes to emphasise that energy drinks must not be consumed by children, are to be avoided during pregnancy, and should be consumed in moderation. Unlike sports drinks, energy drinks should not be consumed in conjunction with intense physical exercise.

Find out more

ANSES's nutritional vigilance scheme
Set up in late 2009 in compliance with the French Act on Regional Health Governance (Loi Hôpital, Patients, Santé et Territoires), the nutritional vigilance scheme's goal is to collect and analyse the adverse effects of fortified foods (including energy drinks), food supplements, novel foods and foods for special dietary uses.
This innovative scheme, unique in Europe, was initially created to monitor foodstuffs of special concern which are not covered by other vigilance schemes (ex. medicinal or exotic plants found in food supplements and not covered by drug monitoring).
A pilot phase was launched for the scheme in 2010-2011 during which 192 reports of adverse effects were received. This phase was replaced in 2012 by the full-scale scheme, which is more fully operational and responsive.

Monitoring the adverse effects of energy drink consumption
In 2008, at the request of the Ministry of Health, a scheme for monitoring adverse effects which might be linked to energy drinks was set up by the French Institute for Public Health Surveillance (InVS) via the network of poison control and toxicant monitoring centres. Twenty-four cases were reported. A possible or probable causal link was established in thirteen of the cases. The effects reported were cardiac (tachycardia) and/or neurological (epileptic seizures, paraesthesia, trembling, vertigo) and/or psychiatric (anxiety, agitation, mental confusion) in nature. In addition, three cases of stroke and three cases of cardiac arrest (including one fatal case) were reported in which the link to energy drink consumption was not clearly established.
The Agency took over monitoring in this area in 2009, as part of its nutritional vigilance mission. Six new cases were reported within this context. All of them concerned individuals under 50 years of age (four of whom were under 30). Five of the individuals had consumed energy drinks with alcohol in a festive context. The adverse effects declared were also cardiac (fatal heart attacks), neurological (epileptic seizure, coma, spatial and temporal disorientation) and psychiatric (behavioural disorders) in nature. One case of kidney damage was also reported (acute renal failure). Investigations are currently under way to provide a more detailed analysis of these cases.