Caffeine opinion not measuring effect of 5 Red Bulls and a bottle of vodka: EFSA

Monika Neuhauser-Berthold, a member of EFSA's working group on caffeine, said: "We don't talk about high doses and I can't rule out the interaction there." ​She said data on such high consumption did not exist.

European Food Safety Authority (EFSA) scientific committee member Josef Schlatter said it was difficult to draw a line between over-consumption and substance 'misuse' or 'abuse', saying the example given by Neuhauser-Berthold of "one bottle of vodka"​ would take consumers up to a 50% risk of dying, but pointed out this risk would be due to the excessive consumption of strong alcohol not the energy drinks.

"There will always be certain kinds of lifestyles and caffeine in combination with all kinds of substances. We didn't look at binge drinking. [Binge drinking] is not recommended so if somebody does that it's their own responsibility," ​Schlatter said. 

Discussing EFSA's draft opinion​​ yesterday, some stakeholders such as Dr Anke Ehlers of Germany's Federal Institute for Risk Assessment (Bfr) challenged whether EFSA's conclusion on the combination failed to account for "realistic situations" ​such as young people in nightclubs where consumption of energy drinks mixed with alcohol at high levels was common.

The European Commission did task EFSA to examine the safety of caffeine when consumed in conjunction with alcohol. Some studies have indicated that the effects of alcohol may be 'masked' by caffeine, leading the consumer to feel less drunk.

Yet EFSA's assessment concluded "caffeine consumed at doses up to 3 mg/kg body weight (corresponding to 210 mg in a 70-kg adult) from all sources, including 'energy drinks', is unlikely to mask the subjective perception of alcohol intoxication which could lead to an increased risk-taking behaviour when alcohol is consumed at doses of about 0.65 g/kg body weight. Higher doses of alcohol have not been systematically investigated."​

Patrick Coppens, senior food and health law and scientific affairs advisor at consultancy, EAS, and director of scientific and regulatory affairs at Brussels-based industry group, Food Supplements Europe (FSE), told us it was important that consumers' personal responsibility was taken into account. He said EFSA had tried to take a straight forward approach to the assessment in contrast to agencies like the BfR, which he said was controlling particularly with regards to its call for a ban on energy shots.

Camille Perrin of the European Consumer Organisation (BEUC) also raised concerns on this point, asking how EFSA had come to such a different conclusion to member state authorities like the French Agency for Food, Environmental and Occupational Health and Safety (ANSES).

A matter of opinion? ​

In 2013 ANSES, analysed 212 cases of adverse effects reported through the French Nutritional Vigilance Scheme and considered that a causal relationship between the consumption of 'energy drinks' and the adverse health effects was very likely or likely in 25 cases (12%) and possible in 54 (24%).

EFSA said such case studies were limited in value given that they were often poorly reported and did not include details of other substances consumed.

In its report Germany's BfR concluded that adverse effects of consuming large amounts of energy drinks in combination with intense exercise or alcohol could not be ruled out and advised individuals who were sensitive to caffeine not to consume energy drinks particularly in large amounts.

The UK Food Standards Agency (FSA) Committee on Toxicity said the available evidence did not support a toxicological or behavioural interaction between caffeine and alcohol, but data limitations prevented it from making any "firm conclusions"​.

Stakeholders have until March 15 to submit comments on the draft opinion to EFSA. Yesterday's meeting was attended by 70 people including researchers, national bodies, consumer groups, trade associations, trade ambassadors, consultants and companies.