The term “energy drink” refers to beverages meant to “boost energy” by stimulating the nervous system, which usually contain ingredients that are supposed to be “energising” such as taurine, caffeine, guarana, ginseng, vitamins, etc. Since 2001, the Agency has received various formal requests to assess the safety and nutritional value of these beverages. Since 2011, ANSES has also been monitoring adverse effects suspected of being linked to the consumption of these products, within the framework of its nutritional vigilance scheme. Details of the Agency’s work and recommendations are given below
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Updated on 01/12/2017
Presentation and role of the Agency
"Energy drink" is a marketing term which has no specific regulatory definition. It includes beverages which are marketed as having energising properties both on the physical and intellectual level. These products contain ingredients such as caffeine, amino acids (taurine), sugar, vitamins and plant extracts (ginseng, guarana). They should not be confused with "sports drinks", which are drink preparations specifically formulated to fulfil certain nutritional requirements when performing intense physical exercise.
ANSES has been monitoring the issue of the safety of so-called energy drinks for many years. In 1996, the marketing of one so-called energy drink was banned in France due to a negative opinion issued by the French High Council for Public Health.
In several opinions published between 2001 and 2006, based on the results of toxicological studies submitted for assessment, the Agency considered that the safety in use of taurine and D-glucuronolactone in so-called energy drinks had not been proven. It emphasised the need to conduct additional studies in order to confirm or refute the suspicions of neurological toxicity (for taurine) and renal toxicity (for D-glucuronolactone).
The Agency also wished to emphasise the fact that some of the consumption patterns commonly associated with energy drinks (sporting activities or mixed with alcohol) may be linked to cardiovascular risks due to their use during intense physical exercise or to lowered perception of effects related to alcohol use.
In the absence of any formal proof of a confirmed risk, and despite the mentioned suspicions of risks (AFSSA, 2006), the marketing of so-called energy drinks was authorised in France in 2008 in compliance with the free circulation of goods legally manufactured or sold within the European market.
Following this, and based on the new toxicological data received, the European Food Safety Authority (EFSA) concluded that exposure to taurine and D-glucuronolactone at the levels currently used in "energy" drinks was not a safety concern" (EFSA, 2009).
In France, the monitoring of reports of adverse effects was initiated in 2008 by the French Institute for Public Health Surveillance (InVS) and was then taken over by ANSES's nutrivigilance scheme in 2009 (Act no. 2009-879 of 21 July 2009).
In this context, over 200 cases of adverse effects were reported to ANSES in conjunction with consumption of these beverages and a possible or probable causal link between consumption of so-called energy drinks and these reported events was established in 12% of the cases. The main symptoms observed are usually cardiovascular (tightness in the chest or chest pain, tachycardia, high blood pressure, heart rhythm disturbances and possible cardiac arrest, etc.), psycho-behavioural or neurological (irritability, nervousness, anxiety, panic attacks, hallucinations and epilepsy).
Avoid consumption along with alcohol or during exercise
Following an analysis of the reported nutrivigilance cases and of the bibliographic data, the caffeine contained in these beverages was considered to be the main factor in the adverse effects reported. Caffeine is a compound which is found naturally in over 60 different plants (coffee, tea, kola nut, guarana, yerba mate, etc.), and is well known for its "stimulant" effects as well as for its numerous adverse effects, including anxiety, tachycardia, sleep disturbances, etc. The effects of caffeine can vary widely from one individual to another. A significant proportion of the French population exceeds the maximum caffeine levels beyond which adverse effects can occur.
While historically caffeine has been used throughout the ages and all over the world, its availability in the form of so-called energy drinks, which is a new and fast-growing phenomenon, has created changes in consumption habits. These habits were assessed in a survey on the topic conducted a first time by ANSES in 2009 (subsequent to the French marketing authorisation of so-called energy drinks in 2008) and then a second time in 2011.
In France, approximately 32% of consumers of so-called energy drinks consume them during festive occasions (in bars, discotheques, at concerts, etc.), 41% in conjunction with a sporting activity, and 16% in combination with alcohol.
The combined consumption of so-called energy drinks and alcohol can promote risk situations due to an over-estimation by individuals of their capacities, which can then lead to continued consumption of alcohol and even higher levels of risk taking.
Concerning sports activities, so-called energy drinks have no nutritional benefit during physical exercise (as opposed to sports drinks, also sometimes called energy drinks); on the contrary these beverages can promote water and salt loss by the body and increase the risk of heat stroke. The consumption of so-called energy drinks in a festive context can favour the multiplication of risk factors: co-consumption with alcohol, physical exercise (dancing, for example) and heat.
ANSES considers that multiplying sources of caffeine, in particular through so-called energy drinks, combined with the current consumption patterns for these beverages can generate risk situations.
The Agency therefore issues the following recommendations:
- avoid consuming so-called energy drinks in combination with alcohol or during physical exercise;
- be particularly vigilant regarding caffeine intake, especially in so-called energy drinks, if you belong to certain groups of consumers, including pregnant and breast-feeding women, children, adolescents, people who are sensitive to the effects of caffeine or who suffer from pathological conditions such as certain cardiovascular, psychiatric or neurological disorders, kidney failure, severe liver disease, etc.;
- in general, beverages containing caffeine should be consumed in moderation.