Rapport de l'Efsa

Supporting Publications 2013:EN-394

Any enquiries related to this output should be addressed to [email protected]

Suggested citation: Zucconi S., Volpato C., Adinolfi F., Gandini E., Gentile E., Loi A., Fioriti L.; “Gathering consumption

data on specific consumer groups of energy drinks”. Supporting Publications 2013:EN-394. [190 pp.]. Available online:

www.efsa.europa.eu/publications

© European Food Safety Authority, 2013.

EXTERNAL SCIENTIFIC REPORT

Gathering consumption data on specific consumer groups of energy drinks1

NOMISMA-ARETÉ Consortium2:

Silvia Zucconia, Chiara Volpato

a, Felice Adinolfi

a, Evita Gandini

a,

Enrica Gentileb, Alberico Loi

b, Linda Fioriti

b

a Nomisma SpA

b Areté Srl

1 Question No EFSA-Q-2011-00309. 2 The Nomisma-Areté consortium acknowledges the EFSA steering Group and in particular the following staff members for

their support and teamwork: Tobin Robinson (EMRISK Unit), Arianna Chiusolo (EMRISK Unit), Andrea Altieri (EMRISK

Unit), Jean-Lou Dorne (EMRISK Unit), Davide Arcella (DCM Unit).

Gathering consumption data on specific consumer groups of energy

drinks

Supporting Publications 2013:EN-394 2

The present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively

by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender

procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the

issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

ABSTRACT

At the end of 2011, a study was commissioned by EFSA to the Consortium Nomisma-Areté, with the

objective of gathering consumption data for “energy” drinks (ED) in specific consumer groups (adults,

adolescents and children) in EU. The study also aims at estimating, for each consumer group, the

exposure to specific active ingredients (caffeine, taurine, and D-glucurono-y-lactone) from ED

consumption, and the relative contribution of ED to the total caffeine exposure. Moreover, specific

consumption habits (co-consumption with alcohol and consumption associated to intense physical

exercise) were analysed for adolescents and adults.

Between February and November 2012, the study team conducted an EU-wide questionnaire-based

survey - involving more than 52.000 participants from 16 different EU Member States3 - among adults

(14.500 participants), adolescents (32.000), and children (5.500).

The highest prevalence of consumption4 was observed for the adolescent consumers group (68%). In

adults prevalence for consumption was 30%, and 18% in children. Among consumers, no relevant

differences were observed in the target groups for prevalence of high chronic consumers5 (12% in

adults and adolescents, 16% in children) and high acute consumers6 (11% for adults and 12% for

adolescents).

Concerning co-consumption with alcohol, similar prevalence was observed for adults (56%) and

adolescents (53%). Consumption associated to sport activities showed prevalence of 52% in adults and

41% in adolescents.

Among ED consumers, the estimated average exposures from ED to caffeine, taurine and D-

glucurono-y-lactone were higher in children (1,01, 12,83 and 5,13 mg/kg b.w./day, respectively) than

adolescents (0,38, 4,6 and 1,65 mg/kg b.w./day, respectively) and adults (0,32, 3,82 and 1,78 mg/kg

b.w./day, respectively). The calculated contribution from ED consumption to total caffeine exposure

was 8% for adults, 13% for adolescents and 43% for children. The contribution increased for the high

chronic consumers to 13% in adults, 16% in adolescents and 48% in children.

© Nomisma-Areté consortium 2012. Parts of this publication may be reproduced, provided acknowledgement is

given to the „Nomisma-Areté consortium‟ , along with the authors, title and year of publication as mentioned on

page 1.

KEY WORDS

Energy drinks, caffeine, taurine, D-glucurono-y-lactone, active ingredients, survey, consumption.

3 Austria, Belgium, Cyprus, Czech Republic, Germany, Greece, Finland, France, Hungary, Italy, Poland,

Romania, Spain, Sweden, The Netherlands, United Kingdom. 4 In the present study “consumers” of ED are subjects who declared to have drunk ED at least once over the last

year. 5 In the present study “high chronic” consumers are respondents who regularly consumed ED “4-5 days a week”

or more (identified in relation to a frequency distribution for ED consumption greater than or equal to the 90th

percentile). 6 In the present study “high acute” consumers are respondents consuming 1 litre or more of ED per single session

in the case of adults and 1,065 litres or more of ED per single session in the case of adolescents (identified in

relation with declared volume consumed in a single session and setting the threshold at the 90th

percentile).


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SUMMARY

At the end of 2011, a study was commissioned by EFSA to the Consortium Nomisma-Areté, with the

objective of gathering consumption data for “energy” drinks (ED) in specific consumer groups (adults,

adolescents and children) in EU). The study also aims at estimating, for the different consumer groups,

the exposure to specific active ingredients (caffeine, taurine, and D-glucurono-y-lactone) from ED

consumption, and the relative contribution of ED to the total caffeine exposure. Moreover, specific

consumption habits (co-consumption with alcohol and consumption associated to intense physical

exercise) should be analysed for adolescents and adults.

Between February and November 2012, the study team conducted an EU-wide questionnaire-based

survey - involving more than 52.000 participants from 16 different EU Member States7(MS) - among

adults (14.500 participants), adolescents (32.000), and children (5.500).

Survey results

Adults

Around 30% of adults interviewed declared to have consumed ED at least once during the last year,

with prevalence varying among MS from 14% in Cyprus to 50% in Austria, and mainly (53%) in

“young adults” (18-29 years). Among ED consumers, the average volume consumed was 2 L/month.

Approximately 12% of adult consumers were identified as “high chronic” consumers, i.e. consuming

ED 4-5 times/week or more (13,3% in “young adult” consumers), consuming an average volume of

4,5 L/month.

“High acute” consumers (consuming at least 1 L/single session), were 11% of the total adult ED

consumers, mainly in “young adults” (13,4%).

The co-consumption of ED and alcohol was evidenced for around 56% of adult ED consumers (71%

in “young adults”). ED consumption in relation with physical exercise resulted for 52% of adult ED

consumers, mainly (55%) in “old adults” (50-65 years).

The average exposure to caffeine from ED was 22,4 mg/day (0,32 mg/kg b.w.8/day) for adult ED

consumers, and the ED contribution to the total caffeine exposure was 8%. Caffeine exposure from

ED increased to 48,3 mg/day (0,7 mg/kg b.w./day) in high chronic consumers, with a ED relative

contribution of approximately 13%.

Average exposure to taurine from ED was 271,9 mg/day (3,82 mg/kg b.w./day) in adult ED

consumers, rising to 585,79 mg/day (8,49 mg/kg b.w./day) in high chronic consumers. Average

exposure to D-glucurono-y-lactone from ED was 125,95 mg/day (1,78 mg/kg b.w./day) on average for

ED consumers, up to 268,84 mg/day (3,91 mg/kg b.w./day) in high chronic consumers.

7 Austria, Belgium, Cyprus, Czech Republic, Germany, Greece, Finland, France, Hungary, Italy, Poland,

Romania, Spain, Sweden, The Netherlands, United Kingdom. 8 Data on the exposure expressed for kg of body weight (b.w.) were calculated for each consumer on the basis of

declared body weight collected through the survey. In case of missing data, data on body weight from EFSA

scientific opinion “Guidance on selected default values to be used by the EFSA Scientific Committee, Scientific

Panels and Units in the absence of actual measured data” (EFSA, 2012) were adopted.


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Adolescents

Prevalence of ED consumption was 68%, varying from 48% in Greece to 82% in Czech Republic9,

and mainly observed (73%) in the 15-18 age subgroup. Among ED consumers, the average volume

consumed was 2,1 L/month.

Around 12% of adolescent consumers were identified as “high chronic” consumers, i.e. consuming ED

4-5 times/ week or more, with an average ED volume of 7 L/month.

Around 12% of adolescent ED consumers resulted to be “high acute” consumers, i.e. consuming at

least 1,065 L of ED per single session.

Co-consumption of ED and alcohol was observed in 53% of adolescent ED consumers, mainly (59%)

in the 15-18 years subgroup, while ED consumption in relation with physical exercise resulted to

interest 41% of adolescent consumers, mainly (48%) in the 10-14 years subgroup.

The average exposure to caffeine from ED was 23,5 mg/day (0,38 mg/kg b.w./day) for adolescent ED

consumers, with an average contribution of ED to the total caffeine exposure of 13%. The caffeine

exposure from ED increased to 75,08 mg/day (1,18 mg/kg b.w./day) in high chronic consumers,

contributing to 16% of total caffeine exposure.

The average exposure to taurine from ED was 283,9 mg/day (4,6 mg/kg b.w./day) in adolescent ED

consumers, rising up to 924,3 mg/day (14,5 mg/kg b.w./day) in high chronic consumers. Average

exposure to D-glucurono-y-lactone from ED was 100,14 mg/day (1,65 mg/kg b.w./day), up to 311,6

mg/day (4,9 mg/kg b.w./day) in high chronic consumers.

Children

Prevalence of ED consumption was 18%, mainly (19%) observed in the 6-10 years subgroup, and

varying among MS from 6% in Hungary to 40% in in Czech Republic. Among ED consumers, the

average volume consumed was 0,49 L/week.

Approximately 16% of ED consumers resulted to be “high chronic” consumers, i.e. consuming ED 4-5

times/ week or more, with an average volume of around 0,95 L /week.

Average caffeine exposure from ED was 21,97 mg/day (1 mg/kg b.w./day), with a relative

contribution of ED to total caffeine exposure of 43%. Caffeine exposure from ED increased to 42,9

mg/day (1,98 mg/kg b.w./day) in high chronic consumers, with a ED relative contribution of 48%.

Average exposure to taurine from ED was 278,37 mg/day (12,83 mg/kg b.w./day), increasing to

543,57 mg/day (25,05 mg/kg b.w./day) in the high chronic consumers.

Finally, average exposure to D-glucurono-y-lactone from ED was 111,35 mg/day (5,13 mg/kg

b.w./day), increasing to 217,43 mg/day (10 mg/kg b.w./day) for high chronic consumers.

Literature review

Results emerging from the literature review highlighted a limited availability of recent and

comprehensive studies or surveys at EU level, providing reliable data on ED consumption and

exposure to specific ingredients (caffeine, taurine, and D-glucurono-y-lactone). Such limitation did not

allow an analysis of the evolution of ED consumption over time.

9 The highest prevalence of ED consumption among total respondents was observed in Belgium (85%) but not

reported due to the small dimension of the sample for this MS (sampling error of estimates exceeds 5%).


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Recommendations

The project represented the first effort at European level of data collection on ED consumption and

contribution to some active ingredients (caffeine, taurine, and D-glucurono-y-lactone) exposure, in

specific consumer groups and in different MS. Due to the exponential growth rate which characterised

the ED market over the last years, the study team suggests to monitor possible further increases in ED

consumption and eventually consider the possibility to update the study.


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TABLE OF CONTENTS

Abstract .................................................................................................................................................... 2 Summary .................................................................................................................................................. 3 Table of contents ...................................................................................................................................... 6 Background .............................................................................................................................................. 8 Terms of reference.................................................................................................................................. 13 1. Introduction and Objectives ........................................................................................................... 14 2. Materials and Methods .................................................................................................................. 15

2.1. Literature review ................................................................................................................... 15 2.2. Stakeholders’ consultation .................................................................................................... 16

2.2.1. Pre-survey and post-survey consultations ........................................................................ 17 2.3. Survey ................................................................................................................................... 18

2.3.1. Selection of MS involved in the survey ............................................................................ 19 2.3.2. Study design ..................................................................................................................... 19 2.3.3. Pilot study and quality checks .......................................................................................... 23 2.3.4. Data processing methods for calculating the exposure to active ingredients ................... 25

2.3.4.1. Caffeine exposure from ED consumption ................................................................ 25 2.3.4.2. Caffeine exposure from consumption of other food products and beverages .......... 29 2.3.4.3. Contribution of ED to total caffeine exposure ......................................................... 31 2.3.4.4. Contribution of ED to total exposure to taurine and D-glucurono-y-lactone .......... 31

2.3.5. Criteria for defining patterns of ED consumption (acute and chronic consumers) .......... 32 2.3.6. Problems encountered, related solutions and limitations of the study .............................. 34

3. Results ........................................................................................................................................... 40 3.1. Literature review ................................................................................................................... 40

3.1.1. Overview .......................................................................................................................... 40 3.1.2. Focus on the most relevant references .............................................................................. 41

3.2. Stakeholders consultation: emerging issues .......................................................................... 44 3.2.1. Literature and sources ....................................................................................................... 45 3.2.2. ED market ......................................................................................................................... 45 3.2.3. Active ingredients ............................................................................................................. 45

3.3. Survey: results ....................................................................................................................... 46 3.3.1. General overview .............................................................................................................. 46 3.3.2. Adults ............................................................................................................................... 48

3.3.2.1. ED consumption ...................................................................................................... 48 3.3.2.2. Co-consumption of ED and alcohol ......................................................................... 57 3.3.2.3. Consumption of ED during sport activities.............................................................. 61 3.3.2.4. ED contribution to total exposure to relevant substances ........................................ 65 3.3.2.5. ED acute consumption: analysis on high acute consumers ...................................... 77 3.3.2.6. Exposure to active ingredients in high acute adult consumers ................................ 81

3.3.3. Adolescents ....................................................................................................................... 90 3.3.3.1. ED consumption ...................................................................................................... 90 3.3.3.2. Co-consumption of ED with alcohol ....................................................................... 99 3.3.3.3. Consumption of ED during sport activities............................................................ 104 3.3.3.4. ED contribution to total exposure to relevant substances ...................................... 109 3.3.3.5. ED acute consumption: analysis on high acute consumers .................................... 124 3.3.3.6. Exposure to active ingredients in high acute adolescent consumers ...................... 127

3.3.4. Children .......................................................................................................................... 136 3.3.4.1. ED consumption .................................................................................................... 136 3.3.4.2. ED contribution to total exposure to relevant substances ...................................... 143

4. Conclusions and recommendations ............................................................................................. 152 4.1. Literature review ................................................................................................................. 152


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4.2. Results emerging from the survey ...................................................................................... 153 4.3. Recommendations ............................................................................................................... 157

References ............................................................................................................................................ 158 Appendices ........................................................................................................................................... 161 A. Appendix - Stakeholders consultation: complete list of contacts ................................................ 162

B. Appendix - Stakeholders consultation: list of questions .............................................................. 165

C. Appendix - Stakeholders consultation: reference documents for the interview .......................... 167

D. Appendix - Stakeholders consultation: main findings ................................................................. 173

E. Appendix - Content of relevant substances in different ed brands indicated as "other" by

respondents in the questionnaire .......................................................................................................... 181

F. Appendix - Details on caffeine content for the categories of food selected for the calculation of

exposure ............................................................................................................................................... 187

Glossary and abbreviations .................................................................................................................. 190


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The present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively by

the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure.

The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and

the conclusions reached in the present document, without prejudice to the rights of the authors.

BACKGROUND

Consumption of ED and related issues

“Energy” drinks (ED) constitute a relatively new product category in the wider soft drinks market.

Lipvitan D™, launched in Japan in 1960 by Taisho Pharmaceuticals, can be considered the first ED

ever. The diffusion of ED in Europe started in 1987 with the launch of Red Bull™, a beverage

containing taurine and produced in Austria, which quickly gained popularity in Europe and, from 1997

onwards, also in the USA. Commercial success of Red Bull™ sparked the proliferation of similar

products on the market.

With an agreed definition of “ED” still missing, such category includes a variety of non-alcoholic

beverages containing caffeine, taurine and vitamins (often in combination with other ingredients),

marketed for their actual or perceived effects as stimulants, energizers and performance enhancers. For

this reason, ED – which should not be confused with isotonic beverages and “sport drinks” – are usually

included in the wider group of “functional foods”.

The most common active substance in ED is caffeine, which is often combined also with taurine, D-

glucurono-y-lactone, guaranà, maltodextrin, ginseng, carnitine, creatine and gingko biloba; other

common ingredients are vitamins and - usually – artificial and natural sweeteners (which are added also

to “mask” the unpleasant flavour of some ingredients).

Caffeine is an alkaloid, acting as central nervous system stimulant. It is present in many beverages and

food products: its content in ED can vary from 70 to 400 mg/L and more (maximum limits concerning

caffeine content are set by regulations in many countries).

Taurine is an amino acid naturally produced by human body, and it is essential for cardiovascular

function, and development and function of skeletal muscle, the retina and the central nervous system

D-glucurono-y-lactone is naturally present in human body, as important structural component of

connective tissues.

The rapid expansion of ED consumption has been one of the most notable trends in the soft drinks

market of many countries (see next §). However, such expansion has also created concern in the

scientific community, in national and international institutions dealing with health-related issues, as well

as in the public opinion, in the light of a number of issues which are often associated to ED

consumption. Indeed in the last years the attention for such issues has been remarkable in scientific

literature, in institutional communication by national health agencies, in specialist publications focusing

on the soft drinks sector10

, and also in the general media.

The issue of ED consumption and over-consumption is highly debated from a scientific point of view,

especially for what the possible related health effects are concerned. Indeed a number of studies (Alford

et al., 2011; Reissig et al., 2009; SHC, 2012; Arria et al., 2011; Marin Institute, 2011; Oteri et al., 2007)

have recently investigated on potential and/or detected effects of “active” ingredients (caffeine,

taurine, D-glucurono-y-lactone, etc.) on highly sensitive subjects (children, pregnant women, heart

patients, etc.), or on potential and/or detected effects of co-consuming of ED with alcohol or with

other products containing active ingredients.

10

A recent example is the article “ANSES warns French nation of risky alcohol energy drink mix”, featured on

Beverage Daily.com website on June 07, 2012: http://www.beveragedaily.com/Regulation-Safety/ANSES-warns-

French-nation-of-risky-alcohol-energy-drink-mix

http://www.beveragedaily.com/Regulation-Safety/ANSES-warns-French-nation-of-risky-alcohol-energy-drink-mix

http://www.beveragedaily.com/Regulation-Safety/ANSES-warns-French-nation-of-risky-alcohol-energy-drink-mix


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Moreover, the issue of co-consumption of ED with alcohol is cause of particular concern, as it appears

to be quite common among youths (Marin Institute, 2007; Miller, 2008; SHC, 2009). Indeed health

effects of co-consumption of alcohol and ED have been dealt with by a number of scientific studies

(Arria et al., 2010; Alford et al. 2011; Brache and Stockwell, 2011; Oteri et al., 2007) and technical

reports (BfR, 2008; EUCAM, 2008, 2009).

Finally, also the association between sport practice and high levels of consumption of ED has raised

some concern, as the combined effect of intense physical effort and of the stimulant action of ED could

pose health risks for some subjects.

In 2003 the Scientific Committee on Food of the European Commission (DG SANCO)11

classified ED

consumption levels into “mean chronic”, “high chronic” and “acute” (table 1).

Table 1 – ED consumption levels

Consumption N° of 250 ml cans per day ml/day

Mean chronic 0,5 125

High chronic 1,4 350

Acute 3,0 750

Source: DG SANCO - Scientific Committee on Food (2003)

Increasing consumption of ED implies a higher exposure to caffeine, taurine and D-glucurono-y-

lactone. Higher exposure to such active substances by children and young adults was identified as a

potential emerging risk at European Food Safety Authority’s (EFSA) Advisory Forum meeting of 19th-

20th May 2010. Indeed available information suggests that ED consumption is becoming more and

more widespread among youths, especially in relation with mass-entertainment and sport practice.

Despite the high scientific interest related to the possible side effects of ED, the limited availability of

detailed and updated information on ED consumption in the EU has been highlighted by many

experts and stakeholders.

EFSA commissioned the present study to gather consumption data for ED and data on exposure to

specific ingredients (caffeine, D-glucurono-y-lactone, taurine) in the context of ED consumption, for

specific consumer groups (children, adolescents and adults) and addressing specific moments of

consumption. The study is also aimed at estimating the relative contribution of ED to the total

exposure to caffeine, D-glucurono-y-lactone and taurine in the diet (in comparison with the

exposure deriving from consumption of coffee, tea, cola drinks and cacao, chocolate products, coffee-

based beverages, etc.).

The market of ED in Europe

In the context of the overall market for non-alcoholic beverages, ED are usually considered as a

segment of the wider category of “functional beverages”.

According to Zenith International’s Global Energy Drinks Report (2009), world total consumption of

ED in 2008 reached 3,9 billion litres (compared to 2 billion litres in 2003). Per capita consumption at

world level was equal to 0,8 litres (up from 0,4 litres in 2003). North America accounted for a 37%

share of overall world consumption in 2008, with the Asia/Pacific area accounting for another 30%; the

share of Western Europe on world total was equal to 15%.

According to estimates by Euromonitor International, the expansion of the ED market at global level

has continued at a fast pace also in recent years (table 2).

11

European Commission health & consumer protection directorate-general Scientific Committee on Food,

“Opinion of the Scientific Committee on Food on Additional information on “energy” drinks”, 2003.


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Table 2 – Growth of the functional drinks market at world level by segment (2006 – 2011; million litres)

Segments 2006 2011 (forecast) % growth

(2011 vs. 2006)

Sports drinks 9.871 13.302 + 35%

Energy drinks 2.429 3.534 + 45%

Functional drinks -

TOTAL 12.621 17.202 + 36%

Source: Euromonitor

On the basis of data provided by the Canadean’s Global Beverage Report (2008), the annual growth rate

for the ED segment in the 2008-2013 period was forecast at +9,3%, compared to a growth rate of +2,6%

for the overall non-alcoholic beverages market.

Red Bull™ is by far the leading brand at world level (40% of total sales in 2008), with Monster™

(owned by Hansen’s Beverage Company) and Rockstar™ ranked second and third, respectively (table

3).

Table 3 – Leading ED brands at world level (2008, market shares)

Brands share

Red Bull™ 40%

Monster™ 23%

Rockstar™ 12,3%

AMP™ 8%

Full Throttle™ 4%

Doubleshot™ 2%

NOS™ 1,5%

No Fear™ 1,4%

Private Labels (retailers’ brands) 1%

SOBE Adrenaline™ 0,7%

Source: Bevnet

With regards to the ED market in Europe, it has experienced a rapid growth of consumption,

especially from 2005 onwards (Zenith International, 2008). Total production of ED in Europe was

estimated at around 490 million litres in 2007, for a value of approximately 3,8 billion Euros. The

expansion of the market has been especially remarkable in some MS (Germany and United Kingdom in

particular12

), and has often resulted in a proliferation of brands, with frequent launch of new

products, many of them with eminently national diffusion. “Convenience” ED (many of them

marketed under private label) and innovative product typologies (“energy shots”, “pre-mixed alcoholic

12

According to Zenith International data featured in the annual reports of the British Soft Drinks Association

(BSDA), ED consumption in the United Kingdom has grown from 175 million litres in 2000 (1,5% of total soft

drinks consumption) to 495 million litres in 2011 (3,4% of total soft drinks consumption, for an increase of 183%

in terms of volume). Per capita consumption levels have increased from 3 litres per person in 2000 to 7,9 litres per

person in 2011. In other MS the growth has been less intense, and overall consumption volumes are quite limited;

in Italy, for instance, consumption of ED (according to GFK-Eurisko data published on MARK UP magazine,

April 2009 and April 2010 issues) has passed from 2,67 million litres in 2006 to 2,97 million litres in 2009 (an

increase of 11%).


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ED”, etc.) have also appeared in some national markets (Alard, Marìn, Cubillo, 2010; EUCAM, 2008

and 2009).

Red Bull™ is by far the leading brand in virtually all national markets; smaller market shares are held

by other international brands (Monster™, Burn™), by national brands (of which some are however

owned by multinational groups) and by private labels.

Outline of the relevant EU labeling legislation

A short overview of the most relevant European legislation on food labelling - with particular attention

to the rules concerning beverages containing active ingredients – is provided hereafter.

Directive 2000/13/EC of the European Parliament and of the Council on “the approximation of

the laws of the MS relating to the labelling, presentation and advertising of foodstuffs”. The

Directive defines mandatory food information to be provided by producers, in order to assure a

high level of protection of consumers’ health and interests. According to this Directive, among

the other features (such as the name of the food) it is mandatory to indicate the list of

ingredients and the quantity of certain ingredients, or category of ingredients, on the product

label.

Directive 2002/67/EC of the European Commission on “the labelling of foodstuffs containing

quinine, and of foodstuffs containing caffeine”. The Directive establishes that beverages

containing more than 150 mg of caffeine per litre must be labelled with the term “high caffeine

content”, in a position close to the name of the food. Furthermore a clear indication of the

amount of caffeine per 100 ml in the product must be provided in the label. In this Directive ED

are explicitly indicated as caffeine containing products which, according to the Scientific

Committee for Food opinion of 21st January 1999, do not represent a cause of concern for their

contribution to the total consumption of caffeine (only for adults, pregnant women excluded).

Regulation (EU) No 1169/2011 of the European Parliament and of the Council on “the

provision of food information to consumers”. From 14th December 2014 this Regulation will

enforce additional caffeine labelling for high caffeine drinks and foods where caffeine is added

for its physiological effects13

. In particular, the following categories of beverages must be

labelled with the statement “High caffeine content. Not recommended for children or pregnant

or breast-feeding women” placed near the name of the product and followed by the caffeine

content specified in mg per 100 ml:

- beverages intended for consumption without modification, containing at least 150 mg/l of

caffeine;

- beverages in concentrated or dried form which after reconstitution contain caffeine in a

proportion in excess of 150 mg/l.

The aforementioned provisions will instead not apply for:

- drinks based on coffee, tea or coffee or tea extract where the name of the food includes the

term “coffee” or “tea”;

13

http://www.food.gov.uk/policy-advice/additivesbranch/energydrinks

http://www.food.gov.uk/policy-advice/additivesbranch/energydrinks


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- beverages where caffeine is added as a flavouring rather than for a physiological purpose: in

this case the term “caffeine” must appear in the ingredients list under the section

“flavouring(s)”.

As for labelling on beverages containing taurine and D-glucurono-y-lactone, there are no specific rules

to be enforced to indicate these substances.


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TERMS OF REFERENCE

As already outlined, the main purpose of the study is gathering information and data on consumption of

ED and of some specific ingredients (specifically caffeine, taurine and D-glucurono-y-lactone) in well-

defined consumer groups in a number of EU MS. The targeted groups of consumers include children

(from 3 to 10 year old), adolescents (from 10 to 18), and adults (from 18 to 65); a focus is also foreseen

on adolescents and adults practising intense physical exercise and co-consuming ED with alcohol.

According to the terms of reference, in the context of the study:

Consumption of ED is analysed at MS level and expressed per subgroup and per unit of time, in

order to reflect acute and chronic exposure.

Consumption of and exposure to specific ingredients (caffeine, taurine, D-glucurono-y-lactone) are

analysed per subgroup for acute and chronic ED consumers in each MS. As for caffeine

consumption, the relative contribution of ED is determined and compared with caffeine

consumption from major sources in the diet (coffee, tea, cola drinks and cacao, chocolate products,

coffee based beverages, etc) to assess whether ED consumption is adding to exposure to caffeine or

whether their consumption is substituting exposure via more traditional foods.

This contract was awarded by EFSA to: Consortium Nomisma-Areté

Contractor: Consortium Nomisma-Areté

Contract title: Gathering consumption data on specific consumer groups of energy drinks

Contract number: CFT/EFSA/EMRISK/2011/03


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1. INTRODUCTION AND OBJECTIVES

According to the terms of reference, the main objectives of the study can be identified in the following:

- Gathering data about consumption of ED in the EU MS (Objective 1);

- Collecting data at MS level about the exposure to specific active ingredients (caffeine, taurine,

D-glucurono-y-lactone) due to ED consumption, and estimating the relative contribution of ED

to caffeine exposure, compared with caffeine consumption from major sources in the diet

(Objective 2).

In order to achieve the above mentioned objectives, a specific data collection strategy was defined,

based on three main elements:

1. review of the relevant literature dealing with the subjects of interest available in the different

MS and published over the last three years;

2. consultation of the relevant stakeholders (experts of EFSA national focal points; officials of

competent authorities in the field of public health; representatives of the main beverages

industry associations both at European and national levels);

3. ad hoc survey, aimed at gathering primary data on the consumption of ED and on the exposure

to specific ingredients.

The present document constitutes the final report for the study “Gathering consumption data on specific

consumer groups of energy drinks”, commissioned by EFSA to the Consortium Nomisma-Areté at the

end of 2011.

According to the tender specifications for the study, and taking into account EFSA’s guidelines for the

submission of official reports, the document is structured as follows:

- A description of the methodology applied in the study (chapter 2);

- A description of the results of the study (chapter 3), divided into:

o A description of the results from the literature review (§ 3.1);

o A description of the results from the stakeholders’ consultation (§ 3.2);

o Final results from the survey (§ 3.3), as a summary of data on acute and chronic

consumption of ED in the previously mentioned subgroups of the population, including

summary statistics for each Member State (MS) and for all MS for which data were

available.

- Conclusions and recommendations (chapter 4).


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2. MATERIALS AND METHODS

Due to the complexity of the study and the kind of information required for the purpose of the analysis,

a specific data collection strategy was defined, including a combination of different methods and tools

(Figure 1).

Figure 1: Data collection strategy

As foreseen in the data collection strategy, the preliminary phase of the study included:

- Literature review, carried out also with the support and contribution of selected stakeholders.

- Identification and contact of stakeholders, aimed at ensuring their contribute to the study via

interviews (stakeholders’ consultation).

- Survey.

The following paragraphs provide details regarding the methodology and tools adopted for each main

phase and specific element of the data collection strategy.

2.1. Literature review

The literature review was performed with the main objectives of:

- Identifying and collecting relevant studies, papers and articles, as well as previous surveys

performed during the last three years with respect to the consumption of ED, the occurrence of

specific ingredients and human exposure to active ingredients.

- Identifying and collecting information and data useful to correctly define the survey design as

well as specific contents for the questionnaires.

Activities related to literature review were developed through the following main steps:


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1. Identification of the available literature and information sources, in the light of the previously

defined objectives and scope of the study.

2. Analysis of the documents collected during step 1.

3. Synthesis of the most relevant documents.

4. Use of the relevant literature for the purposes of the study (survey design and contents of

questionnaires).

The first phase of the literature review was mainly based on web-based research (specialized magazines,

dedicated web-sites, institutional sources, etc.). After this preliminary phase, stakeholders’ consultation

played a relevant role in supporting the identification of additional sources and studies as well as the

selection of the proper and most relevant papers for the purposes of the study. Stakeholders were asked

to comment on the preliminary list of references and sources collected by the study team, and to

eventually add missing references or sources (§ 2.2).

Literature review was focused on recent bibliography (published between 2008 and 2011) addressing

ED and/or their specific ingredients, in terms of consumption habits and possible health effects caused

by these products/ingredients. Due to the specific objectives of the study, however, studies and reports

dealing exclusively with health effects of ED were deemed as falling outside the scope of the study

itself.

From the complete list of the relevant literature, resulting from the stakeholders’ consultation (Appendix

A), a number of references featuring meaningful insights about the research topics were selected (§

3.1.2).

2.2. Stakeholders’ consultation

Two different rounds of stakeholders’ consultations were planned: before (pre-survey consultation) and

after the survey (post-survey consultation).

The main objectives of the pre-survey stakeholders’ consultation is summarised as follows:

a) Supporting literature review, and specifically the identification of relevant sources, studies and

surveys dealing with the issue of ED consumption over the last 3 years.

b) Supporting the collection of data on ED market.

c) Supporting and validating the identification of relevant ED brands for the different MS.

d) Supporting the identification, for each MS, of relevant food products in the diet contributing to

the exposure to active ingredients (caffeine, taurine, D-glucurono-y-lactone).

After the conclusion of the survey, stakeholders who had participated to the first round of consultation

were contacted again as part of the post-survey consultation, whose main objective was to share with

experts the structure of methodology adopted for the study as well as results emerging from the first

round of consultations.

On the basis of the aforementioned objectives, the categories of stakeholders involved in the pre- and

post-survey consultations include:

- Experts from EFSA national focal points14

.

14

Focal Points act as an interface between EFSA and the national food safety authorities, research institutes,

consumers and other stakeholders. The Focal Point network is made up of members from all 27 EU Member

States, Iceland and Norway, as well as observers from Switzerland and (potential) EU candidate countries.


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- Representatives of the main industry associations, both at European level (Union of European

Soft Drinks Associations; Energy Drinks Europe; etc.), and at MS level (national associations of

soft drinks producers).

- Researchers and experts in soft drinks and ED, in particular project managers of relevant studies

on ED and related themes (e.g. University of Wien; European Centre for Monitoring Alcohol

Marketing – EUCAM, etc.).

- Representatives of consumers’ organizations at EU level (e.g. European Consumers’

Organization – BEUC).

The pre-survey consultation was carried out between February and May 2012.

The post-survey consultation was carried out in November 2012, when the survey activities were

approaching completion.

2.2.1. Pre-survey and post-survey consultations

Starting from the identification of the relevant categories of stakeholders to be involved, the study team

selected a list of experts in the study subjects, specifically including:

- experts from MS national health institutes/organisations;

- representatives of EU-level industry organisations;

- representatives of national industry organisations;

- other experts in the field of ED (academics, consultants, etc.), with special focus on ED

consumption and composition.

The final list of stakeholders to be contacted and the list of questions to be asked were validated by the

Steering Group prior to the start of the consultation. The final list of stakeholders also included ones

from MS not covered by the survey, for a total of 40 experts (Appendix B).

All the interviewed experts were provided in advance (Appendix C and D) with:

- list of questions;

- list of relevant literature collected by the study team;

- list of relevant information sources identified by the study team;

- list of the main ED brands marketed in the EU, compiled by the study team on the basis of the

literature review;

- list of food products in the diet (other than ED) supposed to play a significant role in the

assumption of caffeine, taurine, D-glucurono-y-lactone, theophylline and theobromine,

compiled by the study team on the basis of the information retrieved through the literature

review.

The minutes of the interview were sent to each interviewee for validation.

Interviews for the pre-survey consultation were organized around three main topics: literature and

sources; ED market; active ingredients. However, the choice of semi-structured interviews, based on

open-ended questions, encouraged experts not to limit their contributions to such topics, but to provide

also general comments on the study as a whole, as well as additional inputs and ideas.

Some stakeholders were also involved in the post-survey consultations, in which the structure of the

methodology adopted for the survey, as well as results emerging from the first round of consultations

were shared with them.


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2.3. Survey

The literature review and the pre-survey stakeholders’ consultation enabled the study team to better

define the reference frame for the survey, which actually represented the main source of data and

information for the study.

As already outlined, the survey aimed at collecting primary data on different population targets, and

specifically:

1) children (3-10 years old);

2) adolescents (10-18 years old);

3) adults (18-65 years old);

as well as:

a) adolescents and adults practising intense sport activities;

b) adolescents and adults consuming ED mixed with alcohol.

For each target group mentioned at points from 1 to 3 above, a dedicated questionnaire was prepared

and translated in all the languages of the MS covered by the survey. In the specific case of children aged

3-5 an additional questionnaire addressed to parents was also prepared.

The survey was structured to collect data and information to achieve both Objective 1 and 2 (chapter 1).

Questions related to each objective covered a specific section in the questionnaire. Each questionnaire

started with an introductive section aimed at gathering some preliminary information on the respondent

(gender, age, education level, etc.), followed by two dedicated sections, for each of the two objectives.

Additional consumer profile information (e.g. on lifestyle, such as “smoker or not”) was collected

through specific questions.

Objective 1: Data on ED consumption – Study design A. This section featured a number of questions

mainly aimed at investigating:

- Frequency and volume of consumption.

- Reasons for consumption and consumption habits.

- Main typologies, size formats and brands consumed.

- ED consumption and sport activities (in adults and adolescents).

- Co-consumption of ED and alcohol (in adults and adolescents).

Objective 2: Data on consumption of other food products containing caffeine, taurine, D-glucurono-y-

lactone – Study design B. This section featured a number of questions mainly aimed at investigating:

- Relevant food products in the diet that constitute a source of caffeine, taurine and D-glucurono-

y-lactone.

- Consumption frequency and products content in caffeine, taurine and D-glucurono-y-lactone.


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2.3.1. Selection of MS involved in the survey

The survey covered 16 MS out of 27, selected in order to guarantee an adequate coverage of the whole

EU population and of the different consumption styles.

The following selection criteria were adopted:

- Size of ED potential market in terms of population in the relevant age group (from 3 to 65 years).

- Balance among different geographical areas supposed to have potentially different consumption

habits (Western vs. Eastern countries, Northern vs. Southern countries).

- Balance among different food consumption patterns (e.g. Mediterranean countries vs. Nordic

countries).

On the basis of these criteria (also taking into account preliminary findings emerging from the literature

review), and after final validation by the Steering Group, the following 16 MS were selected for the

survey:

1. Austria

2. Belgium

3. Cyprus

4. Czech Republic

5. Germany

6. Greece

7. Finland

8. France

9. Hungary

10. Italy

11. Poland

12. Romania

13. Spain

14. Sweden

15. The Netherlands

16. United Kingdom

2.3.2. Study design

In order to guarantee a wide coverage of each targeted group, the survey was differently defined on the

basis of the target. A description of the survey structure and for each targeted group is provided below.

1. Children

A. Children 3-5 years old

Survey carried out with schools' support ("school survey").

Paper questionnaires, featuring images aimed at helping children to correctly

understand each question and call back to mind food products and beverages.

Questionnaires to be filled in by children, at school, with the help of their teachers.

Additional questionnaires to be filled in by parents, aimed at collecting more

accurate information on the children’s consumption habits and at

confirming/adjusting what declared by children in the respective questionnaire.

B. Children 6-10 years old

“School survey”.

Paper questionnaires, featuring images aimed at helping children to correctly

understand each question and call back to mind food products and beverages.

Questionnaires to be filled in by children, at school, with the help of their teachers.

For a small sample of children, questionnaires to be filled in also by parents

(specifically required for schools covering both the target groups).


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For children and adolescents, the sample of schools for MS was determined on the basis of each target

group (Tables 4 and 5). Official registries containing the complete list of schools, with related contact

details, were requested to the Ministries of Education and other competent Authorities of the MS

covered by the survey. On this basis, sampling activities were carried out on the complete lists of

schools for each level involved (pre-primary, primary, secondary).

For the survey on adults (18-65 years), a mixed mode was preferred, integrating CAWI and CATI

methods. The questionnaires (adults, adolescents, children and parents) were translated in all the

relevant languages for the MS covered by the survey, in order to promote people’s cooperation and

participation.

5. Adolescents and adults Co-Consuming ED with alcohol (CC)

Covered via questionnaires already addressed to adolescents and adults (points 2

and 3 above).

At least one situation of co-consuming during the last year.

Target covered by Adolescents and Adults Survey (points 2 and 3 above).

4. Adolescents and adults practising Intense Physical Exercise (IPE)

Covered through the questionnaires already addressed to adolescents and adults

(points 2 and 3 above).

Practice of sport and/or physical exercise at least twice a week.

Target covered by Adolescent and Adults Survey (points 2 and 3 above).

3. Adults (18-65 years old)

Mixed mode survey – CAWI (Computer Assisted Web Interview) e CATI

(Computer Assisted Telephone Interview).

Maximum share of telephone interviews = 20%.

2. Adolescents

A. Adolescents 10-13 years old


Web questionnaires or alternatively paper questionnaires to be filled in by

students.

B. Adolescents 14-18 years old


Web questionnaires or alternatively paper questionnaires to be filled in by

students.


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Details on the minimum sample dimension defined for each country, in terms of schools to be

contacted, are provided in Table 4.


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Table 4: Sample design – Number of schools included in the sample by country

PRE-SCHOOL

(20x3)(a)

PRIMARY

SCHOOL

(20x5)(a)

LOWER

SECONDARY

(25x3x2)(a)

UPPER

SECONDARY

(22x5x3)(a)

Austria 25 25 10 6

Belgium 30 30 12 5

Cyprus 5 5 5 5

Czech Republic 25 25 10 6

Finland 20 20 10 5

France 100 100 39 23

Germany 100 100 39 23

Greece 18 18 7 5

Hungary 28 28 11 7

Italy 90 90 35 22

Netherlands 40 40 16 10

Poland 75 75 30 18

Romania 40 40 16 10

Spain 79 79 31 19

Sweden 25 25 10 6

United Kingdom 100 100 39 24

TOTAL 800 800 320 194

SCHOOL SAMPLE AND POTENTIAL CONTACTS

(a) Average number of pupils/students per class (class size) multiplied for the average number of school year levels.

The number of contacts with schools in each MS was defined by means of a specific sampling

methodology: the total number of potential contacts was distributed among the 16 MS according to the

total population; the numbers obtained were then adjusted in order to guarantee a minimum number of

contacts in the less compared to the more populous MS. The methodology adopted for the definition

of sample size is therefore proportional with adjustments.

The sample of schools to be contacted in each MS was defined by random sampling methodology,

aimed at guaranteeing nation-wide coverage and representativeness of the group of interviews in terms

of geographical areas for each target group.

During the survey activities, the initially planned number of schools to be contacted was significantly

increased, in order to guarantee a sufficient coverage also in those countries where the actual

participation rate resulted to be much lower than initially expected (50%).

The replacement procedure was based on the representativeness of the sample, including three more

schools from the same region, with similar characteristics (level of education, area, number of

students, etc.).

Even if the sample was built on these premises, the results cannot be deemed as fully matching the

scheme initially proposed, as the participation rate in the survey strongly depended on the schools’

availability.

Therefore, a more intense effort was driven towards replacements and recalls in the MS where the

number of potential ED consumers resulted to be lower.

Details regarding the expected number of “consumers” (consumption of ED at least once over the last

year) to be reached for each target category are reported in Table 5.


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Table 5: Sample design – Expected number of consumers to be reached through the survey

3-10 years

old

10-18 years

old

19-65 years

old

IPE(b)

CC(b)

Austria 200 270 180 72 72

Belgium 240 280 150 60 60

Cyprus 40 60 50 20 20

Czech Republic 200 280 150 60 60

Finland 160 250 150 60 60

France 800 1.100 450 180 180

Germany 800 1.100 450 180 180

Greece 144 200 150 60 60

Hungary 224 310 150 60 60

Italy 720 1.000 430 172 172

Netherlands 320 450 150 60 60

Poland 600 820 350 140 140

Romania 320 450 190 76 76

Spain 632 860 400 160 160

Sweden 200 270 150 60 60

United Kingdom 800 1.100 450 180 180

TOTAL 6.400 8.800 4.000 1.600 1.600

CONSUMERS(a)

of which:

(a) At least one intake over the last year.

(b) Samples for IPE and CC are referred to both adolescents and adults.

2.3.3. Pilot study and quality checks

The tools used in the survey, including questionnaires, were validated following a specific procedure.

All the documents were drafted on the basis of the study team’s expertise in surveys on food

consumption habits, with particular respect to the target groups covered by the study.

Relevant literature in the dietary assessment methodology field has been reviewed in order to use up-

to-date methods to assess the consumption habits on a target population15

. Moreover, a review of

empirical studies on consumption habits was also made16

, in order to grasp the critical aspects of the

tools already used in other surveys and to avoid as much as possible bias in the outcomes of the

survey.

15

One of the reference papers used was “Dietary Assessment Methodology” F. E. Thompson, A. F. Subar,

National Cancer Institute, Bethesda, Maryland, 2008. 16

Specific reference was made to Safefood (A review of health effect of stimulant drinks), Expochi (Dietary

exposure assessments for children in Europe), Food4You project (Healthy Lifestyle in Europe by Nutrition in

Adolescence, European food information council) and Catch kids club (survey on consumption habits in

youngsters). Edmunds, L.D. and Ziebland, S. (2002) Validation of a fruit and vegetable questionnaire for 7–9

year olds. Health Education Research 17: 211-20.


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Professional translators were used to translate documents into the relevant languages; the use of simple

wording and a close cooperation between the translators and the study team also ensured that all the

survey questions and annexed documents were easy to understand.

National experts the pre-survey consultations allowed to tailor the questionnaires to national

characteristics concerning the main ED brands and/or other common food products/beverages

containing caffeine.

Questionnaires for surveys in schools were tested through a pilot survey in 3 MS (Italy, France and

UK). A sample of schools for each level was contacted to complete the pilot questionnaires and to

gather comments/suggestions on the structure and wording. Also head teachers or educational experts

of some schools not involved in the pilot survey provided useful remarks and suggestions on the

survey approach and questionnaires. Comments and suggestions gathered during the pilot phase were

used for fine-tuning methodology and related tools prior starting the survey.

Checks on the documents were initially based on the content validity, which was already part of the

tender specifications and which was tested with the Steering Group.

The specificity validity was achieved through adjustment of the standard methodology for

investigating food consumption habits to the specific kind of product considered, i.e. ED: in particular,

the consumption time reference scale and the occasions of consumption were based on each specific

type of product.

Moreover, a validation of the sensitivity was achieved through three check questions regarding ED

consumption, to have further confirmation of the same and to avoid “non-consumers”. These check

questions also allowed the selection of subgroups of consumers in the population and the investigation

of their specific consumption habits.

The external validity was assured by the outcomes of the pilot survey and by the stakeholders’

consultations, with the aim of allowing generalization of the survey results to the entire reference

population.

As for qualitative checks on the filled in questionnaires, accuracy in compiling the questionnaire was

assured by the constrains foreseen in the online questionnaires (adults and adolescents), which enabled

to continue with the compilation only if all the previous questions had been answered, and blocked the

compilation in case of “unrealistic” answers regarding age, weight, slept hours, etc.

With specific reference to ED consumption, in all those cases where the respondent had indicated a

product which is not an ED (e.g. sport drink), the respondent was reclassified as non-ED consumer,

and all the answers concerning ED consumption and related habits were consequently excluded from

the analysis.

As far as outliers are concerned, in all those answers where a number specification was required (e.g.

“number of cans consumed in an average week”), a reclassification or elimination was always made

for clearly extreme - and hence probably unrealistic - figures (e.g. 100 cans/week). An additional

reclassification was made with specific regards to coffee consumption, in order to assure coherence in

the overall consumption of the three product typologies: specifically, when respondents declared to

consume more than 15 cups per day17

of beverages with coffee - combining declared consumption data

espresso, coffee (instant, ground, ice-coffee) and cappuccino - the number of cups consumed daily has

been reclassified as maximum 5 cup per day for each typology.

17 Over 15 cups of coffee per day have been considered an unrealistic consumption data.


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Finally, the validity of results was also guaranteed by the choice to carry out the survey over a quite

long time period (from March to November), thus avoiding - or at least sharply reducing - possible

distortions due to seasonal trends in consumption.

2.3.4. Data processing methods for calculating the exposure to active ingredients

Processing methods used for calculating the exposure to active ingredients (caffeine, taurine and D-

glucurono-y-lactone) for each subject interviewed (“row analysis” of the data) were applied to data on:

The exposure was derived:

1. ED consumption;

2. consumption of other food products and beverages containing the active substances object of

the analysis.

Such calculations were made for both ED consumers and all respondents18

, and allowed to define the

relative contribution of ED consumption as a source of caffeine, taurine and D-glucurono-y-lactone

through the diet.

Throughout the analysis, calculations were always based on the data of the single respondent, while

average data were used solely to give the final outputs/elaborations or to define the threshold for

further breakdowns of the analysis (i.e. acute or chronic consumption). Final results on the exposure to

active substances were expressed in mg/day and in mg/kg bw/day.

2.3.4.1. Caffeine exposure from ED consumption

Calculation started from ED consumption data retrieved via survey. Data on number of cans of ED

consumed in an average month were combined with data on:

a. the size of cans usually consumed;

b. the top-three ED brands usually consumed;

c. the relative importance of the favourite ED brand among the top-three products;

d. caffeine content of the ED brands concerned (table 6 and 7);

in order to calculate the overall caffeine exposure from ED consumption, weighted according to the

relative importance of the top-three ED brands consumed (each respondent was asked to indicate the

three main ED brands consumed, in decreasing order of importance, and to specify the per cent share

of his/her favourite brand in his/her total ED consumption).

In the specific case of children, a different method had to be used, as no question about the top-three

ED brands was asked. In this case, the average content of caffeine – as well as concerning D-

glucurono-y-lactone and taurine - of the first 3 brands of ED comprehensively indicated by children

has been used.

With regards to the format of ED, a specific analysis was performed for the “energy shots” format: in

this case, the occurrence of active substances results to be remarkably different (and normally higher)

from that of the “standard” EDs, and to sharply vary from one energy shot brand to another. Table 7

provides the contents of active ingredients for the energy shots brands cited by respondents and

18

The calculation of the total exposure (ED and other foods/beverages) is not available for all the respondents in

the target group of adults, since in this case respondents who declared not to consume ED were not asked

additional information on the consumption of other food and beverages containing active ingredients.


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analysed in the study. When the exact occurrence of active ingredients was not available or considered

not fully reliable, a standardized content of active substances was applied19

(§ 2.3.6).

19

The contents adopted for the calculations are: 1.345 mg/L for caffeine, 4.000 mg/L for taurine and 2.400 mg/L

for glucurono-y-lactone. The size is 63 ml.


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Table 6: Content of active ingredients in different ED brands included in the questionnaire (1)

Brand name Caffeine (mg/L) Taurine (mg/L) D-glucurono-y-lactone

(mg/L)

Atomic™ 300 3700 2400

Bad Dog™ 300 4000 Not present

Battery™ 320 4000 Not present

Big Energy Shock™ 322 4000 (b) Not present

Blu™ 300 (a) 4000 b Not present

Bomba™ 320 4000 Not present

Booster energy drink™ 300 (a) 4000 (b) 2400(b)

Brava Italia™ 320 4000 Not present

Bullet™ 300 (a) 4000 (b) Not present

Burn™ 320 4000 2400

Carrefour™ 300 (a) 4000 (b) 2400(b)

Chillo™ 300 (a) 4000 (b) 2400(b)

Clever™ 320 300 2400(b)

Control™ 300 (a) 4000 (b) 2400(b)

Crazy horse™ 150 28 Not present

Dark dog™ 320 4000 Not present

Effect™ 320 4000 2400

Fireball™ 300 (a) 4000 (b) 2400(b)

Flying horse™ 300 (a) 4000 (b) 2400(b)

Full Throttle™ 288 2420 Not present

Green go™ 300 4000 Not present

Grizzly™ 300 (a) 4000 (b) 2400(b)

Hell™ 320 4000 (b) Not present

KX (Tesco)™ 300 4000 2400

Long Horn™ 320 Not present Not present

Mad bat™ 300 (a) 4000 (b) 2400(b)

Mixxed up™ 300 4000 (b) Not present

Mad croc™ 320 4000 240

Monster™ 307 4000 Not present

MX Maximim™ 300 (a) 4000 (b) 2400(b)

Nalu™ 320 Not present Not present

Natural Magic™ 300 (a) 4000 (b) 2400(b)

Power horse™ 320 4000 2000

Premium XO™ 300 (a) 4000 (b) Not present

Raw™ 300 (a) 4000 (b) 2400(b)

Real Power™ 300 (a) 4000 (b) 2400(b)

Red Bull™ 320 4000 2400

Red Devil™ 300 4000 Not present

Relentless™ 320 4000 2400


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(mg/L)

Rhino's™ 120 4000 (b) 2400(b)

Rienergy Refresher™ 303 4000 2400

Rockstar™ 300 4000 Not present

Rodeo™ 320 4000 2400

Semtex™ 320 4000 Not present

Sexy Italia™ 300 (a) 4000 (b) 2400(b)

Shark™ 350 4000 2400(b)

Tiger™ 320 4000 Not present

Tonino Lamborghini™ 320 4000 2400

V™ 310 2000 250

V Power™ 300 (a) 4000 (b) 2400(b)

V12™ 300 (a) 4000 (b) 2400(b)

White Tiger™ 320 Not present Not present

28 Black Acai™ 320 Not present Not present

Note: values highlighted by the light grey background were assumed, as no information on actual content could be retrieved.

(a) assumed as equal to the value in König, 2011.

(b) assumed as equal to the modal value.

(1) Contents of relevant substances in different ED brands indicated as “other” by respondents in the questionnaire are

provided in Appendix F.

Table 7: Content of active ingredients in different energy shots brands


(mg/L) size (ml)

Battery™ 1345 (a) 4000 b 2400(b) 63 (a)

Burn energy shot™ 1600 4000 1400 50

Dark Dog™ x10 Shot 1600 16000 Not present 63 (a)

Mad Croc energy shot™ 13300 (a) 4000 b 2400(b) 60 (a)

Monster Hitman Energy

Shot™ 880 2247 Not present 89

Red Bull energy shot™ 1333 6666 4000 60

Relentless energy shot™ 1600 (a) 4000 b 2400(b) 50 (a)

Rhino's energy shot™ 1345 (a) 4000 b 2400(b) 63 (a)

Rockstar energy shot™ 1345 (a) 4000 b 2400(b) 63 (a)

Shark energy shot™ 1070 4000 Not present 75

Tiger energy shot™ 1333 16670 Not present 60

Note: values highlighted by the light grey background were assumed, as no validated information on actual content could be

retrieved.

(a) assumed as equal to the average of other energy shots indicated in the survey

(b) assumed as equal to the modal value of occurrence in standard ED


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Calculation of the daily exposure to caffeine deriving from ED consumption was made through the

following formula:

ED_caffeine_daily exposure = (ED_monthly volume * ED_caffeine_content) / 30

where:

ED_caffeine_daily exposure = daily exposure to caffeine deriving from ED consumption (mg)

ED_monthly volume = volume of ED consumed in a month (l), calculated by combining the number

of cans consumed in an average month with the size of the cans

ED_caffeine_content = content of caffeine in ED (mg/l), weighted according to the brands consumed

2.3.4.2. Caffeine exposure from consumption of other food products and beverages

Caffeine exposure from consumption of other food products and beverages was calculated by

combining data:

a. on consumption frequency (daily or weekly, according to the type of product concerned);

b. on quantities consumed in a single occasion (taking into account container size or item weight,

whenever relevant);

c. on caffeine content of each product .

The parameters considered in the calculations are reported in table 7.


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Table 8: Caffeine occurrence in other food products and beverages: relevant parameters considered in the

calculations

Type of product Container Size with caffeine

(mg/L or mg/kg)

decaffeinated

(mg/L or mg/kg)

Espresso Coffee cup 0,03 l 1916 250

Coffee (instant, ground, ice coffee…) mug 0,24 l 400 10,7

Cappuccino cup 0,15 l 250 50

Tea (instant, tea bag, ice tea…) cup/glass 0,25 l 100 25

Hot chocolate cup 0,25 l 150

Chocolate bars*

0,10 kg 180

Dark chocolate

0,10 kg 340

Milk chocolate

0,10 kg 183

White chocolate

0,10 kg 0

Chocolate snacks (e.g. Mars, KitKata

0,05 kg 140

Dark chocolate

0,05 kg 264

Milk chocolate

0,05 kg 142

White chocolate

0,05 kg 0

Colas (e.g. Coca Cola, Pepsi) glass 0,25 l 79,2 0

(a) = whenever no distinction was made between dark, milk and white chocolate, values for generic chocolate products as

featured in König J.) were used for calculations.

Sources:

König J., 2011., Final report: Assessment of caffeine intake in a representative sample of the Austrian population

(age 14-39 years).

NZFSA - New Zealand Food Safety Authority (2010), Risk profile: caffeine in energy drinks and energy shots.

Report prepared by the Institute of Environmental Science and Research Limited (ESR).

Food Safety Promotion Board (2002), A review of the health effects of stimulant drinks – Final Report, Safe Food,

Cork, Ireland.

Web page on caffeine - University of Washington: http://faculty.washington.edu/chudler/caff.html

Websites of individual producers.

http://faculty.washington.edu/chudler/caff.html


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The general calculation method can be illustrated through an example referred to espresso coffee.

Total consumed volume in a week was calculated through the formula:

tot_espresso_week = number of cups per day * content of a cup (l) * weekly consumption frequency

Daily exposure was then calculated by applying the formula:

espresso_daily_exposure = (tot_espresso_week * caffeine content espresso mg/l) / 7

The above method was applied (mutatis mutandis) for the various types of coffee, tea and hot

chocolate. In the case of chocolate bars, chocolate snacks and colas, no questions about daily

consumption frequency were asked, as such products are not always consumed on a regular daily

basis20

. Daily exposure for such products was hence calculated ex-post, through the formulas:

tot_product_week = (product content or size in l or kg * weekly consumption volume)

product_daily_exposure = (tot_product_week * product caffeine content mg/l or mg/kg) / 7

In these specific cases, consumption volumes of each item were associated to the respective content of

caffeine, and consumption frequency (already specified in the question – not in the answer) was

reclassified on a daily basis, thus obtaining the exposure to caffeine in mg/day for each specific

food/beverage for each respondent.

2.3.4.3. Contribution of ED to total caffeine exposure

Total daily caffeine exposure was calculated as the sum of both daily exposure from ED consumption

(§ 2.3.4.1) and daily exposure from consumption of all other food products and beverages (§ 2.3.4.2).

Daily exposure from ED consumption was then referred to the above total, to express ED contribution

to caffeine exposure as % of total daily exposure.

Forthe relative contribution of ED to the total exposure to active substances, the mean value presented

in this analysis is calculated as a ratio between the mean exposure to the ingredient (e.g. caffeine)

deriving from ED and the total exposure to the ingredient (e.g. caffeine), on the other.

2.3.4.4. Contribution of ED to total exposure to taurine and D-glucurono-y-lactone

The calculation of daily exposure to taurine and D-glucurono-y-lactone from ED consumption was

carried out by applying the same method used for calculating daily exposure of caffeine from ED

consumption for the three targets involved in the survey (§ 2.3.4.1).

On the contrary, lack of data on content of taurine and D-glucurono-y-lactone in specific food

products and beverages (except for limited “spot” information) did not allow to apply the analytical

method of calculation of daily exposure used for caffeine (§ 2.3.4.2). As a consequence, data on daily

exposure to taurine and D-glucurono-y-lactone from consumption of other food products and

beverages other than ED were not possible to be included in analysis for adolescents and children.

20 For these specific items a weekly frequency has been used, also taking into account indications from the relevant literature

references; the adoption of a week as the reference time frame also allowed to include in the analysis all respondents

consuming less frequently than once a day.


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Concerning adults, this analysis was carried out based on consistent data, derived from EFSA’s

scientific opinion “The use of taurine and D-glucurono-γ-lactone as constituents of the so-called

“energy” drinks” (adopted on January 15, 2009).

More specifically, daily exposure from consumption of other food products and beverages other than

ED was assumed:

For taurine, equal to 58 mg (mean daily exposure to taurine from omnivore diets).

For D-glucurono-y-lactone, equal to 1,5 mg (estimated daily exposure from naturally

occurring sources in the diet).

The calculation of the contribution of ED to total exposure to taurine and D-glucurono-y-lactone was

carried out by:

1. summing daily exposure from ED consumption to daily exposure from consumption of other

food products and beverages, to obtain the total daily taurine and D-glucurono-y-lactone

exposure;

2. referring daily exposure from ED consumption to total daily exposure (point 1), to express ED

contribution to the exposure to taurine and D-glucurono-y-lactone as % of total daily

exposure.

As for caffeine, the relative contribution of ED to the total exposure to active substances, the mean

values presented in the analysis were calculated as a ratio between the mean exposure to the ingredient

deriving from ED and the total exposure to the ingredient for each subgroup considered in the

analysis.

2.3.5. Criteria for defining patterns of ED consumption (acute and chronic consumers)

The identification of respondents that could be defined as “high acute” or “high chronic” ED

consumers was performed on the basis of the frequency distribution of the variables specifically linked

to volume and frequency of ED consumption respectively21

. This means that consumption habits that

stand above or below the average were identified by using the upper decile of frequency distribution of

the correspondent variables as threshold value.

Specifically, “high acute” ED consumers were defined by making reference to the volume consumed

in a single session22

. In particular, the calculation derives from the variable “liters of ED in a single

session”, that combines the number of cans consumed per single session with the size format indicated

by each respondent in the questionnaire. The threshold beyond which ED consumers were considered

“high acute” was set at the 90th percentile

23 of frequency distribution for that variable (excluding

outliers24

), corresponding to a consumption of 1 litre of ED per single session in the case of adults and

of 1,065 litres in the case of adolescents.

21

The methodology used to define acute and chronic consumers refers to the approach presented in the “Opinion

of the Scientific Committee on Food on Additional information on “energy” drinks”, European Commission

health & consumer protection Directorate-General, Scientific Committee on Food, 2003. 22

According to the present study, “single session” is a period of time of a couple of hours (e.g. a night out, a

study or sport session). 23

High acute consumers defined as ≥ 90th

percentile. 24

99% of respondents who declared a consumption of more than 4 cans in a single session actually declared

completely unrealistic consumption volumes (e.g. 30-40 cans in a single session): for such reason, values

declared by these respondents were considered as outliers and were excluded from the analysis.


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For children, the identification of “high acute” consumers has not been assessed, because it was not

foreseen to make specific question on volume of ED consumed in a single session for this target

group.

As for “chronic” ED consumers, two different categories were defined for both adults and

adolescents, referring to weekly ED consumption frequency:

1. “Mean chronic” ED consumers were identified in relation to a frequency distribution for ED

consumption comprised between the 75th and 90

th percentile

25 (respondents who on average

consumed ED “2-3 days a week” in the case of adults, and from 1 to 3 days a week26

in the

case of adolescents).

2. “High chronic” ED consumers were identified in relation to a frequency distribution for ED

consumption greater than or equal to the 90th percentile (respondents who regularly consumed

ED “4-5 days a week” or more).

When frequency distribution for ED consumption was below the threshold set at the 75th percentile,

ED consumers were considered “non-chronic”.

a. In the specific case of children, the rationale adopted for identifying “chronic” ED consumers

is similar, with a significant difference: “high chronic” ED consumers were identified in

relation to the frequency distribution for the variable “weekly ED consumption frequency”

beyond the 90th percentile (respondents who regularly consumed ED “3-5 days a week” or

“about every day”). This subgroup actually corresponds, in this case, to the one identified by

the threshold set for “mean chronic” ED consumers in the other two groups (75th percentile).

Table 9: Parameters for the identification of “chronic” and “acute” consumers

Adults Adolescents Children

High acute ≥90th

1 L/single

session

1,065 L/single

sessionn.a.

High chronic ≥90th

4-5 times/week

or more

4-5 times/week

or more

Mean chronic 75th

- 90th

(excluded) 2-3 times/weekonce a week and

2-3 times/week

Corresponding volume/frequency of ED

consumptionED consumption

threshold

(percentile)

Consumer category

3-5 times a

week

Results are presented specifically focussing on the comparison between “high acute” consumers and

“non-high acute” consumers, and between “high chronic” and “non-high chronic” consumers: such

comparisons are provided for each MS (based on the data collected through the survey) as well as for

the 16 MS as a whole (based on weighted average data).

25

The 90th

percentile has to be intended as excluded (<90th

) 26

Thus covering the two answer choices on frequency: “2-3 days a week” and “once a week”.


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2.3.6. Problems encountered, related solutions and limitations of the study

The complexity of the study and a number of problems encountered in its carrying out required a

number of ad hoc solutions. Some limitations deriving from the adopted solutions need to be

considered when interpreting the results of the present study. Such limitations stem from issues of

different nature:

1. Issues regarding difficulties encountered during the survey conduction.

2. Issues concerning data and information collected.

3. Issues concerning the methodology for data elaboration (mainly assumptions).

Concerning problems encountered carrying out the study, a number of unforeseen events occurred

during the survey, causing a substantial delay in the data collection process. Different procedures to

allow the involvement of schools caused difficulties in some MS. In some cases, complex and time-

consuming procedures were required to obtain the official list of schools, or to obtain official

authorization to contact pre-primary, primary and secondary schools for the purposes of the survey.

Quite often schools contact details, as presented in the official registries provided by Ministries,

resulted to be incomplete or incorrect. Finally, in some MS, cooperation by the contacted schools was

actually low. Nevertheless, to overcome these difficulties in some MS, additional efforts were made,

by contacting a higher number of schools than originally planned (§ 2.3.2), by frequent recalls, and by

intensifying efforts to sensitize the involved institutions (also with the support from EFSA national

contact points). Anyway, the approach adopted for the survey can be considered highly effective,

taking into account a total number of around 51.000 respondents (14.557 adults, 31.901 adolescents,

5.558 children) were reached in the 16 MS covered, and – in the specific case of children - such

coverage was achieved in spite of the final participation rate was lower than initially expected. In most

of the MS covered by the study, the number of respondents was high enough to make the samples

representative of the population. Only in France, Germany, Belgium and United Kingdom the number

of respondents was lower than estimated in the survey design27

.

For the reliability and validity of survey results, it is important to highlight some methodological

aspects in order to correctly interpret the findings of the study. In the case of children, the

questionnaire was addressed to very young kids (from 3 to 10 years old) and specific technical

measures were adopted both to improve children’s capacity of recalling their food consumption habits,

and to minimize the risk of errors and misunderstandings:

lower number of questions compared to the version for adolescents and adults28

;

very simple wording for the questions;

introduction of images to help children to correctly understand each question;

recommendation of filling in the questionnaire with the help of a teacher.

27

In order to take into account differences in composition of the sample among individual MS (see also § 2.3.2

providing a full picture of the sample dimension for each MS and each target group), a specific system of

weights was adopted, structured to guarantee the weighted average data could correctly represent both the total

population and the ED consumers for the 16 MS. 28

For example, for children, a simplified version of the questions regarding ED brands were adopted: children

were asked to indicate just the most consumed brands, without providing information regarding the relative

amount of the favorite brand compared to the total consumption. Similarly, as far as caffeine-containing products

were concerned, children were not asked to make distinctions between caffeinated and decaffeinated products.

For each food product cited in the questionnaire, the content of caffeine was calculated as a weighted average of

the content of caffeinated and decaffeinated product according to the answers provided, with regards to this

specific issue, by parents.


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Despite these measures adopted, it has anyway been considered the possible difficulty, for young

children, to provide reliable data regarding specific consumption habits: for this reason, in order to

avoid losing information, data on more complex figures (i.e. single session consumption, specification

of caffeinated or decaffeinated products, etc.) were gathered through the direct survey to parents. The

two questionnaires and surveys – for children and for parents – were thus complementary and used to

guarantee a higher reliability of data on children’s consumption habits.

For specific issues on the methodology for data elaboration, some of these are linked to the

selection of products to include in the questionnaires, for both ED and “other than ED” product

categories. Limitations are the following:

1. Due to high number and variety of caffeine-containing products, the selection of such products

to be included in the questionnaires was bound to be non-exhaustive.

2. Due to the extreme variability in caffeine content for individual product categories (even if

defined in a very narrow way), “average” caffeine contents had to be assumed for the

purposes of the study.

For the selection of products “other than ED” to be included in the questionnaires, considering the

rather extensive geographical coverage and the complexity of the research, the study team decided to

follow the selection criteria reported below:

only the most popular caffeine containing products had to be considered, with the aim of

making the resulting selection sufficiently representative of the products present and

consumed in every MS involved in the study;

only categories of products with a “standard” content of caffeine had to be considered, in

order to make the calculation of caffeine exposure comparable throughout the 16 MS covered

by the survey.

In this context, two potentially relevant categories of products for quantifying the total exposure to

caffeine were not included in the questionnaire:

Products with chocolate content, as caffeine concentration was too variable to find an average

value for each MS. For example, the category “chocolate biscuits” was not included because

no “standard” typology of such products could be identified which could be deemed as widely

consumed and with comparable caffeine content in every MS. Only categories of products

with a “standard” content of chocolate - and caffeine - were considered, in order to make the

quantification of caffeine exposure comparable throughout the MS.

Drugs, because it was not possible to consider a “standard” caffeine content for these products

valid for all the MS considered. Furthermore, due to constraints related to safeguard of

privacy, collecting consumption data for these products from individual respondents would

have been not feasible.

In this framework, another critical issue was the selection of coffee beverages to be included in the

questionnaire. The study team included only three categories of coffee beverages - espresso coffee,

coffee (including instant, ground and ice coffee) and cappuccino - mainly for the following reasons:

The choice of clustering coffee beverages in these quite broad categories aimed at

representing the most widely consumed products with the highest concentration of caffeine in

all the MS covered by the study. As the present study covers 16 MS, there was the necessity of


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standardizing as much as possible the caffeine content of different coffee beverages to gather

reliable data on their consumption throughout different MS. For this reason, since there was

no possibility of collecting punctual data on caffeine content for each kind of coffee beverages

in single MS, the study team adopted for each category of homogenous products an average

value of caffeine concentration 29

(more details on the assumptions made will be provided in

the following sections).

Instant, ground and ice coffee were included in the general category of “coffee” because they

are the most popular non-espresso coffees, with a similar content of caffeine throughout

Europe and with a caffeine concentration that sharply differs from espresso.

The range of products described in the questionnaire could not be too wide and detailed, as the

questionnaire had to be simple and quick to fill in30

. Furthermore, due to the complexity of the

survey design, the study team deemed not possible to gather information about the coffee

preparation methods from the questionnaires.

Aside from the above limitations, it should be noted that the identification of peculiar coffee-based

beverages which are widely consumed only in specific MS was possible, from stakeholders’

suggestions and information deriving from the pilot survey. In some cases these peculiar beverages

were included in the questionnaire for the survey, with the two-fold aim of making the questions more

understandable and the answers more reliable (e.g. in the questionnaire for children of Greece and

Cyprus the specification “frappe coffee” was included as an additional example within the option

“cappuccino”, because in those countries “frappe coffee” is a very popular beverage containing coffee

and milk, just like cappuccino, and with a very similar caffeine content).

Finally, it is important to underline the assumptions related to the data processing methods applied in

the present study.

An estimated amount of caffeine, taurine and D-glucurono-y-lactone for some ED brands was

considered, in order to quantify the exposure to these substances from ED consumption. In some cases

the quantities of these ingredients are claimed on the labels or in the producers’ websites, so the values

used for the elaboration were derived directly from these sources. In few other cases the list of

ingredients was provided directly by ED producers31

. Due to the very high number of brands covered

(a total number of 223 different brands of ED were considered among the 16 MS) and to the quite low

number of information directly provided by producers (by labels, official websites, or direct

consultation), concerning the brands for which no information was available the amount of caffeine

was considered equal to the average quantity identified by König (2011) in his study about caffeine

29

Also König in his study “Final report: Assessment of caffeine intake in a representative sample of the Austrian

population” (2011) identified different categories of coffee-based products to investigate caffeine exposure:

coffee strong, coffee medium, coffee light, instant coffee, cappuccino, café latte, ice coffee. In the same way, he

associated to each category a mean caffeine concentration, taking into account that this value varies for different

products in the same class. 30

The methodological approach was based on gathering data on a wider sample of interviewees and on

collecting information on a smaller amount of ordinary products, instead of achieving a narrower number of deep

interviews on a wider range of products. 31

For a number of relevant brands for which the quantity of one or more specific ingredients was not indicated

on labels or on the official website of the producing company, data were asked directly to producers.


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exposure in a sample of Austrian population (mean caffeine concentration = 300 mg/L)32

. Concerning

D-glucurono-y-lactone and taurine, in ED brands for which it was not possible to retrieve official data,

the amount of these ingredients was assumed equal to the modal value of their concentration in other

ED brands.

Similar difficulties affected the collection of data on the content of active ingredients for energy shots.

Due to the frequent unavailability of official data, in these cases a standardised content of active

ingredients was used grounding on information retrieved via official sources33

. Specifically, for

caffeine the value was assumed to be equal to the average reliable contents - after eliminating “outlier”

data34

. For taurine and D-glucurono-y-lactone, the modal occurrence in standard ED was used, due to

a lack of consistency of average data. Within the category of energy shots, in all cases in which also

the size of the can resulted to be unknown or more than one energy shot had been indicated, an

“average size” (63 ml) was adopted for the calculation.

Further assumptions were made for the quantification of caffeine exposure and contribution of coffee

beverages to total caffeine exposure itself. As previously underlined, three categories of coffee-based

products were defined, on the basis of the homogeneity of caffeine content. An average content of

caffeine was then associated to each category of products, as follows:

Espresso: 1.916 mg/L of caffeine;

Coffee (including instant, ground, ice-coffee): 400 mg/L of caffeine;

Cappuccino: 250 mg/L of caffeine.

Two main limitations arising from this approach must be underlined:

Caffeine content varies for products in the same category. For instance, in this study drip

coffee, brewed coffee and instant coffee are all included in the same category (coffee).

However, considering a standard cup (225ml), drip coffee has the highest caffeine content,

with 115 to 175 mg per cup; brewed coffee is the next most potent at 80 to 135 mg per cup;

and instant coffee contains 65 to 100 mg per cup (Chou, 1992). As explained later in this

chapter, this variability must be taken into account also for the other categories of caffeine

containing products, such as teas or chocolates.

Caffeine concentration may vary for the same typology of product (i.e. ground coffee) in

different countries, because of different ways of preparing and/or consuming coffee. Indeed in

every geographic area there is a traditional way to prepare and consume coffee that can

influence the average amount of caffeine exposure of the population. Unfortunately, there is

scarcity of academic studies investigating this phenomenon.

As for possible differences in caffeine concentration for the same typology of product in different

countries, a large body of literature assess substantial variations in caffeine content from the variety of

coffee drinks, the preparation and from geographical source of the coffee bean (McCusker et al., 2003;

Mandel, 2002). For instance, ground coffee identifies a wide range of traditional products which may

32

In the case of caffeine, specific data were found for 160 brands, while average data from Konig’s study were

applied to the remaining 63 brands. 33

Specifically, the contents for energy shots used in the elaborations are 1345 mg/L for caffeine, 4000 mg/L for

taurine and 2400 mg/L for glucuronolactone. 34

Energy shots with caffeine content of 13.300 mg/L and 1.600 mg/L were not considered in the calculation of

the average.


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differ a lot in terms of caffeine content. Swedish/Scandinavian brewed coffee, used in Sweden as in

other parts of the Nordic region, tends to be very strong. Greek coffee is prepared much like “Turkish

coffee”, i.e. a very strong coffee served in 60 ml or 90 ml cups with sugar. Overall, drip filtered drinks

are the most prevalent type of coffee beverage, but espresso and mocha were consumed by 100% of

Italian coffee drinkers.

Variability on caffeine concentrations must be considered also for the other categories of caffeine

containing products, such as teas, chocolates and colas. Indeed, black tea is the most caffeinated of the

tea varieties, followed by oolong and green teas (Chou, 1992). Different ranges of caffeine

concentrations are reported in literature for different types of tea: for instance, in Heckman et al.

(2001) a 240 ml cup of black tea was found to contain 25-110 mg of caffeine, while 240 ml of green

tea were found to contain 30-50 mg of caffeine. Also due to such divergence in data on caffeine

content of tea from different authors, the study team decided to associate an average value of caffeine

concentration to the general category of “tea” (including instant tea, bag tea, ice tea): after comparing

different sources, 100 mg of caffeine per litre was deemed to be the most reliable value (König,

2011).Concerning chocolate products, in the present study two categories were considered: chocolate

bars and chocolate snacks. Each of them was split in three subcategories on the basis of the type of

chocolate they can be made of (dark chocolate, milk chocolate and white chocolate). These three

different categories of products have different caffeine concentrations, as reported in a number of

studies (Food Safety Promotion Board, 2002; Gilbert et al., 1976; Heckam et al, 2001; Mayo Clinic

article35

; NZFSA - New Zealand Food Safety Authority, 2010). After a careful process of literature

consultation and online research (snack producers’ web sites;), average values of caffeine

concentration to be adopted in the present study for the calculation of caffeine exposure from

chocolate products were identified36

.

The details of the references and the ranges of caffeine concentration evaluated for the study are

provided in Appendix G.

Another assumption to be taken into consideration is the daily exposure to taurine and D-glucurono-y-

lactone. As the questionnaire for the survey did not allow to collect consumption data of all food

products in an omnivore diet, the average daily exposures to taurine and D-glucurono-y-lactone

(which were needed to calculate the contribution of ED to total exposure of such substances in the

diet) were derived from literature. According to EFSA’s scientific opinion “The use of taurine and D-

glucurono-γ-lactone as constituents of the so-called “energy” drinks” (adopted on January 15, 2009),

the daily exposure to taurine can be assumed equal to 58 mg (mean daily exposure to taurine from

omnivore diets); while 1,5 mg is the estimated daily exposure from naturally occurring sources in the

diet for D-glucurono-y-lactone. In this framework, in absence of solid indications in literature about

daily exposure to taurine and D-glucurono-y-lactone for children and adolescents, the calculation of

the contribution of ED to total daily exposure was not carried out for this specific age group.

Finally, assumptions were also made to manage missing data concerning the variable “weight of

respondent” in the questionnaire, as they were necessary to represent the daily exposure to active

ingredients (mg/kg bw/day). Following the indication of the Steering Group, in case of missing

information about weight, the values indicated in the EFSA scientific opinion “Guidance on selected

35

http://www.mayoclinic.com/health/caffeine/AN01211 36

Chocolate bar 180 mg/kg (dark 340 mg/kg; milk 183 mg/kg; white 0 mg/kg); chocolate snack 140 mg/kg (dark

264 mg/kg; milk 142 mg/kg; white 0 mg/kg). After a similar evaluation process of the different data sources, the

average caffeine content associated to the category of colas in this research was assumed equal to 79,2 mg/L

(König, 2011).

http://www.mayoclinic.com/health/caffeine/AN01211


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default values to be used by the EFSA Scientific Committee, Scientific Panels and Units in the absence

of actual measured data” (2012) were adopted. In any case, these “standard” values were also cross-

checked and compared to the average and median values of the relative age group in the MS

concerned.


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3. RESULTS

A short description of the main findings emerging from literature review and pre-survey stakeholders’

consultation is provided at § 3.1 and 3.2, respectively. Details in this respect are provided in the

annexes (Appendices A and E for further details).

Final results from the survey, for each target subgroup, are instead outlined at § 3.3.


3.1.1. Overview

Results from the literature review is outlined as follows.

- The issue of ED is highly debated from a scientific point of view, especially for health effects

related to the consumption and over-consumption of these products. Several studies (Alford et al.,

2011; Reissig et al., 2009; SHC, 2012; Arria et al., 2011; Marin Institute, 2011; Oteri et al., 2007)

focus:

o on potential and/or evidenced effects of “active” ingredients (caffeine, taurine, D-

glucurono-y-lactone, etc.) on highly sensitive subjects, such as children, pregnant

women, heart-patients, etc.;

o on potential and/or evidenced effects of co-consuming of ED with alcohol or with

other products containing active ingredients.

There is great availability of advisory reports produced by national food safety authorities (SHC,

2008, 2009; Meltzer et al. 2008) and academic papers (Seifert et al., 2011; Reissig et al., 2009)

aiming at assessing the exposure of caffeine through food other than food supplements (e.g. via

coffee, tea, cola beverages and ED), including specific reference to well-defined population

groups, such as children, teenagers and young adults. Most studies also provide analysis and

evaluations on the adverse effects and possible risks from caffeine (BfR, 2009; James et al.,

2011).

There is also evidence for increased ED consumption trend in excessive quantities and in

combination with alcoholic beverages by young people (Miller, 2008; SHC, 2009). Indeed a

number of recent academic studies (Arria et al., 2010; Alford et al. 2011; Brache and Stockwell,

2011; Oteri et al., 2007) and technical reports (BfR, 2008; EUCAM, 2008, 2009) focused on the

issue of health effects of co-consumption of alcohol and ED on young people.

- On the contrary, on consumption habits are much less frequent than those focusing on health

issues. US literature in this sense seems to be wider than the EU one, and studies have recently

been conducted also in Canada and New Zealand (Heckman et al., 2010; Miller, 2008; O’Brien et

al., 2008), even though a number of advisory reports on this issue were recently published in

some MS where the phenomenon seems to have higher relevance (BfR, 2008; Norwegian

Scientific Committee for Food Safety, 2009; SHC, 2009).

- With reference to studies and surveys providing data on ED consumption and human exposure to

caffeine in specific MS, one of the most relevant is the König’s study on caffeine exposure

assessment in a sample of the Austrian population (König, 2011). Moreover, in 2002 a

comprehensive study has been carried out in Ireland and Northern Ireland with the aim of

reviewing the health effects of stimulant drinks, through a survey of the consumption of these

beverages in a representative sample of 11–35 year olds in the Republic of Ireland and in

Northern Ireland. Results of the research demonstrated that the main concerns related to stimulant


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drinks were co-consumption with alcohol, the high caffeine content and the uncertainty among

consumers regarding the actual content in other ingredients (Food Safety Promotion Board,

2002).

3.1.2. Focus on the most relevant references

The final version of the literature review – defined with the support from stakeholders - includes

around 40 references (Appendix A for full references and table 10 for summary).Some of the most

relevant references were selected according to their consistency with the study, their content, and

reference geographical area.

Gathering consumption data on specific consumer groups of energy drinks


The present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively by the author(s) in the context of a contract between the

European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in

the present document, without prejudice to the rights of the authors.

Table 10: Abstracts of relevant references

Paper Objective Methodology Results

König J, 2011

To determine total caffeine

exposure from all foods in the

average healthy population and

the contribution of ED to this

exposure.

A group of 700 subjects (aged 14-39 years) was

selected in Austria. A food frequency

questionnaire was developed for the purpose of

caffeine exposure estimation. A total of 124

samples of different foods and beverages were

analysed in their caffeine concentration.

The vast majority of caffeine exposure resulted

from coffee, providing 60,8% of total caffeine

exposure. ED, as second highest contributor,

provided 11,9% and colas provided 9,5%.

Heckman MA, Sherry K, Gonzalez

de Mejia E, 2010

To analyse the current situation of

U.S. ED market with emphasis on

market size, social aspects of

consumers, active ingredients,

potential benefits, safety and

regulations.

Socio-economic market analysis.

ED have experienced exponential growth since

their launch in the US. The market is becoming

flooded with new ED, many with unusual

names and claims of a higher energy boost

compared to the previous ones. Research needs

to continue regarding the potential benefits of

these products to support the claims.

Gambon DL, Brand HS,

Boutkabout C, Levie D, Veerman

EC, 2011

To determine the frequency of

occurrence and patterns in

consumption of potentially

erosive beverages in school

children in the Netherlands.

A cross-sectional, single centre study was

performed among 502 school children in

Rotterdam, in age varying between 12 and 19

years. Data on consumption of soft drinks, ED,

sports drinks and alcopops were obtained

through a self-reported questionnaire.

Consumption of soft drinks, ED, sports drinks

and alcoholic products by school children is

related to age and gender. Evidence from the

study suggests that a subgroup of school

children with a high cumulative exposure to

these potentially erosive drinks does exist.

Oteri A, Salvo F, Caputi AP,

Calapai G, 2007

Gathering information about food

habits and behaviours of the

students of the School of

Medicine of Messina (Italy)

Dedicated questionnaire focusing on ED in

order to gather information about consumption

patterns of these products, consumed alone or

in association with alcoholic beverages. Five

hundred students of the School of Medicine of

the University of Messina were interviewed,

and 450 filled the questionnaire.

Association of ED + alcohol is very popular

among students. Users of ED + alcoholic

beverages might not feel the signs of alcohol

intoxication, thus increasing the probability of

accidents and/or favouring the possibility of

development of alcohol dependence.



The present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively by the author(s) in the context of a contract between the

European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in

the present document, without prejudice to the rights of the authors.

Paper Objective Methodology Results

Higgins, JP, Phil M, Tuttle TD,

Higgins CL, 2010

To picture the situation of energy

beverages (EBs) market,

describing their ingredients,

discussing safety aspects, and

providing recommendations

regarding their use. The research

query included studies and

information involving non-athlete

consumers. Also, the review

offers recommendations which

are specific to each group.

A search of the English-language scientific

literature was performed primarily by searching

the MEDLINE and EMBASE databases and

using the Google Internet search engine for the

period January 1976 through May 2010.

Ingestion of EBs before an event or during

training can have serious adverse effects.

Limited ingestion of EBs by healthy people is

not likely to cause major adverse effects, but

binge consumption or consumption with

alcohol may lead to adverse effects. Individuals

with medical illnesses, especially underlying

heart disease, should check with their physician

before using EBs.

Meltzer HM, Nordisk Ministerråd

N, Råd Nordisk, 2008

To develop a risk assessment of

caffeine in children and

adolescents in Nordic countries.

The report focuses on effects of

caffeine on the central nervous

system.

An overview of consumption data on caffeine-

containing foods, among children and

adolescents in the Nordic countries, is

presented in the exposure characterisation.

Authors transformed the total caffeine exposure

in the various age-groups and exposure levels

into exposure per kg. This enabled them to

compare more directly Nordic exposure levels

with exposure levels provided in international

literature.

Many Nordic teenagers have an exposure to

caffeine which can be associated with tolerance

development and withdrawal symptoms, while

approximately 20% of the teenagers might be

exposed to levels of caffeine from caffeine-

containing soft drinks inducing anxiety and

jitteriness. If other sources of caffeine such as

chocolate, tea and coffee were also considered,

these figures might be higher..

Alard J, Marìn C, Cubillo JM,

2010

To analyse different types of

promotion strategies used by the

leading brands (including private

labels) of ED in each country, as

well as their long-run effects on

sales for both categories.

The survey, based on scanner data at store-level

in a series which covers 7 years, provides

almost all of the history of the category.

The effect of promotions results to be less

intense for Private Label than for the other

brands. Impacts of different promotional

activities are presented and commented.

Food Safety Promotion Board,

2002

The Food Safety Promotion

Board (FSPB) convened an expert

Committee to review the health

effects of stimulant drinks.

A survey of the consumption of stimulant

drinks in a representative sample of 11 – 35

year olds in the Republic of Ireland (total

sample number (n) = 625)and in Northern

Ireland (n = 635).

Results of the research demonstrated that the

main concerns vis à vis stimulant drinks were

its consumption with alcohol, the perceived

‘high’ caffeine content and the sense of

ambiguity and uncertainty regarding the other

ingredients.


drinks






3.2. Stakeholders consultation: emerging issues

The pre-survey consultation of stakeholders was carried out to identify useful sources and suggestions

for the study, in order to fine-tune the survey design. The post-survey consultation aimed instead at

gathering comments from stakeholders on the analysis developed in the study as well as on results

emerging from the first round of consultations. During the pre-survey consultation, the rationale and

the purpose of the study was introduced by e-mail sent to 41 subjects, as identified in the list of

relevant stakeholders agreed with EFSA. Following this preliminary contacts, and according to the

stakeholders’ availability to cooperate, a total number of 17 interviews (13 phone interviews and 4

based on written contributes) were made between February and May 2012 (table 11).

As for the post-survey consultation, a selection of the stakeholders already interviewed during the first

round of consultations were contacted by email. Written comments were collected by 9 experts on

November 2012 (table 11).

Table 11: List of the contacted stakeholders: pre-survey and post-survey consultation

Country Stakeholder Pre-survey Post - Survey

EU EUCAM – European Centre for Monitoring Alcohol

Marketing Phone interview Contacted

EU UNESDA – Union of European Beverages Associations - Contacted

Belgium FIEB/VIWF - Fédération des Industries des Eaux et des

Boissons Rafraîchissantes Phone interview

Written

comments

Cyprus Cyprus International Institute for Environmental and

Public Health, Cyprus University of Technology Phone interview -

EU EDE – Energy Drinks Europe Phone interview Written

comments

Netherlands NVWA – Netherlands Food and Consumer Product Safety

Authority

Phone interview

/written answers -

France ANSES - French Agency for Food, Environmental and

Occupational Health & Safety Phone interview

Written

comments

Austria University of Vienna - Department of Nutritional Sciences Phone interview Contacted

Greece EFET - Hellenic Food Authority, Nutrition Policy &

Research Directorate Phone interview

Written

comments

Czech

Republic

Ministry of Agriculture of the Czech Republic - Food

Production and Legislation Department Phone interview -

Italy INRAN – Istituto Nazionale di Ricerca per gli Alimenti e

la Nutrizione Phone interview

Written

comments

Germany WAFG - Wirtschaftsvereinigung Alkoholfreie Getränke

e.V. Phone interview

Written

comments

Cyprus Ministry of Health - State General Laboratory Phone interview Written

comments

Belgium SHC - Superior Health Council Phone interview -

Latvia Assessment and Registration Agency of Food and

Veterinary Service of Latvia

Phone

interview/

written answers Contacted

Hungary Hungarian Food Safety Office Phone interview Written

comments

Iceland MAST – Icelandic Food and Veterinary Authority Phone interview Written

comments

Germany BfR - Federal Institute for Risk Assessment

Phone

interview/

written answers -


drinks






A short description of the main issues emerging from the stakeholders’ consultation is provided at §

3.2.1, 3.2.2 and 3.2.3 (details in Appendix E).

3.2.1. Literature and sources

Stakeholders’ contribution to literature review was useful for the identification of relevant scientific

studies, and above all for the collection of reports investigating national features related to the ED

sector in specific MS. Stakeholders also provided interesting remarks on the selection of study

references.

3.2.2. ED market

Interviewees were asked to provide data and information about the situation of the market both at EU

level and for their MS.

Before the interviews, the study team sent the stakeholders a list of the main brands of ED for each

MS; these lists had been compiled mostly using relevant online sources (i.e. ED websites, blogs, web

magazines, etc.). Stakeholders were then asked to comment and - if deemed opportune - modify such

list of brands, on the basis of their knowledge of the market.

In most cases, stakeholders were unable to provide any additional information regarding ED brands

and market shares, but they generally confirmed the validity of information on the 4-5 leading brands

in each national market. In some cases, useful information was provided by stakeholders on the

growing importance of private labels (especially among youngsters), as well as on the significant

presence, in some MS, of pre-mixed alcoholic ED.

With specific reference to the list of ED brands marketed in each MS, most stakeholders confirmed its

validity and representativeness.

3.2.3. Active ingredients

On the basis of outcomes from the literature review, a list of the most relevant food products

containing caffeine, taurine and D-glucurono-y-lactone had been identified for each MS and provided

to the stakeholders.

Experts were then asked to comment this list, especially for the role of the listed products as potential

sources of active ingredients considered in the study. In some cases the stakeholders’ contribution was

extremely helpful to identify a number of food products containing caffeine which were widely

consumed in some MS only37

.

In some cases, experts highlighted that caffeine content in specific products belonging to the same

category may vary significantly38

. As a consequence, some experts suggested the adoption of

questionnaires with reference to local foods/beverages and brands for each MS considered in the

study, and the evaluation of caffeine content for any specific product.

37

This was the case of Frappè coffee, which is an extremely popular coffee-based drink in Greece and Cyprus. 38

For instance, a cappuccino in a bar may contain 70 mg of caffeine whilst a large cappuccino from a coffee

house such as Starbucks may contain 200-250 mg of caffeine.


drinks






A substantial share of interviewees also highlighted the relevant role played by drugs and medicines in

determining the total exposure to “active ingredients” in the diet, especially for some specific groups

of consumers, thus suggesting the inclusion of these product categories in the questionnaires39

.

3.3. Survey: results

3.3.1. General overview

The survey activities were started in February and closed in November 2012.

Table 12 below provides the total number of respondents by target group and by MS at the date when

the survey was officially closed (12th November 2012).

Table 12: Number of total validated respondents (a)

Country Adults Adolescents Children TOTAL

Austria 368 2.115 57 2.540

Belgium 993 67 12 1.072

Cyprus 363 1.443 155 1.961

Czech Republic 408 2.682 479 3.569

Finland 515 1.547 261 2.323

France 2.113 666 209 2.988

Germany 1.553 1.068 30 2.651

Greece 520 1.381 197 2.098

Hungary 469 3.365 218 4.052

Italy 1.533 6.449 1.627 9.609

Netherlands 718 1.028 144 1.890

Poland 799 4.368 326 5.493

Romania 537 865 379 1.781

Spain 1.331 1.794 533 3.658

Sweden 679 1.398 202 2.279

United kingdom 1.658 834 131 2.623

Validated respondents 14.557 31.070 4.960 50.587

Total respondents 14.557 31.901 5.558 52.016 Source: Survey Nomisma – Areté for EFSA

(a) The total number of respondents, including not validated respondents, amount at 52.016. A total number of 1.429

respondents were eliminated after applying quality check procedures.

Survey data are presented as average values of the 16 MS as a whole, or for individual MS in specific

cases.

Additional elaborations by gender (for all the target groups) and by age (only for adults) were made

with the aim of investigating potential differences.

39

In the light of considerations concerning both protection of the respondents’ privacy and operational

difficulties posed by the extremely wide variety of drugs and medicines marketed in the 16 MS covered by the

survey, the study team agreed with the steering group the exclusion of any question on drugs and medicine

consumption from the questionnaire.


drinks






With reference to the results of the analysis in the different samples and subsamples, it is important to

clarify that the figures provided in the following chapters refer to actual sample sizes observed in the

survey - which indicate the actual number of interviews - whilst incidence figures in relation to the

analysis on the 16 MS as a whole are based on weighted data, in order to have more accurate data

replicating the differences in sample composition among individual MS. The system of weights

adopted in the analysis was structured to guarantee that the weighted data correctly represent the

proportion both of the total population and the ED consumers for the 16 MS as a whole.


drinks






3.3.2. Adults

The sample of “adults” (14.557 – total respondents) was composed for 55% by women and 43%40

by

men, the 43% were of the age group 30-49 years and around 72% of total respondents lived in urban

areas. Most respondents declared to have completed the upper secondary school (37%) or to have

university degree 29%). The 63% were workers.

3.3.2.1. ED consumption

Around 30% of the total respondents (14.557 – total respondents) declared to have consumed ED at

least once in the last year, and this value varied from around 14% in Cyprus to 50% in Austria (figure

2). This percentage increased to 53% in the age group 18-29, and decreased to around 17% for

respondents older than 50 (figure 3).

As for ED consumers (4.180 ED consumers), the sample was composed for 53% by men and 47% by

women, and around 75% of them lived in urban areas. Most respondents declared to have completed

the upper secondary school (39%) or to have a university degree (29%). Regular smokers accounted

for around 35% of the sample.

Figure 2: Adults – Prevalence41

of ED consumption by country (Sample size: 14.557 - Total respondents)

Source: Survey Nomisma-Areté for EFSA

40

Being this information N.A. for 2% of respondents. 41

In the present study ED consumers are defined as subjects who have been drinking ED at least once over the

last year, so prevalence of ED consumption was calculated on the basis of this assumption.


drinks






Figure 3: Adults – Prevalence of ED consumption for each age group (Sample size: 14.557 - Total

respondents)


Considering the prevalence of ED consumption by gender, around 26% of females and 37% of males

declared to have consumed ED at least once in the last year.

Around 25% of total adult consumers affirmed to have been drinking ED once or twice a month, while

21% of consumers to have done it once a week. Higher consumption frequencies (at least twice a

week) concern around 33% of consumers. The most common format consumed was the 250 ml can,

while around 6% of consumers declared to consume energy shots42

. Around 22% of consumers

resulted to be used to drink more than 10 cans in a month, while for most consumers the volume was

2-4 cans per month (33%) or 5-10 cans per month (23%). Around 52% of adult consumers declared to

have drunk only 1 can of ED in a single session, and only 3% to consume more than 4 cans in the

same occasion (Figure 4).

As for volumes, the average volume consumed by adults was approximately 2 L/month for ED

consumers, ranging from 1,3 L/month in Italy and 2,9 L/month in Romania.

42

Even if energy shots just cover 6,4% of adult consumers, a particular attention is suggested to be paid to this

product category, due to peculiarities in the content of active substances. Indeed, focusing the analysis on the

specific energy shots brands indicated by respondents, the occurrence of active substances reveals to sharply

differ among energy shots brands: in most cases the absolute content of active substances in mg per serving is

approximately equal to that of the “standard” ED (i.e. 80 mg of caffeine in a 60 ml can), but the concentration of

these substances is consequently much higher. See also details in the chapter “materials and methods”, §2.3.6.


drinks






Figure 4: Adults - ED consumption related features (Sample size: 4.180 – ED consumers)



drinks






According to the final results of the survey, around 25% of adult consumers stated to usually consume

ED in association with sport and physical exercise; for an additional 39% consumption is “sometimes”

associated to such activities.

The most common situations of ED consumption resulted to be “at home in ordinary situations” and

“at home with friends during parties” (both accounting for around 65% of consumers). Also sport and

physical exercise registered high percentages (around 63% of consumers), followed by bar/pubs (52%)

and discos (47%).

As for reasons for consumption, most adult consumers (around 40%) declared to consume ED mainly

as a “source of energy”, or less frequently “to stay awake” (18%), simply because of their taste (16%)

or “to drive for a long time” (around 8%). It is however worth highlighting the presence of other

“secondary” reasons, such as “enhancing sport performance”, ”concentration augmenting” or

“stimulating metabolism” (figure 5).

Red Bull™ resulted to be the most common ED brand: it was included as first choice among the top-

three brands by nearly 89% of consumers. Red Bull™ is followed by Monster™ (first choice for 45%

of consumers) and Burn™ (first choice for 42% of consumers).

Figure 5: Adults – Motivations for ED consumption (first choice) (Sample size: 4.180 – ED consumers)



drinks






Survey data were elaborated according to a specifically defined methodology (§ 3.3.5) in order to

identify “high acute” and “high chronic” consumers.

On this basis, high acute consumers accounted for a 3% of the total respondents, while high chronic

consumers represented around 4% (figure 6).

Figure 6: Adults - Prevalence of ED consumption for ED consumers, high acute consumers and high

chronic consumers on total respondents (Sample size: 14.557 – Total respondents)


Adults identified to be both “high acute” and “high chronic” consumers accounted for 3,4% of ED

consumers, (corresponding to 1% of total respondents): this share was anyway much smaller than the

ones for the purely “high chronic” and “high acute” consumer groups. The “high acute” consumer

profile is provided at § 3.3.2.6.

Table 13: Adults – Overlap between high chronic and high acute ED consumers

(Sample size: 4.180 – ED consumers)

High acute Non high acute Total

High chronic 3,4% 8,4% 11,8%

Non high chronic 7,6% 80,6% 88,2%

Total 11,0% 89,0% 100,0%

% on total ED consumers



drinks






High chronic ED consumers resulted to account for around 12% of adult consumers. This average

value varied from around 21% of adult consumers in United Kingdom, and 5% Italy and Hungary

(figure 7).

Figure 7: Prevalence of high chronic ED consumption by country (Sample size: 4.180 – ED consumers)



drinks






The prevalence of high chronic consumers was 13,3% in “young adult” consumers.

Table 8 provides the distribution of ED consumers and high chronic ED consumers among different

age groups. Among high chronic consumers the percentage of 18-29 years rose from 27% to 31% of

the target group. High chronic consumption resulted to be higher among consumers who declared to

smoke regularly: 15% against 10% of non-smokers.

Figure 8: Adults - Distribution of high chronic ED consumption by age groups (Sample size: 4.180 – ED

consumers)


Around 95% of high chronic consumers declared to have consumed ED in the three days before the

survey, while this share decreased to 60% considering total consumers. The share of consumers who

declared to drink ED at least 4 times a week was higher for high chronic consumers than for total

consumers (73% and 9%, respectively). As for consumed volumes, only 21% of total consumers

resulted to drink more than 10 cans of ED per month, against a share of 61% of “high chronic”

consumers (figure 9). The average consumed volume was 4,47 L/month in the case of adult high

chronic consumers.


drinks






Figure 9: Adults – ED consumption patterns: characteristics for high chronic and ED consumers (Sample

size: 4.180 - ED consumers; 486 - High chronic consumers)


drinks








drinks






3.3.2.2. Co-consumption of ED and alcohol

Survey results highlighted the co-consumption habit (ED and alcohol)43

among adults. Around 56% of

ED consumers declared to consume ED and alcohol, ranging from 24% in Cyprus to 67% in Germany.

With reference to the total respondents, this percentage decreased to 17%, and ranged from 3% in

Cyprus to 29% in Austria, while percentages for ED consumers varied from 24% in Cyprus and 67%

in Germany (figure 10).

Figure 10: Adults - Prevalence of co-consumption of ED and alcohol by country (Sample size: 14.557 -

Total respondents; 4.180 - ED consumers)


43

In this study, co-consumers of ED and alcohol are defined as subjects who have been drinking ED and alcohol

in a single session at least once over the last year.


drinks






Concerning the different age groups identified within the target group “adults”, the highest prevalence

of co-consumption of ED and alcohol was reported in the age group 18-29, as around 71% of ED

consumers and 38% of total respondents in this group declared to consume ED with alcohol in the

same session (figure 11).

Focusing on ED consumers, there were no differences in co-consumption habits by gender. On the

other hand, only 14% of female declared to consume ED and alcohol, while prevalence of such habit

increased for male (21%).

Figure 11: Adults - Prevalence of co-consumption of ED and alcohol by age groups – Comparison between

total respondents (Sample size: 14.557 – Total respondents; 4.180 - ED consumers)



drinks






Around 60% of respondents declared to co-consume ED and alcohol mostly mixing them at the

moment of consumption. Co-consumption resulted to occur at least once a week for 38% of ED

consumers drinking ED and alcohol. Around 57% of ED consumers stated that they mix ED and

alcohol at least twice in a single session of consumption (figure 12).

Figure 12: Adults - Co-consumption of ED and alcohol and related features

(Sample size: 4.180 - ED consumers)

(Sample size: 2.276 – Consumers drinking ED and alcohol)

(Sample size: 2.276 - Consumers drinking ED and alcohol)

(Sample size: 2.276 – Consumers drinking ED and alcohol)



drinks






As illustrated in figure 13, co-consumption was identified to occur at least twice a week for 56% of

high chronic consumers, against 20% of consumers. The share of high chronic consumers combining

ED with alcohol about every time was 23% (against an average 9% for consumers).

Figure 13: Adults – Monthly frequency of co-consumption of ED and alcohol: high chronic and average

consumers drinking ED and alcohol (Sample size: 2.276 - Consumers drinking ED and alcohol; 486 – High

chronic consumers)



drinks






3.3.2.3. Consumption of ED during sport activities

Around 52% of adult ED consumers declared to usually drink ED before/in association with/after

sport activities44

. Remarkably, this percentage increased for ED consumers practising sport activities.

Around 49% of consumers stated to practise sport or physical exercise at least twice a week (figure

14).

Figure 14: Adults – Consumption of ED during sport activities



44

In the context of the study respondents who declare to practice physical activities at least once a week are

considered as “subjects practicing sport activities”.


drinks






Around 75% of ED consumers who practise sport activities at least once a week declared to drink ED

at least “sometimes” during such activities, with 14% drinking ED “about every time” they practise

such activities. Around 53% of consumers declared to drink 2 cans or more in a single sport/physical

exercise session (figure 15).

Figure 15: Adults - Consumption of ED during sport activities and related features

(Sample size: 2.832 – ED consumers practicing sport

activities)

(Sample size: 2.070- ED consumers drinking ED during sport

activities)


The average prevalence of ED consumption during sport activities masks some differences at MS level

(figure 16): the lowest prevalence was recorded in Hungary (around 41% of ED consumers), while the

highest in the United Kingdom and Greece (around 88% of ED consumers). With regards to the total

respondents and ED consumers, the highest prevalence of ED consumption during physical activities

was registered respectively in Poland (26%) and in Spain (62%).


drinks






Figure 16: Adults - Prevalence of ED consumption during sport activities by country (Sample size: 14.557

– Total respondents; 4.180 - ED consumers; 2.832 - ED consumers practicing sport activities)


The main reasons for ED consumption during sport practice were “endurance time at the maximum

intensity” (40%) and “vitality” (26%), but also “aerobic endurance” and “concentration” were

mentioned (figure 17).


drinks






Figure 17: Adults – Motivations for consumption of ED during sport practice (Sample size: 2.070 – ED

consumers drinking ED during sport activities)


Concerning respondents who practise physical activities, the share of high chronic consumers who

declared to consume ED about every time they engage in sport activities (figure 18) was much higher

(45%) than the share of total respondents (14%).

Figure 18: Adults – Prevalence and frequency of consumption of ED during sport activities: high chronic

and average consumers practicing sport (Sample size: 2.832 – ED consumers practicing sport activities; 486

– High chronic consumers)



drinks






3.3.2.4. ED contribution to total exposure to relevant substances

Tables 14 and 15 provide absolute values of chronic exposure45

to caffeine for total respondents, ED

consumers and high chronic consumers, calculated on the basis of the methodology (§ 2.3.4.1).

For adults, chronic exposure to caffeine from ED varied from around 7 mg/day for total respondents

to around 48 mg/day for high chronic consumers. Accordingly, total caffeine exposure (from ED and

other products in the diet) varied from 272 mg/day (ED consumers) to around 382 mg/day (high

chronic consumers). Consequently, chronic exposure to caffeine from ED ranged from 0,10 mg/kg

bw/day for total respondents to 0,70 mg/kg bw/day for high chronic consumers.

Table 14: Adults – Chronic exposure to caffeine from ED and from all products

(a) (values in mg/day)

(Sample size: 14.557 – Total respondents; 4.180 – ED consumers; 486– High chronic consumers)

Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev

exposure from ED:

Total respondents 6,82 0,00 0,00 229,33 2,78 20,00 39,79 19,10

ED consumers 22,43 11,15 0,53 229,33 28,17 50,63 77,30 29,14

High chronic consumers 48,32 39,80 2,50 228,98 56,80 107,72 158,65 43,12

Total exposure:

Total respondents NA NA NA NA NA NA NA NA

ED consumers 271,73 237,67 2,67 1.920,36 365,83 528,36 670,39 202,09

High chronic consumers 381,91 334,01 11,07 1.920,36 503,71 688,96 855,94 252,33 Source: Survey Nomisma-Areté for EFSA

(a) Including ED

Table 15: Adults – Chronic exposure to caffeine from ED and from all products (a)

(values in mg/kg

bw/day) (Sample size: 14.557 – Total respondents; 4.180 – ED consumers; 486 – High chronic consumers)


exposure from ED:

Total respondents 0,10 0,00 0 6,15 0,05 0,29 0,53 0,29

ED consumers 0,32 0,15 0 6,15 0,38 0,71 1,02 0,46

High chronic consumers 0,70 0,51 0 6,15 0,80 1,59 2,32 0,76

Total exposure:

Total respondents NA NA NA NA NA NA NA NA

ED consumers 3,87 3,11 0 79,60 5,05 7,54 9,60 4,08

High chronic consumers 5,78 4,35 0 76,09 7,17 10,60 13,90 6,66 Source: Survey Nomisma-Areté for EFSA

(a) *Including ED

45

The calculations of exposure to the different active ingredients were based on usual consumption patterns:

hence, the volume of consumption for each food/beverage investigated in the survey was linked to the average

consumption frequency, e.g. “average month over the last year”. Therefore the exposure here represented has to

be considered as chronic exposure.


drinks






On average, ED consumption contributed for 8% of the overall daily exposure to caffeine (figure 19),

a figure increasing to 13% for high chronic consumers (to 12% considering daily caffeine exposure

per kg bw).

Figure 19: Adults – ED contribution to the total daily exposure to caffeine (%): high chronic and ED

consumers (Sample size: 4.180 – ED consumers; 486 - High chronic consumers)



drinks






Concerning total respondents at MS level, chronic exposure to caffeine from ED ranged from around

14 mg/day (0,20 mg/kg bw/day) in Austria to around 3 mg/day (0,04 mg/kg bw/day) in Cyprus (tables

16 and 17).

Table 16: Adults – Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in

mg/day) – Total respondents (Sample size: 14.557)


Austria 13,99 2,52 0 228,98 19,54 40,00 66,67 30,21

Belgium 3,53 0,00 0 227,20 0,00 7,95 20,00 15,55

Cyprus 2,67 0,00 0 160,42 0,00 7,63 19,10 12,04

Czech Republic 8,81 0,00 0 227,20 8,01 21,26 39,80 20,68

Finland 5,20 0,00 0 151,00 2,67 10,99 28,40 17,16

France 6,09 0,00 0 229,33 0,00 11,47 38,90 22,30

Germany 6,33 0,00 0 162,41 2,67 19,83 39,20 16,93

Greece 5,83 0,00 0 227,24 3,78 20,13 39,15 15,19

Hungary 6,80 0,00 0 160,00 7,52 20,00 39,88 17,35

Italy 4,46 0,00 0 159,03 2,66 11,39 23,31 12,56

Netherlands 4,34 0,00 0 159,19 0,00 8,34 28,35 14,52

Poland 10,57 0,00 0 218,06 8,00 39,59 40,64 23,14

Romania 12,10 0,00 0 183,18 17,38 39,81 56,46 25,42

Spain 7,53 0,00 0 227,20 7,75 26,77 39,89 20,08

Sweden 3,46 0,00 0 158,38 0,00 8,00 19,90 12,27

United Kingdom 6,36 0,00 0 228,27 2,66 20,00 39,75 17,44 Source: Survey Nomisma-Areté for EFSA

Table 17: Adults – Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in

mg/kg bw /day) - Total respondents (Sample size: 14.557)


Austria 0,20 0,03 0 3,63 0,17 0,54 0,95 0,48

Belgium 0,05 0,00 0 2,78 0,00 0,11 0,31 0,21

Cyprus 0,04 0,00 0 1,93 0,00 0,11 0,24 0,17

Czech Republic 0,11 0,00 0 3,07 0,11 0,33 0,53 0,27

Finland 0,07 0,00 0 1,99 0,03 0,12 0,45 0,23

France 0,09 0,00 0 3,72 0,00 0,18 0,47 0,34

Germany 0,08 0,00 0 3,25 0,04 0,28 0,47 0,23

Greece 0,08 0,00 0 3,92 0,06 0,27 0,44 0,23

Hungary 0,11 0,00 0 5,51 0,07 0,26 0,51 0,37

Italy 0,06 0,00 0 2,65 0,04 0,20 0,34 0,18

Netherlands 0,06 0,00 0 3,15 0,00 0,14 0,35 0,23

Poland 0,14 0,00 0 2,97 0,13 0,45 0,67 0,31

Romania 0,17 0,00 0 2,82 0,19 0,60 0,85 0,35

Spain 0,11 0,00 0 4,94 0,09 0,34 0,57 0,29

Sweden 0,04 0,00 0 1,79 0,00 0,12 0,25 0,15



drinks






Comparing the average values in the 16 MS for adult ED consumers, the highest level of chronic

exposure to caffeine from ED was around 32 mg/day for Romanian consumers (against a total daily

exposure to caffeine of 277 mg) (table 18).


in the 16 MS covered

by the survey (values in mg/day) – ED Consumers (Sample size: 4.180)

Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev% from

ED/Total

exposure from ED 27,82 19,28 2,51 228,98 39,75 66,67 126,32 37,86

total exposure 246,91 225,56 3,56 891,67 351,40 472,67 611,95 169,71

exposure from ED 23,38 8,00 2,51 227,20 28,40 41,84 91,55 33,80

total exposure 324,30 258,46 16,27 1.228,94 466,42 713,23 819,21 257,56

exposure from ED 19,35 8,75 2,50 160,42 21,88 43,72 85,84 27,23

total exposure 204,89 156,66 11,43 680,59 270,35 390,59 507,00 141,34

exposure from ED 19,23 8,05 2,08 227,20 20,09 39,95 56,71 27,11

total exposure 248,24 211,28 7,50 958,42 355,30 467,71 544,04 171,95

exposure from ED 18,11 7,98 1,33 151,00 15,99 55,92 80,00 28,19

total exposure 343,98 323,24 11,07 1.238,85 493,99 684,03 704,80 232,00

exposure from ED 27,30 11,13 2,01 229,33 28,11 65,63 133,33 40,67

total exposure 276,66 225,19 3,74 1.275,49 399,58 540,47 687,25 215,31

exposure from ED 21,01 10,98 1,51 162,41 27,31 52,90 64,34 25,37

total exposure 311,82 268,20 2,67 1.335,02 431,06 630,46 718,75 222,63

exposure from ED 18,48 11,07 2,52 227,24 27,99 40,03 55,14 22,35

total exposure 207,15 183,94 9,48 669,52 279,86 404,48 490,10 132,18

exposure from ED 16,97 7,99 0,53 160,00 19,99 40,00 69,67 24,08

total exposure 224,13 211,45 4,30 1.074,50 292,54 434,10 493,38 168,63

exposure from ED 15,76 8,00 1,33 159,03 20,00 39,92 41,33 19,48

total exposure 231,95 234,50 9,41 736,46 307,93 416,19 477,80 138,23

exposure from ED 20,92 8,00 2,50 159,19 28,17 52,50 76,56 25,94

total exposure 327,69 274,90 8,98 926,06 511,48 708,96 776,56 242,39

exposure from ED 23,34 11,31 2,50 218,06 28,40 41,73 71,85 29,76

total exposure 269,27 255,45 3,81 960,64 366,40 460,04 565,63 162,59

exposure from ED 31,71 20,00 2,54 183,18 39,87 78,17 109,70 32,77

total exposure 276,93 242,76 8,00 1.271,05 369,82 525,05 638,10 196,45

exposure from ED 24,39 15,42 2,50 227,20 29,20 55,43 79,42 29,92

total exposure 215,04 167,26 8,00 1.057,87 307,84 454,29 589,73 177,36

exposure from ED 15,79 7,98 1,31 158,38 19,74 39,76 54,04 22,23

total exposure 318,60 273,98 5,32 1.252,61 432,67 696,14 738,81 236,01

exposure from ED 22,96 11,36 1,27 228,27 28,40 55,91 63,25 26,80

total exposure 308,27 251,59 4,27 1.920,36 435,30 637,94 786,37 255,29

Cyprus 9,4%

Austria 11,3%

Belgium 7,2%

Czech Republic 7,7%

Finland 5,3%

France 9,9%

Germany 6,7%

Greece 8,9%

Hungary 7,6%

Italy 6,8%

Netherlands 6,4%

Poland 8,7%

Romania 11,5%

Spain 11,3%

Sweden 5,0%

United Kingdom 7,4%


(a) Including ED


drinks






Exposure to caffeine from ED ranged from 0,20 mg/kg bw/day for Swedish ED consumers to 0,44

mg/kg bw/day for Romania (table 19).


in the 16 MS covered

by the survey (values in mg/kg bw/day) – ED Consumers (Sample size: 4.180)


ED/Total

exposure from ED 0,40 0,16 0,03 3,63 0,43 0,95 1,68 0,62

total exposure 3,34 3,03 0,06 12,49 4,52 6,66 7,42 2,32

exposure from ED 0,32 0,13 0,03 2,78 0,37 0,70 1,39 0,45

total exposure 4,53 3,47 0,22 16,61 5,98 9,90 13,28 3,77

exposure from ED 0,28 0,14 0,03 1,93 0,28 0,56 1,46 0,38

total exposure 2,91 2,23 0,16 9,07 4,15 6,04 7,24 2,00

exposure from ED 0,25 0,13 0,00 3,07 0,30 0,55 0,78 0,36

total exposure 3,17 2,76 0,00 14,30 4,36 6,47 8,11 2,35

exposure from ED 0,24 0,09 0,00 1,99 0,23 0,68 1,17 0,39

total exposure 4,33 3,94 0,00 34,98 6,12 8,36 10,03 3,93

exposure from ED 0,40 0,16 0,03 3,72 0,41 0,99 1,76 0,62

total exposure 4,12 3,18 0,06 24,53 5,47 8,68 10,80 3,51

exposure from ED 0,28 0,14 0,00 3,25 0,34 0,62 0,86 0,35

total exposure 4,17 3,48 0,00 16,59 5,64 8,46 10,78 3,15

exposure from ED 0,24 0,14 0,02 3,92 0,32 0,50 0,66 0,35

total exposure 2,72 2,44 0,14 9,75 3,94 5,15 5,60 1,83

exposure from ED 0,27 0,11 0,00 5,51 0,26 0,57 1,35 0,55

total exposure 3,37 2,65 0,00 47,53 4,36 6,18 8,03 4,09

exposure from ED 0,22 0,13 0,00 2,65 0,28 0,50 0,71 0,29

total exposure 3,23 3,10 0,00 14,34 4,43 5,56 6,97 2,06

exposure from ED 0,30 0,13 0,02 3,15 0,35 0,69 1,03 0,44

total exposure 4,28 3,26 0,14 14,72 6,19 8,84 10,80 3,23

exposure from ED 0,31 0,16 0,00 2,97 0,39 0,70 0,98 0,40

total exposure 3,71 3,45 0,00 14,18 5,06 6,84 8,10 2,38

exposure from ED 0,44 0,29 0,00 2,82 0,62 0,95 1,31 0,45

total exposure 3,90 3,27 0,00 19,05 5,42 7,72 10,01 2,88

exposure from ED 0,34 0,20 0,00 4,94 0,42 0,73 1,02 0,45

total exposure 3,01 2,38 0,00 13,93 4,22 6,52 8,20 2,53

exposure from ED 0,20 0,11 0,02 1,79 0,24 0,49 0,72 0,27

total exposure 4,18 3,35 0,10 15,86 5,89 8,96 11,25 3,28

exposure from ED 0,37 0,17 0,00 6,15 0,42 0,78 1,09 0,59

total exposure 5,25 3,14 0,00 79,60 5,90 9,76 14,91 8,66

Germany

Greece

Hungary

Italy

Austria

Belgium

Cyprus

Czech Republic

Finland

France

Romania

Spain

Sweden

United Kingdom

Netherlands

Poland

8,8%

11,9%

7,0%

9,5%

7,8%

5,6%

9,8%

6,6%

4,9%

7,0%

8,1%

6,9%

6,9%

8,5%

11,2%

11,4%


(a) Including ED

As for the differences between genders, chronic caffeine exposure from ED consumption was equal to

nearly 21 mg/day for female consumers and to about 23 mg/day for male ones. The values of total

daily caffeine exposure were similar between genders.

The highest value of caffeine exposure deriving from ED consumption was around 23 mg/day reported

in the 30-49 age group, whereas the highest value of total caffeine exposure concerned the 50-65 age

group, with an average value of 310 mg/day.


drinks






Concerning the contribution of ED to chronic exposure to taurine and D-glucurono-y-lactone,

differences between total respondents, ED consumers and high chronic consumers showed to be much

higher than those observed for caffeine.

Tables 20 and 21 show that average taurine exposure in high chronic consumers resulted to be nearly

twice the average value for all consumers, and seven times higher than the average value for total

respondents.

Table 20: Adults – Chronic exposure to taurine from ED (values in mg/day) (Sample size: 14.557 – Total

respondents; 4.180 – ED consumers; 486 – High chronic consumers)


Total respondents 82,71 0,00 0,00 2.840 33,33 250,00 500,00 236,26

ED consumers 271,88 120,71 0,00 2.840 355,00 500,00 915,40 363,42

High chronic consumers 585,79 500,00 7,10 2.840 710,00 1.337,70 2.000,00 544,46 Source: Survey Nomisma-Areté for EFSA

Table 21: Adults – Chronic exposure to taurine from ED (values in mg/kg bw/day) (Sample size: 14.557 –

Total respondents; 4.180 – ED consumers; 486 – High chronic consumers)



ED consumers 3,82 1,80 0 76,92 4,46 8,76 12,50 5,65


The relative contribution from ED to the total exposure to taurine resulted to be 82% in ED

consumers, picking up to 91% in high chronic consumers.


drinks






Tables 22 and 23 report the daily exposure to taurine from ED for total respondents (respectively in

mg/day and in mg/kg bw/day) in the 16 MS covered by the survey.

Table 22: Adults – Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 157,25 5,58 0 2.840,00 108,44 500,00 767,14 359,25

Belgium 36,92 0,00 0 2.840,00 0,00 68,80 178,75 180,55

Cyprus 31,49 0,00 0 1.833,33 0,00 100,00 250,00 139,63

Czech Republic 109,80 0,00 0 2.840,00 100,00 308,50 500,00 259,17

Finland 64,46 0,00 0 2.000,00 33,33 134,13 355,00 216,24

France 71,25 0,00 0 2.840,00 0,00 142,00 355,00 266,35

Germany 80,81 0,00 0 2.130,00 33,33 250,00 500,00 219,22

Greece 70,64 0,00 0 2.840,00 41,95 250,00 355,00 188,63

Hungary 85,03 0,00 0 2.000,00 77,40 250,00 500,00 217,95

Italy 51,45 0,00 0 2.000,00 33,33 142,00 250,00 150,61

Netherlands 49,85 0,00 0 2.000,00 0,00 100,00 355,00 168,11

Poland 130,14 0,00 0 2.840,00 100,00 500,00 500,00 290,49

Romania 150,07 0,00 0 2.366,67 142,00 500,00 710,00 322,97

Spain 89,56 0,00 0 2.840,00 57,48 250,00 500,00 246,55

Sweden 42,86 0,00 0 2.000,00 0,00 100,00 250,00 155,06

United Kingdom 77,80 0,00 0 2.840,00 33,33 250,00 500,00 217,09



mg/kg bw/day) - Total respondents (Sample size: 14.557)


Austria 2,27 0,08 0 45,08 1,72 5,63 11,58 5,79

Belgium 0,51 0,00 0 30,45 0,00 0,86 2,29 2,42

Cyprus 0,45 0,00 0 22,09 0,00 1,30 2,85 1,98

Czech Republic 1,41 0,00 0 38,38 1,37 4,44 6,72 3,39

Finland 0,85 0,00 0 25,00 0,36 1,50 4,75 2,94

France 1,05 0,00 0 47,33 0,00 2,03 5,55 3,98

Germany 1,06 0,00 0 42,60 0,53 3,53 6,10 2,99

Greece 0,92 0,00 0 48,97 0,64 3,13 5,41 2,81

Hungary 1,37 0,00 0 70,00 0,86 3,33 6,49 4,71

Italy 0,72 0,00 0 33,33 0,41 2,00 3,99 2,18

Netherlands 0,70 0,00 0 41,67 0,00 1,54 4,13 2,69

Poland 1,76 0,00 0 37,10 1,67 5,56 8,33 3,91

Romania 2,06 0,00 0 36,41 2,11 7,20 11,11 4,41

Spain 1,25 0,00 0 61,74 0,83 3,99 7,12 3,60

Sweden 0,55 0,00 0 23,67 0,00 1,45 3,21 1,92

United Kingdom 1,24 0,00 0 76,92 0,41 3,49 6,95 4,33



drinks






Focusing only on ED consumers, the highest exposure to taurine from ED was evidenced for Romania

(around 393 mg/day, corresponding to 5,41 mg/kg bw/day) (tables 24 and 25), while the relative

contribution from ED to the total exposure to taurine varied from 75,8% in Italy and 87,1% in

Romania.

Chronic taurine exposure from ED showed the highest value in the 30-49 age group of consumers,

even though differences among values for the different age groups were limited. The average exposure

to taurine for male consumers resulted slightly higher than the one for female consumers.


mg/day) – ED Consumers (Sample size: 4.180)


% taurine

ED/total

taurine

Austria 312,81 100,00 5,58 2.840,00 369,69 757,92 1.404,79 456,61 84,4%

Belgium 244,40 99,51 0,00 2.840,00 250,00 500,00 972,50 407,42 80,8%

Cyprus 228,62 100,00 33,33 1.833,33 250,00 500,00 1.000,00 313,11 79,8%

Czech Republic 239,56 100,00 13,33 2.840,00 250,00 500,00 710,00 340,19 80,5%

Finland 224,31 100,00 0,00 2.000,00 200,00 710,00 1.000,00 356,93 79,5%

France 319,63 100,00 6,01 2.840,00 355,00 710,00 1.654,09 489,10 84,6%

Germany 268,15 142,00 0,00 2.130,00 355,00 710,00 833,33 330,71 82,2%

Greece 223,97 142,00 0,00 2.840,00 315,44 500,00 710,00 280,59 79,4%

Hungary 212,13 100,00 5,65 2.000,00 250,00 500,00 880,00 302,95 78,5%

Italy 181,73 100,00 6,67 2.000,00 250,00 500,00 500,00 237,76 75,8%

Netherlands 240,23 100,00 0,00 2.000,00 250,00 500,00 933,33 301,43 80,6%

Poland 287,24 142,00 6,67 2.840,00 355,00 500,00 928,33 375,87 83,2%

Romania 393,11 250,00 7,10 2.366,67 500,00 1.000,00 1.394,00 421,96 87,1%

Spain 290,03 142,00 8,40 2.840,00 355,00 674,50 988,75 372,70 83,3%

Sweden 195,30 100,00 5,00 2.000,00 250,00 500,00 710,00 283,14 77,1%

United Kingdom 281,04 142,00 0,00 2.840,00 355,00 710,00 733,33 336,54 82,9% Source: Survey Nomisma-Areté for EFSA


drinks







mg/kg bw/day) – ED Consumers (Sample size: 4.180)


Austria 4,51 1,72 0 45,08 4,78 11,52 18,34 7,52

Belgium 3,35 1,33 0 30,45 3,92 7,40 16,93 5,41

Cyprus 3,26 1,79 0 22,09 3,27 6,90 16,95 4,44

Czech Republic 3,08 1,54 0 38,38 3,85 6,90 9,77 4,47

Finland 2,97 1,09 0 25,00 2,83 8,78 14,66 4,89

France 4,70 1,82 0 47,33 4,90 11,73 19,72 7,35

Germany 3,53 1,80 0 42,60 4,18 7,89 11,40 4,58

Greece 2,91 1,68 0 48,97 3,70 6,25 8,19 4,38

Hungary 3,43 1,39 0 70,00 3,32 7,49 16,94 6,96

Italy 2,56 1,44 0 33,33 3,21 5,93 8,33 3,49

Netherlands 3,36 1,52 0 41,67 3,85 7,97 12,46 5,09

Poland 3,88 1,90 0 37,10 4,81 8,77 12,24 5,06

Romania 5,41 3,57 0 36,41 7,47 12,12 16,51 5,74

Spain 4,05 2,04 0 61,74 5,10 8,84 12,00 5,53

Sweden 2,52 1,28 0 23,67 2,89 6,01 9,12 3,45

United Kingdom 4,46 2,06 0 76,92 5,07 10,00 13,33 7,30


The average chronic exposure to D-glucurono-y-lactone in high chronic consumers was 269 mg/day,

around twice the average value for all consumers (126 mg/day). The average value for total

respondents was 38 mg/day (tables 26 and 27).

The relative contribution from ED to the total exposure to D-glucurono-y-lactone was 98,8% among

ED consumers and 99,4% in high chronic consumers.

Table 26: Adults – Chronic exposure to D-glucurono-y-lactone exposure from ED (values in mg/day) (Sample size: 14.557 – Total respondents; 4.180 – ED consumers; 486– High chronic consumers)


Total respondents 38,31 0,00 0 1.704 18,64 120,00 225 117,65

ED consumers 125,95 60,00 0 1.704 150,00 300,00 426 185,65

High chronic consumers 268,84 200,59 0 1.704 340,80 633,62 900 284,32 Source: Survey Nomisma-Areté for EFSA

Table 27: Adults – Chronic exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/day) (Sample

size: 14.557 – Total respondents; 4.180 – ED consumers; 486 – High chronic consumers)



ED consumers 1,78 0,83 0 46,15 2,08 4,27 6,20 2,95


Tables 28 and 29 illustrate the daily exposure to D-glucurono-y-lactone from ED (in mg/day and in

mg/kg bw/day) for total respondents, comparing the 16 MS covered by the survey. In both cases the

highest data were registered in Romania (83 mg/day corresponding to 1,14 mg/ kg bw/day

respectively).


drinks






Table 28: Adults – Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the

survey (values in mg/day) – Total respondents (Sample size: 14.557)


Austria 79,69 0 0 1.704,00 60,00 255,00 340,35 189,84

Belgium 19,60 0 0 1.704,00 0,00 26,99 60,00 105,70

Cyprus 17,43 0 0 1.100,00 0,00 20,00 85,20 82,88

Czech Republic 31,78 0 0 1.704,00 20,00 85,20 146,63 108,25

Finland 15,18 0 0 1.080,00 0,10 19,00 64,75 78,91

France 33,11 0 0 1.704,00 0,00 60,00 159,75 129,91

Germany 38,04 0 0 1.278,00 19,00 127,68 213,00 112,16

Greece 32,30 0 0 1.704,00 19,38 113,85 201,82 99,33

Hungary 23,32 0 0 576,52 10,00 52,50 116,25 76,12

Italy 27,34 0 0 1.020,00 17,00 72,26 150,00 81,43

Netherlands 22,76 0 0 1.080,00 0,00 58,68 142,50 86,30

Poland 50,03 0 0 1.513,60 51,00 150,00 262,50 118,26

Romania 83,33 0 0 1.200,00 60,00 300,00 420,25 180,48

Spain 44,44 0 0 1.704,00 20,00 146,25 255,00 128,28

Sweden 19,35 0 0 900,00 0,00 57,00 90,00 71,25

United Kingdom 37,43 0 0 1.704,00 18,00 127,50 240,00 112,77 Source: Survey Nomisma-Areté for EFSA


survey (values in mg/kg bw/day) - Total respondents (Sample size: 14.557)


Austria 1,13 0 0 27,05 0,97 3,10 5,44 2,95

Belgium 0,27 0 0 18,27 0,00 0,35 1,01 1,40

Cyprus 0,25 0 0 13,25 0,00 0,35 1,36 1,18

Czech Republic 0,43 0 0 23,03 0,30 1,00 2,08 1,52

Finland 0,20 0 0 13,25 0,00 0,22 0,82 1,03

France 0,49 0 0 26,22 0,00 1,00 2,35 1,98

Germany 0,50 0 0 25,56 0,24 1,50 2,69 1,57

Greece 0,43 0 0 29,38 0,28 1,35 2,52 1,54

Hungary 0,42 0 0 42,00 0,14 0,68 1,85 2,24

Italy 0,39 0 0 19,61 0,21 1,08 2,19 1,19

Netherlands 0,33 0 0 22,50 0,00 0,75 1,79 1,44

Poland 0,68 0 0 22,26 0,63 2,13 3,64 1,66

Romania 1,14 0 0 17,14 1,13 4,20 6,26 2,44

Spain 0,62 0 0 37,04 0,34 1,97 3,50 1,91

Sweden 0,24 0 0 9,28 0,00 0,71 1,39 0,83

United Kingdom 0,59 0 0 46,15 0,14 1,59 3,22 2,27 Source: Survey Nomisma-Areté for EFSA


drinks






Tables 30 and 31 provide the daily exposure to D-glucurono-y-lactone from ED (in mg/day and in

mg/kg bw/day) for ED consumers, comparing the 16 MS covered by the survey.

Exposure to D-glucurono-y-lactone from ED showed the highest value in Romania, where the average

daily exposure for ED consumers was around 218 mg (3 mg/kg bw/day). The lowest value was

recorded in Finland (69 mg/day corresponding to 0,70 mg/kg bw/day). Similarly, the relative

contribution from ED to the total exposure to D-glucurono-y-lactone varied from 97,2% in Finland

and 99,3% in Romania.


survey (values in mg/day) – ED Consumers (Sample size: 4.180)

Mean Median Min Max75th

perc.

90th

perc.

95th

perc.StdDev

% ED

glucuronolactone /

total

glucuronolactone

Austria 158,51 60,00 0 1.704,00 150,00 334,80 671,65 243,56 99,1%

Belgium 129,78 50,76 0 1.704,00 115,50 300,00 570,00 244,92 98,9%

Cyprus 126,51 60,00 0 1.100,00 150,00 300,00 600,00 191,50 98,8%

Czech Republic 69,33 24,00 0 1.704,00 75,00 150,00 270,00 151,73 97,9%

Finland 52,83 10,00 0 1.080,00 40,47 120,10 271,65 140,60 97,2%

France 148,55 60,00 0 1.704,00 142,50 300,00 776,00 242,19 99,0%

Germany 126,24 60,00 0 1.278,00 150,00 300,00 426,00 175,08 98,8%

Greece 102,40 59,07 0 1.704,00 142,50 237,50 300,00 155,54 98,6%

Hungary 58,17 15,00 0 576,52 52,50 193,53 300,00 111,63 97,5%

Italy 96,58 57,00 0 1.020,00 135,00 255,00 300,00 129,45 98,5%

Netherlands 109,68 57,00 0 1.080,00 138,75 271,56 355,73 162,74 98,7%

Poland 110,42 57,00 0 1.513,60 135,00 270,00 383,40 155,66 98,7%

Romania 218,29 150,00 0 1.200,00 300,00 447,60 800,00 236,61 99,3%

Spain 143,91 63,90 0 1.704,00 181,05 300,00 431,60 197,56 99,0%

Sweden 88,19 54,00 0 900,00 80,94 210,00 300,00 130,94 98,3%

United Kingdom 135,21 60,00 0 1.704,00 181,05 300,00 390,00 181,00 98,9% Source: Survey Nomisma-Areté for EFSA


drinks







survey (values in mg/kg bw/day) – ED Consumers (Sample size: 4.180)


Austria 2,25 0,96 0 27,05 2,33 5,43 8,51 3,85

Belgium 1,77 0,64 0 18,27 1,72 4,44 9,63 3,23

Cyprus 1,82 0,88 0 13,25 1,89 4,14 10,17 2,72

Czech Republic 0,93 0,33 0 23,03 0,92 2,14 3,39 2,15

Finland 0,70 0,11 0 13,25 0,44 1,71 3,41 1,84

France 2,20 0,86 0 26,22 2,13 5,18 10,05 3,72

Germany 1,67 0,85 0 25,56 2,11 3,79 5,53 2,49

Greece 1,36 0,78 0 29,38 1,73 3,17 3,80 2,51

Hungary 1,04 0,23 0 42,00 0,68 2,92 3,88 3,45

Italy 1,36 0,76 0 19,61 1,66 3,33 5,00 1,92

Netherlands 1,58 0,71 0 22,50 1,78 3,57 5,25 2,83

Poland 1,51 0,74 0 22,26 1,91 3,94 4,95 2,20

Romania 3,00 1,88 0 17,14 4,33 6,99 9,41 3,18

Spain 2,02 1,03 0 37,04 2,54 4,60 6,24 2,99

Sweden 1,11 0,66 0 9,28 1,30 2,59 4,48 1,48



drinks






3.3.2.5. ED acute consumption: analysis on high acute consumers

Prevalence of high acute consumption on the population was around 8% (figure 6).

High acute consumers were approximately 11% of total adult ED consumers, ranging from 19% in

Germany, to 0% in Cyprus (figure 20).

Figure 20: Adults – Prevalence of high acute ED consumption by country (Sample size: 4.180 – ED

consumers)



drinks






Concerning the different age groups of ED consumers (figure 21), the highest prevalence of high acute

consumption was in “young adults” (13% in 18-29 years).

The distribution of high acute consumers among age groups evidenced a higher percentage of 30-49

aged consumers (49%).

Prevalence of high consumption of ED was about 11% among ED consumers, and approximately 16%

among regular smoking consumers.

Figure 21: Adults - Prevalence of high acute ED consumption by age (Sample size: 4.180 – ED consumers)



drinks






Approximately 96% of high acute consumers declared to drink at least 3 cans of ED in a single

session, against about 18% of ED consumers (figure 22).

Figure 22: Adults - Recent ED consumption acts: high acute and total consumers (Sample size: 4.180 – ED

consumers; 448 - High acute consumers)


As illustrated in figure 23, around 61% of high acute consumers resulted to drink 3 or more cocktails

of ED and alcohol in a single session, compared to 30% for ED consumers.


drinks






Figure 23: Adults – Acute consumption of ED in association with alcohol: high acute and average

consumers drinking ED and alcohol (Sample size: 2.832 – ED consumers drinking ED and alcohol; 448 –

High acute consumers)


Concerning acute consumption of ED during sport activities, 57% of high acute consumers resulted to

drink 3 or more cocktails of ED and alcohol in a single session; 27% of total consumers consumed the

same quantity in a single session of physical activity (figure 24).

Figure 24: Adults – Acute consumption of ED during sport practice: high acute and average consumers

practicing sport (Sample size: 2.832 – ED consumers practicing sport activities; 448 – High acute consumers)



drinks






3.3.2.6. Exposure to active ingredients in high acute adult consumers

Tables 32 and 33 provide the average values of exposure to caffeine in a single session of

consumption for total respondents, ED consumers and high acute consumers. Acute exposure form ED

ranged from about 47 mg/single session for total respondents to around 374 mg for high acute

consumers. Considering exposure to caffeine expressed in mg/kg bw/single session, the highest value

was around 5 mg/kg bw/single session for high acute consumers.

Table 32: Adults – Acute exposure to caffeine from ED (values in mg/single session) (Sample size: 14.557 –

Total respondents; 4.180 - ED consumers; 448 - High acute consumers)


Total respondents 47,17 0,00 0,00 800 79,59 160,00 237,53 89,45

ED consumers 155,07 113,60 16,00 800 215,40 316,19 344,25 97,84

High acute consumers 373,70 340,35 175,05 800 400,00 464,35 565,24 76,80 Source: Survey Nomisma-Areté for EFSA

Table 33: Adults – Acute exposure to caffeine from ED (values in mg/kg bw/single session) (Sample size:

14.557 – Total respondents; 4.180 - ED consumers; 448 - High acute consumers)



ED consumers 2,16 1,64 0,29 10,90 2,75 4,13 5,08 1,44

High acute consumers 5,14 4,91 2,43 10,90 6,00 7,15 8,15 1,48 Source: Survey Nomisma-Areté for EFSA


drinks






Tables 34 and 35 provide results for acute exposure to caffeine from ED in a single session (in

mg/single session and in mg/kg bw/single session) for total respondents, comparing the 16 MS

covered by the survey. Values expressed in mg/single session ranged from around 12 in Cyprus to

around 81 in Austria.

Table 34: Adults – Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in

mg/single session) – Total respondents (Sample size: 14.557)


Austria 80,73 75 0 454,40 152,00 240,00 320,00 107,11

Belgium 24,24 0 0 568,00 0,00 80,00 160,00 70,01

Cyprus 12,08 0 0 150,00 0,00 83,07 87,50 30,66

Czech Republic 77,08 0 0 480,90 122,09 239,52 321,10 109,49

Finland 39,93 0 0 800,00 79,50 113,60 219,51 86,39

France 32,20 0 0 565,69 0,00 153,78 194,29 71,61

Germany 53,96 0 0 574,04 78,76 204,76 310,10 103,35

Greece 49,22 0 0 571,02 80,00 160,81 243,06 93,48

Hungary 61,68 0 0 568,00 80,00 225,82 319,63 101,94

Italy 36,70 0 0 565,69 79,40 158,38 160,75 71,00

Netherlands 30,83 0 0 449,43 0,00 151,72 160,76 71,58

Poland 67,98 0 0 562,68 87,34 224,43 240,00 95,82

Romania 58,23 0 0 568,00 80,00 160,00 238,85 94,72

Spain 48,32 0 0 771,25 79,68 159,68 234,20 89,07

Sweden 34,03 0 0 636,10 0,00 113,60 226,03 81,56


Table 35: Adults - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in

mg/kg bw/single session) - Total respondents (Sample size: 14.557)


Austria 1,12 0,62 0 7,65 1,69 3,05 4,69 1,57

Belgium 0,34 0,00 0 10,90 0,00 1,23 2,44 1,02

Cyprus 0,17 0,00 0 2,63 0,00 1,05 1,33 0,46

Czech Republic 1,03 0,00 0 7,61 1,46 3,16 4,35 1,52

Finland 0,51 0,00 0 9,39 0,89 1,67 2,42 1,12

France 0,48 0,00 0 9,12 0,00 1,80 2,97 1,10

Germany 0,73 0,00 0 9,29 1,03 2,66 3,78 1,42

Greece 0,66 0,00 0 8,83 1,06 2,27 3,66 1,26

Hungary 0,87 0,00 0 10,33 1,22 2,67 4,38 1,54

Italy 0,52 0,00 0 6,98 0,95 1,88 2,64 1,01

Netherlands 0,41 0,00 0 6,81 0,00 1,67 2,48 0,98

Poland 0,94 0,00 0 9,70 1,46 2,86 3,53 1,34

Romania 0,83 0,00 0 8,89 1,27 2,65 3,85 1,39

Spain 0,69 0,00 0 9,22 1,14 2,36 3,37 1,29

Sweden 0,45 0,00 0 9,69 0,00 1,68 2,76 1,09



drinks






With regards to ED consumers, acute exposure to caffeine from ED ranged from around 88 mg/single

session in Cyprus to around 180 mg/single session for Austrian consumers. At the same time, acute

exposure per body weight in a single session ranged from 1,27 mg /kg bw/single session in Cyprus to

2,42 mg/kg bw/single session in Germany (tables 36 and 37).


mg/single session) – ED Consumers (Sample size: 4.180)


Austria 160,58 152,00 75,00 454,40 230,18 320,00 397,54 99,95

Belgium 160,47 113,87 60,21 568,00 227,95 319,64 340,80 103,05

Cyprus 87,69 87,50 75,00 150,00 87,50 104,60 122,30 13,38

Czech Republic 168,17 157,20 62,50 480,90 233,40 323,52 400,15 104,06

Finland 138,94 80,00 39,75 800,00 160,00 290,21 360,99 110,66

France 144,45 112,91 60,21 565,69 163,75 240,00 320,00 82,44

Germany 179,07 155,46 49,70 574,04 230,63 337,37 401,13 114,21

Greece 156,07 110,92 69,50 571,02 226,16 321,78 345,10 105,11

Hungary 153,88 80,00 16,00 568,00 211,39 320,00 396,38 108,37

Italy 129,63 82,06 39,92 565,69 159,84 237,04 319,35 75,90

Netherlands 148,59 150,68 75,00 449,43 160,00 281,23 331,75 84,91

Poland 150,05 113,60 75,00 562,68 164,80 245,29 320,00 89,14

Romania 152,54 113,60 64,00 568,00 175,10 312,18 346,31 95,47

Spain 156,48 154,15 39,63 771,25 220,74 243,83 339,21 93,63

Sweden 155,09 113,60 39,25 636,10 192,07 301,35 396,94 107,57

United Kingdom 157,70 113,01 38,19 583,98 221,34 320,00 350,39 102,50 Source: Survey Nomisma-Areté for EFSA


mg/kg bw/single session) – ED Consumers (Sample size: 4.180)


Austria 2,22 1,67 0,62 7,65 2,78 4,69 6,22 1,56

Belgium 2,26 1,68 0,61 10,90 2,94 4,81 5,17 1,58

Cyprus 1,27 1,17 0,73 2,63 1,48 1,60 2,08 0,35

Czech Republic 2,24 1,62 0,65 7,61 2,93 4,40 5,74 1,53

Finland 1,79 1,21 0,35 9,39 1,99 3,70 4,96 1,45

France 2,16 1,63 0,69 9,12 2,86 3,74 4,93 1,35

Germany 2,42 1,98 0,66 9,29 3,08 4,86 5,93 1,62

Greece 2,08 1,51 0,65 8,83 2,81 4,32 4,87 1,43

Hungary 2,18 1,38 0,29 10,33 2,67 4,62 6,48 1,74

Italy 1,83 1,43 0,57 6,98 2,20 3,17 4,35 1,08

Netherlands 1,98 1,58 0,71 6,81 2,43 3,82 4,47 1,23

Poland 2,06 1,59 0,70 9,70 2,75 3,78 4,63 1,28

Romania 2,17 1,59 0,66 8,89 2,70 4,19 5,44 1,47

Spain 2,22 1,78 0,59 9,22 2,71 4,09 5,08 1,41

Sweden 2,05 1,58 0,51 9,69 2,64 4,08 4,89 1,45



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Concerning the analysis of acute exposure to taurine, data expressed in mg/single session varied from

around 568 mg for total respondents, 1.869 for ED consumers, and around 4.654 mg for high acute

consumers (tables 38). Values are also provided in mg/ kg bw/single session (table 39).

Table 38: Adults – Acute exposure to taurine from ED (values in mg/single session) (Sample size: 14.557 –

Total respondents; 4.180 - ED consumers; 448 - High acute consumers)


Total respondents 568,61 0 0 10.000 1.000 2.000 3.000 1.104,87

ED consumers 1.869,16 1.420 0 10.000 2.000 4.000 4.260 1.257,80

High acute consumers 4.654,53 4.260 142 10.000 5.000 5.680 7.100 1.061,20 Source: Survey Nomisma-Areté for EFSA

Table 39: Adults – Acute exposure to taurine from ED (values in mg/kg bw/single session) (Sample size:

14.557 – Total respondents; 4.180 - ED consumers; 448 - High acute consumers)



ED consumers 25,95 19,23 0 140,00 33,33 50,58 63,58 18,35

High acute consumers 64,04 61,54 2 136,54 74,93 88,96 101,43 19,54 Source: Survey Nomisma-Areté for EFSA


drinks






With reference to the variations registered among the 16 MS, acute exposure to taurine from ED

ranged from around 145 mg/day in Cyprus to around 972 mg/day in Czech Republic (table 40).

Calculations in terms of mg/kg bw/single session are provided in table 41.

Table 40: Adults - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 881,45 158,75 0 5.680 1.000,00 2.734,25 3.843,02 1.218,43

Belgium 248,60 0,00 0 7.100 0,00 950,00 1.994,75 778,23

Cyprus 145,12 0,00 0 2.000 0,00 1.000,00 1.000,00 369,49

Czech Republic 971,88 0,00 0 9.100 1.420,00 3.000,00 4.000,00 1.425,54

Finland 493,54 0,00 0 10.000 1.000,00 1.420,00 2.168,00 1.084,00

France 378,77 0,00 0 7.100 0,00 1.420,00 2.000,00 871,05

Germany 680,01 0,00 0 7.100 1.000,00 2.840,00 4.000,00 1.317,51

Greece 584,66 0,00 0 7.100 1.000,00 2.000,00 3.000,00 1.127,63

Hungary 766,84 0,00 0 7.100 1.000,00 2.000,00 4.000,00 1.282,15

Italy 421,11 0,00 0 7.100 789,76 1.420,00 2.000,00 854,41

Netherlands 362,56 0,00 0 5.680 0,00 1.420,00 2.000,00 864,70

Poland 824,78 0,00 0 7.100 1.000,00 2.840,00 3.000,00 1.182,32

Romania 706,77 0,00 0 7.100 1.000,00 2.000,00 3.000,00 1.153,44

Spain 571,44 0,00 0 10.000 1.000,00 2.000,00 2.840,00 1.081,02

Sweden 410,10 0,00 0 8.000 0,00 1.420,00 2.700,00 1.001,32

United Kingdom 532,26 0,00 0 7.100 1.000,00 2.000,00 2.840,00 1.092,88 Source: Survey Nomisma-Areté for EFSA Table 41: Adults - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 12,31 1,25 0 98,04 18,18 34,48 47,99 17,99

Belgium 3,51 0,00 0 136,54 0,00 12,47 25,00 11,25

Cyprus 2,11 0,00 0 35,09 0,00 12,69 15,63 5,55

Czech Republic 12,97 0,00 0 140,00 18,62 40,61 55,10 20,02

Finland 6,35 0,00 0 117,65 10,53 20,95 29,91 14,07

France 5,66 0,00 0 118,33 0,00 20,88 35,77 13,44

Germany 9,18 0,00 0 118,33 13,16 33,33 48,39 18,11

Greece 7,77 0,00 0 109,23 12,63 24,39 44,43 15,08

Hungary 10,89 0,00 0 129,09 15,15 33,33 54,80 19,36

Italy 5,91 0,00 0 87,65 9,41 20,67 30,91 12,01

Netherlands 4,77 0,00 0 86,06 0,00 19,28 28,59 11,62

Poland 11,35 0,00 0 122,41 17,86 35,50 43,48 16,57

Romania 10,05 0,00 0 116,28 15,50 33,33 46,59 17,00

Spain 8,09 0,00 0 116,11 13,33 28,57 40,00 15,60

Sweden 5,39 0,00 0 91,03 0,00 20,29 33,90 13,00

United Kingdom 7,37 0,00 0 129,09 10,48 26,33 41,92 15,50 Source: Survey Nomisma-Areté for EFSA Concerning ED consumers, acute exposure to taurine showed the highest value in Germany (around

2.256 mg/single session and 30 mg/kg bw/single session), and the lowest in Cyprus (tables 42 and 43).


drinks









Austria 1.753,37 1.000 150,00 5.680 2.000 3.835,38 4.630 1.193,30

Belgium 1.645,71 1.000 0,00 7.100 2.000 3.792,75 4.117 1.310,52

Cyprus 1.053,60 1.000 1.000,00 2.000 1.000 1.378,00 1.420 178,54

Czech Republic 2.120,46 2.000 399,96 9.100 3.000 4.260,00 5.000 1.413,54

Finland 1.717,38 1.000 0,00 10.000 2.000 3.640,00 4.667 1.411,59

France 1.699,23 1.420 185,74 7.100 2.000 3.000,00 4.000 1.077,44

Germany 2.256,51 2.000 0,00 7.100 3.000 4.260,00 5.000 1.484,51

Greece 1.853,81 1.310 0,00 7.100 2.840 4.000,00 4.260 1.296,73

Hungary 1.913,03 1.000 169,40 7.100 2.000 4.000,00 5.000 1.381,94

Italy 1.487,46 1.000 152,60 7.100 2.000 2.840,00 4.000 996,51

Netherlands 1.747,08 1.420 0,00 5.680 2.000 3.000,00 4.260 1.089,55

Poland 1.820,44 1.420 200,00 7.100 2.000 3.000,00 4.000 1.128,04

Romania 1.851,38 1.420 142,00 7.100 2.000 3.400,00 4.182 1.168,81

Spain 1.850,57 1.420 199,89 10.000 2.000 3.000,00 4.260 1.190,77

Sweden 1.868,83 1.420 150,00 8.000 2.000 3.976,00 5.000 1.359,66

United Kingdom 1.922,65 1.420 0,00 7.100 2.840 4.000,00 4.260 1.281,46 Source: Survey Nomisma-Areté for EFSA




Austria 24,48 18,18 1,15 98,04 29,80 47,59 69,97 18,60

Belgium 23,22 16,26 0,00 136,54 31,79 53,79 61,88 19,54

Cyprus 15,30 14,29 9,52 35,09 17,32 19,89 26,06 4,66

Czech Republic 28,29 20,41 5,00 140,00 37,50 56,80 72,88 21,00

Finland 22,11 15,15 0,00 117,65 24,87 48,62 63,62 18,48

France 25,41 18,87 2,55 118,33 34,48 45,74 60,60 17,58

Germany 30,45 25,00 0,00 118,33 38,46 62,56 75,30 20,99

Greece 24,63 17,92 0,00 109,23 32,94 50,06 58,51 17,51

Hungary 27,16 17,28 1,88 129,09 33,33 58,91 82,86 22,21

Italy 20,88 15,87 2,13 87,65 25,97 37,80 53,64 14,03

Netherlands 22,97 18,87 0,00 86,06 28,45 44,44 51,89 15,26

Poland 25,05 19,23 2,86 122,41 34,04 46,88 57,56 16,20

Romania 26,32 19,23 2,03 116,28 33,33 51,81 66,02 18,14

Spain 26,19 21,88 2,68 116,11 31,91 47,73 61,62 17,72

Sweden 24,57 18,68 2,38 91,03 31,40 47,62 61,25 17,31



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The average exposure to D-glucurono-y-lactone in acute consumers ranged from 263 mg/single

session for total respondents, to 864 mg for ED consumers, and 2.119 mg for high acute consumers

(tables 44 and 45).

Table 44: Adults – Acute exposure to D-glucurono-y-lactone from ED (values in mg/single session) (Sample

size: 14.557 – Total respondents; 4.180 - ED consumers; 448 - High acute consumers)


Total respondents 262,98 0 0 4.344 360 960 1.440 548,48

ED consumers 864,50 600 0 4.344 1.170 1.737 2.300 684,82

High acute consumers 2.118,90 2.280 0 4.344 2.726 3.191 3.616 959,27 Source: Survey Nomisma-Areté for EFSA

Table 45: Adults – Acute exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/single session) (Sample size: 14.557 – Total respondents; 4.180 - ED consumers; 448 - High acute consumers)



ED consumers 12,03 9,13 0 77,83 15,62 24,88 32,77 9,89



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Concerning the differences among MS, the highest values of acute exposure to D-glucurono-y-lactone

for total respondents were registered in Austria (around 488; tables 46 and 47).

Table 46: Adults - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey

(values in mg/single session) – Total respondents (Sample size: 14.557)


Austria 488,14 0 0 3.237,60 600,00 1.542,24 1.800,00 700,01

Belgium 126,28 0 0 4.260,00 0,00 450,00 858,00 420,56

Cyprus 78,48 0 0 1.200,00 0,00 600,00 600,00 212,38

Czech Republic 296,20 0 0 3.067,20 450,00 960,00 1.600,29 547,54

Finland 109,28 0 0 4.344,00 3,00 320,58 600,00 373,08

France 178,20 0 0 3.834,00 0,00 639,00 1.140,00 423,56

Germany 324,57 0 0 4.260,00 420,00 1.200,00 1.800,00 679,98

Greece 269,53 0 0 4.047,00 420,00 828,57 1.704,00 567,09

Hungary 199,23 0 0 3.621,00 180,00 600,00 1.080,00 456,19

Italy 222,69 0 0 3.834,00 255,60 722,52 1.200,00 463,54

Netherlands 169,97 0 0 2.811,60 0,00 600,00 1.142,46 426,63

Poland 324,05 0 0 3.621,00 540,00 1.022,40 1.440,00 522,28

Romania 394,16 0 0 4.260,00 600,00 1.200,00 1.785,42 656,70

Spain 279,86 0 0 4.260,00 450,00 1.050,00 1.592,52 544,53

Sweden 199,78 0 0 4.260,00 0,00 600,00 1.170,00 512,44

United Kingdom 252,67 0 0 4.260,00 300,00 852,00 1.440,42 542,78 Source: Survey Nomisma-Areté for EFSA


(values in mg/kg bw/single session) - Total respondents (Sample size: 14.557)


Austria 6,71 0 0 54,55 9,74 20,14 26,79 10,07

Belgium 1,77 0 0 77,83 0,00 5,72 10,91 6,05

Cyprus 1,14 0 0 21,05 0,00 7,04 9,35 3,20

Czech Republic 4,01 0 0 48,39 4,99 13,09 21,71 7,82

Finland 1,42 0 0 63,88 0,03 4,18 9,01 4,98

France 2,67 0 0 61,84 0,00 10,36 16,47 6,50

Germany 4,37 0 0 68,16 5,52 16,20 23,72 9,32

Greece 3,60 0 0 52,43 4,87 10,96 20,80 7,62

Hungary 2,85 0 0 54,22 2,38 8,57 14,49 6,81

Italy 3,13 0 0 48,56 4,11 11,07 16,24 6,50

Netherlands 2,29 0 0 45,00 0,00 9,38 14,25 5,97

Poland 4,46 0 0 62,43 7,29 13,92 19,81 7,32

Romania 5,61 0 0 69,77 8,57 17,94 25,85 9,70

Spain 3,97 0 0 65,22 6,00 14,19 20,48 7,97

Sweden 2,60 0 0 54,62 0,00 9,50 15,85 6,53



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Regarding ED consumers (tables 48 and 49), acute exposures ranged from around 380 mg/single

session in Finland to over 1.000 mg in Germany.


(values in mg/single session) – ED Consumers (Sample size: 4.180)


Austria 970,99 600,00 0 3.237,60 1.200 1.800,00 2.554,20 711,30

Belgium 836,00 570,00 0 4.260,00 1.140 2.082,00 2.307,00 761,75

Cyprus 569,76 600,00 0 1.200,00 600 826,80 852,00 218,17

Czech Republic 646,25 511,20 0 3.067,20 900 1.620,00 2.136,00 654,66

Finland 380,25 150,00 0 4.344,00 480 982,80 1.557,00 618,82

France 799,42 600,00 0 3.834,00 1.080 1.575,96 1.800,00 555,41

Germany 1.077,05 809,40 0 4.260,00 1.530 2.400,00 3.000,00 851,13

Greece 854,62 585,00 0 4.047,00 1.080 1.800,00 2.428,20 721,72

Hungary 497,01 300,00 0 3.621,00 600 1.237,86 1.800,00 609,95

Italy 786,60 600,00 0 3.834,00 1.080 1.363,20 1.829,25 561,80

Netherlands 819,04 600,00 0 2.811,60 1.140 1.704,00 2.010,00 588,69

Poland 715,24 570,00 0 3.621,00 1.020 1.530,00 1.797,30 567,81

Romania 1.032,52 809,40 0 4.260,00 1.200 1.800,00 2.400,00 686,12

Spain 906,32 681,60 0 4.260,00 1.200 1.710,00 2.167,49 626,67

Sweden 910,43 600,00 0 4.260,00 1.140 1.710,00 2.662,50 742,71

United Kingdom 912,70 600,00 0 4.260,00 1.188 1.800,00 2.400,00 679,82 Source: Survey Nomisma-Areté for EFSA Table 49: Adults - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey

(values in mg/kg bw/single session) – ED Consumers (Sample size: 4.180)


Austria 13,35 9,68 0 54,55 17,44 26,70 36,80 10,64

Belgium 11,69 8,01 0 77,83 14,40 30,26 34,31 11,24

Cyprus 8,30 8,22 0 21,05 10,29 11,36 15,63 3,88

Czech Republic 8,75 5,88 0 48,39 11,49 22,61 29,26 9,59

Finland 4,92 1,72 0 63,88 5,57 13,17 22,89 8,32

France 11,96 9,50 0 61,84 15,43 24,00 29,86 8,85

Germany 14,51 11,05 0 68,16 18,99 31,13 40,85 11,89

Greece 11,43 8,00 0 52,43 13,90 26,67 32,38 9,73

Hungary 7,10 4,11 0 54,22 8,52 17,50 27,83 9,25

Italy 11,06 8,77 0 48,56 13,90 20,34 28,29 7,85

Netherlands 11,04 9,19 0 45,00 13,85 22,48 30,38 8,68

Poland 9,85 7,86 0 62,43 12,98 21,12 25,69 8,07

Romania 14,70 10,80 0 69,77 18,32 29,77 36,46 10,62

Spain 12,87 10,25 0 65,22 16,67 24,84 33,40 9,55

Sweden 11,86 8,81 0 54,62 14,55 23,75 33,06 9,22



drinks






3.3.3. Adolescents

As already mentioned at § 2.3.6, the sample of schools for the survey on adolescents was considerably

enlarged with respect to the original sample design, especially for all the MS where the progress of

survey activities was slower than expected. A total number of 31.901 filled-in questionnaires (of

which 31.070 validated) were collected in the 16 MS covered by the survey.

It is worth highlighting that the average results presented in this paragraph often hide relevant

differences at MS level, which are highlighted wherever opportune.

The sample appeared to be well balanced between boys and girls, with an average age of 16 years.

58% of the total respondents resided in urban areas and 90% lived with parents. Regular smokers

accounted for 17% of the total number of respondents.


With reference to the prevalence of ED consumption, around 68% of the total respondents (31.070 –

Total respondents) declared to have consumed ED at least once during the last year, while around 28%

of total respondents declared to have consumed ED in the three days before the survey (figure 25).

Figure 25: Adolescents – ED consumption and related features (Sample size: 31.070 – Total respondents)



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As highlighted by figure 26, prevalence of ED consumption varied from around 48% in Greece to

82% in Czech Republic46

.

Figure 26: Adolescents - Prevalence of ED consumption by country (Sample size: 31.070 – Total

respondents)


46

The highest prevalence of ED consumption among total respondents was observed in Belgium (85%).

Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates

exceeds 5%, it was preferred to indicate the highest value as observed in Czech Republic.


drinks






ED consumers had higher prevalence in the 15-18 age group (73% of total population; figure 27) than

in the 10-14 age group (55% of total population). Among male respondents a higher prevalence of ED

consumption was reported (74 %) than among female ones (63%).

Share of ED consumers increased among respondents who smoke regularly: around 85% of regular

smokers consumed ED, against 64% of non-smokers.

Figure 27: Adolescents - Prevalence of ED consumption by age groups and by gender (Sample size: 31.070

– Total respondents)



drinks






Around 26% of total consumers has been usually drinking ED twice a week or more (with around 5%

drinking ED every day and around 6% drinking them 4-5 times a week). The most consumed size

format was by far the 250 ml can (around 60% of total consumers), while around 11% of consumers

declared to consume energy shots47

. Around 19% of ED consumers stated to have been drinking more

than 10 can per month; around 49% of ED consumers declared to drink two or more cans in a single

occasion (figure 28).

As for volumes, adolescent ED consumers declared to drink on average around 2 L/month, varying

from 1,3 L/month in Italy to 3,1 L/month in the UK.

Figure 28: Adolescents - Features of ED consumption (Sample size: 20.713- ED consumers)


47

See also considerations on energy shots at § 3.3.2.


drinks






As for the reasons behind ED consumption (figure 29), the most important (“first choice”) among

adolescents resulted to be the taste of the product (for around 40% of ED consumers), the need for

energy (21%) and the need to stay awake (17%); also mentioned were consumption to enhance sport

performance (7%) and to treat hangover (4%).

The most common situations of ED consumption resulted to be “at home with friends during parties”

(for around 65% of consumers) and “at home in ordinary situations” (for around 56% of consumers).

Also discos and bar/pubs resulted to be quite common consumption situations, together with sport and

physical exercise (these three were mentioned by at least 40% of consumers).

Red Bull™ was by far the most popular brand among adolescents (it was mentioned as first choice

among the top-three ED brands by 48% of consumers), followed by Monster™ (22%). No other ED

brands were mentioned as first choice among the top-three ones by more than 5% of consumers.

Figure 29: Adolescents - Motivations for ED consumption (First choice) (Sample size: 20.713 – ED

consumers)



drinks






As previously seen for adults (§ 3.3.2.2), also in the case of adolescents data were elaborated

according to a specifically defined methodology (§ 2.3.5), in order to identify “high acute” and “high

chronic” consumers.

With reference to total respondents, prevalence of ED high acute consumption was about 8% and the

same share is recorded for the prevalence of high chronic consumption (figure 30).

As highlighted in figure 31, high chronic consumers represent around 17% of total ED consumers.

Figure 30: Adolescents - Prevalence of ED consumption for ED consumers, high acute consumers and

high chronic consumers on total respondents (Sample size: 31.070– Total respondents)

Similarly to adults, an overlap between “high acute” and “high chronic” profiles was observed in

adolescents, accounting for 4,5% of ED consumers (corresponding to 3% of total respondents). Again,

being this percentage smaller than the overall incidence of purely “high acute” and “high chronic”

consumers on total ED consumers, a dedicated analysis for “high acute” consumers will be provided at

§ 3.3.3.5.

Table 50: Adolescents – Overlap between high chronic and high acute groups of ED consumers

High acute Non high acute Total

High chronic 4,5% 7,2% 11,7%

Non high chronic 7,2% 81,1% 88,3%

Total 11,7% 88,3% 100,0%

% on total ED consumers



drinks






Considering the 16 MS involved in the survey, high chronic consumers had the lowest prevalence in

Italy and France (7% of total ED consumers) and the highest one in the Netherlands (27%) (figure 31).

Among ED consumers who declared to regularly smoke the percentage of high chronic ED consumers

was about 21%, while among total consumers this share decreases at 12%.

Concerning the different age groups of the target group “adolescents”, the highest prevalence of high

chronic ED consumers was recorded among consumers aged 10-14 (15% against 11% in 15-18 years

group).

Figure 31: Prevalence of high chronic ED consumption by country (Sample size: 20.713 – ED consumers)



drinks






Around 88% of high chronic consumers declared to have consumed ED in the three days before the

survey, compared to around 42% of total ED consumers. As for the frequency of consumption, around

47% of high chronic consumers drank ED every day. About 69% of high chronic consumers declared

to drink more than 10 cans of ED in an average month and with an average ED volume of around 7

L/month, against 18% of total consumers (figure 32).

Figure 32: Adolescents – Recent consumption acts: high chronic and total consumers (Sample size: 20.713 -

ED consumers; 2.077 – High chronic consumers)


drinks








drinks






3.3.3.2. Co-consumption of ED with alcohol

In the case of adolescents, the phenomenon of co-consumption of ED and alcohol involved, on

average, around 36% of the total population (figure 33) and around 53% of ED consumers.

Figure 33: Adolescents - Co-consumption of ED and alcohol (Sample size: 31.070 – Total respondents)



drinks






Prevalence of co-consumption among ED consumers ranged from 29% in the Netherlands to 71% in

Austria48

(figure 34). When referring to total respondents, the prevalence ranged from 20% in the

Netherlands to 57% in Czech Republic.

Figure 34: Adolescents – Co-consumption of ED and alcohol by country (Sample size: 31.070 – Total

respondents; 20.713– ED consumers)


48

The highest prevalence of co-consumption of ED and alcohol was observed in Belgium (81%). Nevertheless,

due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it

was preferred not to cite this figure.


drinks






Prevalence of co-consumption among ED consumers was higher in the 15-18 age group (59%: figure

35) than in the 10-14 one (32%). Even if the prevalence of co-consumption was slightly higher in the

male population (38% vs. 35%), prevalence among male ED consumers was lower than prevalence

among female ones (51% vs. 55% respectively).

Figure 35: Adolescents - Prevalence of co-consumption of ED and alcohol by age groups and gender

(Sample size: 31.070 – Total respondents; 20.713 – ED consumers)



drinks






Consumers drinking ED and alcohol “about every time” or “often” accounted for 29% of the total

number of co-consumers. Co-consumption occurred every day for a relatively small share of co-

consumers (7%); most consumers experienced co-consumption less frequently (16% once a week,

24% once-twice a month, 31% with lower frequency). Around 39% of co-consumers mixed ED and

alcohol more than twice in a single session (figure 36).

Figure 36: Adolescents - Co-consumption of ED and alcohol and related features


(Sample size: 11.034 – ED consumers drinking ED and

alcohol)

(Sample size: 11.034 – ED consumers drinking ED

and alcohol)

(Sample size: 11.034– ED consumers drinking ED and

alcohol) Source: Survey Nomisma-Areté for EFSA


drinks






Among co-consumers, 31% of high chronic ones mixed ED and alcohol every day, while just 12% of

total co-consumers do the same. About 36% of high chronic consumers declared to drink ED in

association with alcohol about every time they drink ED (figure 37).

Figure 37: Adolescents – Monthly frequency of co-consumption of ED with alcohol: high chronic and total

co-consumers (Sample size: 11.034 – ED consumers drinking ED and alcohol; 2.077 – High chronic

consumers)



drinks






3.3.3.3. Consumption of ED during sport activities

Around 77% of ED consumers were found to usually practise sport or physical exercise, while around

41% of total ED consumers declared to consume ED before, during, or just after practising sport or

physical activities (figure 38).

Figure 38: Adolescents - Consumption of ED during sport activities (Sample size: 20.713- ED consumers)



drinks






Around 37% of ED consumers usually practising sport declared to associate ED consumption with

sport practice “about every time” or “often”. Around 14% of ED consumers usually practising sport

drank four or more cans of ED in a single sport session; 48% of them limited instead themselves to

one can only (figure 39).

Figure 39: Adolescents – Consumption of ED during sport practice and related features

(Sample size: 16.055 – ED consumers practicing

sport)

(Sample size: 7.767 - ED consumers drinking ED during

sport activities)



drinks






Prevalence of ED consumption during sport activities showed substantial differences at MS level

(figure 40): the lowest prevalence was recorded in Sweden (around 14% of ED consumers and 10% of

total respondents), while the highest prevalence was recorded in the United Kingdom (around 65% of

ED consumers and 45% of total respondents, reaching 81% of ED consumers practicing sport

activities).

Figure 40: Adolescents - Prevalence of ED consumption during sport activities by country (Sample size:

31.070 – Total respondents; 20.713 - ED consumers; 16.055 - ED consumers practicing sport activities)



drinks






The most common motivations behind ED consumption during sport activity (first choice: figure 41)

were ED capacity to increase endurance time at a high intensity (43%) and power (21%); also cited as

the most important reason were ED capacity to improve vitality (12%), concentration (11%), and

aerobic endurance (8%).

Figure 41: Adolescents - Motivations for consumption of ED during sport activity (Sample size: 7.767 – ED

consumers drinking ED during sport activities)


Around 65% of high chronic consumers drank ED during sport activities, while the prevalence was

41% among total consumers (figure 42).

Figure 42: Adolescents - Prevalence and frequency of consumption of ED during sport activities: high

chronic and total consumers (Sample size: 20.713 – ED consumers; 2.077 – High chronic consumers)



drinks






Around 62% of high chronic consumers drank ED in association with sport practice “about every

time” or “often” (figure 43), whereas this happened for just around 21% of ED consumers usually

practising sports.

Figure 43: Adolescents - Frequency of consumption of ED during sport practice: high chronic and ED

consumers practicing sport activities (Sample size: 16.055- ED consumers practicing sport activities; 2.077 –

High chronic consumers)



drinks







Tables 51 and 52 report data on chronic exposure to caffeine for the different categories of

consumers, calculated on the basis of the methodology (§ 2.3.4.1).

Average caffeine exposure from ED varied from around 16 mg/day for total respondents to around 75

mg/day for high chronic consumers. Accordingly, total caffeine exposure (from ED and other products

in the diet) varied from around 150 mg/day (total respondents) to around 477 mg/day (high chronic

consumers), with an average caffeine exposure for ED consumers of around 185 mg/day. Average

caffeine exposure from ED in high chronic consumers was nearly three times the average value for

total ED consumers and was seven times higher than the average value for total respondents. ED

contribution to total caffeine exposure in high chronic consumers was around 16%, and not

remarkably higher than the average one (13%) applying for all ED consumers (table 51).

Table 51: Adolescents – Chronic exposure to caffeine from ED and from all products (a)

(values in

mg/day) (Sample size: 31.070 – Total respondents; 20.713- ED consumers; 2.077 – High chronic consumers)


exposure from ED:


ED consumers 23,51 8,00 0,01 340,70 20,31 58,10 106,64 37,08


Total exposure:


ED consumers 184,92 101,85 0,62 2395,54 215,21 404,85 636,09 265,84

High chronic consumers 476,99 267,79 2,50 2395,54 574,70 1281,04 1895,09 536,38 Source: Survey Nomisma-Areté for EFSA

(a) Including ED

Data for the chronic exposure to caffeine in mg//kg bw/day are provided in table 52. The total

exposure varied from 2,45 mg in total respondents to around 3 in ED consumers and 7,3 in high

chronic consumers.

The average ED contribution to total caffeine exposure was 13% in ED consumers and 16% in in high

chronic consumers (figure 44).


(values in mg/kg

bw/day) (Sample size: 31.072 – Total respondents; 20.709 - ED consumers; 2.077 – High chronic consumers)


exposure from ED:


ED consumers 0,38 0,15 0,00 6,95 0,41 0,94 1,59 0,60


Total exposure:


ED consumers 3,01 1,73 0,01 50,17 3,53 6,74 10,27 4,12


(a) Including ED


drinks






Figure 44: Adolescents - ED contribution to total daily exposure to caffeine (%) (Sample size: 20.713- ED

consumers)


As for the variations registered among different MS, it can be observed that:

chronic exposure to caffeine from ED for total respondents varied from around 6,9% (9

mg/day and 0,24 mg/kg bw/day) in Italy, to around 14,2% (22,3 mg/day and 0,39 mg/kg

bw/day) in the UK (tables 53 and 54);

chronic exposure to caffeine from ED for ED consumers varied from around 9% (around 16

mg/day) in the case of Italy to nearly 17% (around 32 mg/day) in the case of United Kingdom

(tables 55 and 56);

As for variations among different age groups, chronic exposure to caffeine from ED varied from

around 12% (corresponding to 23 mg/day) in adolescents aged 15-18, to around 15% (corresponding

to 26 mg/day) in the age group 10 - 14 years;

Some differences were also registered according to gender: the ED contribution was around 11%

(corresponding to 16 mg/day) for female consumers, around 14% (corresponding to 28 mg/day) for

male ones.


drinks






Table 53: Adolescents – Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values

in mg/day) – Total respondents (Sample size: 31.070)


ED/Total

exposure from ED 16,53 7,90 0 320,00 19,80 41,33 79,55 30,52

total exposure 122,45 65,43 0 2.233,65 140,57 266,09 391,83 192,36

exposure from ED 25,14 8,00 0 218,50 20,00 76,52 148,16 43,83

total exposure 264,64 148,62 0 2.062,77 284,61 885,75 1217,75 386,71

exposure from ED 10,36 2,56 0 340,70 8,30 21,73 44,27 27,62

total exposure 107,34 51,78 0 2.116,23 113,98 247,46 389,53 182,62

exposure from ED 15,42 7,70 0 210,27 19,24 40,96 66,11 26,16

total exposure 134,73 80,89 0 1.959,07 162,83 303,37 424,64 179,18

exposure from ED 15,29 2,67 0 227,20 11,36 40,00 82,67 33,33

total exposure 167,58 79,37 0 2.229,59 210,85 406,56 525,67 258,63

exposure from ED 13,89 2,76 0 326,00 10,22 39,73 58,25 31,30

total exposure 141,36 86,12 0 1.281,04 177,81 316,10 488,11 168,92

exposure from ED 13,19 2,64 0 305,60 11,13 39,03 57,50 28,94

total exposure 129,48 54,89 0 2.229,14 142,91 305,28 477,69 221,42

exposure from ED 9,34 0,00 0 314,00 7,90 20,08 40,99 27,91

total exposure 95,91 40,08 0 2.153,32 101,53 230,05 336,17 172,17

exposure from ED 18,59 7,81 0 320,00 19,96 41,33 80,00 34,25

total exposure 153,50 84,37 0 2.204,71 188,90 351,40 497,89 216,03

exposure from ED 8,94 2,64 0 226,49 7,99 20,00 41,12 21,27

total exposure 130,48 70,18 0 2.395,54 159,20 298,98 426,84 199,76

exposure from ED 13,04 2,67 0 317,13 10,94 40,49 57,98 26,62

total exposure 98,91 56,54 0 2.189,21 113,11 214,66 302,91 171,12

exposure from ED 16,20 3,79 0 320,00 19,35 41,33 76,83 32,71

total exposure 171,44 101,85 0 2.361,57 195,83 373,18 534,73 237,54

exposure from ED 17,79 7,58 0 211,13 20,00 41,76 101,39 29,96

total exposure 143,15 78,57 0 2.110,16 163,02 334,09 463,51 220,24

exposure from ED 12,60 2,66 0 224,89 11,09 38,60 57,98 25,98

total exposure 95,92 41,00 0 2.060,74 111,10 254,59 363,82 161,53

exposure from ED 13,63 2,67 0 296,07 11,13 39,45 58,70 29,87

total exposure 122,15 46,77 0 2.228,34 129,03 302,69 461,71 227,97

exposure from ED 22,29 7,57 0 304,00 19,63 66,69 123,45 40,90

total exposure 156,48 63,48 0 2.190,67 165,13 323,28 672,59 288,98

France

Germany

Greece

Hungary

Italy

Netherlands

Austria

Belgium

Cyprus

Czech Republic

Finland

Poland

Romania

Spain

Sweden

United Kingdom

12,1%

6,9%

13,2%

9,4%

12,4%

13,1%

13,5%

9,5%

9,7%

11,4%

9,1%

9,8%

10,2%

9,7%

11,2%

14,2%



drinks






Table 54: Adolescents – Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values

in mg/kg bw/day) - Total respondents (Sample size: 31.070)


ED/Total

exposure from ED 0,28 0,12 0 4,94 0,31 0,75 1,33 0,52

total exposure 2,14 1,17 0 46,47 2,48 4,62 7,00 3,42

exposure from ED 0,44 0,14 0 3,97 0,43 1,23 3,04 0,82

total exposure 4,19 2,37 0 25,78 4,28 15,09 19,12 5,74

exposure from ED 0,18 0,04 0 5,41 0,16 0,45 0,77 0,45

total exposure 1,88 0,94 0 50,17 2,06 4,42 6,71 3,14

exposure from ED 0,25 0,11 0 3,77 0,28 0,66 1,00 0,42

total exposure 2,17 1,32 0 43,47 2,65 4,90 7,15 2,88

exposure from ED 0,23 0,05 0 4,92 0,19 0,61 1,20 0,49

total exposure 2,56 1,26 0 40,89 3,39 6,30 8,22 3,87

exposure from ED 0,23 0,06 0 5,02 0,18 0,61 0,97 0,48

total exposure 2,42 1,51 0 20,02 3,26 5,53 8,11 2,79

exposure from ED 0,22 0,05 0 6,95 0,20 0,62 1,04 0,48

total exposure 2,18 1,03 0 49,54 2,50 5,10 7,83 3,68

exposure from ED 0,14 0,00 0 4,48 0,12 0,34 0,61 0,40

total exposure 1,47 0,69 0 42,24 1,63 3,58 5,51 2,44

exposure from ED 0,29 0,11 0 5,61 0,34 0,77 1,23 0,53

total exposure 2,46 1,40 0 42,85 3,08 5,62 8,39 3,32

exposure from ED 0,14 0,04 0 4,26 0,14 0,37 0,67 0,34

total exposure 2,15 1,19 0 47,41 2,62 4,88 7,16 3,16

exposure from ED 0,24 0,06 0 3,59 0,20 0,67 1,09 0,46

total exposure 1,82 1,05 0 45,87 2,14 3,93 5,63 3,01

exposure from ED 0,26 0,07 0 6,40 0,25 0,69 1,07 0,53

total exposure 2,79 1,68 0 48,14 3,24 6,26 9,04 3,76

exposure from ED 0,32 0,11 0 4,69 0,39 0,89 1,43 0,55

total exposure 2,63 1,45 0 44,56 3,09 5,99 8,67 3,91

exposure from ED 0,21 0,05 0 4,59 0,20 0,59 1,02 0,43

total exposure 1,62 0,71 0 29,63 1,99 4,31 6,09 2,53

exposure from ED 0,20 0,05 0 4,14 0,16 0,52 1,02 0,44

total exposure 1,86 0,72 0 47,00 1,97 4,72 6,83 3,54

exposure from ED 0,39 0,12 0 4,83 0,40 1,23 2,02 0,73

total exposure 2,64 1,18 0 31,77 2,95 6,18 10,33 4,26

Austria

Greece

Hungary

Italy

Netherlands

Poland

Romania

Belgium

Cyprus

Czech Republic

Finland

France

Germany

Spain

Sweden

United Kingdom

13,2%

10,6%

9,3%

11,3%

8,8%

9,4%

12,2%

13,2%

10,9%

14,9%

10,0%

9,4%

11,9%

6,7%

13,1%

9,2%



drinks







in the 16 MS

covered by the survey (values in mg/day) – ED Consumers (Sample size: 20.713)


ED/Total

exposure from ED 22,05 8,00 1,07 320,00 20,00 57,78 105,76 33,49

total exposure 140,77 80,77 2,58 2.233,65 159,37 296,11 438,42 207,41

exposure from ED 29,55 11,18 2,51 218,50 27,83 112,90 152,49 46,17

total exposure 304,22 178,24 5,82 2.062,77 334,70 1015,87 1301,61 405,93

exposure from ED 19,64 8,20 0,26 340,70 20,08 43,21 75,70 35,57

total exposure 153,11 82,25 1,36 2.116,23 175,13 329,22 519,11 227,52

exposure from ED 18,88 7,97 0,10 210,27 19,92 41,36 79,74 27,80

total exposure 148,73 91,10 2,56 1.959,07 181,31 328,25 445,48 186,23

exposure from ED 23,58 8,00 0,11 227,20 21,06 66,02 106,67 38,97

total exposure 210,24 118,32 1,60 2.229,59 282,76 467,21 594,25 287,96

exposure from ED 21,07 8,00 0,11 326,00 20,00 45,23 80,75 36,55

total exposure 172,36 110,41 2,34 1.281,04 213,29 415,17 580,33 190,08

exposure from ED 21,90 8,00 0,79 305,60 20,00 55,48 81,65 34,65

total exposure 173,20 88,68 2,50 2.229,14 205,20 400,95 629,39 257,82

exposure from ED 19,33 7,96 0,10 314,00 19,63 41,20 80,25 37,69

total exposure 143,20 75,57 2,08 2.153,32 158,92 312,80 551,38 213,67

exposure from ED 23,74 8,00 0,26 320,00 26,87 56,95 105,07 37,09

total exposure 176,18 104,63 2,50 2.204,71 217,11 395,24 546,67 228,89

exposure from ED 15,97 7,94 0,02 226,49 19,76 40,91 58,39 26,38

total exposure 172,45 102,45 2,13 2.395,54 214,07 367,92 503,06 232,94

exposure from ED 19,57 7,97 0,81 317,13 20,00 41,33 79,36 30,59

total exposure 121,02 70,59 2,63 2.189,21 138,09 237,99 348,36 199,48

exposure from ED 22,24 8,00 0,01 320,00 20,00 56,00 104,57 36,53

total exposure 198,81 118,71 2,43 2.361,57 232,73 416,74 629,56 259,30

exposure from ED 25,51 9,24 0,11 211,13 39,14 76,26 106,66 33,03

total exposure 183,76 110,91 2,67 2.110,16 215,77 391,80 580,77 248,81

exposure from ED 20,36 8,00 0,10 224,89 19,96 56,31 80,48 30,54

total exposure 127,60 63,63 0,62 2.060,74 150,93 307,36 432,39 188,00

exposure from ED 19,79 7,92 0,21 296,07 19,84 42,96 90,12 34,26

total exposure 155,78 70,57 0,65 2.228,34 184,15 343,83 553,15 258,15

exposure from ED 32,11 11,22 2,07 304,00 39,00 99,31 145,67 45,77

total exposure 189,86 91,83 2,07 2.190,67 209,13 422,31 796,85 309,77

Austria

Belgium

Cyprus

Czech Republic

Finland

France

Romania

Spain

Sweden

United Kingdom

Germany

Greece

Hungary

Italy

Netherlands

Poland

11,2%

12,2%

12,6%

13,5%

13,5%

9,3%

15,7%

9,7%

12,8%

12,7%

16,2%

11,2%

13,9%

16,0%

12,7%

16,9%


(a) Including ED


drinks






In table 56, data on exposure to caffeine are expressed in mg/kg bw/day. The highest exposure to

caffeine deriving from ED was reported for United Kingdom’s consumers (0,57 mg/kg bw/day), while

the lowest value was registered in Italy (0,26 mg/kg bw/day).


in the 16 MS

covered by the survey (values in mg/kg bw/day) – ED Consumers (Sample size: 20.713)


ED/Total

exposure from ED 0,38 0,15 0,02 4,94 0,38 0,91 1,65 0,58

total exposure 2,41 1,40 0,03 46,47 2,76 5,08 7,42 3,62

exposure from ED 0,52 0,18 0,02 3,97 0,45 1,95 3,05 0,87

total exposure 4,80 2,93 0,10 25,78 4,66 15,76 20,06 6,00

exposure from ED 0,33 0,15 0,00 5,41 0,35 0,75 1,31 0,57

total exposure 2,64 1,43 0,02 50,17 2,90 5,95 9,02 3,93

exposure from ED 0,30 0,13 0,00 3,77 0,33 0,74 1,18 0,44

total exposure 2,39 1,47 0,03 43,47 2,92 5,28 7,46 3,01

exposure from ED 0,35 0,13 0,00 4,92 0,36 0,95 1,61 0,57

total exposure 3,16 1,81 0,01 40,89 4,17 7,06 9,63 4,21

exposure from ED 0,35 0,15 0,00 5,02 0,36 0,81 1,44 0,56

total exposure 2,90 1,91 0,04 20,02 3,74 6,26 9,24 3,10

exposure from ED 0,36 0,16 0,02 6,95 0,39 0,92 1,34 0,57

total exposure 2,84 1,51 0,04 49,54 3,32 6,42 10,55 4,27

exposure from ED 0,29 0,12 0,00 4,48 0,27 0,63 1,04 0,54

total exposure 2,14 1,18 0,03 42,24 2,39 4,89 7,79 3,01

exposure from ED 0,38 0,15 0,01 5,61 0,42 0,90 1,46 0,57

total exposure 2,82 1,72 0,02 42,85 3,46 6,45 9,21 3,54

exposure from ED 0,26 0,12 0,00 4,26 0,28 0,62 0,98 0,42

total exposure 2,76 1,68 0,03 47,41 3,44 6,17 8,37 3,57

exposure from ED 0,36 0,16 0,01 3,59 0,41 0,89 1,44 0,52

total exposure 2,20 1,31 0,05 45,87 2,58 4,47 6,43 3,47

exposure from ED 0,35 0,15 0,00 6,40 0,37 0,84 1,44 0,59

total exposure 3,20 1,91 0,02 48,14 3,76 7,16 10,28 4,13

exposure from ED 0,46 0,19 0,00 4,69 0,62 1,24 1,85 0,60

total exposure 3,33 2,09 0,05 44,56 4,07 7,33 10,28 4,40

exposure from ED 0,35 0,16 0,00 4,59 0,40 0,89 1,34 0,51

total exposure 2,13 1,11 0,01 29,63 2,56 5,22 7,47 2,90

exposure from ED 0,30 0,11 0,00 4,14 0,30 0,75 1,43 0,50

total exposure 2,36 1,08 0,01 47,00 2,58 5,54 8,71 4,04

exposure from ED 0,57 0,21 0,02 4,83 0,63 1,59 2,33 0,82

total exposure 3,21 1,64 0,02 31,77 3,55 7,23 13,36 4,62

Finland

France

Germany

Greece

Austria

Belgium

Sweden

United Kingdom

Hungary

Italy

Netherlands

Poland

Romania

Spain

Cyprus

Czech Republic

15,7%

10,9%

12,5%

17,7%

13,3%

9,3%

16,3%

11,0%

13,8%

16,2%

12,6%

12,6%

11,0%

11,9%

12,7%

13,4%


(a) Including ED


drinks






Figure 45 focuses on the average values of ED contribution to total caffeine exposure for the 16 MS

covered by the study, considering both total respondents and ED consumers. The relative contribution

from ED in total respondents varies from around 6% in Greece to 14% in Austria, while referring only

to ED consumers the relative contribution varies from 9% in Italy to around 17% in the UK.

Figure 45: Adolescents - ED contribution to total daily exposure to caffeine (%) by country

(Sample size: 31.070 – Total respondents; 20.713 –ED consumers)



drinks






Also in the case of adolescents, as already seen for adults (§ 3.3.2.5), differences in the total exposure

to active ingredients other than caffeine (i.e. taurine and D-glucurono-y-lactone) among total

respondents, ED consumers, and high chronic consumers were higher than the differences already

described for the case of caffeine.

Exposure to taurine from ED varied from an average value of 192 mg/day in total respondents, to

around 283 mg/day in ED consumers, till around 924 in high chronic consumers (tables 57 and 58).

Table 57: Adolescents – Chronic exposure to taurine from ED (values in mg/day)

(Sample size: 31.070 – Total respondents; 20.713 - ED consumers; 2.077 – High chronic consumers)



ED consumers 283,88 100,00 0,00 4000 250,00 733,67 1333,33 465,05

High chronic consumers 924,34 733,67 0,00 4000 1333,33 2000,00 2366,67 795,41


Table 58: Adolescents – Chronic exposure to taurine from ED (values in mg/kg bw/day)




ED consumers 4,63 1,82 0,00 90,91 4,90 11,48 18,81 7,56



drinks






With regards to differences among MS, it is worth noting that:

for total respondents, average value of exposure to taurine ranged from around 100 mg/day

(corresponding to 1,62 mg/kg bw/day) in Italy, to around 284 mg/day (corresponding to 5

mg/kg bw/day) in United Kingdom (tables 58 and 59);

for ED consumers the highest value in absolute terms – around 410 mg/day in the United

Kingdom (corresponding to around 7mg/kg bw/day) – was more than twice the lowest one

(around 180 mg/day corresponding to around 3 mg/kg bw/day in Italy: tables 60 and 61).

With regards to differences between genders, exposure was around 345 mg/day in male ED

consumers, versus around 213 mg/day in female ones.

Table 59: Adolescents – Chronic exposure to taurine from ED in the 16 MS covered by the survey (values

in mg/day) – Total respondents (Sample size: 31.070)


Austria 178,93 64,55 0 3075,00 180,63 516,67 833,33 349,48

Belgium 302,22 85,00 0 2840,00 250,00 960,00 1893,33 564,87

Cyprus 120,32 13,33 0 4000,00 100,00 250,00 516,67 327,04

Czech Republic 191,02 100,00 0 2666,67 250,00 516,67 833,33 332,58

Finland 191,75 33,33 0 2840,00 142,00 500,00 1033,33 420,09

France 157,14 33,33 0 4000,00 100,00 362,92 733,67 372,85

Germany 165,07 33,33 0 4000,00 142,00 500,00 733,67 368,19

Greece 106,66 0,00 0 4000,00 100,00 250,00 516,67 326,05

Hungary 229,50 100,00 0 4000,00 250,00 516,67 1000,00 433,88

Italy 100,98 13,33 0 2840,00 100,00 250,00 516,67 260,87

Netherlands 160,62 33,33 0 3750,00 100,00 516,67 733,67 332,94

Poland 195,81 47,33 0 4000,00 200,00 516,67 800,00 405,17

Romania 209,31 40,00 0 2666,67 250,00 516,67 1183,33 369,52

Spain 148,54 33,33 0 2840,00 142,00 355,00 733,67 324,06

Sweden 163,04 33,33 0 2840,00 142,00 465,00 733,67 358,17



drinks







in mg/kg bw/day) - Total respondents (Sample size: 31.070)


Austria 3,06 1,02 0 61,45 3,00 8,13 14,16 6,05

Belgium 5,35 1,43 0 51,64 4,46 15,40 38,77 10,64

Cyprus 2,05 0,27 0 63,11 1,87 5,46 8,88 5,39

Czech Republic 3,03 1,22 0 47,33 3,38 8,34 12,55 5,31

Finland 2,83 0,61 0 61,74 2,37 7,69 15,11 6,18

France 2,57 0,62 0 61,54 2,13 6,78 10,78 5,79

Germany 2,73 0,61 0 90,91 2,50 7,72 13,34 6,13

Greece 1,58 0,00 0 54,79 1,35 3,95 7,38 4,64

Hungary 3,63 1,31 0 72,73 4,17 9,41 15,43 6,73

Italy 1,62 0,24 0 53,33 1,54 4,24 7,62 4,11

Netherlands 2,94 0,74 0 47,33 2,50 8,08 13,34 5,75

Poland 3,09 0,75 0 80,00 2,96 7,96 13,34 6,49

Romania 3,76 0,95 0 59,26 4,44 10,51 17,47 6,76

Spain 2,52 0,56 0 57,96 2,22 7,10 12,34 5,41

Sweden 2,43 0,60 0 51,64 2,00 6,42 11,29 5,26

United Kingdom 5,03 1,52 0 63,49 5,00 15,78 26,04 9,42



in mg/day) – ED Consumers (Sample size: 20.713)


Austria 238,76 100,00 3 3075,00 250,00 516,67 1033,33 385,63

Belgium 355,24 130,68 10 2840,00 253,69 1413,33 1904,00 597,40

Cyprus 228,14 100,00 0 4000,00 250,00 516,67 733,67 422,26

Czech Republic 233,83 100,00 0 2666,67 250,00 516,67 1000,00 354,10

Finland 295,75 100,00 0 2840,00 250,00 833,33 1333,33 491,42

France 238,39 100,00 1 4000,00 250,00 516,67 944,94 437,78

Germany 274,17 100,00 0 4000,00 250,00 733,67 1033,33 441,98

Greece 220,84 100,00 0 4000,00 225,00 516,67 800,00 441,62

Hungary 293,08 100,00 0 4000,00 250,00 733,33 1333,33 470,94

Italy 180,40 100,00 0 2840,00 173,59 512,60 733,67 327,49

Netherlands 241,04 100,00 0 3750,00 250,00 516,67 1000,00 383,44

Poland 268,79 100,00 0 4000,00 250,00 700,00 1183,33 453,59

Romania 300,26 100,00 1 2666,67 355,00 733,67 1333,33 410,64

Spain 240,07 100,00 0 2840,00 250,00 718,00 1033,33 384,44

Sweden 236,69 100,00 0 2840,00 250,00 516,67 1033,33 410,91

United Kingdom 409,73 142,00 6 4000,00 500,00 1230,67 1893,33 590,05



drinks







in mg/kg bw/day) – ED Consumers (Sample size: 20.713)


Austria 4,08 1,67 0 61,45 4,31 9,94 17,56 6,68

Belgium 6,29 2,18 0 51,64 5,12 24,27 39,41 11,29

Cyprus 3,89 1,79 0 63,11 4,02 8,63 13,54 6,93

Czech Republic 3,71 1,67 0 47,33 4,17 9,39 14,44 5,65

Finland 4,37 1,56 0 61,74 4,55 11,83 20,11 7,22

France 3,90 1,72 0 61,54 4,31 9,39 14,71 6,76

Germany 4,54 1,92 0 90,91 5,00 11,47 17,05 7,36

Greece 3,27 1,43 0 54,79 3,08 7,38 11,81 6,24

Hungary 4,63 1,82 0 72,73 5,10 11,23 18,50 7,30

Italy 2,89 1,31 0 53,33 2,91 6,88 11,48 5,15

Netherlands 4,41 1,95 0 47,33 5,04 10,86 18,38 6,57

Poland 4,24 1,72 0 80,00 4,55 10,33 16,67 7,28

Romania 5,40 2,22 0 59,26 7,40 14,54 21,10 7,53

Spain 4,07 1,79 0 57,96 4,55 11,03 16,47 6,40

Sweden 3,53 1,42 0 51,64 3,52 8,69 15,54 6,03

United Kingdom 7,25 2,63 0 63,49 7,95 21,21 30,30 10,58



drinks






Contribution from ED to chronic exposure to D-glucurono-y-lactone in high chronic consumers was

more than three times the average value for all ED consumers, and over four times the average value

for total respondents (tables 63 and 64).

Table 63: Adolescents – Chronic exposure to D-glucurono-y-lactone from ED (values in mg/day)



Total respondents 67,72 14,00 0 2400 60,00 159,75 310 167,29

ED consumers 100,14 32,68 0 2400 105,00 248,00 420 195,09

High chronic consumers 311,60 156,49 0 2400 425,00 875,00 1136 368,58 Source: Survey Nomisma-Areté for EFSA

Table 64: Adolescents – Chronic exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/day)




ED consumers 1,65 0,55 0 43,64 1,67 4,13 6,77 3,18



drinks






Focussing on the differences registered among MS, with reference to the chronic exposure to D-

glucurono-y-lactone, it can be highlighted that:

with regards to total respondents, average exposure to D-glucurono-y-lactone ranged from

around 41 mg/day (0,60 mg/kg bw/day) in Greece, to around 104,5 mg/day (1,91 mg/kg

bw/day) in Romania49

(tables 65 and 66);

with regards to ED contribution in ED consumers, values varied from around 51 mg/day in

Czech Republic to around 150 mg/day in Romania;

Similarly to what observed for taurine, some differences also appeared between genders: ED

contribution to total exposure was around 117 mg/day for male ED consumers, versus around 80

mg/day for female ones.

Table 65: Adolescents – Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the



Austria 95,94 24,00 0 2400,00 85,20 279,00 440,20 196,48

Belgium 105,21 40,00 0 1136,00 120,00 213,00 662,00 208,98

Cyprus 46,04 0,00 0 2160,00 30,00 105,00 191,70 149,52

Czech Republic 41,73 6,00 0 1200,00 30,00 105,00 205,37 112,40

Finland 59,04 6,39 0 1600,00 33,00 139,52 300,00 168,77

France 62,59 15,06 0 2400,00 57,00 150,00 265,01 163,55

Germany 54,39 6,00 0 1695,48 42,00 149,19 270,69 151,08

Greece 40,86 0,00 0 1704,00 20,08 80,94 150,00 151,00

Hungary 41,51 4,00 0 2160,00 26,25 93,00 186,00 132,10

Italy 46,05 5,63 0 1704,00 42,00 120,00 213,00 127,48

Netherlands 69,85 19,00 0 1831,25 60,00 186,00 310,00 156,82

Poland 51,84 8,00 0 2400,00 42,00 124,00 253,65 143,11

Romania 104,45 20,00 0 1600,00 136,25 310,00 500,00 191,94

Spain 46,10 4,92 0 1704,00 36,00 124,72 217,00 126,36

Sweden 67,39 16,60 0 1600,00 59,64 155,00 310,00 162,44

United Kingdom 81,08 15,00 0 1600,00 66,56 215,00 397,14 181,62


49

The highest chronic exposure to glucuronolactone on total respondents was observed in Belgium (105 mg/day

corresponding to 1,95 mg/kg bw/day). Nevertheless, due do the small dimension of the sample for Belgium, for

which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure.


drinks









Austria 1,64 0,44 0 36,86 1,42 4,46 7,08 3,34

Belgium 1,95 0,54 0 24,70 1,76 3,60 11,82 4,42

Cyprus 0,77 0,00 0 37,87 0,54 1,88 3,48 2,42

Czech Republic 0,66 0,10 0 22,72 0,50 1,61 3,13 1,80

Finland 0,87 0,10 0 33,34 0,51 2,06 4,25 2,50

France 1,01 0,26 0 36,92 0,97 2,72 4,57 2,43

Germany 0,89 0,10 0 29,43 0,67 2,45 4,44 2,30

Greece 0,60 0,00 0 27,61 0,36 1,24 2,50 2,06

Hungary 0,64 0,06 0 27,88 0,43 1,50 3,10 1,95

Italy 0,74 0,09 0 30,98 0,65 1,90 3,30 2,00

Netherlands 1,25 0,33 0 21,82 1,13 3,56 5,64 2,50

Poland 0,81 0,13 0 43,64 0,65 2,00 3,88 2,26

Romania 1,91 0,43 0 35,56 2,28 5,58 9,10 3,60

Spain 0,78 0,08 0 26,08 0,60 2,12 3,78 2,08

Sweden 1,01 0,25 0 23,24 0,86 2,54 5,21 2,37

United Kingdom 1,44 0,27 0 29,09 1,33 3,68 7,53 3,23



survey (values in mg/day) – ED Consumers (Sample size: 20.713)


Austria 128,02 56,70 0 2400,00 135,00 310,00 567,00 217,74

Belgium 123,67 48,00 0 1136,00 129,78 247,44 817,76 221,69

Cyprus 87,30 28,97 0 2160,00 75,00 186,00 328,14 197,00

Czech Republic 51,09 14,00 0 1200,00 45,00 127,20 248,00 122,42

Finland 91,06 20,00 0 1600,00 68,20 226,84 440,20 202,56

France 94,96 42,00 0 2400,00 93,00 217,00 374,17 193,73

Germany 90,33 30,00 0 1695,48 85,20 240,00 358,43 186,24

Greece 84,61 22,68 0 1704,00 60,00 150,00 310,00 208,66

Hungary 53,01 10,00 0 2160,00 40,30 124,00 248,00 147,23

Italy 82,27 28,40 0 1704,00 68,62 185,82 310,00 161,42

Netherlands 104,83 48,00 0 1831,25 132,47 279,00 419,46 182,35

Poland 71,16 18,00 0 2400,00 60,00 174,69 308,40 163,53

Romania 149,83 60,00 0 1600,00 170,50 323,75 704,32 214,63

Spain 74,50 21,30 0 1704,00 60,86 175,51 310,00 153,94

Sweden 97,83 30,00 0 1600,00 90,00 270,75 426,44 187,99

United Kingdom 116,78 45,00 0 1600,00 120,00 310,00 528,24 208,24



drinks






The highest contribution from ED to D-glucurono-y-lactone exposure was recorded in Romania (2,74

mg/kg bw/day, against an average value of 1,65 mg/day/kg for total ED consumers).


survey (values in mg/kg bw/day) – ED Consumers (Sample size: 20.713)


Austria 2,18 0,93 0 36,86 2,32 5,52 8,82 3,70

Belgium 2,29 0,86 0 24,70 2,19 3,95 15,82 4,71

Cyprus 1,46 0,48 0 37,87 1,26 3,40 5,49 3,18

Czech Republic 0,81 0,20 0 22,72 0,69 2,02 3,70 1,96

Finland 1,34 0,34 0 33,34 1,09 3,43 6,55 3,00

France 1,54 0,65 0 36,92 1,63 3,67 5,64 2,85

Germany 1,47 0,47 0 29,43 1,50 4,01 6,12 2,81

Greece 1,24 0,39 0 27,61 1,07 2,59 4,43 2,83

Hungary 0,82 0,17 0 27,88 0,64 2,02 3,82 2,17

Italy 1,32 0,49 0 30,98 1,25 3,00 5,17 2,53

Netherlands 1,88 0,86 0 21,82 2,34 4,98 7,71 2,87

Poland 1,12 0,30 0 43,64 0,99 2,72 4,94 2,58

Romania 2,74 1,15 0 35,56 3,49 6,77 10,79 4,04

Spain 1,27 0,39 0 26,08 1,14 3,26 5,46 2,53

Sweden 1,46 0,45 0 23,24 1,32 3,88 6,52 2,73



drinks






3.3.3.5. ED acute consumption: analysis on high acute consumers

As previously seen for adults (§ 3.3.2.2), also in the case of adolescents data were elaborated

according to a specifically defined methodology, in order to identify “high acute” consumers (§ 2.3.5).

High acute consumers represented around 12% of total ED consumers; prevalence of high acute

consumers ranged from 7% of total ED consumers in Romania and the Netherlands to 17% in

Germany and Sweden50

(figure 46).

Figure 46: Adolescents – Prevalence of high acute ED consumption by country (Sample size: 20.713 – ED

consumers)


Prevalence of high acute consumption was slightly higher in the 15-18 years age group towards the

younger one (12% and 11% respectively). It reached a share of 23% among smokers (ED consumers

who declare to regularly smoke), while among non-smoker consumers it was around 9%.

Around 54% of high acute consumers declared to have consumed more than 4 cans of ED in a single

session of consumption over the last year. About 50% of high acute consumers among the adolescents

involved in the survey have drunk 4 or more cocktails of ED and alcohol in a single session. Then,

22% of high acute consumers declared of having drunk more than 4 cans of ED during sport activities

(figure 47).

50

The highest prevalence of high acute ED consumption was observed in Belgium (26%). Nevertheless, due do

the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was

preferred not to cite this figure.


drinks






Figure 47: Adolescents - ED consumption: high acute and total consumers (Sample size: 20.713 – ED

consumers; 2.170 – High acute consumers; 11.034 – ED consumers drinking ED and alcohol; 16.055 - ED

consumers practicing sport activities)


drinks








drinks






3.3.3.6. Exposure to active ingredients in high acute adolescent consumers

Tables 69 and 70 illustrate the average values of acute exposure to caffeine of total respondents, ED

consumers and high acute consumers. Values in mg/single session varied from around 119 mg for total

respondents, to 175 for ED consumers till around 458 for high acute consumers.

Table 69: Adolescents – Acute exposure to caffeine from ED (values in mg/single session)

(Sample size: 31.070 – Total respondents; 20.713 - ED consumers; 2.170 – High acute consumers)


Total respondents 118,63 79,84 0,00 1.110,25 159,96 316,10 397,56 135,76

ED consumers 175,62 149,00 0,32 1.110,25 229,80 340,80 449,51 131,45

High acute consumers 457,98 426,67 197,50 1.110,25 546,26 614,85 760,00 119,59 Source: Survey Nomisma-Areté for EFSA

Table 70: Adolescents – Acute exposure to caffeine from ED (values in mg/kg bw/single session)

(Sample size: 31.070 – Total respondents; 20.713- ED consumers; 2.170 – High acute consumers)



ED consumers 2,92 2,13 0,00 17,78 3,67 5,82 7,24 2,16

High acute consumers 7,21 6,76 2,06 17,78 8,66 10,83 11,87 2,39 Source: Survey Nomisma-Areté for EFSA

Also with respect to acute exposure to caffeine from ED, some differences were observed at MS level:

as for total respondents, acute exposure to caffeine ranged from around 83 mg/single session

(1,32 mg/kg bw/single session) in the case of Greece, to nearly 146 mg/single session (2,34

mg/kg bw/single session) in the case of Czech Republic51

(tables 71 and 72);

as for ED consumers, the highest value of acute exposure to caffeine was registered in

Germany52

, with around 202 mg/single session (3,44 mg/kg bw/single session) Belgium, with

around 226 mg/single session (3,77 mg/kg bw/single session) (tables 73 and 74).

As for differences among age groups, the average value of acute exposure to caffeine for total

respondents was around 130 mg/single session in adolescents aged 15-18, versus around 92 mg/single

session in the age group between 10 and 14 years;

With regards to differences between genders, male respondents presented an average acute exposure to

caffeine equal to about 140 mg/single session, against 100 mg/single session registered for female

respondents.

51

The highest acute exposure to caffeine on total respondents was observed in Belgium (192 mg/single session

corresponding to 3,21 mg/kg bw/single session). Nevertheless, due do the small dimension of the sample for

Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. 52

The highest acute exposure to caffeine on ED consumers was observed in Belgium (226 mg/single session and

3,77 mg/kg bw/single session). Nevertheless, due do the small dimension of the sample for Belgium, for which

the sampling error of estimates exceeds 5%, it was preferred not to cite this figure.


drinks






Table 71: Adolescents – Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in



Austria 143,38 80,82 0 800,00 237,08 337,93 400,00 133,05

Belgium 192,38 159,35 0 779,38 240,00 449,88 540,75 171,77

Cyprus 99,15 76,43 0 851,75 160,85 309,80 352,90 133,37

Czech Republic 145,96 109,66 0 805,00 220,17 320,24 398,59 130,75

Finland 113,50 80,00 0 800,00 159,50 320,00 400,00 144,17

France 105,81 79,84 0 652,00 159,19 239,30 338,24 118,60

Germany 121,88 77,53 0 920,05 159,89 322,44 447,21 155,29

Greece 82,84 0,00 0 785,00 113,60 237,53 343,95 122,43

Hungary 136,65 80,00 0 800,00 160,01 320,00 400,00 130,66

Italy 87,36 79,03 0 799,84 153,44 236,29 329,87 113,11

Netherlands 105,56 79,55 0 781,15 158,35 240,00 320,00 117,32

Poland 110,44 80,00 0 800,00 158,38 240,00 340,80 117,49

Romania 103,67 79,68 0 800,00 156,13 240,00 323,88 115,82

Spain 97,02 78,09 0 822,50 153,15 237,08 329,28 119,35

Sweden 138,36 80,00 0 1.110,25 224,87 339,42 449,87 153,31



drinks






Table 72: Adolescents - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in



Austria 2,47 1,78 0,00 15,42 3,75 5,85 7,01 2,32

Belgium 3,21 2,37 0,00 11,58 4,90 7,88 9,59 2,97

Cyprus 1,73 1,12 0,00 13,74 2,73 4,97 6,27 2,31

Czech Republic 2,34 1,75 0,00 16,34 3,24 5,16 6,45 2,09

Finland 1,71 1,33 0,00 16,00 2,27 4,27 6,15 2,14

France 1,81 1,43 0,00 11,24 2,67 4,41 5,80 2,01

Germany 2,07 1,35 0,00 15,35 3,05 5,78 7,59 2,63

Greece 1,31 0,00 0,00 14,88 1,83 3,81 5,20 1,96

Hungary 2,23 1,54 0,00 17,78 3,14 5,31 6,68 2,17

Italy 1,44 1,13 0,00 17,77 2,10 3,74 5,23 1,90

Netherlands 1,98 1,51 0,00 16,76 2,86 5,17 6,38 2,22

Poland 1,79 1,38 0,00 15,99 2,35 4,25 5,62 1,92

Romania 1,92 1,59 0,00 17,59 2,61 4,64 6,27 2,14

Spain 1,69 1,33 0,00 16,35 2,34 4,45 5,78 2,07

Sweden 2,07 1,43 0,00 11,88 3,19 5,33 6,88 2,24





Austria 191,32 159,68 32,00 800,00 240,00 397,20 400,00 120,20

Belgium 226,13 160,00 67,57 779,38 340,75 454,36 548,73 164,33

Cyprus 188,02 159,96 7,72 851,75 245,91 349,80 435,64 130,46

Czech Republic 178,67 155,60 3,07 805,00 235,13 335,90 400,78 122,80

Finland 175,06 113,60 3,20 800,00 164,50 340,80 490,80 145,89

France 160,52 113,14 3,23 652,00 224,43 318,70 397,53 112,04

Germany 202,44 153,89 21,00 920,05 302,70 426,73 546,70 154,10

Greece 171,53 116,62 3,07 785,00 223,35 359,67 445,08 125,80

Hungary 174,51 154,80 3,20 800,00 236,10 375,00 400,00 123,26

Italy 156,06 112,22 0,61 799,84 165,85 319,91 398,38 110,15

Netherlands 158,41 113,60 16,17 781,15 217,26 316,10 394,28 110,82

Poland 151,61 85,66 0,32 800,00 160,00 320,00 395,13 112,72

Romania 148,72 85,66 3,20 800,00 160,00 314,22 383,32 112,00

Spain 156,81 109,91 3,07 822,50 217,84 319,83 397,93 116,81

Sweden 200,86 158,38 6,37 1.110,25 249,00 400,00 513,98 146,85



drinks









Austria 3,30 2,75 0,53 15,42 4,53 6,35 7,27 2,11

Belgium 3,77 2,75 0,68 11,58 5,65 8,67 10,07 2,87

Cyprus 3,27 2,63 0,12 13,74 4,34 6,17 7,59 2,25

Czech Republic 2,86 2,31 0,08 16,34 3,69 5,64 6,90 1,96

Finland 2,64 1,88 0,05 16,00 2,91 5,34 7,38 2,15

France 2,74 2,00 0,06 11,24 3,54 5,14 6,32 1,89

Germany 3,44 2,57 0,42 15,35 4,52 6,82 9,20 2,61

Greece 2,71 1,92 0,06 14,88 3,42 5,24 6,88 2,04

Hungary 2,85 2,13 0,07 17,78 3,66 5,85 7,11 2,06

Italy 2,57 1,85 0,01 17,77 3,16 4,99 6,40 1,87

Netherlands 2,97 2,21 0,16 16,76 3,73 5,87 7,23 2,11

Poland 2,45 1,67 0,00 15,99 3,02 4,88 6,28 1,85

Romania 2,75 1,88 0,06 17,59 3,33 5,34 7,05 2,07

Spain 2,73 1,93 0,05 16,35 3,41 5,33 6,77 2,03

Sweden 3,00 2,32 0,14 11,88 4,06 6,06 7,51 2,12


Acute exposure to taurine from ED in high acute consumers was more than two times the average

value for all ED consumers, and over four times the average value for total respondents (tables 75 and

76).

Table 75: Adolescents – Acute exposure to taurine from ED (values in mg/single session)



Total respondents 1.414,48 1.000 0 10.000 2.000 4.000 5.000 1.722,44

ED consumers 2.094,16 1.420 0 10.000 2.840 4.260 5.680 1.723,13

High acute consumers 5.821,87 5.396 0 10.000 7.100 8.000 10.000 1.577,68 Source: Survey Nomisma-Areté for EFSA Table 76: Adolescents – Acute exposure to taurine from ED (values in mg/kg bw/single session)




ED consumers 34,70 23,81 0 222,22 44,44 72,73 90,91 28,35


Tables from 77 to 80 provides data on acute exposure to taurine from ED (in mg/single session and

mg/kg bw/single session) in the 16 MS considered in the study (total respondents and ED

consumers).Concerning differences among MS, the highest values of acute exposure to taurine for

total respondents (tables 77 and 78) were registered in Czech Republic53

with 1.791 mg/single session

(28,62 mg/kg bw/single session).

53

The highest acute exposure to taurine on total respondents was observed in Belgium (2.222 mg/single session


Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure.


drinks






Table 77: Adolescents - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 1.558,12 1.000,00 0 10.000,00 2.167,50 4.000 5.000 1.577,45

Belgium 2.222,25 1.500,00 0 9.812,50 3.000,00 5.680 7.100 2.183,24

Cyprus 1.155,69 375,32 0 10.000,00 2.000,00 3.000 4.260 1.619,02

Czech Republic 1.790,56 1.000,00 0 10.000,00 2.840,00 4.000 5.000 1.692,00

Finland 1.414,45 1.000,00 0 10.000,00 2.000,00 4.000 5.000 1.822,57

France 1.202,62 1.000,00 0 8.000,00 2.000,00 3.000 4.169 1.488,84

Germany 1.514,17 1.000,00 0 10.000,00 2.000,00 4.025 5.680 2.000,93

Greece 942,75 0,00 0 10.000,00 1.199,94 2.840 4.234 1.476,85

Hungary 1.653,05 1.000,00 0 10.000,00 2.000,00 4.000 5.000 1.673,26

Italy 952,01 375,32 0 10.000,00 1.200,00 2.840 4.000 1.378,07

Netherlands 1.297,04 1.000,00 0 10.000,00 2.000,00 3.000 4.000 1.476,73

Poland 1.322,45 1.000,00 0 10.000,00 2.000,00 3.000 4.260 1.460,94

Romania 1.192,18 1.000,00 0 10.000,00 2.000,00 3.000 4.000 1.456,53

Spain 1.119,39 992,50 0 10.000,00 1.420,00 3.000 4.260 1.502,39

Sweden 1.685,33 1.000,00 0 10.000,00 2.840,00 4.260 5.680 1.902,17

United Kingdom 1.590,74 1.000,00 0 10.000,00 2.000,00 4.000 5.170 1.837,52 Source: Survey Nomisma-Areté for EFSA

Table 78: Adolescents – Acute exposure to taurine from ED acute consumption in the 16 MS covered by

the survey (values in mg/kg bw/single session) - Total respondents (Sample size: 31.070)


Austria 26,80 18,53 0 185,19 40,00 67,12 83,33 27,43

Belgium 37,10 27,88 0 154,35 55,10 98,66 124,51 38,08

Cyprus 20,08 7,27 0 177,50 31,56 60,00 76,07 28,06

Czech Republic 28,62 20,41 0 212,77 40,54 66,67 81,63 26,93

Finland 21,35 16,67 0 200,00 28,40 54,56 76,92 27,07

France 20,48 15,33 0 142,00 29,94 54,55 71,43 25,24

Germany 25,71 15,70 0 200,00 37,83 73,29 95,81 34,07

Greece 14,83 0,00 0 166,67 20,73 44,44 62,50 23,31

Hungary 26,88 18,18 0 222,22 38,46 66,67 83,53 27,70

Italy 15,59 6,15 0 222,22 21,74 43,69 61,74 22,85

Netherlands 24,31 18,18 0 217,39 35,71 64,59 80,35 27,98

Poland 21,32 16,67 0 200,00 28,17 51,56 66,67 23,76

Romania 21,90 17,39 0 222,22 30,15 53,77 76,92 26,76

Spain 19,43 14,25 0 212,77 26,30 52,94 71,43 26,03

Sweden 25,13 17,54 0 145,45 38,99 65,54 83,34 27,78



drinks






With regards to ED consumers, the highest values of acute exposure to taurine among MS (tables 79

and 80) were registered in Germany54

with 2.515 mg/single session (42.71 mg/kg bw/single session). Table 79: Adolescents - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 2.079,14 1.815,00 75,00 10.000,00 3.000 4.260 5.000,00 1.495,66

Belgium 2.612,11 2.000,00 252,92 9.812,50 4.047 5.744 7.100,00 2.140,36

Cyprus 2.191,41 2.000,00 0,00 10.000,00 3.000 4.260 5.000,00 1.643,40

Czech Republic 2.191,82 2.000,00 7,00 10.000,00 3.000 4.260 5.000,00 1.620,13

Finland 2.181,60 1.420,00 0,00 10.000,00 2.000 4.260 6.000,00 1.857,39

France 1.824,48 1.000,00 40,00 8.000,00 2.808 4.000 5.000,00 1.492,75

Germany 2.514,98 2.000,00 0,00 10.000,00 4.000 5.680 7.100,00 2.033,03

Greece 1.951,94 1.420,00 0,00 10.000,00 2.769 4.260 5.520,00 1.595,79

Hungary 2.111,01 2.000,00 0,00 10.000,00 3.000 4.260 5.000,00 1.615,13

Italy 1.700,69 1.000,00 0,00 10.000,00 2.000 4.000 5.000,00 1.455,79

Netherlands 1.946,51 1.420,00 0,00 10.000,00 2.000 4.000 5.000,00 1.417,13

Poland 1.815,35 1.000,00 0,00 10.000,00 2.000 4.000 5.000,00 1.426,55

Romania 1.710,17 1.000,00 40,00 10.000,00 2.000 4.000 5.000,00 1.468,82

Spain 1.809,18 1.295,81 0,00 10.000,00 2.000 4.000 5.000,00 1.549,28

Sweden 2.446,62 2.000,00 0,00 10.000,00 3.000 5.000 6.640,50 1.841,15

United Kingdom 2.291,32 1.420,00 180,44 10.000,00 2.840 4.260 6.000,00 1.805,01 Source: Survey Nomisma-Areté for EFSA

Table 80: Adolescents – Acute exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 35,76 28,57 0,63 185,19 48,98 74,67 88,75 26,15

Belgium 43,61 30,77 2,86 154,35 61,56 109,68 130,40 37,68

Cyprus 38,07 30,77 0,00 177,50 50,00 74,74 90,50 28,43

Czech Republic 35,03 27,78 0,13 212,77 46,15 71,43 86,21 25,75

Finland 32,93 23,67 0,00 200,00 36,36 67,42 92,55 27,36

France 31,07 21,28 0,70 142,00 42,39 63,11 78,89 25,25

Germany 42,71 31,25 0,00 200,00 57,14 89,13 119,95 34,67

Greece 30,71 21,28 0,00 166,67 40,00 63,54 82,79 25,24

Hungary 34,33 24,48 0,00 222,22 44,78 72,96 88,89 26,91

Italy 27,85 19,72 0,00 222,22 35,71 59,70 76,92 24,31

Netherlands 36,49 26,30 0,00 217,39 46,15 73,90 90,30 27,04

Poland 29,27 20,00 0,00 200,00 36,36 59,06 76,92 23,28

Romania 31,41 22,22 0,71 222,22 37,74 64,94 88,54 26,98

Spain 31,40 21,85 0,00 212,77 40,82 65,54 86,54 26,82

Sweden 36,49 27,84 0,00 145,45 50,00 72,73 94,60 26,57


54

The highest acute exposure to taurine on ED consumers was observed in Belgium (2.612 mg/single session


Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure.


drinks






With regards to the acute exposure to D-glucurono-y-lactone from ED, data in mg/single session vary

from around 512 mg for total respondents, to around 759 for ED consumers and around 1.934 in high

acute consumers (tables 81 and 82).

Table 81: Adolescents – Acute exposure to D-glucurono-y-lactone from ED (values in mg/single session)



Total respondents 512,62 240,00 0 6.000 600 1.440 2.100 744,18

ED consumers 759,24 540,00 0 6.000 1.050 1.800 2.400 795,64

High acute consumers 1.934,11 2.044,80 0 6.000 2.982 3.834 4.260 1.319,83 Source: Survey Nomisma-Areté for EFSA

Table 82: Adolescents – Acute exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/single

session)




ED consumers 12,70 8,96 0 132,67 16,73 29,51 39,71 13,44


For what concerns differences among MS, it can be noted that:

with regards to total respondents, acute exposure to D-glucurono-y-lactone ranges from

around 306 mg/single session (4,96 mg/kg bw/single session) in Hungary, to around 828

mg/single session (14,28 mg/kg bw/single session) in the case of Austria55

(tables 83 and 84);

with regards to ED consumers, the highest value of acute exposure to D-glucurono-y-lactone

is registered in Austria, with around 1.105 mg/single session (19 mg/kg bw/single session)

(tables 85 and 86);

As for differences among age groups of total respondents, the average value of acute exposure to D-

glucurono-y-lactone is around 566 mg/single session in adolescents aged 15-18, versus around 375

mg/single session in the age group between 10 and 14 years;

Passing to variations between genders, the average acute exposure to D-glucurono-y-lactone results to

be around 582 mg/single session for males and 455 mg/single session for females.

55

The highest acute exposure to glucuronolactone on total respondents was observed in Belgium (890 mg/single

session and 15,25 mg/kg bw/single session. Nevertheless, due do the small dimension of the sample for Belgium,

for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure.


drinks






Table 83: Adolescents - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the

survey (values in mg/single session) – Total respondents (Sample size: 31.070)


Austria 828,01 600,00 0 6.000 1.200,00 2.202,60 2.700,00 872,91

Belgium 890,91 532,50 0 4.500 1.200,00 1.920,00 2.992,80 962,77

Cyprus 447,53 0 0 5.400 600,00 1.533,60 2.040,00 738,25

Czech Republic 390,66 150,00 0 5.400 540,00 1.200,00 1.704,00 610,37

Finland 412,30 120,00 0 5.850 546,00 1.102,62 1.953,36 720,62

France 517,10 240,00 0 4.800 600,00 1.440,00 2.080,68 726,62

Germany 481,75 120,00 0 5.100 600,00 1.533,60 2.241,90 763,44

Greece 359,52 0 0 4.260 540,00 1.080,00 1.620,00 663,14

Hungary 306,41 60,00 0 5.400 360,00 900,00 1.440,00 558,92

Italy 442,91 127,26 0 6.000 600,00 1.200,00 1.800,00 686,26

Netherlands 569,67 429,38 0 4.800 769,20 1.575,00 2.044,80 711,40

Poland 352,16 135,00 0 6.000 480,00 960,00 1.405,80 565,27

Romania 600,36 480,00 0 5.400 766,80 1.704,00 2.392,80 752,96

Spain 341,22 90,36 0 6.000 525,00 960,00 1.507,50 561,83

Sweden 691,80 450,00 0 6.000 1.080,00 1.800,00 2.556,00 875,85

United Kingdom 488,23 207,30 0 6.000 600,00 1.278,00 2.055,00 743,48 Source: Survey Nomisma-Areté for EFSA


survey (values in mg/kg bw/single session) - Total respondents (Sample size: 31.070)


Austria 14,28 10,00 0 92,15 21,82 37,19 46,15 15,18

Belgium 15,25 9,68 0 92,61 21,60 34,51 55,48 17,46

Cyprus 7,67 0,00 0 94,67 10,84 25,04 33,94 12,62

Czech Republic 6,28 2,35 0 85,20 8,71 18,62 26,18 9,95

Finland 6,19 1,91 0 85,20 8,11 16,94 27,83 10,49

France 8,76 4,58 0 85,20 12,00 25,54 35,10 12,21

Germany 8,23 2,03 0 86,51 11,16 25,16 37,02 13,14

Greece 5,67 0,00 0 85,20 8,33 17,53 26,63 10,47

Hungary 4,96 1,15 0 100,00 6,00 14,20 23,41 9,08

Italy 7,28 2,27 0 132,67 10,34 20,69 29,47 11,44

Netherlands 10,58 7,66 0 82,29 15,00 28,15 39,13 13,15

Poland 5,66 2,27 0 109,09 7,75 15,27 23,95 9,08

Romania 11,18 8,15 0 121,71 15,00 27,69 40,47 14,22

Spain 5,92 1,63 0 94,67 8,88 16,83 25,66 9,64

Sweden 10,38 6,55 0 80,38 15,33 28,44 38,07 12,97



drinks







survey (values in mg/single session) – ED Consumers (Sample size: 20.713)


Austria 1.104,88 852,00 0 6.000 1.620 2.400,00 2.984,10 843,10

Belgium 1.047,21 840,00 0 4.500 1.444 2.484,00 3.126,00 962,21

Cyprus 848,59 596,40 0 5.400 1.200 1.893,60 2.400,00 832,65

Czech Republic 478,20 240,00 0 5.400 600 1.260,00 1.800,00 643,57

Finland 635,92 390,00 0 5.850 768 1.381,08 2.400,00 811,71

France 784,48 540,00 0 4.800 1.080 1.800,00 2.400,00 769,01

Germany 800,18 540,00 0 5.100 1.170 2.100,00 2.400,00 844,68

Greece 744,36 540,00 0 4.260 900 1.628,28 2.400,00 790,14

Hungary 391,30 180,00 0 5.400 480 1.080,00 1.704,00 604,77

Italy 791,23 600,00 0 6.000 1.059 1.753,50 2.400,00 752,16

Netherlands 854,92 600,00 0 4.800 1.200 1.800,00 2.400,00 718,09

Poland 483,42 300,00 0 6.000 600 1.192,80 1.704,00 612,52

Romania 861,22 600,00 0 5.400 1.200 1.800,00 2.400,00 767,24

Spain 551,49 420,00 0 6.000 639 1.260,00 1.800,00 627,91

Sweden 1.004,30 600,00 0 6.000 1.350 2.385,60 3.000,00 894,33

United Kingdom 703,25 480,00 0 6.000 900 1.704,00 2.400,00 803,22 Source: Survey Nomisma-Areté for EFSA


survey (values in mg/kg bw/single session) – ED Consumers (Sample size: 20.713)


Austria 19,05 14,29 0 92,15 26,53 41,67 49,09 14,71

Belgium 17,93 12,74 0 92,61 24,22 40,68 58,44 17,62

Cyprus 14,55 10,19 0 94,67 21,31 33,33 42,60 14,22

Czech Republic 7,69 4,00 0 85,20 10,34 20,69 29,95 10,51

Finland 9,54 6,00 0 85,20 11,52 22,04 33,76 11,73

France 13,30 9,38 0 85,20 17,04 31,03 38,57 12,88

Germany 13,66 9,23 0 86,51 18,46 34,29 43,92 14,57

Greece 11,74 8,57 0 85,20 15,00 27,00 35,50 12,48

Hungary 6,33 2,86 0 100,00 7,89 17,14 26,67 9,83

Italy 13,00 9,31 0 132,67 16,67 27,88 37,87 12,63

Netherlands 15,87 11,80 0 82,29 21,05 34,16 44,67 13,24

Poland 7,77 5,12 0 109,09 9,82 18,87 26,67 9,84

Romania 16,04 12,00 0 121,71 20,00 33,09 46,41 14,57

Spain 9,56 6,67 0 94,67 12,12 22,50 31,51 10,74

Sweden 15,07 10,84 0 80,38 21,05 34,09 43,64 13,18



drinks






3.3.4. Children

The sample of “children” featured a marked prevalence of male respondents (4.960 Total

respondents). Children living in urban areas accounted for around 53% of the sample; around 99% of

respondents attended primary schools, while around 1% attended pre-schools. Children aged 3-5

accounted for around 1% of the sample; children aged 6-10 accounted for the remaining share (around

99%).


On average, around 18% of children stated to have consumed ED at least once in the last year; the

figure presents differences at MS level (from a prevalence of around 6% in Hungary to a prevalence of

around 40% in the Czech Republic) (figure 48).

Prevalence of ED consumption was around 19% in the age group 6-10 years, and decreased to around

2% in the age group 3-5 age. Prevalence was higher among male: around 22%, versus around 14%

among female (figure 49)

Figure 48: Children – Prevalence of ED consumption by country (Sample size: 4.960 – Total respondents)



drinks






Figure 49: Children – Prevalence of ED consumption by age groups and gender (Sample size: 4.960 – Total

respondents)


Among ED consumers (930 ED consumers), around 16% stated to have been drinking ED 3 times a

week or more during the last months before the survey (figure 50). As for the consumption location,

most children consumed ED at home (35%), during sport and physical exercise (27%) and at parties

(26%). Consumption frequency resulted to be one glass per week for around 56% of consumers, and 2

glasses per week for around 24%, with an average ED consumption volume of 0,49 L/week for ED

consumers, ranging from 0,25 L/week in Belgium to 0,63 L/week in Germany. Children declared that

they drank ED for their taste (around 60% of consumers) or as a source of energy (around 31% of

consumers). When asked whether they considered drinking ED the same as drinking colas, around

55% of consumers declared that they were aware of the difference between the two product categories,

while around 23% of consumers declared that they simply did not know. Around 19% of consumers

considered ED and colas equivalent.


drinks






Figure 50: Children – ED consumption and related features (Sample size: 930 – ED consumers)



drinks






Also in the case of children, data were elaborated in order to identify “high chronic” consumers (§

2.3.5 for details on methodology). Among children, high chronic consumers accounted for around

16% of ED consumers (figure 51) and had an average consumption volume of ED of around 0,95

L/week.

Figure 51: Children - Prevalence of high chronic ED consumption (Sample size: 930– ED consumers)



drinks






Around 39% of high chronic consumers drank ED about every day (compared to just 6% of total

consumers; figure 52). Around 69% of high chronic consumers drank 3 or more glasses of ED per

week (compared to just 21% of total consumers).

Figure 52: Children – Monthly frequency of ED consumption and weekly consumed volumes: high

chronic and total consumers (Sample size: 930 – ED consumers; 154 – High chronic consumers)



drinks






Focusing on situations of ED consumption, there were some differences between high chronic and

total consumers (figure 53): consumption at home occurred for around 50% of high chronic

consumers, compared to around 35% on the other ones; consumption during parties was instead more

common among consumers (around 26%, versus around 14% of high chronic consumers).

Figure 53: Children – Situations of ED consumption: high chronic and total consumers (Sample size: 930–

ED consumers; 154 – High chronic consumers)



drinks






With regards to the motivations behind consumption, most children declared to consume ED because

they like their taste, both in the case of total consumers (60%) and high chronic consumers (54%;

figure 54).

Figure 54: Children – Motivations for ED consumption: high chronic and total consumers (Sample size:

930– ED consumers; 154 – High chronic consumers)



drinks







Tables 87 and 88 provide data on chronic exposure to caffeine for the different categories of

consumers, calculated on the basis of the methodology (§ 2.3.4.1).

In the case of children, chronic caffeine exposure from ED varied from 3,98 mg/day for total

respondents to around 43 mg/day for high chronic consumers. Accordingly, total caffeine exposure

(from ED and other products in the diet) varied from 23 mg/day (total respondents) to around 90

mg/day (high chronic consumers).

Table 87: Children – Chronic exposure to caffeine from ED and from all products

(a) (values in mg/day)

(Sample size: 4.960 – Total respondents; 930 – ED consumers: 154 – High chronic consumers)


exposure from ED:


ED consumers 21,97 11,27 11,27 112,74 22,55 45,10 67,64 18,18


Total exposure:


ED consumers 51,38 41,61 11,27 288,09 60,66 98,76 110,39 36,28


(a) Including ED

Table 88: Children – Chronic exposure to caffeine from ED and from all products

(a) (values in mg/kg

bw/day) (Sample size: 4.960 – Total respondents; 930 – ED consumers: 154 – High chronic consumers)


exposure from ED:


ED consumers 1,01 0,52 0,52 5,20 1,04 2,08 3,12 0,84


Total exposure:


ED consumers 2,37 1,92 0,52 13,28 2,80 4,55 5,09 1,67


(a) Including ED


drinks






Differences in ED contribution to total caffeine exposure between all consumers and high chronic

consumers are reported in figure 55: ED consumption accounted for around 43% of total daily

exposure of all consumers, compared to around 48% in the case of high chronic consumers.

Differences in the importance of ED’s contribution to caffeine exposure according to gender are

relatively limited: ED contributed to 42% of total daily exposure in the case of male consumers, and

44% in the case of female ones. Also differences in the importance of ED’s contribution to caffeine

exposure in the two age groups considered were relatively limited: ED contributed to around 43% of

total daily exposure in the age group 6-10, and around 46% in the age group 3-5.

Figure 55: Children - ED contribution to total daily exposure to caffeine (%): high chronic and total

consumers (Sample size: 4.960 – Total respondents; 154 – High chronic consumers)



drinks






Also in the case of children, some differences were observed from one MS to another. In this case the

highest values in terms of relative contribution of ED to the chronic exposure to caffeine were

registered in Spain (33%) and Netherlands (21%). The highest values in terms of exposure from ED

appeared in Czech Republic (7,41 mg/day and 0,34 mg/kg bw/day, tables 89 and 90).

Table 89: Children – Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in



ED/Total

exposure from ED 1,58 0,00 0,00 22,55 0,00 2,25 22,55 5,41

total exposure 24,84 16,72 0,00 109,39 32,41 69,06 95,42 26,33

exposure from ED 0,94 0,00 0,00 11,27 0,00 7,89 - 3,25

total exposure 9,88 6,99 1,69 24,15 17,45 23,30 - 7,66

exposure from ED 2,11 0,00 0,00 56,37 0,00 11,27 22,55 7,13

total exposure 21,39 13,33 0,00 107,91 28,81 54,86 72,14 21,97

exposure from ED 7,41 0,00 0,00 112,74 11,27 22,55 33,82 13,00

total exposure 39,49 31,73 0,00 292,21 49,12 81,40 109,95 34,35

exposure from ED 3,02 0,00 0,00 33,82 0,00 11,27 22,55 7,24

total exposure 25,97 18,85 0,00 145,33 31,62 56,17 75,07 25,03

exposure from ED 3,83 0,00 0,00 67,64 0,00 11,27 22,55 8,87

total exposure 25,34 19,19 0,00 206,22 38,80 50,05 59,82 23,79

exposure from ED 3,76 0,00 0,00 67,64 0,00 11,27 42,84 13,02

total exposure 22,01 14,90 0,00 100,05 27,57 57,82 78,31 22,27

exposure from ED 2,06 0,00 0,00 45,10 0,00 11,27 12,40 7,27

total exposure 17,41 11,80 0,00 118,77 22,66 38,07 54,71 17,89

exposure from ED 1,29 0,00 0,00 45,10 0,00 0,00 11,27 5,93

total exposure 21,38 18,23 0,00 170,79 25,76 39,20 55,27 20,07

exposure from ED 3,33 0,00 0,00 78,92 0,00 11,27 22,55 8,97

total exposure 22,19 15,17 0,00 187,11 29,42 52,67 68,52 22,19

exposure from ED 4,78 0,00 0,00 112,74 0,00 11,27 33,82 14,08

total exposure 22,91 16,71 0,00 183,02 31,76 48,34 64,19 24,26

exposure from ED 3,04 0,00 0,00 112,74 0,00 11,27 29,88 10,84

total exposure 28,16 19,12 0,00 204,65 37,17 63,47 77,74 28,26

exposure from ED 1,76 0,00 0,00 33,82 0,00 11,27 11,27 5,25

total exposure 20,02 15,69 0,00 101,05 26,46 40,84 49,37 16,42

exposure from ED 6,26 0,00 0,00 112,74 11,27 22,55 33,82 14,01

total exposure 18,79 11,24 0,00 243,55 22,15 43,25 68,01 26,71

exposure from ED 2,46 0,00 0,00 45,10 0,00 11,27 11,27 7,13

total exposure 20,38 13,49 0,00 105,30 27,01 49,29 66,00 20,29

exposure from ED 6,20 0,00 0,00 112,74 0,00 22,55 33,82 16,73

total exposure 27,05 17,49 0,00 288,09 39,62 54,52 70,95 31,19

Netherlands

Austria

Belgium

Cyprus

Czech Republic

Finland

France

Germany

Greece

Hungary

Italy

15,1%

Poland

Romania

Spain

Sweden

United Kingdom

6,4%

9,5%

9,9%

18,8%

11,6%

10,8%

17,1%

11,8%

6,0%

15,0%

20,8%

8,8%

33,3%

12,1%

22,9%



drinks






Table 90: Children – Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in



ED/Total

exposure from ED 0,07 0,00 0,00 1,04 0,00 0,10 1,04 0,25

total exposure 1,14 0,77 0,00 5,04 1,49 3,18 4,40 1,21

exposure from ED 0,04 0,00 0,00 0,52 0,00 0,36 - 0,15

total exposure 0,46 0,32 0,08 1,11 0,80 1,07 - 0,35

exposure from ED 0,10 0,00 0,00 2,60 0,00 0,52 1,04 0,33

total exposure 0,99 0,61 0,00 4,97 1,33 2,53 3,32 1,01

exposure from ED 0,34 0,00 0,00 5,20 0,52 1,04 1,56 0,60

total exposure 1,82 1,46 0,00 13,47 2,26 3,75 5,07 1,58

exposure from ED 0,14 0,00 0,00 1,56 0,00 0,52 1,04 0,33

total exposure 1,20 0,87 0,00 6,70 1,46 2,59 3,46 1,15

exposure from ED 0,18 0,00 0,00 3,12 0,00 0,52 1,04 0,41

total exposure 1,17 0,88 0,00 9,50 1,79 2,31 2,76 1,10

exposure from ED 0,17 0,00 0,00 3,12 0,00 0,52 1,97 0,60

total exposure 1,01 0,69 0,00 4,61 1,27 2,66 3,61 1,03

exposure from ED 0,09 0,00 0,00 2,08 0,00 0,52 0,57 0,33

total exposure 0,80 0,54 0,00 5,47 1,04 1,75 2,52 0,82

exposure from ED 0,06 0,00 0,00 2,08 0,00 0,00 0,52 0,27

total exposure 0,99 0,84 0,00 7,87 1,19 1,81 2,55 0,92

exposure from ED 0,15 0,00 0,00 3,64 0,00 0,52 1,04 0,41

total exposure 1,02 0,70 0,00 8,62 1,36 2,43 3,16 1,02

exposure from ED 0,22 0,00 0,00 5,20 0,00 0,52 1,56 0,65

total exposure 1,06 0,77 0,00 8,43 1,46 2,23 2,96 1,12

exposure from ED 0,14 0,00 0,00 5,20 0,00 0,52 1,38 0,50

total exposure 1,30 0,88 0,00 9,43 1,71 2,93 3,58 1,30

exposure from ED 0,08 0,00 0,00 1,56 0,00 0,52 0,52 0,24

total exposure 0,92 0,72 0,00 4,66 1,22 1,88 2,28 0,76

exposure from ED 0,29 0,00 0,00 5,20 0,52 1,04 1,56 0,65

total exposure 0,87 0,52 0,00 11,22 1,02 1,99 3,13 1,23

exposure from ED 0,11 0,00 0,00 2,08 0,00 0,52 0,52 0,33

total exposure 0,94 0,62 0,00 4,85 1,24 2,27 3,04 0,93

exposure from ED 0,29 0,00 0,00 5,20 0,00 1,04 1,56 0,77

total exposure 1,25 0,81 0,00 13,28 1,83 2,51 3,27 1,44

Germany

Greece

Hungary

Italy

Austria

Belgium

Cyprus

Czech Republic

Finland

France

Romania

Spain

Sweden

United Kingdom

Netherlands

Poland

11,8%

6,4%

9,5%

9,9%

18,8%

11,6%

15,1%

17,1%

12,1%

22,9%

6,0%

15,0%

20,8%

10,8%

8,8%

33,3%



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The average exposure to taurine for high chronic consumers varied from 50 mg/day in total

respondents, to around 278 mg/day in ED consumers, till around 543 mg/day in high chronic

consumers (tables 91 and 92).

Table 91: Children – Chronic exposure to taurine from ED (values in mg/day) (Sample size: 4.960 – Total

respondents; 930 – ED consumers: 154 – High chronic consumers)



ED consumers 278,37 142,86 142,86 1429 285,71 571,43 857,14 230,39

High chronic consumers 543,57 428,57 142,86 1429 571,43 1.000,00 1428,57 341,82


Table 92: Children – Chronic exposure to taurine from ED (values in mg/kg bw/day) (Sample size: 4.960 –

Total respondents; 930 – ED consumers: 154 – High chronic consumers)



ED consumers 12,83 6,58 6,58 65,83 13,17 26,33 39,50 10,62



Tables 93 and 94 show the differences of chronic exposure to taurine for total respondents among the

16 MS involved in the study.

Besides, values of chronic exposure to taurine of male and female consumers were similar. Chronic

taurine exposure was higher in the 6-10 age group (around 279 mg/day) than in the 3-5 one (around

220 mg/day.

Table 93: Children – Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 20,05 0 0 285,71 0,00 28,57 285,71 68,50

Belgium 11,90 0 0 142,86 0,00 100,00 - 41,24

Cyprus 26,73 0 0 714,29 0,00 142,86 285,71 90,33

Czech Republic 93,95 0 0 1.428,57 142,86 285,71 428,57 164,77

Finland 38,31 0 0 428,57 0,00 142,86 285,71 91,74

France 48,53 0 0 857,14 0,00 142,86 285,71 112,45

Germany 47,62 0 0 857,14 0,00 142,86 542,86 164,96

Greece 26,11 0 0 571,43 0,00 142,86 157,14 92,08

Hungary 16,38 0 0 571,43 0,00 0,00 142,86 75,20

Italy 42,23 0 0 1.000,00 0,00 142,86 285,71 113,63

Netherlands 60,52 0 0 1.428,57 0,00 142,86 428,57 178,46

Poland 38,56 0 0 1.428,57 0,00 142,86 378,57 137,31

Romania 22,24 0 0 428,57 0,00 142,86 142,86 66,46

Spain 79,34 0 0 1.428,57 142,86 285,71 428,57 177,53

Sweden 31,12 0 0 571,43 0,00 142,86 142,86 90,36

United Kingdom 78,52 0 0 1.428,57 0,00 285,71 428,57 212,05



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Table 94: Children – Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in



Austria 0,92 0 0 13,17 0,00 1,32 13,17 3,16

Belgium 0,55 0 0 6,58 0,00 4,61 - 1,90

Cyprus 1,23 0 0 32,92 0,00 6,58 13,17 4,16

Czech Republic 4,33 0 0 65,83 6,58 13,17 19,75 7,59

Finland 1,77 0 0 19,75 0,00 6,58 13,17 4,23

France 2,24 0 0 39,50 0,00 6,58 13,17 5,18

Germany 2,19 0 0 39,50 0,00 6,58 25,02 7,60

Greece 1,20 0 0 26,33 0,00 6,58 7,24 4,24

Hungary 0,75 0 0 26,33 0,00 0,00 6,58 3,47

Italy 1,95 0 0 46,08 0,00 6,58 13,17 5,24

Netherlands 2,79 0 0 65,83 0,00 6,58 19,75 8,22

Poland 1,78 0 0 65,83 0,00 6,58 17,45 6,33

Romania 1,02 0 0 19,75 0,00 6,58 6,58 3,06

Spain 3,66 0 0 65,83 6,58 13,17 19,75 8,18

Sweden 1,43 0 0 26,33 0,00 6,58 6,58 4,16

United Kingdom 3,62 0 0 65,83 0,00 13,17 19,75 9,77



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With regards to the average chronic exposure to D-glucurono-y-lactone, data varied from around 20

mg/day in total respondents to 111 mg/day in ED consumers and around 217 mg/day in high chronic

consumers (tables 95 and 96).

Table 95: Children – Chronic exposure to D-glucurono-y-lactone from ED (values in mg/day) (Sample size:

4.960 – Total respondents; 930 – ED consumers: 154 – High chronic consumers)


Total respondents 20,15 0,00 0,00 571,43 0,00 57,14 114 58,09

ED consumers 111,35 57,14 57,14 571,43 114,29 228,57 343 92,15

High chronic consumers 217,43 171,43 57,14 571,43 228,57 400,00 571 136,73 Source: Survey Nomisma-Areté for EFSA

Table 96: Children – Chronic exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/day)

(Sample size: 4.960 – Total respondents; 930 – ED consumers: 154 – High chronic consumers)



ED consumers 5,13 2,63 3 26,33 5,27 10,53 15,80 4,25



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With respect to total respondents, chronic exposure to D-glucurono-y-lactone ranged from around 5

mg/day (0,22 mg/kg bw/day) in Belgium to around 38 mg/day (1,73 mg/kg bw/day) in Czech

Republic (tables 97 and 98).

Similarly to what observed for taurine, chronic exposures to D-glucurono-y-lactone for male and

female consumers were similar. Exposure to D-glucurono-y-lactone resulted to be higher in the 6-10

age group (around 111 mg/day) than in the 3-5 one (around 88 mg/day) .

Table 97: Children – Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the



Austria 8,02 0 0 114,29 0,00 11,43 114,29 27,40

Belgium 4,76 0 0 57,14 0,00 40,00 - 16,50

Cyprus 10,69 0 0 285,71 0,00 57,14 114,29 36,13

Czech Republic 37,58 0 0 571,43 57,14 114,29 171,43 65,91

Finland 15,33 0 0 171,43 0,00 57,14 114,29 36,70

France 19,41 0 0 342,86 0,00 57,14 114,29 44,98

Germany 19,05 0 0 342,86 0,00 57,14 217,14 65,98

Greece 10,44 0 0 228,57 0,00 57,14 62,86 36,83

Hungary 6,55 0 0 228,57 0,00 0,00 57,14 30,08

Italy 16,89 0 0 400,00 0,00 57,14 114,29 45,45

Netherlands 24,21 0 0 571,43 0,00 57,14 171,43 71,38

Poland 15,43 0 0 571,43 0,00 57,14 151,43 54,92

Romania 8,90 0 0 171,43 0,00 57,14 57,14 26,58

Spain 31,73 0 0 571,43 57,14 114,29 171,43 71,01

Sweden 12,45 0 0 228,57 0,00 57,14 57,14 36,14



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Table 98: Children – Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the



Austria 0,37 0 0 5,27 0,00 0,53 5,27 1,26

Belgium 0,22 0 0 2,63 0,00 1,84 - 0,76

Cyprus 0,49 0 0 13,17 0,00 2,63 5,27 1,67

Czech Republic 1,73 0 0 26,33 2,63 5,27 7,90 3,04

Finland 0,71 0 0 7,90 0,00 2,63 5,27 1,69

France 0,89 0 0 15,80 0,00 2,63 5,27 2,07

Germany 0,88 0 0 15,80 0,00 2,63 10,01 3,04

Greece 0,48 0 0 10,53 0,00 2,63 2,90 1,70

Hungary 0,30 0 0 10,53 0,00 0,00 2,63 1,39

Italy 0,78 0 0 18,43 0,00 2,63 5,27 2,09

Netherlands 1,12 0 0 26,33 0,00 2,63 7,90 3,29

Poland 0,71 0 0 26,33 0,00 2,63 6,98 2,53

Romania 0,41 0 0 7,90 0,00 2,63 2,63 1,23

Spain 1,46 0 0 26,33 2,63 5,27 7,90 3,27

Sweden 0,57 0 0 10,53 0,00 2,63 2,63 1,67



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4. CONCLUSIONS AND RECOMMENDATIONS


Results emerging from the literature review highlighted a limited availability of recent and

comprehensive studies or surveys at EU level, providing reliable data on ED consumption and

exposure to specific ingredients. Such limitation did not allow an analysis of the evolution of ED

consumption over time.

Results emerging from the literature review evidenced an increasing attention – by both the scientific

community and mass media - for ED consumption and human exposure to active ingredients (caffeine

in particular).

The availability of recent and comprehensive studies or surveys at European level providing reliable

data on ED consumption and exposure to active ingredients (caffeine, taurine, and D-glucurono-y-

lactone), is however very limited. Such lack of data did not allow an exhaustive analysis of the

evolution of ED consumption over time, nor any full and reliable comparison with results from the

survey performed in the context of this study.

Focusing on studies and surveys performed during the last three years in specific MS, the Austrian

survey only provided an exhaustive analysis of ED consumption in the context of human exposure

assessment to caffeine (König, 2011).Significant differences between the scopes of the two studies,

their coverage, and the methodologies adopted for both survey and data processing, make difficult to

perform trustworthy comparisons among data. Other less recent studies were also collected and

analysed, mostly covering the issues of exposure to active ingredients (caffeine, taurine and D-

glucurono-y-lactone) and, in a few cases, providing some specific data on ED consumption (EFSA,

2009; Andersson et al., 2004; Food Safety Promotion Board, 2002).

Considering the prevalence of ED consumption (percentage of people declaring to have consumed

ED at least once over a defined period), the comparison with data provided by the study performed in

Ireland (Food Safety Promotion Board, 2002)56

would suggest – in spite of some differences in the

methodology - that the prevalence of ED consumption among adolescents and young adults might

have increased over the last ten years.

For exposure to caffeine, results from the present study and the study by König appear to be

substantially comparable for caffeine exposure from ED57

, whilst data regarding total exposure to

caffeine present some differences, justified by differences in the number and typologies of caffeine

sources covered by the two surveys.

Finally, concerning exposure to taurine and D-glucurono-y-lactone, the availability of data from

scientific literature on human exposure is very limited, not covering ED as source of these substances,

nor for specific groups of population (i.e. children). The possible comparison, in this respect, is with

56In the study covering Northern Ireland, a consumption prevalence of around 51% was reported for age group

11-35 years. Data from the present study shown a prevalence of around 69% for adolescents (11-17) in the UK

and of 53% for adults between 18 and 29 years on average.

57 In Austria, age group 18-29 years, caffeine exposure from ED: 45,2 mg/day (present study) versus 47,1

mg/day (König’s study). However, it is worth underlying that König considered 700 subjects aged 14-39 years

and that caffeine exposure and contribution of specific foods to total caffeine exposure have been assessed

quantifying caffeine in foods and beverages samples by HPLC method.


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the average exposure to these ingredients for a non-ED consumer adult. On the basis of this

comparison, the exposure to taurine and D-glucurono-y-lactone in ED consumers results to be higher

of – respectively - one and two orders of magnitude in ED consumers than non-ED consumers.

4.2. Results emerging from the survey

4.2.1. Adults

Around 30% of adults interviewed declared to have consumed ED at least once during the last year,

with prevalence varying among MS from 14% in Cyprus to 50% in Austria, and mainly (53%)

observed in “young adults” (18-29 years). The most common (71%) consumed size of ED resulted to

be 250 ml can. Among ED consumers, the average volume consumed by adults was approximately 2

L/month, ranging from 1,3 L/month in Italy to 2,9 L/month in Romania. Approximately 12% of adult

consumers were identified as “high chronic” consumers i.e. consuming ED 4-5 times/week or more,

with an average volume consumed of 4,5 L/month. The prevalence of high chronic consumers was

13,3% in “young adult” consumers. Data for MS showed the highest prevalence for high chronic

consumers in UK (21%).

Analysis of consumption data per single session allowed to identify the group of “high acute”

consumers (consuming at least 1 L/single session), resulted on average 11% of ED consumers. The

prevalence was 19% in Germany, and 13,4% on average with specific reference to the group of

“young adults”.

The co-consumption of ED and alcohol was evidenced for around 56% of consumers, ranging from

24% in Cyprus to 67% in Germany, and mainly (71%) observed in the age group of “young adults”.

Among “co-consumers”, 38% declared to habitually consume ED and alcohol more than once/week,

and 57% more than two cocktails of ED and alcohol/single session.

Concerning ED consumption in relation with physical exercise, around 52% of consumers (and

75,4% of adult ED consumers practising sport) declared to consume ED during sport activities,

ranging from 26% in Cyprus to 62% in Spain. Within the consumer group declaring to consume ED

and practicing physical exercise, around 37% declared to drink ED during sport “often” (23%) or

“every time” (14%), and around 27% of them declared to drink 3 or more cans of ED/single sport

session. The highest prevalence (55%), in this context, was evidenced for the group of “old adults”

(50-65 years).

The average exposure to caffeine from ED was 22,4 mg/day (0,32 mg/kg b.w.58

/day) for consumers,

and the contribution of ED to the total caffeine exposure was 8%. Caffeine exposure from ED

increased to 48,3 mg/day (0,7 mg/kg b.w./day) in high chronic consumers, with a relative contribution

of ED of approximately 13%. Caffeine exposure from ED ranged from 15,7 mg/day (0,22 mg/kg

b.w./day) in Italy to 31,7 mg/day (0,44 mg/kg b.w./day) in Romania. Relative contributions from ED

to the total caffeine exposure in adult ED consumers ranged from 5% in Sweden to 11,3% in Austria.

Average exposure to taurine from ED was 271,9 mg/day (3,82 mg/kg b.w./day) in consumers, rising

to 585,79 mg/day (8,49 mg/kg b.w./day) in high chronic consumers, and varying between 181,7

mg/day (2,56 mg/kg b.w./day) in Italy and 393,1 mg/day (5,41 mg/kg b.w./day) in Romania. Relative

58

Data on the exposure for kg of body weight were calculated for each consumer on the basis of data on body

weight (b.w.) collected through the survey. In case of missing data, data on body weight from EFSA scientific

opinion “Guidance on selected default values to be used by the EFSA Scientific Committee, Scientific Panels

and Units in the absence of actual measured data” (EFSA, 2012) were adopted.


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contributions from ED to the total exposure to taurine59

in adult ED consumers was 82,4% (91% in

high chronic consumers), ranging from 75,8% in Italy to 87,1% in Romania.

Finally, exposure to D-glucurono-y-lactone from ED was 125,95 mg/day (1,78 mg/kg b.w./day) on

average for ED consumers, raising to 268,84 mg/day (3,91 mg/kg b.w./day) in high chronic

consumers, and ranging from 52,8 mg/day (0,7 mg/kg b.w./day) in Finland to 218,29 mg/day (3 mg/kg

b.w./day) in Romania. Relative ED contributions to the total exposure to D-glucurono-y-lactone60

in

adult ED consumers was 98,8% (99,4% in high chronic consumers), varying from 97,2% in Finland to

99,3% in Romania.

4.2.2. Adolescents

Prevalence of ED consumption was 68%, varying from 48% in Greece to 82% in Czech Republic61

,

and mainly (73%) observed in the 15-18 years age subgroup. Also in this case, the most common

(60%) consumed size of ED resulted to be 250 ml can. As for volumes, adolescent consumers declared

to drink on average around 2,1 L/month, varying from 1,3 L/month in Italy to 3,1 L/month in the UK.

Around 32% of consumers declared to drink 2-4 cans/ month, while 19% consume 5-10 cans/month,

and around 19% declared to usually consume more than 10 cans/month.

Around 12% of adolescent consumers were identified as “high chronic” consumers, i.e. consuming

ED 4-5 times per week or more, with an average ED volume of around 7 L/month. The highest

prevalence of high chronic consumers was 27% in Netherlands. No relevant differences were

registered among different age subgroups.

Around 12% of adolescent ED consumers resulted to be “high acute” consumers consuming at least

1,065 L of ED per single session. The highest prevalence of high acute consumers was 17% in

Germany and Sweden62

.

Concerning co-consumption of ED and alcohol, prevalence was around 53% for adolescents, ranging

from 29% in Netherlands to 71% in Austria63

. The highest prevalence of co-consumption (59%)

characterised the age group 15-18 years old. Among “co-consumers”, around 45% declared to

habitually consume ED and alcohol more than once a week, and 39% to consume 3 or more cocktails

of ED and alcohol in a single consumption session.

Results on ED consumption in relation with physical exercise evidenced that around 41% of

adolescent (and 75% of ED consumers practising sport) consume ED during sport activities, ranging

from 14% in Sweden to 65% in UK. Around 27% of ED consumers drinking ED during sport

activities declared to consume 3 or more cans of ED in a single sport session (prevalence of such

consumption habit rises to 48% in the 10-14 years subgroup).

The average exposure to caffeine from ED was 23,5 mg/day (0,38 mg/kg b.w./day) for adolescent ED

consumers, with an average contribution of ED to the total caffeine exposure of 13%. The caffeine

exposure from ED increased to 75,08 mg/day (1,18 mg/kg b.w./day) in high chronic consumers,

contributing to 16% of total caffeine exposure. Among MS, caffeine exposure from ED varied

59

Taurine occurrence data in other sources than ED (58 mg as mean daily exposure from omnivore diet) was

extrapolated from literature (EFSA, 2009) for adults only. 60

D-glucurono-y-lactone occurrence data in other sources than ED (1,2 mg as mean daily exposure from

omnivore diet) was extrapolated from literature (EFSA, 2009) for adults only. 61

The highest prevalence of ED consumption among total respondents was observed in Belgium (85%) but not

reported due to the small dimension of the sample for this MS (sampling error of estimates exceeds 5%). 62

The highest prevalence of high acute ED consumption was observed in Belgium (26%) but not reported due

to the small dimension of the sample for this MS (sampling error of estimates exceeds 5%). 63

The highest prevalence of co-consumption of ED and alcohol was observed in Belgium (81%) but not reported

due to the small dimension of the sample for this MS (sampling error of estimates exceeds 5%).


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between 16 mg/day (0,26 mg/kg b.w./day) in Italy and 32 mg/day (0,57 mg/kg b.w./day) in UK, while

the relative contribution of ED to the total caffeine exposure ranged from 9% in Italy to 17% in UK.

The average exposure to taurine from ED was 283,9 mg/day (4,6 mg/kg b.w./day) in adolescent ED

consumers, rising to 924,3 mg/day (14,5 mg/kg b.w./day) in high chronic consumers, and varying

between 180,4 mg/day (2,89 mg/kg b.w./day) in Italy and 409,73 mg/day (7,25 mg/kg b.w./day) in the

UK.

Average exposure to D-glucurono-y-lactone from ED was 100,14 mg/day (1,65 mg/kg b.w./day),

rising to 311,6 mg/day (4,9 mg/kg b.w./day) in high chronic consumers, and varying between 51,09

mg/day (0,81 mg/kg b.w./day) in Czech Republic and 149,83 mg/day (2,74 mg/kg b.w./day) in

Romania.

4.2.3. Children

Prevalence of ED consumption in children was 18%, varying from a 6% in Hungary to 40% in the

Czech Republic, with the highest prevalence in the 6-10 year age group (19%).

Approximately 44% of children consumers declared to drink 2 or more glasses of ED per week, and

16% to consume ED 3 times a week or more. On average, consumption volume of ED was 0,49

L/week among children consumers, and varied from 0,25 L/week in Belgium to 0,63 L/week in

Germany.

Among the children consumers, 16% resulted to be “high chronic” consumers (around 0,95 L of ED

consumed per week).

Average caffeine exposure from ED was 21,97 mg/day (1 mg/kg b.w./day), with a relative

contribution of ED to total caffeine exposure of 43%. Caffeine exposure from ED in high chronic

consumers was 42,9 mg/day (1,98 mg/kg b.w./day), with ED contributing for 48% to total caffeine

exposure.

Average exposure to taurine from ED was 278,37 mg/day (12,83 mg/kg b.w./day) in ED consumers,

increasing to 543,57 mg/day (25,05 mg/kg b.w./day) in the high chronic consumers.

Finally, average exposure to D-glucurono-y-lactone from ED was 111,35 mg/day (5,13 mg/kg

b.w./day) in ED consumers, increasing to 217,43 mg/day (10 mg/kg b.w./day) for high chronic

consumers.

4.2.4. Final overview

A summary of results from the survey is reported:

1. ED consumption: higher prevalence among the total respondents was observed for adolescents

(68%), and in particular for the 15-18 age sub-group (73%). In adults prevalence for consumption

was 30% (up to 53% for “young adults”), and 18% in children, mainly in the 6-10 years subgroup

(19%).

2. High chronic consumers: no relevant differences were observed for prevalence in the 3 target

groups of ED consumers, ranging from 12% in adults (mainly in the 30-49 years subgroup) and

adolescents to 16% in children.

3. High acute consumers: among ED consumers, similar prevalence was evidenced for adults

(11%, mainly in the 30-49 years subgroup) and adolescents (12%, mainly in the 15-18 years

subgroup).


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4. Co-consumption of ED and alcohol: among ED consumers, similar prevalence was observed for

adults (56%, mainly in “young adults”) and adolescents (53%, mainly in the 15-18 years

subgroup).

5. ED consumption associated to sport activities: higher prevalence among ED consumers was

observed for adults (52%), mainly in the 50-65 years subgroup. In adolescents ED consumers the

prevalence was 41%, mainly in the 10-14 years subgroup.

6. ED contribution to the total exposure to caffeine: the calculated contribution from chronic ED

consumption was 43% for children, 13% for adolescents, and 8% for adults. Result obtained in

children was mainly due to higher levels of caffeine exposure from ED in this consumer group

(1,01 mg/kg b.w./day) than in the adolescents and adults (0,38 and 0,32 mg/kg b.w./day,

respectively). The contribution rates increased for the high chronic consumers to 48% in children,

16% in adolescents, and 12% in adults, due to increase in the caffeine exposure from ED (1,98,

1,18, and 0,70 mg/kg b.w./day, respectively). Levels of exposure to caffeine from ED were

significantly increased for the high acute consumers to 7,21 and 5,14 mg/kg b.w./single session in

adolescents and adults, respectively.

7. Exposure to taurine: higher average levels of exposure were evidenced in children (12,83 mg/kg

b.w./day), in comparison to adolescents (4,6 mg/kg b.w./day) and adults (3,82 mg/kg b.w./day),

increasing for high chronic consumers (25,05, 14,5 and 8,49 mg/kg b.w./day, respectively).

8. Exposure to D-glucurono-y-lactone: higher levels of exposure were evidenced in children (5,13

mg/kg b.w./day), in comparison to adolescents (1,65 mg/kg b.w./day) and adults (1,78 mg/kg

b.w./day), increasing for high chronic consumers (10, 4,9 and 3,9 mg/kg b.w./day, respectively).


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4.3. Recommendations

This project represented the first effort at European level of data collection on ED consumption and

contribution to some active ingredients (caffeine, taurine, and D-glucurono-y-lactone) exposure, in

specific consumer groups (considering also consumption habits) and in different MS.

Results emerging from the study - in terms of prevalence of ED consumption, prevalence of patterns

of consumption (chronic and acute), as well as levels of exposure to the active ingredients- are

comprehensive and could be used for a full risk assessment, in the light of the available information on

potential risks associated to ED consumption and exposure to specific active ingredients.

Moreover, due to the exponential growth rate which characterised the ED market over the last years,

the study team suggests to monitor possible further increases in ED consumption and eventually

consider the possibility to update the present study, considering specific analysis of “caffeine

consumption models” (i.e., energy shots).


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Heckman MA, Sherry K, DeMejia EG, 2010, Energy drinks: An assessment of their market size,

consumer demographics, ingredient profile, functionality, and regulations in the United States.

Comprehensive reviews in Food Science and Food Safety, 9, 303-317

Higgins JP, Phil M, Tuttle TD, Higgins CL, 2010, Energy Beverages: Content and Safety, Mayo

Clinic Proceedings, 85, 11, 1033-1104

Høstmark AT, 2010, The Oslo health study: soft drink intake is associated with the metabolic

syndrome, Appl Physiol Nutr Metab, 35, 5, 635-42

James JE, Kristjánsson AL, Sigfúsdóttir ID, 2011, Adolescent substance use, sleep, and academic

achievement: evidence of harm due to caffeine, Journal of Adolescence, 34, 4, 665-673

Kaminer Y, 2010, Problematic use of energy drinks by adolescents, Child and Adolescent Psychiatric

Clinics of North America, 19, 3, 643-650

König J, xxx, Final report: Assessment of caffeine intake in a representative sample of the Austrian

population (age 14-39 years), (forthcoming)

Leclercq C, Arcella D, Piccinelli R, Sette S, Le Donne C, Turrini A; INRAN-SCAI 2005-06 Study

Group, 2009, The Italian National Food Consumption Survey INRAN-SCAI 2005-06: main results

in terms of food consumption, Public Health Nutrition, 12, 12, 2504-2532

Marin Institute, 2007, Alcohol, Energy Drinks, and Youth: A Dangerous Mix, San Rafael, CA, US

Meltzer HM, Nordisk Ministerråd N, Råd Nordisk, 2008, Risk assessment of caffeine among children

and adolescents in the Nordic countries, TemaNord, Nordic council of Ministers, Copenhagen

Miller KE, 2008, Energy Drinks, race, and problem behaviors among college students, Journal of

Adolescent Health, 43, 5, 490–497

Norwegian Scientific Committee for Food Safety, 2009, New information on ingredients in so-called

”energy drinks”. Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials

in Contact with Food and Cosmetics of the Norwegian Scientific Committee for Food Safety, 11

May 2009

NZFSA - New Zealand Food Safety Authority, 2010, Risk profile: caffeine in energy drinks and

energy shots. Report prepared by the Institute of Environmental Science and Research Limited

(ESR). Available from: http://www.nzfsa.govt.nz/science/risk-profiles/fw10002-caffeine-in-

beverages-risk-profile.pdf

O’Brien MC, McCoy TP, MS, Rhodes SD, Wagoner A, Wolfson M, 2008, Caffeinated cocktails:

Energy drink consumption, high-risk drinking, and slcohol-related consequences among college

students, Academic Emergency Medicine, 15, 5, 453-460

http://www.nzfsa.govt.nz/science/risk-profiles/fw10002-caffeine-in-beverages-risk-profile.pdf



drinks






Oteri A, Salvo F, Caputi AP, Calapai G, 2007, Intake of energy drinks in association with alcoholic

beverages in a cohort of students of the School of Medicine of the University of Messina,

Alcoholism: Clinical and Experimental Research, 31, 10, 1677-1680

Reissig CJ, Strain EC, Griffiths RR, 2009, Caffeinated energy drinks – A growing problem, Drug and

Alcohol Dependence, 99, 1-3, 1-10

Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE, 2011, Health effects of energy drinks on

children, adolescents, and young adults, Pedriatics, 127, 511-528

SHC-Superior Health Council, 2009, Energy Drinks, Publication of the Superior Health Council, No

8622. Available from: www.health.fgov.be/CSS_HGR

SHC-Superior Health Council, 2012, The use of caffeine in foodstuffs. Advisory report of the Superior

Health Council, No 8689. Available from: www.csh-hgr.be

Thompson FE, Subar AF, 2008, Dietary Assessment Methodology”, chapter in Nutrition in the

Prevention and Treatment of Disease, (edited by Coulston AM, Boushey CJ, Ferruzzi M), second

edition, National Cancer Institute, Bethesda, Maryland

Velazquez CE, Poulos NS, Latimer LA, Pasch KE, 2012, Associations between energy drink

consumption and alcohol use behaviors among college students. Drug Alcohol Depend, 1, 123, 1-3,

167-172

http://www.health.fgov.be/CSS_HGR

http://www.csh-hgr.be/


drinks






LIST OF APPENDICES

A. STAKEHOLDERS CONSULTATION: COMPLETE LIST OF CONTACTS

B. STAKEHOLDERS CONSULTATION: LIST OF QUESTIONS

C. STAKEHOLDERS CONSULTATION: REFERENCE DOCUMENTS FOR THE INTERVIEW

D. STAKEHOLDERS CONSULTATION: MAIN FINDINGS

E. CONTENT OF RELEVANT SUBSTANCES IN DIFFERENT ED BRANDS INDICATED AS "OTHER"

BY RESPONDENTS IN THE QUESTIONNAIRE

F. DETAILS ON CAFFEINE CONTENT FOR THE CATEGORIES OF FOOD SELECTED FOR THE

CALCULATION OF EXPOSURE


drinks






GATHERING CONSUMPTION DATA

ON SPECIFIC CONSUMER GROUPS OF ENERGY DRINKS


APPENDIX A

STAKEHOLDERS CONSULTATION: COMPLETE LIST OF CONTACTS


drinks






- EU Organizations

European Consumers´ Organisation (BEUC)

European Centre for Monitoring Alcohol Marketing (EUCAM)

Energy Drinks Europe (EDE)

Union of European Soft Drinks Associations (UNESDA)

- National Industry Organizations

Institution/Organisation Member State

Verband der Hersteller Alkoholfreier Erfrischungsgetränke (V.D.H.A.E.) Austria

Fédération des Industries des Eaux et des Boissons Rafraîchissantes

(F.I.E.B. /V.I.W.F.) Belgium

Union of Beverage Producers (S.V.N.N.) Czech Republic

Syndicat National des Boissons Rafraîchissantes (S.N.B.R.) France

Wirtschaftsvereinigung Alkoholfreie Getränke e.V. (WAFG) Germany

Association of Greek Soft Drinks Industries (SEVA) Greece

Magyarországi Üdítital, Gyümölcslé- és Ásványvízgyártok Szövetsége Hungary

Nederlands Vereniging Frisdranken, Waters, Sappen (FWS) The Netherlands

National Chamber of Business Beverage Industry (KIGPR) Poland

Romanian Soft Drinks Association (ANBR) Romania

Asociacion Nacional de Fabricantes de Bebidas Refrescantes Analcoholicas

(ANFABRA) Spain

Sveriges Bryggerier / Brewers of Sweden Sweden

British Soft Drinks Assocation Ltd. (B.S.D.A.) United Kingdom

PANIMOLIITTO (Finnish Federation of the Brewing and Soft Drinks

Industry) Finland


drinks






- National Health Organizations

Institution/Organisation Member State

University of Vienna - Department of Nutritional Sciences Austria

- Scientific Institute of Public Health

- Superior Health Council Belgium

National Center of Public Health and Analyses - Foods and Nutrition

Department Bulgaria

- Ministry of Health - State General Laboratory

- Cyprus University of Technology – Cyprus International Institute for

Environmental and Public Health

Cyprus

Ministry of Agriculture of the Czech Republic - Food Production and

Legislation Department Czech Republic

Finnish Food Safety Authority Evira - Risk Assessment Research Unit Finland

French Agency for Food, Environmental and Occupational Health & Safety

(ANSES) France

Unit Nutritional Risks, Allergies and Novel Foods - Food Safety

Department - Federal Institute for Risk Assessment (BfR) Germany

Hellenic Food Authority (EFET) - Nutrition Policy & Research Directorate Greece

Ministry of National Resources - Department for Health Policy - Unit for

Public Health, Infectious Diseases, Health Administration and Defense Hungary

Icelandic Food and Veterinary Authority (MAST) Iceland

Irish Universities Nutrition Alliance (IUNA) Ireland

Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN) Italy

Assessment and Registration Agency of Food and Veterinary Service of

Latvia Latvia

National Food and Veterinary Risk Assessment Institute - Nutrition Unit Lithuania

Slovak Public Health Authority Slovak Republic

National Institute of Public Health Slovenia

Spanish Food Safety and Nutrition Agency (AESAN) Spain

Sweeden National Food Agency - Food Data Unit Sweden

Netherlands Food and Consumer Product Safety Authority (NVWA) -

Office for Risk Assessment and Research (BuRo) The Netherlands

Gathering consumption data on energy drinks









APPENDIX B

STAKEHOLDERS CONSULTATION: LIST OF QUESTIONS

Gathering consumption data on energy drinks






STAKEHOLDERS CONSULTATION: LIST OF QUESTIONS

1 Identification of relevant literature

IMPORTANT: the interviewee is provided in advance with a list of the relevant literature collected by

the study team

a. After looking at the list of relevant bibliographic references for the study, do you think that

some recent (i.e. published in the last 3 years) important references are missing? If yes, could you

please indicate which ones?

2 Identification of available data sources

IMPORTANT: the interviewee is provided in advance with a list of the relevant information sources

identified by the study team

a. After looking at the list of relevant information sources for the study, do you think that some

authoritative sources are missing? If yes, could you please indicate which ones?

3 Identification of the main energy drinks

IMPORTANT: the interviewee is provided in advance with a list of the main energy drinks marketed

in the European Union, compiled by the study team on the basis of the information retrieved. Such list

might be incomplete: in such case, the interviewee will be asked to add the missing brands he/she

knows.

a. After looking at the list of the most important brands of energy drinks marketed in the

European Union, do you think that some brands (including brands with national diffusion) are

missing? If yes, could you please indicate which ones?

b. Could you please provide information on the market shares/marketed volumes of the main

energy drinks in the European Union and in individual Member States, if available?

4 Identification of main food products in the diet (other than energy drinks) with significant

content in caffeine, taurine, glucuronolactone, theophylline and theobromine

IMPORTANT: the interviewee is provided in advance with a list of the food products in the diet (other

than energy drinks) with significant content in caffeine, taurine, glucuronolactone, theophylline and

theobromine, compiled by the study team on the basis of the information retrieved. Such list might be

incomplete: in such case, the interviewee will be asked to add the missing food products he/she knows.

a. After looking at the list of the most important food products in the diet (other than energy

drinks) with significant content in caffeine, taurine, glucuronolactone, theophylline and theobromine,

do you think that some products are missing? If yes, could you please indicate which ones?


drinks









APPENDIX C

STAKEHOLDERS CONSULTATION: REFERENCE DOCUMENTS FOR THE

INTERVIEW


drinks






STAKEHOLDERS CONSULTATION: REFERENCE DOCUMENTS FOR THE INTERVIEW

1 List of the relevant literature

Alard J, Marìn C, Cubillo JM, 2010, Effects of sales promotion in the long term in National Brand and

Private Label in the energy drink category, International Journal of Communication research-AD

Research ESIC, 1, 115-130

Alford C, König J, Aufricht C, Verster JC, 2011, Proceedings of the 2010 Energy Drinks Symposium,

The Open Neuropsychopharmacology Journal, 4, 1-4

BfR - Federal Institute for Risk Assessment, 2009, Health risks of excessive energy shot intake. BfR

Opinion, No. 1, 2 December 2009

BfR - Federal Institute for Risk Assessment, 2008, New Human Data on the Assessment of Energy

Drinks. BfR Information, No. 16, 13 March 2008

Calle Aznar S, 2011, Determinación analìtica de la cafeìna in diferentes productos comerciales, Final

project for graduation in Ingeniería Técnica Industrial, Universitat Politècnica de Catalunya (UPC),

Barcelona

CRIOC – Centre de Recherche et d’Information des Organisations de Consommateurs, 2010, Boissons

Energisantes. Fondation de utilité publique, Bruxelles

EFSA - European Food Safety Authority, 2009, The use of taurine and D-glucuronolactone as

constituants of the so-called energy drinks, The EFSA Journal, 935, 1-31. Available from:

http://www.efsa.europa.eu/cs/BlobServer/Scientific_Opinion/ans_ej935_Taurine%20and%20D-

glucuronolactone_op_en,1.pdf?ssbinary=true

EUCAM - European Center for monitoring Alcohol Marketing, 2009, The raise of alcoholic energy

drinks in Europe - A first exploration of the availability of these drinks in Europe. Available from:


EUCAM – European Center for monitoring Alcohol Marketing, 2008, Drinks with a Boost: Alcoholic

energy drinks trends in alcohol marketing -EUCAM Report 2008. Available from: www.eucam.info

Food Safety Promotion Board, 2002, A review of the health effects of stimulant drinks – Final Report,

Safe Food, Cork, Ireland

Gros L and Healey K, 2009, Chemistry changes everything - Do energy drinks really give you wings?.

Final publication of the EC COMENIUS project CITIES (Chemistry and Industry for Teachers in

European Schools). Socrates Comenius Project

James JE, Kristjánsson AL, Sigfúsdóttir ID, 2011, Adolescent substance use, sleep, and academic

achievement: evidence of harm due to caffeine, Journal of Adolescence, 34, 4, 665-73

König J, xxxx, Final report: Assessment of caffeine intake in a representative sample of the Austrian

population (age 14-39 years), (forthcoming)

NZFSA - New Zealand Food Safety Authority, 2010, Risk profile : caffeine in energy drinks and

energy shots. Report prepared by the Institute of Environmental Science and Research Limited (ESR).

Available at: http://www.nzfsa.govt.nz/science/risk-profiles/fw10002-caffeine-in-beverages-risk-

profile.pdf

Reissig CJ, Strain EC, Griffiths RR, 2009, Caffeinated energy drinks – A growing problem, Drug and

Alcohol Dependence, 99, 1-3, 1-10

SHC-Superior Health Council, 2009, Energy Drinks, Publication of the Superior Health Council, No.

8622. Available from: www.health.fgov.be/CSS_HGR







http://www.health.fgov.be/CSS_HGR


drinks






SHC-Superior Health Council, 2012, The use of caffeine in foodstuffs, Advisory report of the Superior

Health Council, N°8689. Available from: www.csh-hgr.be.

2 List of the relevant information sources

British Soft Drinks Association, 2007, The 2007 Soft Drinks Report - UK Market Review. British Soft

Drinks Association, London









Britvic Soft Drinks, 2010, Britvic Soft Drinks Report 2010, available from: www.softdrinksreport.com

Britvic Soft Drinks, 2011, Britvic Soft Drinks Report 2011, available from: www.softdrinksreport.com

Datamonitor Report, 2004, Red Bull Gmbh, October 2004

GDO Week, issue: April 2008

Hansen Natural Corporation, 2010, Annual Report 2010. Available from:

http://monsterbevcorp.com/index.php

Hansen Natural corporation, 2009, Annual Report 2009. Available from:


HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence), Study Coordinator Prof. Moreno

Aznar LA, Universidad de Zaragoza. Available from: http://www.helenastudy.com

IDEFICS project (Identification and prevention of dietary- and lifestyle-induced health effects in

children and infants). Available from: http://www.idefics.eu/Idefics/

INRA – Dietary behaviours and practices: determinants, actions, outputs, 2010. Available from:

http://www.international.inra.fr/search?select=&go=1&access=p&client=instit_en&filter=0&getfields

=*&ie=latin1&oe=latin1&output=xml_no_dtd&proxystylesheet=instit_en&site=INRAINSTITUTION

AL&sort=date%3AD%3AL%3Ad1&q=energy+drink

INRAN SCAI 2005-06 survey. Italian food consumption survey. Detailed data on:

http://www.inran.it/710/I_consumi_alimentari__INRAN-SCAI_2005-06.html

LDV Capital management, 2010, Energy drink due diligence report: Hansen Natural Corporation.

Florida, USA. Available from: http://www.ldvcapitalmanagement.com/

Mark Up, issues: July/August 2008; April 2009; April 2010

Red Bull, North America Inc., 2009, Red Bull Media Kit. California, USA

Soft Drinks International – The Global Beverage Industry Monthly, issues from June 2009 to February

2011




http://www.helenastudy.com/

http://www.idefics.eu/Idefics/

http://www.international.inra.fr/search?select=&go=1&access=p&client=instit_en&filter=0&getfields=*&ie=latin1&oe=latin1&output=xml_no_dtd&proxystylesheet=instit_en&site=INRAINSTITUTIONAL&sort=date%3AD%3AL%3Ad1&q=energy+drink



http://www.inran.it/710/I_consumi_alimentari__INRAN-SCAI_2005-06.html

http://www.ldvcapitalmanagement.com/


drinks






UK Essays, 2011, Red Bull. Downloaded from: http://www.ukessays.com/essays/marketing/red-

bull.php?utm_source=socialmedia&utm_medium=downloadpdf&utm_term=pdf&utm_content=essay

&utm_campaign=marketing-rb&utm_nooveride=1

Zenith International – Functional Drinks News, newsletter 2008 - 2009, issues: 181, 185, 191, 203,

204, 205

Websites:

www.ages.at

www.anfabra.es

www.anses.fr

www.assobibe.it

www.atomicdrinks.com

www.batterydrink.com

www.beuc.org

www.beverfood.com

www.bfr.bund.de

www.boissonsrafraichissantes.com

www.brava-italia.com

www.burn.si

www.cesualus.lv/en/produkti/sporta

www.csh-hgr.be

www.datamonitor.com

www.dumpsoda.org

www.dynamit.lv/pillowing

www.energyfiend.com

http://energy-drinks.cz/ (news from Czech energy drink market)

www.energydrink.lv

www.eucam.info

www.foedevarestyrelsen.dk

www.food.gov.uk

www.fsai.ie

www.hansens.com

www.hc-sc.gc.ca

www.inran.it

www.international.inra.fr

www.invs.sante.fr (French Institute for public health surveillance - InVS)

http://www.ukessays.com/essays/marketing/red-bull.php?utm_source=socialmedia&utm_medium=downloadpdf&utm_term=pdf&utm_content=essay&utm_campaign=marketing-rb&utm_nooveride=1



http://www.ages.at/

http://www.anfabra.es/

http://www.anses.fr/

http://www.assobibe.it/

http://www.atomicdrinks.com/

http://www.batterydrink.com/

http://www.beuc.org/

http://www.beverfood.com/

http://www.bfr.bund.de/

http://www.boissonsrafraichissantes.com/

http://www.brava-italia.com/

http://www.burn.si/

http://www.cesualus.lv/en/produkti/sporta


http://www.datamonitor.com/

http://www.dumpsoda.org/

http://www.dynamit.lv/pillowing

http://www.energyfiend.com/

http://energy-drinks.cz/

http://www.energydrink.lv/


http://www.foedevarestyrelsen.dk/

http://www.food.gov.uk/

http://www.fsai.ie/

http://www.hansens.com/

http://www.hc-sc.gc.ca/

http://www.inran.it/

http://www.international.inra.fr/

http://www.invs.sante.fr/


drinks






www.monsterbevcorp.com/index.php

www.nutritiondusport.fr/sfns/ (French society of nutrition and sport - SFNS)

www.monsterenergy.com

www.pinelli.cz

www.reddevildrinks.com

www.redbull.com

www.redbull.it

www.sante.gouv.fr/les-boissons-energisantes.html (Ministry of Health, France)

www.sharkenergy.com

www.shockenergy.cz

www.slv.se

www.unesda.org

www.wikipedia.org

3 List of the main energy drinks marketed in the European Union and in some Member

States suggested by the stakeholders during the interviews

AUSTRIA: Alpenjodlenergy, Bad Dog, Blue Bear, Bomba, Booster energy drink, Burn, Clever energy

drink, Dark Dog, Flying Power, Full Speed, Mixxedup energy, Monster, Oxxnkracherl, Pure cafaine,

Power Horse, Race energy, Red Bull, Red Eye, Rockstar, S-Budget energy, Shark

BELGIUM: Atomic, Boosted, Burn, Energy, Hell, Monster, Nalu, Red Bull, Rockstar, Rodeo, Shark,

Taurine Force, Virus

CYPRUS: Big Energy Shock, Blu, Bullet, Burn, Chillo, Life is Drive, M-150, Mixxed up, Monster,

Premium XO, Red Bull, Rienergy Refresher, Shark

CZECH REPUBLIC: Big Shock, Burn, Crazy Horse, Crazy Wolf (Kaufland), Erectus, Kamikaze,

Monster, Red Bull, Rockstar, Semtex, Shark, V 12 Energy Power drink

FINLAND: Battery, Mad Croc, Monster, Red Bull, Rockstar, Shark

FRANCE: Atomic, Burn, Coca Blāk, Dark Dog, Energy Drink Taurine Force (Carrefour), Fireball,

Hype, Long Horn, Monster, Red Bull, Rockstar, Shark; X-tense (Leclerc)

GERMANY: Effect, Fireball, Flying Horse, Hell, Monster, Red Bull, Rhino’s, Rockstar, Shark

GREECE: Fireball, Monster Energy, Monster Ripper, Monster Khaos, Monster Lo Carb, Red Bull,

Red Bull Sugar Free, Rockstar Energy, Rockstar Recovery, Shark, 28 Black Acai, Chillo, Lucozade

Alert

HUNGARY: Adrenalin, BIG, B!Bomb, Booster, Burn, Cocaine, Hell, Big Energy, Blue bear, Booster,

Fit Energy, Fütyülős, Kalaschnikow, Kerozin, Kobra, Light Kick, Max, Playboy, Power, Red Bull,

Reload, Shark, Tiger, UP, Watt, XL

ITALY: Atomic, Brava Italia, Burn, Effect, Monster, Red Bull, Sexy Italia, Shark, Tonino

Lamborghini

NETHERLANDS: Atomic, Monster, Red Bull, Red Devil, Rockstar, Rodeo, Shark, V

http://www.monsterbevcorp.com/index.php

http://www.nutritiondusport.fr/sfns/

http://www.monsterenergy.com/

http://www.pinelli.cz/

http://www.reddevildrinks.com/

http://www.redbull.com/

http://www.redbull.it/

http://www.sante.gouv.fr/les-boissons-energisantes.html

http://www.sharkenergy.com/

http://www.shockenergy.cz/

http://www.slv.se/

http://www.unesda.org/

http://www.wikipedia.org/


drinks






POLAND: Burn, Control, GreenGo, Monster, Pitbull, Red Bull, Rockstar, Tiger, Vpower

ROMANIA: Burn, Power Horse, Red Bull, Rienergy Refresher Energy Drink

SPAIN: Burn, Long Horn, Monster, Real Power Atomic, Red Bull, Rockstar, Shark, V

SWEDEN: Battery; Burn, FullStrike, Magic, Monster, Red Bull, Rockstar, Shark, White Tiger

UNITED KINGDOM: Atomic, Battery, Blue Bolt (Sainsbury’s), Blue Charge (Asda), Boost, Burn,

Fireball, Full Throttle, Kx (Tesco), Monster , Red Bull, Red Rooster, Relentless, Rockstar, Shark, V

4 List of the main food products in the diet (other than energy drinks) with significant

content in caffeine, taurine, glucuronolactone, theophylline and theobromine

a. Espresso coffee

b. Coffee (instant, ground, ice-coffee, frappè coffee, Turkish or Greek coffee, canned coffee,

3in1 and 2in 1 coffees, etc.)

c. Cappuccino

d. Tea (instant, tea bag, ice-tea, etc.)

e. Hot chocolate

f. Chocolate bars (dark chocolate, milk chocolate, white chocolate, energy chocolate bars, etc.)

g. Other bars (i.e. soya bars)

h. Colas and other soft drinks (i.e. lemonade; Fanta Verdia ; IRN-BRU , etc.)

i. Meal substitutes and sport nutrition (i.e. protein shakes)

j. Capsule, pills, gels (i.e. energy pills available in pubs, night clubs, etc., labelled as food

supplement)

k. All foods and beverages with coffee and chocolate as ingredient (e.g. yogurt with coffee or

chocolate, biscuits with chocolate wafers filled and/or coated with/by chocolate cream, breakfast

cereals with cacao, Puddings with cocoa, Ice creams with cocoa or chocolate, cottage cheese desserts

with chocolate, Pastry with cocoa or chocolate, etc.).

l. Supplement and medicine

m. Caffeinated chewing gums (i.e. Black Rhino…)

n. Syrups


drinks









APPENDIX D

STAKEHOLDERS CONSULTATION:

MAIN FINDINGS



The present document has been produced and adopted by the bodies identified above as author(s). This task has been carried out exclusively by the author(s) in the context of a contract between the European Food

Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the

rights of the authors.

A. STAKEHOLDERS CONSULTATION: MAIN FINDINGS Country Stakeholder Literature Review Energy Drinks Market Food products with Active Ingredients

EU EUCAM – European Centre for

Monitoring Alcohol Marketing Additional literature (in Dutch)

No consumption/sales data. List of brands

complete; increasing popularity of energy

drinks with retailers’ brands (private

labels); presence of pre-mixed alcoholic

ED in some MS

Lack of expertise to add any information

Belgium

FIEB/VIWF - Fédération des

Industries des Eaux et des

Boissons Rafraîchissantes

Remarks on references of American studies

No consumption data. On the basis of her

personal knowledge, the interviewee

indicated RED BULL, MONSTER, BURN

and NALU as the most common ED

brands in Belgian market. No market data,

but Anses is conducting a study with

Nielsen and from the preliminary results

on sales: Red Bull 41.8%, private labels

25.4% , Monster 13.8%, Burn 6.5% and

Dark Dog 3.4%; other brands represent

9.1% of the sales.

No additional food products

Cyprus

Cyprus International Institute

for Environmental and Public

Health, Cyprus University of

Tachnology

Comprehensive

ED brands and market shares: Cypriot

market divided into SHARK (55%), RED

BULL (30%), MONSTER (12%) and XL

(3%).

Frappé coffee, a Greek foam-covered iced

coffee drink very popular in Greece and

Cyprus

EU EDE – Energy Drinks Europe

The literature from EUCAM and Marin Institute not

helpful; BfR opinions do not deal with ED intake but

only with their safety; no reference should be made

to US literature

List of brands comprehensive; reasonable

to focus on the main 4-5 brands in each

specific national situation; energy shots

belong to another product category

Coffee-containing products, such as

yoghurt, desserts, pralines/toffees (e.g

“Pocket coffee”), etc. Focus on a

comprehensive and country-specific list of

such products

Netherlands

NVWA - Netherlands Food and

Consumer Product Safety

Authority

In 2009 NVWA studied the combined intake of

alcohol and energy drinks. The advice (in Dutch) can

be found at:

http://www.vwa.nl/actueel/bestanden/bestand/42525


Additional ED brands: Rodeo; there are

also brands of ED pre-mixed with alcohol No further information








Country Stakeholder Literature Review Energy Drinks Market Food products with Active Ingredients

France

ANSES - French Agency for

Food, Environmental and

Occupational Health & Safety

Additional literature:

Attila S, Cakir B, 2011, Energy-drink consumption

in college students and associated factors. Nutrition,

27, 316-322;

Heckman MA, Weil J, Gonzalez de Mejia, E,

2010, Caffeine in foods: a comprehensive review on

consumption, functionality, safety, and regulatory

matters, J Food Sci, 75, R77- 87;

Bigard, AX, 2010, Risks of energy drinks in youths,

Arch Pediatr, 17, 1625-1631

Main ED brands: BURN, HYPE, COCA

BLACK, PEPSI X. Consumption of ED

with retailers’ brands (private labels) is

also significant in France, as such products

are usually cheaper than the leading ED.

The interviewee indicated Carrefour

Energy Drink Taurine force and Leclerc X-

tense as examples of this category of

products.

The interviewee concluded that the food

products listed had been mostly identified

in relation to their caffeine and

theobromine content. So she suggested to

add some food products which are high in

glucuronolactone, such as wine and

stabilizing ingredients used in industrial

products and meat in small quantities; and

also some food products high in taurine,

such as seafood, meat and dairy products.

Austria

University of Vienna -

Department of Nutritional

Sciences

Comprehensive

Additional ED brands: Red Bull Energy

Drink, Red Bull Sugarfree, Burn, Flying

Power, Flying Power sugarfree, Full

Speed, Blue Bear, Blue Bear sugarfree, S-

Budget energy, S-Budget energy sugarfree,

Race energy, Race energy sugarfree,

Bomba, Booster energy drink, Mixxedup

energy, Mixxedup energy light, Race

Mango fruit energy, Alpenjodlenergy, Pure

cafaine, Power Horse, Clever energy drink,

Oxxnkracherl

Coffee flavour in food products

assortments should also be considered. It

could be necessary to include coffee

yoghurt in the study, as it is very popular

in Austria. Important to specify how coffee

and coffee beverages are made to evaluate

caffeine concentration in these products.

The interviewee proposed to include drugs

in the list.

Greece

EFET - Hellenic Food

Authority, Nutrition Policy &

Research Directorate

Comprehensive

ED brands on the Greek market: Fireball,

Monster Energy, Monster Ripper, Monster

Khaos, Monster Lo Carb, Red Bull, Red

Bull Sugar Free, Rockstar Energy,

Rockstar Recovery, as well as Shark, 28

Black Acai, Chillo, Lucozade Alert.

May be important also to investigate in

which way and how “strong” the coffee

was prepared (i.e. for a hot cup of Nescafé

whether one or two spoons of the instant

coffee powder were added in hot water). Concerning Taurine, the respondent

considered diet supplements (in general

available in gyms and sport centres or

through internet) as one of the main

sources potentially available on the market.

Czech

Republic

Ministry of Agriculture of the

Czech Republic Comprehensive

Czech market characterised by a wide

range of local ED brands; importance of

ED with retailers’ brands. Additional ED

brands: Burn, Semtex, Erectus, Big Shock,

Crazy Wolf (Kaufland), V 12 Energy

Power drink, Kamikaze

Additional food products such as food

supplements, especially in capsules and

tablets. Additional categories of food

products that should be considered in the

study: other bars (i.e. soya bars); capsule,

pills, gels, sports drinks (even

concentrated).







Italy

INRAN – Istituto Nazionale di

Ricerca per gli Alimenti e la

Nutrizione


Gambon DL, Brand HS, Boutkabout C, Levie D,

Veerman EC, 2011, Patterns in consumption of

potentially erosive beverages among adolescent

school children in the Netherlands. Int Dent J.; 61, 5,

247-51;

Oteri A, Salvo F, Caputi AP, Calapai G, 2007,

Intake of energy drinks in association with alcoholic

beverages in a cohort of students of the School of

Medicine of the University of Messina. Alcohol Clin

Exp Res.;31, 10, 1677-80.

Kaminer Y, 2010, Problematic use of energy drinks

by adolescents. Child Adolesc Psychiatr Clin N Am.,

19, 3, 643-50.

James JE, Kristjánsson AL, Sigfúsdóttir ID, 2011,

Adolescent substance use, sleep, and academic

achievement: evidence of harm due to caffeine. J

Adolesc.;34, 4, 665-73.

Høstmark AT, 2010, The Oslo health study: soft

drink intake is associated with the metabolic

syndrome, Appl Physiol Nutr Metab, 35, 5, 635-42.

Leclercq C, Arcella D, Piccinelli R, Sette S, Le

Donne C, Turrini A; INRAN-SCAI 2005-06 Study

Group, 2009, The Italian National Food

Consumption Survey INRAN-SCAI 2005-06: main

results in terms of food consumption, Public Health

Nutr;12, 12, 2504-32.

List of brands complete. No data on ED

market.

Additional food products: all foods and

beverages with coffee and chocolate as

ingredient (e.g. yogurt with coffee or

chocolate, biscuits with chocolate, etc.);

meal substitutes and sport nutrition;

supplements and medicines







Germany

WAFG -

Wirtschaftsvereinigung

Alkoholfreie Getränke e.V.

BfR documents listed in the literature for the study

can create some misunderstandings. The Federal

Institute for Risk Assessment (BfR) in Germany is in

charge of assessing food safety risks (from a

scientific point of view), but has no legal authority to

judge whether food products can be marketed or not.

This is an important issue that must be addressed, in

particular referring to the BfR publication on energy

shots’ safety.

No data about ED market (difficult to

obtain). A general overview of household

consumption of ED in Germany was

provided. These data do not take into

account products sold in petrol stations or

exported. Significant increase in marketed

volumes of ED, but despite this fact it is

obvious that ED, with only 0,4 % of

overall beverage consumption, still have a

very low market share or impact.

BURN is not anymore present in the

German market, while EFFECT should be

added to the list of ED brands marketed in

Germany. There are a lot of local brands in

each different region of the country.

Emerging energy products: energy

chocolate bars and sweets.

Cyprus Ministry of Health - State

General Laboratory Comprehensive.

Additional ED brands marketed in Cyprus:

Red Bull, Shark, Big Energy Shock,

Bullet, Blu, Chillo, Life is Drive, M-150,

Mixxed up, Monster, Premium XO,

Rienergy Refresher. Red Bull has the

biggest market share followed by Shark

(information provided from the Public

Health Services of Cyprus)

Additional food products: canned coffee to

the category of “coffee”; a category called

“other soft drinks” where including soft

drinks other than colas containing caffeine

(i.e. Fanta Verdia and Irn-Bru, popular

brands in Cyprus and Greece).

Belgium SHC - Superior Health Council


Superior Health Council, 2012, The use of caffeine

in foodstuffs. Advisory report of the Superior Health

Council, N°8689;

Meltzer HM, Nordisk Ministerråd N, Råd

Nordisk, 2008, Risk assessment of caffeine among

children and adolescents in the Nordic countries.

Nordic council of Ministers, Copenhagen.

TemaNord;

NZFSA - New Zealand Food Safety Authority,

2010, Risk profile : caffeine in energy drinks and

energy shots. Report prepared by the Institute of

Environmental Science and Research Limited (ESR)

Additional ED brands marketed in

Belgium: Rodeo, Virus, Boosted, Hell,

Taurine Force, Energy. Provided some info

about energy shots.

Other potential sources of caffeine

available in Belgium: “Lemonades”, very

often presented as 25 or 33 cl cans;

Chewing gums “Black Rhino”, 3 tablets of

which are believed to amount to 80 mg of

caffeine; “Energy” pills available in pubs,

night clubs, labelled as food supplements.

Effervescent tablets - intended to be

dissolved in water - should provide not

more than 320 mg of caffeine per litre (see

lemonades); Syrups should also provide no

more than 320 mg/l caffeine after having

been diluted with water.







Latvia Agency of Food and Veterinary

Service of Latvia

Arria AM, et al., 2010, Energy drink consumption

and increased risk of alcohol dependence, Alcohol

Clin Exp Res.;

Velazquez CE, Poulos NS, Latimer LA, Pasch

KE, 2012, Associations between energy drink

consumption and alcohol use behaviors among

college students. Drug Alcohol Depend, 1, 123, 1-3,

167-172

O'Brien MC, McCoy TP, Rhodes SD, Wagoner A,

Wolfson, M, 2008, Caffeinated cocktails: energy

drink consumption, high-risk drinking, and alcohol-

related consequences among college students,

Acad.Emerg.Med, 15, 5, 453-460;

Brache K, Stockwell T, 2011, Drinking patterns and

risk behaviors associated with combined alcohol and

energy drink consumption in college drinkers,

Addictive Behaviors, 36, 12, 1133-1140

Popular ED brands in the Latvian market:

Dynamit, Arkta energy, Starter

Additional food products: food

supplements, sports drinks, caffeinated

chewing gums







Hungary State Secretariat for Health,

Ministry of National Resources


Higgins JP, Phil M, Tuttle TD, Higgins CL, 2010.

Energy Beverages: Content and Safety. Mayo Clin

Proc, 85, 11, 1033-104;

Norwegian Scientific Committee for Food Safety:

New information on ingredients in so-called ”energy

drinks”. Opinion of the Panel on Food Additives,

Flavourings, Processing Aids, Materials in Contact

with Food and Cosmetics of the Norwegian

Scientific Committee for Food Safety, 11 May 2009;

Committee on Nutrition and the Council on

Sports Medicine and Fitness. Sports drinks and

energy drinks for children and adolescents: are they

appropriate? Pediatrics 2011 Jun,12, 6, 1182-9.

Seifert SM, Schaechter JL, Hershorin, ER,

Lipshultz SE, 2011, Health effects of energy drinks

on children, adolescents, and young adults.

Pediatrics 127, 3, 511-28.

Kaminer Y, 2010, Problematic use of energy drinks

by adolescents. Child Adolesc Psychiatr Clin N Am

19, 3, 643-50.

Bigard AX, 2010, Risks of energy drinks in youths,

Arch Pediatr 17, 11, 1625-31.

Integration of the list of ED brands with:

Adrenalin, BIG, B!Bomb, Booster, Burn,

Cocaine, Big Energy, Blue bear, Booster,

Fit Energy, Fütyülős, Kalaschnikow,

Kerozin, Kobra, Light Kick, Max,

Playboy, Power, Reload, Tiger, UP, Watt,

XL. The respondent mentioned Red Bull

and Hell as the most popular energy drink

brands in Hungary, but she underlined that

she had no consumption/sales data to

support her opinion.

Addition of the following food products:

3in1 and 2in1 coffees; biscuits, wafers

(filled and/or coated with/by chocolate

cream); breakfast cereals with cocoa;

puddings with cocoa; cottage cheese

desserts with chocolate; ice creams with

cocoa or chocolate; pastry with cocoa or

chocolate. Might be more appropriate to

use the wording “food supplements”

instead of “capsules, pills, gels”, and

“foods for special dietary purposes”

instead of “sport drinks” in the original list.

Iceland MAST – Icelandic Food and

Veterinary Authority

Additional papers:

Eucam, 2009, Dutch Minister doesn’t follow advise

on labeling alcoholic energy drinks, Utrecht;

O’Brien MC, McCoy TP, Rhodes SD, Wagoner

A,Wolfson M, 2008,Caffeinated Cocktails: Energy

DrinkConsumption, High-risk Drinking, and

Alcohol-related Consequences among College

Students, Academic Emergency Medicine, 15: 1–-8;

Arria AM, Caldeira MK, Kasperski SJ, Vincent

KB,Griffiths RR, O’Grady KE, 2011, Energy

Drink Consumption and Increased Risk for Alcohol

Dependence”, Alcoholism: Clinical and

Experimental Research, Vol. 35, No. 2.

List of brands quite complete. No data on

ED consumption. No additional food products.







Germany BfR - Federal Institute for Risk

Assessment


Heckman MA, Weil J, Gonzalez de Mejia E.,

2010, Caffeine in foods: a comprehensive review on

consumption, functionality, safety, and regulatory

matters. J Food Sci, 75, R77- 87;

Heckman MA, Sherry K, DeMejia EG, 2010,

Energy drinks: An assessment of their market size,

consumer demographics, ingredient profile,

functionality, and regulations in the United States.

Comprehensive reviews in Food Science and Food

Safety, 9, 303-317.

http://energydrinkblog.de/von-a-z/ No further information available.

http://energydrinkblog.de/von-a-z/


drinks









APPENDIX E

CONTENT OF RELEVANT INGREDIENTS IN ED BRANDS INDICATED AS “OTHER”


drinks






CONTENT OF RELEVANT SUBSTANCES IN DIFFERENT ED BRANDS INDICATED AS “OTHER” BY

RESPONDENTS IN THE QUESTIONNAIRE

Brand name Caffeine (mg/L) - as

declared on the label

Taurine (mg/L) - as


Glucuronolactone (mg/L)-

as declared on the label

666™ 1666 Not present Not present

9mm™ 320 4000 Not present

Action™ 315 3800 2400 (**)

Adrenalin™ 320 4000 Not present

Afri power™ 320 Not present Not present

Albert Hejin™ (private label) 300 (*) 4000 (**) 2400 (**)

AMP-Mountain Dew™ 300 4000 (**) Not present

Appie™ (private label) 300 (*) 4000 (**) 2400 (**)

BePOwer- Biedronka™ 320 4000 Not present

Bigpump: Taurine™ 240 4000 Not present

Biturbo™ 300 (*) 4000 (**) 2400 (**)

Black cat™ 320 4000 2400 (**)

Black energy™ 320 3000 Not present

Black Horse™ 480 4000 2400

Black Panter™ 300 (*) 4000 (**) 2400 (**)

Blitz™ 300 4000 2400

Blow™ 240 2000 Not present

Blue Bear™ 300 (*) 4000 (**) Not present

Blue bear™ (private label Spar

UK) 320 4000 2400

Boom Boom™ 300 (*) 4000 (**) 2400 (**)

Boost™ 300 4000 Not present

Buffalo™ 320 Not present Not present

Bullit™ (private label Penny) 300 4000 Not present

c1000™ (private label) 300 (*) 4000 (**) 2400 (**)

Cannabis™ 320 4000 2400

Celcius™ 300 (*) 4000 (**) 2400 (**)

Club-Mate™ 200 Not present Not present

Cobra™ 300 (*) 4000 (**) 2400 (**)

Cocaine™ 640 4000 Not present

Crazy wolf™ 250 4000 (**) 2400 (**)

C-Strong energy™ 300 (*) 4000 (**) 2400 (**)

Demon™ 320 4000 Not present

Denner Energy™ 300 3800 2400

Devil™ 350 4000 (**) Not present

Doc Weingart™ 300 (*) Not present Not present

Dr Pepper Energy™- Venom 320 4000 2400

Dragster™ 320 4000 Not present

Dynamite ™ 260 3100 Not present


drinks








Taurine (mg/L) - as




E2™ 300 (*) 4000 (**) Not present

Ed™ 320 4000 Not present

Emerge™ 300 4000 Not present

Energgy2000™ 320 4000 Not present

Energia Lecha™ 320 4000 Not present

Energy™ (private label

Euroshopper) 320 4000 2400 (**)

Energy slammers™ 320 Not present 2400 (**)

Enerji™ 133 Not present Not present

Fenix™ 300 (*) 4000 Not present

Flying Power™ (private label

Hofer) 320 4000 Not present

Frank’s™ 320 4000 Not present

Full size™ 320 3800 3000

Full Speed™ 320 4000 2400 (**)

Full Strike™ 320 4000 1200

Gasoline for humans™ 320 4000 2400 (**)

Glontz™ 320 4000 2400 (**)

Golden eagle™ 320 4000 2400

Golden Power™ 320 4000 (**) 2400 (**)

Gordon’s space™ 300 (*) 4000 (**) 2400 (**)

Grasshopper™ 300 (*) 4000 (**) 2400 (**)

Green up™ 320 Not present Not present

Guru™ 500 Not present Not present

Hacendado™ (private label

Mercadona) 150 4000 2400 (**)

Herbapol - Green Up™ 320 Not present Not present

Hijinks energy™ 300 (*) 4000 (**) 2400 (**)

Hools™ 320 4000 2400 (**)

Hot Blood™ 320 4000 2400 (**)

Hunter™ 300 4000 (**) 2400 (**)

Hustler™ 200 3000 Not present

Hype™ 320 4000 2400

Ica energidryck™ (private

label) 300 (*) 4000 (**) 2400 (**)

Imola™ 320 4000 2400 (**)

Inferno™ 320 4000 Not present

Jaguar™ 320 4000 2400

Jolt™ 300 (*) 4000 (**) 2400 (**)

Jump in! ™ 300 (*) 4000 (**) 2400 (**)

Kalashnikov™ 315 4000 Not present

Kamikaze™ 610 Not present 2400 (**)

Kaufland™ (private label) 300 (*) 4000 (**) 2400 (**)


drinks








Taurine (mg/L) - as




Kick™ 300 4000 2400

Killerfish™ 320 3000 Not present

Kite™ 300 Not present Not present

Koks™ 320 400 2500

Kombucha™ 300 (*) Not present Not present

Kratin daeng™ 320 4000 2400

Las Vegas™ 320 4000 2400 (**)

Leszarom™ 300 (*) 4000 (**) 2400 (**)

Lift Off™ 300 (*) 4000 (**) Not present

Lipovitan™ 300 (*) 4000 (**) 2400 (**)

Liquid Lightnin™ 400 4000 (**) 2400 (**)

Locura™ 320 4000 2400 (**)

Lucozade original™ 120 Not present Not present

M power™ 300 (*) 4000 (**) Not present

M-150™ 330 Not present Not present

Magic Man™ 320 3000 Not present

Mask™ 320 4000 2400 (**)

Matrix™ 300 (*) 4000 (**) 2400 (**)

Max Force™ 320 4000 (**) 2400 (**)

Maxx™ 320 4000 Not present

Megaforce™ 320 4000 1200

Motion™ 300 (*) 4000 (**) 2400 (**)

Nae danger energy drink™ 320 4000 (**) Not present

N-gine (private label Tesco)™ 320 4000 Not present

No Fear™ 300 4000 2400

NY Razor™ 320 4000 (**) Not present

Olimp™ 560 4000 2400 (**)

Onyx Energy Drink™ 300 (*) 4000 (**) 2400 (**)

Oxxenkracherl™ 320 3000 2400 (**)

Ozone Energy Drink™ 320 4000 Not present

Party Power™ 320 4000 Not present

Pink Fish™ 300 4000 2400

Pitbull™ 320 4000 Not present

Planet Energy™ 300 (*) 4000 (**) 2400 (**)

Plus™ 300 (*) 4000 (**) 2400 (**)

pokka™ 300 (*) 4000 (**) 2400 (**)

Power King™ 320 4000 2400

Power UP™ 480 Not present Not present

Powerade™ 320 Not present Not present

Powerking™ 320 4000 2400

Private label Casino™ 300 (*) 4000 (**) 2400 (**)


drinks








Taurine (mg/L) - as




Puma™ 300 3800 2400

R20™ 300 4000 2400

Race™ 300 (*) 4000 (**) 2400 (**)

Race™ 300 4000 2400 (**)

Rasta Sta™r 320 4000 (**) 2400 (**)

Red dragon™ 300 (*) 4000 (**) 2400 (**)

Red force™ 300 (*) 4000 (**) Not present

Red hell™ 320 Not present 2400 (**)

Red rooster™ 320 4000 Not present

Red thunder™ 315 4000 (**) Not present

Riders™ 300 (*) 4000 (**) Not present

Ronin™ 320 4000 Not present

Rox™ 300 (*) 4000 (**) 2400 (**)

Sainsbury's Blue Bolt™ 300 4000 2400 (**)

Sbudget - Privale Label Spar™ 320 4000 (**) Not present

Schartner clue™ 315 4000 (**) 1000

Scheckter's Organic™ 340 Not present Not present

Schwarze dose™ 320 Not present Not present

Sexergy™ 320 3000 Not present

She™ 300 (*) 4000 (**) Not present

Slammers™ 320 Not present 2400 (**)

Spam™ 300 4000 2400

Speed™ 310 300 Not present

Speedstar™ 320 4000 (**) 2400 (**)

Spike Shotgun™ 700 Not present Not present

Spoko energy drnik™ 1066 Not present Not present

T400™ 300 4000 100

Tabu™ 320 4000 Not present

Take off™ 300 (*) 4000 (**) 2400 (**)

TDI™ 300 4000 Not present

Teho™ 320 4000 Not present

Thunder energy™ 320 4000 Not present

Titanium - private label

Eroski™ 300 (*) 4000 (**) 2400 (**)

Trigger™ 300 (*) 4000 (**) Not present

Tunnel™ 230 2900 Not present

Ursus energy drink™ 320 4000 Not present

Verve™ 320 4000 Not present

Vibe™ 300 (*) 4000 (**) 2400 (**)

Vipera™ 320 4000 Not present

Vitamin™ 315 Not present Not present

V-MAX™ 320 4000 Not present


drinks








Taurine (mg/L) - as




Volcaz™ 300 4000 (**) Not present

Vulcano™ 300 (*) 4000 (**) Not present

Wake up™ 300 (*) 4000 (**) Not present

Watt™ 300 4000 Not present

Wild Dragon™ 300 3900 2400

X act™ 320 4000 2400 (**)

XL™ 320 4000 Not present

X-Ray™ 240 Not present Not present

Xtreme™ 320 4000 2400

XXL™ 320 4000 Not present

Note: values highlighted by the light grey background were assumed, as no information on actual content could be retrieved;

further investigations are being carried out to achieve a final validation of the assumptions made.

* assumed as equal to the value in König, 2011.

** assumed as equal to the modal value.


drinks









APPENDIX F

DETAILS ON CAFFEINE CONTENT FOR THE CATEGORIES OF FOOD SELECTED FOR

THE CALCULATION OF EXPOSURE






DETAILS ON CAFFEINE CONTENT FOR THE CATEGORIES OF FOOD SELECTED FOR THE CALCULATION OF EXPOSURE

References for products with caffeine (segue)

WITH CAFFEINE

(mg/L o mg/kg)

Konig

(forthcoming)Mayo clinic

http://faculty.washi

ngton.edu/chudler/

caff.html

Heckman et al.

(2010)

McCuscker et

al.(2003)

Safe Food (2002)-

Ireland

NZFSA (2010) -

New Zealand Chou (1992)

Anderson et al.

(2004)-Norden

Espresso Coffee 1916 1320-2475 402-1005 1008-3024 250-2140

Coffee (instant, ground, ice-coffe..) 400 368

‐

494 113,4-840 113,4-840 310-544,5 105-340 90-1180 286-770 355-690

Cappuccino 250 194

‐

310 315

Tea (instant, tea bag, ice-tea …) 100 50-150 58,8-256,2 268-536 (no ice tea) 105-504 (no ice tea) 95-430 (no ice tea) 50-390 134-234,5 25,5-405

Hot chocolate 150 6,7-53,6 21-150 5,36-71

Chocolate bars 180 165-211 60-1260

Dark chocolate 340 340 330-1250

Milk chocolate 183 183 210 50-540 (220-300)

White chocolate 0 0 130-400

Chocolate snacks (e.g. Mars, Kit kat..) 140 108-250

Dark chocolate 264

Milk chocolate 142

White chocolate 0

Colas (e.g. Coca-cola, Pepsi) 79,2 41-132 75,6-131,6 64,4-179,2 93-127 97,2-123,1

Range caffeine content mg/kg (min-max)






References for products without caffeine

DECAFFEINATED

(mg/L o mg/kg)

Mayo clinic

http://faculty.was

hington.edu/chud

ler/caff.html

Heckman et al.

(2010)

Safe Food (2002)-

IrelandChou (1992)

Espresso Coffee 250

Coffee (instant, ground, ice-coffe..) 10,7 8,4-50,4 13,4-33,5 12,6-50,4 3,3-13,3 13,2-17,6

Cappuccino 50

Tea (instant, tea bag, ice-tea …) 25 0-50,4

Hot chocolate NO

Chocolate bars

Dark chocolate

Milk chocolate

White chocolate

Chocolate snacks (e.g. Mars, Kit kat..)

Dark chocolate

Milk chocolate

White chocolate

Colas (e.g. Coca-cola, Pepsi)

Range caffeine content mg/kg (min-max)


drinks






GLOSSARY AND ABBREVIATIONS

CATI: Computer Assisted Telephone Interview

CAWI: Computer Assisted Web Interview

ED: Energy Drinks

EU: European Union

MS: Member States

UK: United Kingdom

US: United States

Rapport de l'Efsa

Technology

ed consumers

ed consumption greater

adults prevalence

present study consumers

energy drinks ed

case of adults

drunk ed

case of adolescents