A recent high-level report may mark the end for a favourite cocktail of young Irish drinkers – vodka and Red Bull.
Ross Cooney was only 18 when he died suddenly while playing in a basketball tournament. He was said to have gone into some sort of fit. He stopped breathing and his skin began to turn grey. The inquest into his death concluded that he had died of Sudden Adult Death Syndrome - a very rare condition affecting about one in 30,000 people. But the inquest also called for immediate research to be done into the effects of drinking stimulant or high energy drinks.
Mr Cooney had, it seems, drunk up to three cans of Red Bull on the day he collapsed and died.
A representative of Red Bull from Austria was among those giving evidence at the inquest. Dr Volker Viechtbauer explained that Red Bull was sold in 44 countries worldwide, that it had never been banned in any country, and that he had never received any report of a person dying after consuming it.
The inquest was informed that an EU committee, which had looked into high-energy drinks, concluded that more research was needed to establish upper safety limits for consumption of two particular ingredients in Red Bull - taurine and glucuronolactone. Dr Viechtbauer pointed out, though, that the EU report had also noted that there was no evidence the two ingredients were toxic.
Mr Cooney’s basketball coach, Mr Paul Marrinan, said that some weeks before Mr Cooney's death a representative from Red Bull had told him people playing games and drinking Red Bull should dilute it with four times as much water to avoid dehydration. It seems clear that such care is not being exercised widely.
Red Bull is a carbonated non-alcoholic drink with a high caffeine content. It was introduced to Ireland in 1995 and has achieved massive sales, becoming especially popular among clubbers. Sales of Red Bull are at about 1 million cans per year in Ireland. Other similar high energy drinks on sale include Top Secret, Erektus, Semtex forte, Shark V, American Bull, Lipovitan B3 and Spiked Silver.
Red Bull itself comes in an attractively slim can, with the word Stimulation appearing prominently, and the lines: “With Taurine. Vitalizes body and mind.” In smaller writing the can also states that “Red Bull Energy Drink® is especially developed for times of increased stress and strains: Stimulates metabolism, Increases physical endurance, Improves and increases concentration and reaction speed.”
The website, in a cartoonish presentation, goes further, and claims that Red Bull’s “unique composition of ingredients” also increases mental alertness, improves overall feeling of well being, and increases stamina. There is also a list of occasions when Red Bull is “the ideal energy drink:
“Wherever and whenever.
When a long day is over and a long night starts.
On long sleep-inducing motorways.
During intensive working days when the date planner is filling up and your energy reserves are emptying out.
Prior to demanding athletic activities, or in a performance drop during a game. As Red Bull has not been formulated to deliver re-hydration, we encourage people who are engaged in sport also to drink lots of water during intense exercise.
Before tests and exams, when there's no time to sleep.
Or as first-aid after a long party night.”
In January 2001 the UK Advertising Standards Authority upheld complaints about claims made for Red Bull in their promotions. The makers of the drink had from then to seek prior approval for advertisements of the product. The authority explained that newspaper, magazine and poster advertisements all contained claims that the manufacturers could not prove at the time the complaints were made.
A prominent feature on the website is profiles of various athletes. It is stated that “Red Bull has always supported exceptional athletes and exceptional sports.” A list of athletes follows representing sports such as Surfing, BMX, Motorcross, and Paragliding. However, sports nutritionists have pointed out that because these drinks have high levels of caffeine and sugar they are not appropriate for sports. That combination is more likely to slow the body's ability to absorb water, and therefore cause dehydration. “Caffeine in a can with a lot of sugar,” is how one American nutritionist described it. Cardiologists say that large amounts of either caffeine or alcohol can be dangerous to the heart, resulting in cardiac changes such as racing heartbeat, increased blood pressure and even heart attack.
One regular clubber, Jane, explains that in the pub she and her friends would drink their normal drinks, whether wine or gin and tonic or beer. But if they go to a club afterwards they would all have vodka and Red Bull, anything up to five each in one night. Jane continues: “We would also drink it quite often at work too – to stay awake or whatever. As a boost. I used to drink a lot of it in college as well, when I was studying for exams.”
One nightclub owner said that from the start customers paired Red Bull with alcohol. The marketing strategy was to work closely with pubs. Red Bull claims that this is in fact to offer an alternative to alcohol in the pubs. But the demand for Red Bull as a mixer with vodka was a very sudden and pronounced development.
In 1999 two men who had been drinking beer and Red Bull all day stabbed a Dublin man in an unprovoked attack. In the ensuing court case Judge Patrick McCartan said that drinking Red Bull had become a "daily excuser" and made him wonder if it should be on sale at all.
The Taoiseach, Mr Ahern, expressed his concern about the possible connection between street violence involving young men and their consumption of stimulant drinks, and asked gardaí to investigate the possible link.
Mr John Gormley, Green Party TD, said at the time: "At the very least drinks such as Red Bull carry very high levels of caffeine and should carry a comprehensive warning and not just a passing reference to caffeine allergies and a warning to diabetics. In particular, the Minister [of Health] needs to examine if there are any serious side-effects when stimulant drinks are mixed with alcohol."
Mr David Byrne, the EU Commissioner for Health and Consumer Protection, backed the recommendation by the Ross Cooney inquest jury to do research into the safety of such drinks. Mr Byrne said: "It has been brought to my attention also that there is a mix sometimes between alcohol and the stimulants, and this is something that we are going to have to address .. to see whether this is a cause for concern.”
The Government established a committee to investigate Red Bull and other high-energy drinks, to decide on whether stimulant drinks should be regulated. The Stimulant Drinks Committee was established by the Food Safety Promotion Board (FSPB) as an all-Ireland body under the Belfast Agreement. A committee member, Dr Thomas Quigley, FSPB chief consultant in food safety, said it would examine areas such as the potential adverse physiological effects of the drinks’ individual and combined ingredients, either on their own or combined with alcohol.
The committee's first task was to conduct a survey of the drinking patterns associated with these drinks in the country. Subjects as young as 10 years were asked how often they take stimulant drinks, how much they drink and what other drinks, including alcohol, they mix with them. It was found that 51% of 11 to 25 year-olds had consumed stimulant drinks at least once, and one in ten of those did so regularly, with the highest consumption among men between 19 and 24.
The FSPB liaised with Sweden's National Food Administration who had previously advised Swedes not to take Red Bull mixed with alcohol or after exercise. The warning followed deaths of three people there, all of whom were thought to have consumed Red Bull before they died. One woman, 31, collapsed on the floor of a nightclub. Another died after drinking several cans following a workout at the gym.
A spokesman for Red Bull said the links between the Swedish deaths and the company's product were extremely tentative. "We don't even know if the people who died had been taking Red Bull," the spokesman said.
The Food Safety Promotion Board’s final report makes a number of recommendations including
· stimulant drinks should be labelled with an indication that they are unsuitable for children (under 16 years of age), pregnant women and individuals sensitive to caffeine
· they should be classified with other beverages of high caffeine content
· the consumption of stimulant drinks by children under 16 years should be discouraged
· caution should be exercised in the consumption of stimulant drinks with alcohol
· they should not be consumed in association with sport and exercise as a thirst quencher
· they are unsuitable rehydration agents for use in sport and during exercise.
Commenting further Professor Sean Strain, Chairman of the Stimulant Drinks sub-committee said, “The Committee was constrained by the limited amount of comprehensive information, risk assessment data and peer reviewed scientific research in this area. In light of this limited information and in order to protect public health, we have adopted a precautionary approach to its review.”
Red Bull Ireland have said they welcome report, “in particular that there is nothing in it to dissuade people from using Red Bull energy drink.” They concluded: “Red Bull is used for energy by many leading athletes. It has always been marketed in this way and not as a thirst quencher.”