Health Committee on June 8th, 2010

[Justin Sherwood]

My last point is that there is no evidence based on these spontaneous reported events that the risks of these events are any greater than the background rate of the general population. In fact, the available evidence in reviews by authoritative regulatory bodies around the world would suggest otherwise.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Sherwood.

We'll now go to Dr. Kadi, chief science officer for Red Bull.

Dr. Kadi.

[Andreas Kadi, Chief Science Officer, Red Bull GmbH]

Thank you, Madam Chair, members of the committee. On behalf of Red Bull, I thank the members of the committee for the invitation and I am glad to participate in this study on the use of caffeine as a food additive.

My name is Andreas Kadi. It is my pleasure to appear before this committee today in my capacity as the chief science officer of Red Bull to address scientific issues about the safe use of caffeine in beverages

Red Bull is an Austrian company with headquarters near Salzburg. The company has almost 7,000 employees worldwide and about 300 employees and contractors in Canada.

Red Bull energy drink was launched in 1987 as the first carbonated energy drink in Austria. Red Bull is now widely and safely consumed around the world in 160 countries. Health authorities across the world have concluded that Red Bull is safe.

Last year alone, close to 4 billion cans and bottles were consumed across the world, and over 3 million in Canada. Since the launch of Red Bull in 1987, a total of 21 billion cans and bottles have been consumed in Canada and around the world.

Red Bull shares Health Canada's commitment to ensuring that Canadians have access to safe, effective, and quality natural health products and is proud to say that in 2004 Red Bull was the first energy drink approved by Health Canada.

Red Bull supports a science-based approach on the overall objectives of this committee towards safe and responsible use by Canadians of caffeine in foods and beverages.

Red Bull contains a moderate level of caffeine: 80 milligrams per 250-millilitre can. This is equal to the amount of caffeine contained in one cup of instant coffee and it is less than the amount of caffeine in a medium-sized coffee or in an iced cappuccino from the most popular coffee chain in Canada.

The label on the Red Bull 250-millilitre can in Canada clearly limits the recommended consumption of Red Bull to two cans per day. Two cans of Red Bull contain 160 milligrams of caffeine in total. The label also recommends against the use of Red Bull by children, by pregnant and breast-feeding women, and by caffeine-sensitive persons. The label also warns against mixing Red Bull with alcohol.

The Canadian label statements represent the most stringent requirements for energy drinks anywhere in the world. In addition, Canada has the most stringent requirements for licensing the Red Bull product and for its quality.

Caffeine, in its natural and added forms, is found in a variety of consumer products, including coffee, tea, cola beverages, energy drinks, chocolate, and even some medicines. According to Health Canada, Canadian adults get an estimated 60% of their caffeine from coffee and about 30% from tea, with the remaining 10% coming from other beverages, chocolate products, and medicines.

Health Canada, in their web publication, which was updated in March 2010, confirmed that healthy adults should limit their caffeine intake to 400 milligrams per day. For children, Health Canada recommends a maximum daily intake of no more than 2.5 milligrams per kilogram of body weight. For children aged 10 to 12 years, this translates into a maximum of 85 milligrams. For women of childbearing age, the recommendation is a maximum daily caffeine intake of no more than 300 milligrams.

For healthy adults, Health Canada advises a daily intake of no more than 500 milligrams. This is five times the amount of caffeine in a 250-millilitre can of Red Bull. Two cans, as advised for daily consumption, would contribute only 160 milligrams, which is less than 50% of Health Canada's maximum daily recommendation for healthy adults.

Red Bull urges this committee to ensure that the assessment and regulation of caffeinated beverages is based on sound science. Red Bull is fully prepared to partner with Health Canada and other stakeholders to achieve these ends. Health authorities in various countries and scientific expert panels in the European Union, Australia, New Zealand, and the United States have unanimously concluded that Red Bull and its ingredients are safe.

As recently as 2009, the European Food Safety Authority reviewed more than 70 of the most recent scientific articles, review papers, and safety studies on energy drinks and their ingredients. EFSA confirmed the safety of the active ingredients found in energy drinks at the concentrations used and found that there is no harmful interaction from the combination of these ingredients, and that neither alcohol nor physical exercise altered the way in which the ingredients combined.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Kadi. I'm sorry, but your time is up. Can you quickly wrap up?

[Andreas Kadi]

I have one sentence left.

This EFSA opinion concludes a history of more than 10 years of safety assessment of energy drinks and their ingredients in Europe.

Madam Chair, thank you again for giving me the opportunity to make this presentation. I will gladly answer any questions.

[The Chair, Conservative, Joy Smith]

Thank you, Mr. Kadi.

We're going to be going into our first round of seven minutes. I must say to all the witnesses that I'm sorry, but we have to keep very close track of time so everyone gets a chance. If there's anything in your presentations that you wanted to put forward and that you didn't get an opportunity to say, when questions are put to you, you can slip it in. You have seven minutes to do that.

We will begin with the lovely Dr. Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair.

Thank you to all the witnesses.

Before I begin, I would just like to tell you, Mr. Shepherd, how very sorry I am. I thank you for having the courage to come here today.

Dr. Godefroy, I'm wondering how many different brands of caffeinated energy drinks are now marketed in Canada. What is the range of caffeine and taurine content, please?

[Dr. Samuel Godefroy]

Thank you, Madam Chair.

Energy drinks are currently regulated as natural health products. Therefore, I'm going to ask my colleague, Michelle Boudreau, who is the director general of the natural health products directorate, to take any questions on the subject.

[The Chair, Conservative, Joy Smith]

Ms. Boudreau.

[Michelle Boudreau, Director General, Natural Health Products Directorate, Department of Health]

Merci.

The number of energy drinks currently licensed in Canada is 18. We've issued 9 product licences, and that equates to 18 different products. What this means is that you can have one licence for a few different formats, for example, or for flavours. There are 18 licensed products.

As far as the range of caffeine within those products is concerned, I can certainly provide this in writing as well if you'd like. We'd be happy to do that for the committee.

As you can see, I have it here. The range of caffeine is from 50 milligrams per unit, so in this case that I'm looking at, per a 150-millilitre unit, to about 150 milligrams per unit, and which case we're talking about a unit about the size of 473 millilitres.

With respect to taurine, the range of the amount of taurine in these products that have been licensed to date by the natural health products directorate is approximately 1,892 milligrams per unit at the higher end, and about 1,000 milligrams per unit at the lower end. Again, the unit size varies between 150 millilitres to 473 millilitres.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

In the scientific literature, have there been any changes in the reports of caffeine intoxication from energy drinks? Are we seeing changes in dependence and withdrawal?

[Michelle Boudreau]

I'm not quite sure how to answer your question. If you're speaking more about adverse reactions, I would probably call on my colleague to give you a much more complete answer to that. My colleague, Dr. Chris Turner, is here from the marketed health products directorate. If the committee would permit me, I would invite him to take my chair. I think he could give you a much more complete answer, if that's okay with the chair.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

In order not to waste time, I will ask another question.

What pre-existing health conditions might make adolescents more susceptible or at risk to caffeinated energy drinks?

[Dr. Chris Turner, Director General, Marketed Health Products Directorate, Department of Health]

I think she wants me to take that, too.

[Michelle Boudreau]

Yes. I think Dr. Turner will take that, too, so you may have to repeat it.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

These are the two questions. In the scientific literature, have we seen any changes, for example, regarding reports of caffeine intoxication from energy drinks, of dependence, or of withdrawal? Have there been increases seen in the scientific literature? Second, what pre-existing health conditions might make adolescents more susceptible or at risk to caffeinated energy drinks?

[The Vice-Chair, Liberal, Joyce Murray]

Dr. Turner.

[Dr. Chris Turner]

First of all, we want to acknowledge Mr. Shepherd's testimony as well, because it's bringing forward information from individual cases on which we can base early signals and trends to start doing research.

In answer to your basic question, there really isn't good information collected in the literature to date that would support any ban on energy drinks based on intoxication, dependence, or those kinds of things.

But we do have case reports. We receive case reports that are spontaneous adverse reaction reports, because in Canada we regulate these products as drugs. In other countries, where they're regulated as food and food supplements, there are perhaps less well organized systems, although, as was testified, there have been reports that have been looked at by various other agencies.

In Canada, we have to date 60 serious adverse reaction reports involving energy drinks across all the different product types. Of these, 15 are cardiac, which is a matter of concern, but then you have to go down to what the level of precision is in the report, and unfortunately—for example, we use a World Health Organization classification system as “probable, possible, or unassessable”—we have had two reports of death as an outcome. These are suspicions; they're not proven. The reports on the deaths, both of which were said to be associated with arrhythmia, are incomplete in terms of definitely assigning causality, or in other words, in saying that it's certain that the product caused the reaction.

That's part of the early days of this, but what it does do is push us towards more research and allows us to focus the research, and then to build scientific evidence on which we can take better decisions. We started in 2005 with “It's Your Health”, which identified that there are reports; we're trying to communicate this to Canadians so they can make choices.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

I would suggest that there are increasing reports of caffeine intoxication from energy drinks, and there is concern that problems with caffeine dependence and withdrawal will also increase. I think the fact that there have been deaths really needs to be paid attention to.

What is the safe daily amount of caffeine, and caffeine and taurine together, for adolescents aged 12 to 18 years?

[The Vice-Chair, Liberal, Joyce Murray]

There's just half a minute left.

[Michelle Boudreau]

To some extent, the answer to that has been referred to by the other witnesses, although I think primarily what you've heard about to date is the amount of caffeine that is looked at, has been well examined, and is cited in the “It's Your Health” letter as far as safe amounts of caffeine are concerned. You've heard various references from the perspective of milligrams per kilogram, as well as an overall daily consumption of approximately 400 milligrams.

I can tell you, though, that one of the things we look at when we are assessing natural health products of all types is the safety. This was also referred to by other witnesses: that a natural health product, when it is examined as to whether it should be licensed, undergoes a complete safety review, so the precise question you're asking would be looked at in every single application we receive.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Okay.

[The Vice-Chair, Liberal, Joyce Murray]

Thank you. The time is up.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Can I just comment?

I didn't get an answer as to what the safe daily amount is of caffeine and of caffeine and taurine together for adolescents of that specific age group, who are the ones consuming this.

[The Vice-Chair, Liberal, Joyce Murray]

Thank you.

Mr. Malo.