(12 years, 4 months ago)
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Mr Rob Wilson (Reading East) (Con)
I am grateful to have secured this important debate on an issue of great concern to my constituents, and I very much welcome the opportunity to engage the House in considering the health effects of high energy caffeine drinks. At the outset, I must say that I have absolutely no intention of being alarmist about high energy caffeine drinks, as it is important to raise these issues in a temperate and moderate way. Furthermore, I do not intend to focus on any particular brand, because I am concerned with the issues and not with singling out individual brands; I shall mention them only in passing. When I use examples of specific brands, it will not be an attempt to target them; it will be because they will be useful to illustrate my arguments. It is my aim to bring to the House’s attention a serious issue that requires rigorous examination. It is my view that we need a sensible discussion on this topic in order to assess the availability of high energy caffeine drinks to at-risk people, their health effects and any risks or dangers associated with them.
This issue was brought to my attention by my constituent, Mrs Rebecca Rye. When I met Mrs Rye, she expressed her concerns about the availability of high energy caffeine drinks after she had discovered her son, Edward, then aged 12, buying a 500 ml can of a product called Monster. She suspects that he might have been drinking such products without her knowledge for some time while on his way to school. Fortunately, she was able to put an end to his drinking them. The point is that Edward was drinking them without his mother’s knowledge or permission because they were, and still are, so easy to get a hold of. After some challenges—I will not go into them tonight—Edward no longer drinks these high energy drinks and is aware of the health concerns: a happy conclusion was reached for the Rye family.
That is not always the case, however, and tragedy, with perhaps a connection to energy drinks, is no stranger to the Reading area. On new year’s day 2010, Shaun Biggs of Lower Earley lost his life as a result of sudden death syndrome. Shaun, who was 21, had been out celebrating the new year and was drinking the popular mixture of vodka and Red Bull with his friends. After a few drinks, Shaun collapsed in his hotel room and later died at Wexham Park hospital. Following the police autopsy report, toxicology results showed an alcohol reading of 76 mg in 100 ml of his blood—notably less than the legal drink-drive limit of 80 mg. The amount of caffeine in his blood told a different story, as it showed an excessive level. Consequently, the coroner found that Shaun died of sudden cardiac arrest.
Shaun’s parents are convinced that he died as a result of the caffeine he had ingested from the Red Bull. Peter Biggs, Shaun’s father, has founded the campaign SAFE, which stands for the Shaun Awareness Foundation for Energy Drinks. In memory of Shaun, Mr Biggs aims to raise awareness of the potentially lethal health consequences of high energy drinks. It is to raise awareness of that issue that I asked for this debate.
I believe it is time that the UK carried out an authoritative medical study into the health effects of these drinks. Perhaps this could be carried out by the NHS itself or by engaging a leading university’s toxicology or pharmacology departments. I therefore look forward to hearing from my hon. Friend the Minister about what can be done to facilitate an in-depth study here in the United Kingdom. As I will demonstrate, there is quite a lot of partial evidence from around the world, but a definitive UK study is needed so that we can have evidence-based Government policy in this area.
At present, the UK Food Standards Agency advises that
“children, or other people sensitive to caffeine, should only consume in moderation drinks with high levels of caffeine”.
This is sensible guidance, but apart from that, there is no regulation or any other particular guidance except for the wording on product packaging to emphasise that it is “not recommended” for children and pregnant women. In the circumstances, I do not feel this is sufficient for the dangers that appear to be present, particularly for vulnerable groups.
The Minister will be aware that EU regulations due to come into force in 2014 will require nutrition labelling and that this will have implications for the soft drinks industry and energy labels. That might be a good juncture significantly to improve labelling on these products and any additional warnings that might be deemed appropriate by the Department of Health.
At this point, I would like to give the British Soft Drinks Association credit for ensuring at least that information is available on the can as part of its code of conduct. Advising that a drink is high in caffeine content and therefore unsuitable for children under 16 or pregnant women is helpful. The industry deserves credit, too, for its precautionary policy of not marketing or promoting energy drinks to those under 16. We all know that energy drinks are popular, however, and are clearly branded to attract young people, but the industry needs to recognise that children under 16 are attracted to the manufacturers’ marketing as much as their older peers. I see these drinks all the time in my Reading East constituency, and nine times out of 10 they are in the hands of someone under the age of 25, including many clearly under 16. Regardless of the labelling due to arrive in 2014, the attractiveness of these products to young people will remain.
Energy drinks are now marbled into British youth culture. Their manufacturers claim the benefits of drinking them include increased mental alertness, wakefulness, attention, physical endurance and stamina. Indeed, one brand claims it “gives you wings”. Their caffeine content can vary significantly, from 50 mg to 240 mg, depending on container, brand and size. Some products contain a very high caffeine potency, some the equivalent of 12 cans of cola or of four to five cups of coffee. The typical caffeine measurement of a mug of instant coffee is 100 mg, and 140 mg for filter coffee, according to the BBC health website, but no sensible parent would hand their 10-year-old or 12-year-old child a mug of filter coffee, would they?
I believe that now is the time to make such assessments, asking whether those levels of caffeine in drinks are wise or acceptable, and whether there is a need to take action. We cannot undertake a proper analysis of the situation, however, without the required knowledge and advice, provided to us by professionals. Any action taken must of course be evidence-based, hence the need for a comprehensive study and for this debate.
It is worth the House noting that concerns about these drinks have been voiced for some time, but little has really been done to tackle the issue throughout the country. That is not a party political point; it is just a statement of fact. As a free-market Conservative, it is not my instinct to lunge for regulation or to ban things—quite the contrary. It is my view that informed adults should be free to purchase goods as and when they see fit, so long as they do no harm to others. Indeed, that is part of the reason why I sought election to this Chamber.
If a product is dangerous and proven to be, however, the state has a legitimate role to play in protecting consumer interests, particularly when vulnerable groups are involved. Indeed, we as Members of this House are duty bound to do so for our constituents, and I also believe that manufacturers have a responsibility to do so for their customers.
In considering the matter, it is helpful to look at the approach that is undertaken overseas. In Europe, Denmark and Norway did not authorise Red Bull for general sale for several years; in Sweden, energy drinks are not sold in major outlets to children under the age of 15, because of a self-imposed ban by companies; and in Argentina, not usually a country from which I take guidance, there is an ongoing debate about banning their sale in nightclubs. We can see the merit in that, as energy drink consumption is prevalent among young people having a night out. Pubs and clubs in Reading, including the university’s bars, sell plenty of drinks that include products such as Red Bull.
Across the Channel, France banned energy drinks in 1996, but its ban did not last and energy drinks are now on sale there. Sticking with the example of France, I note that awareness on the issue was raised when Irish athlete Ross Cooney, aged 18, died hours after drinking four cans of Red Bull, following a basketball match. His death prompted the French Government to ban Red Bull, but, following legal challenges from the European Commission in the European Court of Justice, the ban on the sale of Red Bull was lifted.
The ruling came about because EU regulations stipulate that a product made or sold in other EU countries cannot be banned unless a health risk is proven, and that is one of the key points—access to information and, importantly, awareness of the issue. That is where I believe a state-sponsored medical study could help us to understand energy drinks and their consequences for health, particularly among vulnerable groups such as children, adolescents and young adults.
In this country, energy drinks such as Monster, Red Bull and Relentless are readily available in shops and supermarkets and are sold like any other soft drink. Many people actually consider them a soft drink, but in reality they are not just any old soft drink; they are something very different. The average soft drink does not risk causing heart palpitations, hallucinations, seizures, mania, stroke, diabetes or sudden death.
That is not my list, but a list of findings in pockets of medical research and studies taken from numerous journals. Studies carried out in Canada, Australia and the United States warn of the health effects of energy drinks. Let us take, for example, a recent study from the university of Miami, published in February last year in Pediatrics, the official journal of the American Academy of Pediatrics.
According to the report,
“these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioural disorders or those who take certain medications.”
The report concludes:
“Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy-drink use.”
Those strong words pose serious questions and challenges. The need for more research, possibly leading to regulation, seems clear to me.
One of the ingredients that have been identified as needing further attention is taurine, an amino-acid commonly found in caffeine and sugar-laden drinks that jump-starts the metabolism. It is normally manufactured in the human body, and plays an important role in a good balanced diet. It is also found in, for example, meat and dairy products. However, some studies have indicated that synthetic taurine—the kind that is found in energy drinks—is linked to a range of illnesses, including high blood pressure, strokes, heart seizures and heart disease. Each 8 oz can of Red Bull contains 1,000 mg of taurine, and a can of Monster of the same size contains roughly same amount.
Given that taurine is such a prominent ingredient in energy drinks, it is surprising that we know so little about it. Researchers at Weill Cornell medical college in New York have said that
“Remarkably little is known about the effects”
of taurine in energy drinks, particularly on the brain, and other medical studies have indicated that it is linked to irritability and even hallucinations. Australian professor, Dan Lubman, director of the Turning Point Drug and Alcohol Centre, has said that it has been associated with self-mutilation in rats. Professor Lubman’s view on energy drinks is that
“just because they are freely available in our market does not mean they are safe.”
I am strongly inclined to agree with him.
Changes in behaviour have been linked to heavy consumption of energy drinks, again with tragic consequences. I am mindful of the sad case of 11-year-old Tyler Johns from Bolton, whose personality completely changed as he began to drink excessive amounts of energy drinks, according to a national newspaper report. Tyler hanged himself in his bedroom, and his parents allegedly blame energy drinks for his “addiction”. Described by his father as once a happy-go-lucky child, he changed when he began consuming those drinks, which were freely available and cheap. He was suspended from school and enrolled in a re-integration programme at another school. During that time he was not drinking energy drinks, and his behaviour improved. He even scooped several certificates. When he resumed drinking, the poor pattern of his behaviour resumed, and tragically ended in suicide. When his mother found him, a 1 litre caffeine drink was found near his body.
Following an open verdict at Tyler’s inquest, his parents remained convinced that energy drinks had claimed their son. After his son’s inquest, Lee Johns said:
“Tyler is so missed. These drinks did affect him. They should not be sold to those under 16. There is so much said about what children should eat and there are links between children’s behaviour and food. Yet these drinks are freely available.”
Picking up Mr Johns’s point, I urge the Government to consider a temporary ban on the sale of energy drinks to under-16s until research has been commissioned, or, at the very least, much clearer and mandatory labelling. Given the British Soft Drinks Association’s policy of not targeting the under-16 age bracket, I cannot see why they would object to that suggestion.
Behaviour change in the young following the consumption of energy drinks is painfully obvious. In yesterday’s edition of the London Evening Standard, the celebrity chef Jamie Oliver said that he would ban such drinks, remarking that parents
“might as well be giving them cocaine”
owing to the hyperactivity and disruption that they can cause in schools. Mr Oliver’s words ware passionate—that is his way—but he also made the point that teaching children who have downed a can of an energy drink is extremely challenging, and given his understanding of nutrition and his involvement with young people, I think that his opinions are well worth listening to.
Mr David Hanson (Delyn) (Lab)
I am listening carefully to the hon. Gentleman’s comments and would like to support his argument. In my constituency, a group of parents is collecting a petition on exactly his points about sales to under-16s and investigations into the long-term effects. They have seen a marked impact on their children from these drinks, which, as he said, can contain the equivalent of up to eight or nine cups of coffee. Unfortunately, parents cannot control their children at the point of purchase and are not with their children every moment of the day. I support his objectives, therefore, and will listen carefully to what the Minister says.
Mr Wilson
I welcome that intervention and wish the parents collecting that petition the best of luck. I am sure that the right hon. Gentleman will speak up on their behalf on many occasions in the House, and perhaps we can work together to push this campaign through the House.
I understand that Oxted school in Surrey has banned these drinks, as has Chatsmore Catholic high school in Goring, and that Cardinal Newman school in East Sussex has asked local shops not to sell drinks to their pupils. Concern also extends to the police. I understand that in Whitchurch, Hampshire, the police have asked local shops to stop selling the products to under-16s on Friday nights. I urge the Minister to be mindful of the concerns of our police and schools.
I have also mentioned hallucinations. In 2010, a study published in the American Journal of Pharmacology and Toxicology found that taurine is implicated in hallucination. Closer to home, academics at the University of Durham have recorded increased likelihood of hallucination from high caffeine intake. Similar conclusions were drawn by Professor Simon Crowe from the school of psychological sciences at La Trobe university in Australia. High caffeine intake is linked to auditory hallucination, according to the professor.
Concerns have been relayed to me that the hallucinogenic risks of taurine are far more potent in the young. I am not a toxicologist—and as far as I am aware there are not many in this House or the other place—but it seems clear to me that we need a study into taurine in energy drinks and its effect on the human body. At present, it seems that we have a situation in which a form of Russian roulette is being played with energy drinks, sometimes with tragic consequences. An in-depth study would increase our understanding of these drinks and their consequences for health. Once we have that greater medical understanding, we can take appropriate action, if needed.
As I touched on earlier, energy drinks are targeted at the young. The drinks have become a sort of fashion status, a symbol, the trendy thing. It is not unusual to see their logos on T-shirts or baseball caps these days. As I said, these drinks are marbled into the youth culture in our country, and given the concerns surrounding their health effects a serious examination needs to take place here as well.
Stars in sport and the music industry are increasingly linked to energy drinks. For example, Relentless is a sponsor of 2013’s UK-wide tour from the music channel Kerrang!, Welsh international rugby player Jamie Roberts advertises Red Bull, and the Welsh rock band Bullet For My Valentine feature on the Monster website. The advice of the Food Standards Agency—that children should consume heavily caffeinated drinks in moderation—clearly does not seem to be working. If young people think it cool and trendy to consume the drinks and they are easily and readily available, there is little we can do about it.
The study from the University of Miami viewed young people with cardiac or seizure disorders as particularly vulnerable. We just have to look at the figures to see the overall vulnerability. The study highlights the fact that, in 2007, 46% of the caffeine overdoses in the US occurred in people under the age of 19. In Ireland, between 1999 and 2005, 17 separate incidents of specifically energy drink-related adverse events were recorded, including confusion, rapid heartbeat, seizures and two deaths. Similarly, between 2005 and 2009, New Zealand’s poison centre reported 20 energy drink-related adverse events, with 12 cases of vomiting, nausea, abdominal pain, jitteriness, rapid heartbeat and agitation referred for treatment.
The Miami report does not make it clear whether the Irish and New Zealand figures are those for young people, but we should hold this in mind: even if they are not exclusively younger cases and they apply solely to adults, the effects on younger people are presumably much worse. Polish research published by the European Society of Hypertension in May showed that energy drinks ranging in strength from 120 mg to 340 mg of caffeine have adverse effects for otherwise healthy adults aged between 20 and 35, including irregular heartbeats, anxiety and insomnia.
In February, Time magazine’s “Healthland” section was right to label the Miami report’s findings as “especially worrisome” for children suffering from attention deficit hyperactivity disorder, heart conditions or diabetes. Medical research has made a link—
Mr Wilson
Medical research has also made a link between energy drinks and the development of type 2 diabetes, but more work needs to be done on that. We must not lose sight of the fact that the treatment of type 2 diabetes cost the NHS £11.7 billion in 2010. When we include the cost to the economy, the total cost is roughly £27 billion lost to type 2 diabetes each year. I have few doubts that high energy drinks can claim some responsibility for adding to those costs. I shall be interested to learn whether the Minister can shed any light on this, so that we can see the economic as well as the health cost of these high energy drinks.
In summary, I believe that the case for a Government-initiated study is overwhelming—we should simply get on with it. But while the Government look at the research data with the experts, it would be wise to take a precautionary approach, particularly in respect of the under-16s. If we can prevent even one death with a temporary ban on shop sales to under-16s, we should do it. I urge the Minister and the Government to consider this very carefully.
As an absolute minimum we should ensure much clearer labelling on products, their ingredients and the dangers they pose to young people. That is not the nanny state at work; it would be a sensible and responsible Government intervention to inform the public of the scientific and medical facts on an issue that may well be costing lives. Similarly, it is not an attack on the soft drinks industry. In fact, I believe we should work with it on the issue, and I look forward to doing so.
Let me finish by saying that an evidence-based study, perhaps carried out by the Food Standards Agency and supervised by the NHS, will allow us to do our job in this place in making evidence-based decisions and ensuring that consumers, especially the vulnerable, are properly protected.
The Parliamentary Under-Secretary of State for Health (Anne Milton)
I congratulate my hon. Friend the Member for Reading East (Mr Wilson) on securing this debate and applaud his desire not to be alarmist, as it is easy to be alarmist on occasions such as this, particularly given the tragic stories he quoted this evening. I also applaud his desire to have an evidence-based approach. Such an approach always sounds simple, but it is not always that easy to obtain in practice, because the evidence is sometimes conflicting and confusing.
There is no doubt that nothing is more important than the food and drink we give to our children. Innumerable studies have been done on how it affects their education, their behaviour and their development. It is our responsibility as politicians, as adults and as parents to make sure that all children are eating a good and varied diet. My hon. Friend is clearly well aware that caffeine appears in many different foods, from various sources. It occurs naturally in things such as tea, coffee and chocolate, and is traditionally used as a component for the flavouring of cola drinks. In addition, of course, the reason for this debate is that it is also added as a stimulant to energy drinks. What is interesting for me in doing this job is that it is sometimes staggering how low awareness is. I think that most people are aware that caffeine is present in coffee, but they are perhaps not so aware that it is also present in tea and chocolate.
We need to recognise, of course, that in sensible doses caffeine is perfectly all right. However, as my hon. Friend will no doubt know if he has ever drunk one too many espressos, it does have its side effects. In 2003, the European Scientific Committee on Food specifically looked at high-caffeine soft drinks, finding that in its opinion those drinks did indeed cause increased excitability, irritability, nervousness or anxiety in some people who drank them, particularly if those people were normally low consumers of caffeine—that is where we get into the issue about children. Such effects were seen when someone consumed about 5 mg of caffeine per kilogram of bodyweight. That is the equivalent of about 300 mg of caffeine for an average adult and 150 mg for an average 10-year-old child. As a comparison, the amount of caffeine in a can of a typical high-caffeine energy drink is 80 mg, which is about the same as that found in a mug of instant coffee.
The committee said that caffeine appears to affect people’s heart rate and blood pressure, but it also said that those effects were short term and did not appear to have any long-term effects or cause heart attacks. I remind my hon. Friend that that study was conducted in 2003. The Committee did not at that time consider it necessary to establish a recommended daily limit for caffeine.
There are many anecdotal reports of young people having heart attacks after drinking too many energy drinks—my hon. Friend mentioned some of those cases—but those reports are not always complete, and these cases have often involved someone drinking such drinks along with consuming alcohol or drugs, thus clearly limiting the ability to draw conclusions. That shows why building up a good evidence base can be quite difficult.
The independent UK Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment is currently investigating the interaction between caffeine and alcohol, and is expected to report back later this year. My hon. Friend mentioned a number of tragic cases and the campaign started by some of the families who have been affected, and I want to applaud their efforts. It is always remarkable to see how families can turn a tragic incident into a campaign to do good for others. The committee’s study will be important in further informing us about the effects of caffeine.
Consumers need to be aware that there is information about caffeine content on the labels of high-energy drinks. Because some people may be particularly sensitive to caffeine, legislation was introduced across Europe in 2003 that stated that drinks with high levels of caffeine had to be labelled with the words “high caffeine content”. Those drinks also had to carry an indication of the actual caffeine content in milligrams per litre, so people can see exactly how much caffeine they are drinking. That labelling is not needed for tea and coffee, or drinks based on them, because it is generally accepted that people already know they contain caffeine. We do need to be much better at informing consumers, and persuading them to be better consumers and to read the labels of the products they eat and drink. The labelling requirement comes into play when a drink contains more than 150 mg of caffeine per litre. A typical high-caffeine energy drink would contain 320 mg of caffeine per litre, and therefore would have to be labelled.
In line with the May 2010 voluntary code of practice developed by the British Soft Drinks Association, many high-caffeine drinks also carry extra labelling to make it clear that such drinks are not suitable for children or people sensitive to caffeine. My hon. Friend praised the BSDA for its action and mentioned that recent changes at European level will make such labelling mandatory by December 2014. I am always pleased to see UK manufacturers acting responsibly by pre-empting legislation and making sure such labelling is already the norm. The code of practice also states that high-caffeine soft drinks should not be advertised, marketed or promoted to those under 16.
Finally, Government advice is that children and other people who are sensitive to caffeine should be careful with high-caffeine soft drinks, just as they should be with other products with lots of caffeine, such as coffee. Our advice is that they should be sensible and drink them only in moderation. If only it was that easy, and people just took the advice they were given; sadly, however, they do not always do so.
Mr Rob Wilson
My hon. Friend seems to acknowledge that children under 16 should not be drinking these drinks, and I think that that is even the advice of the industry. However, while a 12-year-old can go to their corner shop and buy those drinks there is no deterrent and nothing to stop them. What can the Minister say to me tonight about what will help to stop 12-year-olds going into local shops and buying these drinks unless we do something about it in this place?
Anne Milton
I thank my hon. Friend for his question and I will go into that point in a little more detail. We live in a world where children and adults are bombarded with information and it is not always possible to legislate our way out of a problem. I will say something more about that in a minute.
My hon. Friend referred to a report by the University of Miami on the possible effects of energy drinks on children and young people. Officials at the Food Standards Agency consider the study a useful review of a great deal of existing information, but it does not provide conclusive evidence to change the conclusions previously drawn by the EU Scientific Committee on Food. It does, however, add to our information base, to which we must continue to add.
I want to reassure my hon. Friend, just as I would like to reassure everyone, that the Food Standards Agency will continue to monitor the situation. It is extremely important that all Governments remain open minded and continue to look at any new evidence that becomes available. At the moment, the scientific advice is that the effects of caffeine are short term and information labelling is thorough and widespread, but, as I have said, that is not the end of the story.
My hon. Friend quoted extensively from the experiences of other countries. It is critical to remain open minded as new evidence emerges. I do not often have the privilege of being able to talk about this but I sit on the European Health Council, which gives me an opportunity to meet Health Ministers from other European countries and, indeed, such issues come up at those meetings. It is important to share experiences. He talked about raising awareness and I have no doubt that the opportunity he has taken to raise the issue tonight will play its part in doing just that.
The difficulty and the challenge in considering evidence, of course, is filtering out the impact of the particular ingredients in these drinks when there are so many confounding factors. That is why the Government need to be mindful of the research that is produced, particularly when there are also obvious and immediate commercial pressures. We are always battling against that.
I note my hon. Friend’s quote from Jamie Oliver. Passion is never a bad thing. It is good to feel the passion from other people and it helps raise awareness. The problem of the sale of alcohol to under-age children is not easy in itself. I note and commend the action taken by some schools that have taken a lead, presumably because they have had problems with the behaviour of children and are concerned about the quantity of high energy drinks their children are drinking. My hon. Friend has covered a lot of detail, particularly about the impact of taurine. Sadly, I cannot respond specifically on the question of that one ingredient this evening, but if there is any more information that I feel will be useful or helpful to him I will ensure that he receives it in a letter.
Responsibility for public health will move to local authorities. We are keen to achieve much better informed consumers, and that includes children. Smoking is taken up by 320,000 children each year, and we have a big battle on our hands. In my role as Minister with responsibility for public health, it is important that I understand that some of the choices that children face are very complex. We need to ensure that they have the skills they need to make good decisions about their life and that they have the information on which to base those decisions.
My hon. Friend strayed into type 2 diabetes, and there is a danger of my straying much further tonight. However, I finish by commending my hon. Friend for raising this issue and for the work that he has obviously done with some of those people and families who have been affected. I look forward to working with him in the future to ensure that we do all that we can to further the cause he has raised.
Question put and agreed to.