NOW Magazine Online Edition: Dec 9

If booze is the poor man's opium, then what are we to make of Red Bull, the potent energy drink that's become a party favourite mixed with alcohol? At least two European countries have banned it, citing "dangers to public health." Its connection when mixed with alcohol to several deaths in Sweden – Red Bull and vodka is a world-renowned potable these days – remains unproven but nevertherless continues to raise more questions abroad.

Although Red Bull's label expressly warns against its consumption with alcohol, in the U.S. the company has sent undercover operatives into bars and filed suit against establishments that substitute other mixes when customers have ordered Red Bull.

"There's no reason why Red Bull energy drink should not be mixed with alcohol like any other drink as long as people don't underestimate that alcohol consumption might impair their mental and physical activities," writes Red Bull spokesperson Patrice Radden in an e-mail response to a list of questions sent the company. Red Bull declined to make a company rep available for a telephone interview.

The European Economic Community Scientific Committee on Foods has looked at anecdotal reports of side effects ranging from dizziness and muscle weakness to headache and hypoventilation in people who have shown up at hospitals after consuming the energy drink.

Radden writes that Red Bull is "not aware of such reports," pointing out that last year alone 1.6 billion cans and bottles of the product were consumed in 120 countries worldwide. "No one anywhere has ever shown any link between Red Bull energy drink and harmful effects."

The syrupy sludge was green-lighted for sale in Canada in June, thanks to changes – a loophole, critics say – to the Natural Health Products Regulations. Those changes allow a product to be sold if a company can present data to back up efficacy claims.

While some complementary and alternative health practitioners are pleased the rewritten regs will ensure the availability of botanical and homeopathic medicines and dietary supplements not previously available for patient treatment, there is a downside – specifically, the danger of mammoth corporations deploying considerable resources to generate whatever amount of "independent" research it takes to get their products on the shelves and into the guts of the masses.

Enter Red Bull, with $1.5 billion U.S. in annual sales and more than $330 million spent on advertising and promo in the last six years in the U.S. alone. The Austria-based powerhouse filed its application for approval for sale in Canada the day after the new regs were passed.

But contrary to popular thinking, the Bull was never banned in these parts, just "previously not approved for sale," says Nathalie Lalonde of Health Canada.

Red Bull claims, among other things, to improve "performance..., concentration and reaction..., vigilance (and) emotional status." The Red Bull Web site further recommends use "on long, sleep-inducing motorways, during intensive working days, prior to demanding athletic activities or before tests and exams."

All of this is good by Health Canada. According to Lalonde, "A product cannot be approved if we don't have enough data to substantiate its claims – any claims."

Red Bull's claims have led to legions of college and grade-school students pounding away before class and while cramming. The Web is full of bloggers attributing their meteoric rise in grades to use of the drink.

But while Health Canada's Lalonde refers to the new regulations as "an opening" for Red Bull and products of that ilk, others, like Eric Marsden, a naturopathic doctor and energy drink expert with the Ontario Association of Naturopathic Doctors, considers the changes a ready-made loophole.

Energy drinks can be marketed as beneficial for your health because they contain vitamins and minerals.

Marsden says they're pseudo-drugs – in fact, most of Red Bull's ingredients are synthetically produced by pharmaceutical companies – that have physiological effects on the body, but because of the labelling, or lack thereof, many people don't even think about the heightened effect of these torqued-up puppies.

Marsden says there "could be an understating of the potential risks of long-term ingestion of caffeine, taurine and glucuronolactone," all ingredients in Red Bull.

Both taurine, a semi-essential amino acid, and glucuronolactone, a sugar, occur naturally in the body.

Taurine shows up in meat, and massive meat-munchers take in about 400 mg per day. Red Bull contains a whopping 1,000 mg in each 250 ml tin.

Glucuronolactone is found in wine at a concentration of about 20 mg/L at most. Red Bull rides on 600 mg per 250 ml can. The problem is that there are no long-term studies on either substance. Marsden cautions, "A lot of naturally occurring things are hard on the body."

Too-high levels of caffeine and taurine were what Lalonde says held back initial approval of the product. The elevated levels of taurine and glucuronolactone are also why the product is not recommended for children or pregnant or lactating women.

Deaths in Sweden allegedly related to Red Bull-and-alcohol consumption led the European Economic Community Scientific Committee on Foods to consider the potential detrimental health effects of the product in both 1999 and 2003.

Toxicity studies on rodents whose water supply was laced with Red Bull, and on the "possibility" of interactions between taurine and alcohol, and caffeine and alcohol were also explored by the committee based on "anecdotal reports of acute adverse effects in young persons consuming energy drinks, usually together with alcohol and/or drugs used socially, such as ecstasy and amphetamines."

Red Bull's submission to the EEC committee states that "no adverse health effects attributable to taurine have been reported in more than 30 clinical investigations reported over a period of 30 years."

As in 1999, the committee found in 2003 that "there is insufficient information on which to set an upper safe level for daily intake" for both glucuronolactone and taurine.

France and Denmark, which have pre-market testing procedures in place, have banned Red Bull outright.

The European Commission of the EEC challenged the ban on energy drinks on the basis of "failure of a member state to fulfill obligations."

But the right of both France and Denmark to ban them was upheld earlier this year by European courts, which found that "the Commission has not adduced evidence sufficient to call into question (the) authorities' analysis as regards the dangers those drinks pose to public health."

However, Italy was unable to defend its ban on energy drinks containing more than 125 mg/L of caffeine (Red Bull has 320 mg/L). The courts ruled that its prohibition was instituted "without showing that that limit is necessary and proportionate to the protection of public health."

Although the company says it advises against mixing Red Bull with booze, it has filed suit against bars in the U.S. "passing off," i.e., substituting another product for Red Bull as a mix.

South of the border, Red Bull is considered a dietary supplement. Under the U.S. Dietary Supplement Health And Education Act, energy drink products "do not need Food and Drug Administration (FDA) approval before they are marketed," nor are they required to provide the "evidence (they rely) on to substantiate safety or effectiveness."

Last month, however, the FDA announced major new initiatives on dietary supplements to improve the "transparency, predictability and consistency of (the FDA's) scientific evaluations and regulatory actions." Ikhlas Khan, assistant director of the National Center for Natural Products Research, can see the energy drink stink from both sides. Says Khan, "As much as we like to blame the companies, consumers see everything as a wonder drug.There's no 'magic drink,' and that's the bottom line."

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