Gathering consumption data on specific consumer groups of energy drinks 1

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1 Supporting Publications 2013:EN-394 EXTERNAL SCIENTIFIC REPORT Gathering consumption data on specific consumer groups of energy 1 NOMISMA-ARETÉ Consortium 2 : Silvia Zucconi a, Chiara Volpato a, Felice Adinolfi a, Evita Gandini a, Enrica Gentile b, Alberico Loi b, Linda Fioriti b a Nomisma SpA b Areté Srl 1 Question No EFSA-Q The Nomisma-Areté consortium acknowledges the EFSA steering Group and in particular the following staff members for their support and teamwork: Tobin Robinson (EMRISK Unit), Arianna Chiusolo (EMRISK Unit), Andrea Altieri (EMRISK Unit), Jean-Lou Dorne (EMRISK Unit), Davide Arcella (DCM Unit). Any enquiries related to this output should be addressed to emrisk@efsa.europa.eu Suggested citation: Zucconi S., Volpato C., Adinolfi F., Gandini E., Gentile E., Loi A., Fioriti L.; Gathering consumption data on specific consumer groups of energy. Supporting Publications 2013:EN-394. [190 pp.]. Available online: European Food Safety Authority, 2013.

2 ABSTRACT At the end of 2011, a study was commissioned by EFSA to the Consortium Nomisma-Areté, with the objective of gathering consumption data for energy (ED) in specific consumer groups (adults, adolescents and children) in EU. The study also aims at estimating, for each consumer group, the exposure to specific active ingredients (caffeine, taurine, and D-glucurono-y-lactone) from ED consumption, and the relative contribution of ED to the total caffeine exposure. Moreover, specific consumption habits (co-consumption with alcohol and consumption associated to intense physical exercise) were analysed for adolescents and adults. Between February and November 2012, the study team conducted an EU-wide questionnaire-based survey - involving more than participants from 16 different EU Member States 3 - among adults ( participants), adolescents (32.000), and children (5.500). The highest prevalence of consumption 4 was observed for the adolescent consumers group (68%). In adults prevalence for consumption was 30%, and 18% in children. Among consumers, no relevant differences were observed in the target groups for prevalence of high chronic consumers 5 (12% in adults and adolescents, 16% in children) and high acute consumers 6 (11% for adults and 12% for adolescents). Concerning co-consumption with alcohol, similar prevalence was observed for adults (56%) and adolescents (53%). Consumption associated to sport activities showed prevalence of 52% in adults and 41% in adolescents. Among ED consumers, the estimated average exposures from ED to caffeine, taurine and D- glucurono-y-lactone were higher in children (1,01, 12,83 and 5,13 mg/kg b.w./day, respectively) than adolescents (0,38, 4,6 and 1,65 mg/kg b.w./day, respectively) and adults (0,32, 3,82 and 1,78 mg/kg b.w./day, respectively). The calculated contribution from ED consumption to total caffeine exposure was 8% for adults, 13% for adolescents and 43% for children. The contribution increased for the high chronic consumers to 13% in adults, 16% in adolescents and 48% in children. Nomisma-Areté consortium Parts of this publication may be reproduced, provided acknowledgement is given to the Nomisma-Areté consortium, along with the authors, title and year of publication as mentioned on page 1. KEY WORDS Energy, caffeine, taurine, D-glucurono-y-lactone, active ingredients, survey, consumption. 3 Austria, Belgium, Cyprus, Czech Republic, Germany, Greece, Finland, France, Hungary, Italy, Poland, Romania, Spain, Sweden, The Netherlands, United Kingdom. 4 In the present study consumers of ED are subjects who declared to have drunk ED at least once over the last year. 5 In the present study high chronic consumers are respondents who regularly consumed ED 4-5 days a week or more (identified in relation to a frequency distribution for ED consumption greater than or equal to the 90 th percentile). 6 In the present study high acute consumers are respondents consuming 1 litre or more of ED per single session in the case of adults and 1,065 litres or more of ED per single session in the case of adolescents (identified in relation with declared volume consumed in a single session and setting the threshold at the 90 th percentile). Supporting Publications 2013:EN-394 2

3 SUMMARY At the end of 2011, a study was commissioned by EFSA to the Consortium Nomisma-Areté, with the objective of gathering consumption data for energy (ED) in specific consumer groups (adults, adolescents and children) in EU). The study also aims at estimating, for the different consumer groups, the exposure to specific active ingredients (caffeine, taurine, and D-glucurono-y-lactone) from ED consumption, and the relative contribution of ED to the total caffeine exposure. Moreover, specific consumption habits (co-consumption with alcohol and consumption associated to intense physical exercise) should be analysed for adolescents and adults. Between February and November 2012, the study team conducted an EU-wide questionnaire-based survey - involving more than participants from 16 different EU Member States 7 (MS) - among adults ( participants), adolescents (32.000), and children (5.500). Survey results Adults Around 30% of adults interviewed declared to have consumed ED at least once during the last year, with prevalence varying among MS from 14% in Cyprus to 50% in Austria, and mainly (53%) in young adults (18-29 years). Among ED consumers, the average volume consumed was 2 L/month. Approximately 12% of adult consumers were identified as high chronic consumers, i.e. consuming ED 4-5 times/week or more (13,3% in young adult consumers), consuming an average volume of 4,5 L/month. High acute consumers (consuming at least 1 L/single session), were 11% of the total adult ED consumers, mainly in young adults (13,4%). The co-consumption of ED and alcohol was evidenced for around 56% of adult ED consumers (71% in young adults ). ED consumption in relation with physical exercise resulted for 52% of adult ED consumers, mainly (55%) in old adults (50-65 years). The average exposure to caffeine from ED was 22,4 mg/day (0,32 mg/kg b.w. 8 /day) for adult ED consumers, and the ED contribution to the total caffeine exposure was 8%. Caffeine exposure from ED increased to 48,3 mg/day (0,7 mg/kg b.w./day) in high chronic consumers, with a ED relative contribution of approximately 13%. Average exposure to taurine from ED was 271,9 mg/day (3,82 mg/kg b.w./day) in adult ED consumers, rising to 585,79 mg/day (8,49 mg/kg b.w./day) in high chronic consumers. Average exposure to D-glucurono-y-lactone from ED was 125,95 mg/day (1,78 mg/kg b.w./day) on average for ED consumers, up to 268,84 mg/day (3,91 mg/kg b.w./day) in high chronic consumers. 7 Austria, Belgium, Cyprus, Czech Republic, Germany, Greece, Finland, France, Hungary, Italy, Poland, Romania, Spain, Sweden, The Netherlands, United Kingdom. 8 Data on the exposure expressed for kg of body weight (b.w.) were calculated for each consumer on the basis of declared body weight collected through the survey. In case of missing data, data on body weight from EFSA scientific opinion Guidance on selected default values to be used by the EFSA Scientific Committee, Scientific Panels and Units in the absence of actual measured data (EFSA, 2012) were adopted. Supporting Publications 2013:EN-394 3

4 Adolescents Prevalence of ED consumption was 68%, varying from 48% in Greece to 82% in Czech Republic 9, and mainly observed (73%) in the age subgroup. Among ED consumers, the average volume consumed was 2,1 L/month. Around 12% of adolescent consumers were identified as high chronic consumers, i.e. consuming ED 4-5 times/ week or more, with an average ED volume of 7 L/month. Around 12% of adolescent ED consumers resulted to be high acute consumers, i.e. consuming at least 1,065 L of ED per single session. Co-consumption of ED and alcohol was observed in 53% of adolescent ED consumers, mainly (59%) in the years subgroup, while ED consumption in relation with physical exercise resulted to interest 41% of adolescent consumers, mainly (48%) in the years subgroup. The average exposure to caffeine from ED was 23,5 mg/day (0,38 mg/kg b.w./day) for adolescent ED consumers, with an average contribution of ED to the total caffeine exposure of 13%. The caffeine exposure from ED increased to 75,08 mg/day (1,18 mg/kg b.w./day) in high chronic consumers, contributing to 16% of total caffeine exposure. The average exposure to taurine from ED was 283,9 mg/day (4,6 mg/kg b.w./day) in adolescent ED consumers, rising up to 924,3 mg/day (14,5 mg/kg b.w./day) in high chronic consumers. Average exposure to D-glucurono-y-lactone from ED was 100,14 mg/day (1,65 mg/kg b.w./day), up to 311,6 mg/day (4,9 mg/kg b.w./day) in high chronic consumers. Children Prevalence of ED consumption was 18%, mainly (19%) observed in the 6-10 years subgroup, and varying among MS from 6% in Hungary to 40% in in Czech Republic. Among ED consumers, the average volume consumed was 0,49 L/week. Approximately 16% of ED consumers resulted to be high chronic consumers, i.e. consuming ED 4-5 times/ week or more, with an average volume of around 0,95 L /week. Average caffeine exposure from ED was 21,97 mg/day (1 mg/kg b.w./day), with a relative contribution of ED to total caffeine exposure of 43%. Caffeine exposure from ED increased to 42,9 mg/day (1,98 mg/kg b.w./day) in high chronic consumers, with a ED relative contribution of 48%. Average exposure to taurine from ED was 278,37 mg/day (12,83 mg/kg b.w./day), increasing to 543,57 mg/day (25,05 mg/kg b.w./day) in the high chronic consumers. Finally, average exposure to D-glucurono-y-lactone from ED was 111,35 mg/day (5,13 mg/kg b.w./day), increasing to 217,43 mg/day (10 mg/kg b.w./day) for high chronic consumers. Literature review Results emerging from the literature review highlighted a limited availability of recent and comprehensive studies or surveys at EU level, providing reliable data on ED consumption and exposure to specific ingredients (caffeine, taurine, and D-glucurono-y-lactone). Such limitation did not allow an analysis of the evolution of ED consumption over time. 9 The highest prevalence of ED consumption among total respondents was observed in Belgium (85%) but not reported due to the small dimension of the sample for this MS (sampling error of estimates exceeds 5%). Supporting Publications 2013:EN-394 4

5 Recommendations Gathering consumption data on specific consumer groups of energy The project represented the first effort at European level of data collection on ED consumption and contribution to some active ingredients (caffeine, taurine, and D-glucurono-y-lactone) exposure, in specific consumer groups and in different MS. Due to the exponential growth rate which characterised the ED market over the last years, the study team suggests to monitor possible further increases in ED consumption and eventually consider the possibility to update the study. Supporting Publications 2013:EN-394 5

6 TABLE OF CONTENTS Abstract... 2 Summary... 3 Table of contents... 6 Background... 8 Terms of reference Introduction and Objectives Materials and Methods Literature review Stakeholders consultation Pre-survey and post-survey consultations Survey Selection of MS involved in the survey Study design Pilot study and quality checks Data processing methods for calculating the exposure to active ingredients Caffeine exposure from ED consumption Caffeine exposure from consumption of other food products and beverages Contribution of ED to total caffeine exposure Contribution of ED to total exposure to taurine and D-glucurono-y-lactone Criteria for defining patterns of ED consumption (acute and chronic consumers) Problems encountered, related solutions and limitations of the study Results Literature review Overview Focus on the most relevant references Stakeholders consultation: emerging issues Literature and sources ED market Active ingredients Survey: results General overview Adults ED consumption Co-consumption of ED and alcohol Consumption of ED during sport activities ED contribution to total exposure to relevant substances ED acute consumption: analysis on high acute consumers Exposure to active ingredients in high acute adult consumers Adolescents ED consumption Co-consumption of ED with alcohol Consumption of ED during sport activities ED contribution to total exposure to relevant substances ED acute consumption: analysis on high acute consumers Exposure to active ingredients in high acute adolescent consumers Children ED consumption ED contribution to total exposure to relevant substances Conclusions and recommendations Literature review Supporting Publications 2013:EN-394 6

7 4.2. Results emerging from the survey Recommendations References Appendices A. Appendix - Stakeholders consultation: complete list of contacts B. Appendix - Stakeholders consultation: list of questions C. Appendix - Stakeholders consultation: reference documents for the interview D. Appendix - Stakeholders consultation: main findings E. Appendix - Content of relevant substances in different ed brands indicated as "other" by respondents in the questionnaire F. Appendix - Details on caffeine content for the categories of food selected for the calculation of exposure Glossary and abbreviations Supporting Publications 2013:EN-394 7

8 BACKGROUND Consumption of ED and related issues Energy (ED) constitute a relatively new product category in the wider soft market. Lipvitan D, launched in Japan in 1960 by Taisho Pharmaceuticals, can be considered the first ED ever. The diffusion of ED in Europe started in 1987 with the launch of Red Bull, a beverage containing taurine and produced in Austria, which quickly gained popularity in Europe and, from 1997 onwards, also in the USA. Commercial success of Red Bull sparked the proliferation of similar products on the market. With an agreed definition of ED still missing, such category includes a variety of non-alcoholic beverages containing caffeine, taurine and vitamins (often in combination with other ingredients), marketed for their actual or perceived effects as stimulants, energizers and performance enhancers. For this reason, ED which should not be confused with isotonic beverages and sport are usually included in the wider group of functional foods. The most common active substance in ED is caffeine, which is often combined also with taurine, D- glucurono-y-lactone, guaranà, maltodextrin, ginseng, carnitine, creatine and gingko biloba; other common ingredients are vitamins and - usually artificial and natural sweeteners (which are added also to mask the unpleasant flavour of some ingredients). Caffeine is an alkaloid, acting as central nervous system stimulant. It is present in many beverages and food products: its content in ED can vary from 70 to 400 mg/l and more (maximum limits concerning caffeine content are set by regulations in many countries). Taurine is an amino acid naturally produced by human body, and it is essential for cardiovascular function, and development and function of skeletal muscle, the retina and the central nervous system D-glucurono-y-lactone is naturally present in human body, as important structural component of connective tissues. The rapid expansion of ED consumption has been one of the most notable trends in the soft market of many countries (see next ). However, such expansion has also created concern in the scientific community, in national and international institutions dealing with health-related issues, as well as in the public opinion, in the light of a number of issues which are often associated to ED consumption. Indeed in the last years the attention for such issues has been remarkable in scientific literature, in institutional communication by national health agencies, in specialist publications focusing on the soft sector 10, and also in the general media. The issue of ED consumption and over-consumption is highly debated from a scientific point of view, especially for what the possible related health effects are concerned. Indeed a number of studies (Alford et al., 2011; Reissig et al., 2009; SHC, 2012; Arria et al., 2011; Marin Institute, 2011; Oteri et al., 2007) have recently investigated on potential and/or detected effects of active ingredients (caffeine, taurine, D-glucurono-y-lactone, etc.) on highly sensitive subjects (children, pregnant women, heart patients, etc.), or on potential and/or detected effects of co-consuming of ED with alcohol or with other products containing active ingredients. 10 A recent example is the article ANSES warns French nation of risky alcohol energy drink mix, featured on Beverage Daily.com website on June 07, 2012: French-nation-of-risky-alcohol-energy-drink-mix Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

9 Moreover, the issue of co-consumption of ED with alcohol is cause of particular concern, as it appears to be quite common among youths (Marin Institute, 2007; Miller, 2008; SHC, 2009). Indeed health effects of co-consumption of alcohol and ED have been dealt with by a number of scientific studies (Arria et al., 2010; Alford et al. 2011; Brache and Stockwell, 2011; Oteri et al., 2007) and technical reports (BfR, 2008; EUCAM, 2008, 2009). Finally, also the association between sport practice and high levels of consumption of ED has raised some concern, as the combined effect of intense physical effort and of the stimulant action of ED could pose health risks for some subjects. In 2003 the Scientific Committee on Food of the European Commission (DG SANCO) 11 classified ED consumption levels into mean chronic, high chronic and acute (table 1). Table 1 ED consumption levels Consumption N of 250 ml cans per day ml/day Mean chronic 0,5 125 High chronic 1,4 350 Acute 3,0 750 Source: DG SANCO - Scientific Committee on Food (2003) Increasing consumption of ED implies a higher exposure to caffeine, taurine and D-glucurono-ylactone. Higher exposure to such active substances by children and young adults was identified as a potential emerging risk at European Food Safety Authority s (EFSA) Advisory Forum meeting of 19th- 20th May Indeed available information suggests that ED consumption is becoming more and more widespread among youths, especially in relation with mass-entertainment and sport practice. Despite the high scientific interest related to the possible side effects of ED, the limited availability of detailed and updated information on ED consumption in the EU has been highlighted by many experts and stakeholders. EFSA commissioned the present study to gather consumption data for ED and data on exposure to specific ingredients (caffeine, D-glucurono-y-lactone, taurine) in the context of ED consumption, for specific consumer groups (children, adolescents and adults) and addressing specific moments of consumption. The study is also aimed at estimating the relative contribution of ED to the total exposure to caffeine, D-glucurono-y-lactone and taurine in the diet (in comparison with the exposure deriving from consumption of coffee, tea, cola and cacao, chocolate products, coffeebased beverages, etc.). The market of ED in Europe In the context of the overall market for non-alcoholic beverages, ED are usually considered as a segment of the wider category of functional beverages. According to Zenith International s Global Energy Drinks Report (2009), world total consumption of ED in 2008 reached 3,9 billion litres (compared to 2 billion litres in 2003). Per capita consumption at world level was equal to 0,8 litres (up from 0,4 litres in 2003). North America accounted for a 37% share of overall world consumption in 2008, with the Asia/Pacific area accounting for another 30%; the share of Western Europe on world total was equal to 15%. According to estimates by Euromonitor International, the expansion of the ED market at global level has continued at a fast pace also in recent years (table 2). 11 European Commission health & consumer protection directorate-general Scientific Committee on Food, Opinion of the Scientific Committee on Food on Additional information on energy, Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

10 Table 2 Growth of the functional market at world level by segment ( ; million litres) % growth Segments (forecast) (2011 vs. 2006) Sports % Energy % Functional - TOTAL Source: Euromonitor % On the basis of data provided by the Canadean s Global Beverage Report (2008), the annual growth rate for the ED segment in the period was forecast at +9,3%, compared to a growth rate of +2,6% for the overall non-alcoholic beverages market. Red Bull is by far the leading brand at world level (40% of total sales in 2008), with Monster (owned by Hansen s Beverage Company) and Rockstar ranked second and third, respectively (table 3). Table 3 Leading ED brands at world level (2008, market shares) Source: Bevnet Brands share Red Bull 40% Monster 23% Rockstar 12,3% AMP 8% Full Throttle 4% Doubleshot 2% NOS 1,5% No Fear 1,4% Private Labels (retailers brands) 1% SOBE Adrenaline 0,7% With regards to the ED market in Europe, it has experienced a rapid growth of consumption, especially from 2005 onwards (Zenith International, 2008). Total production of ED in Europe was estimated at around 490 million litres in 2007, for a value of approximately 3,8 billion Euros. The expansion of the market has been especially remarkable in some MS (Germany and United Kingdom in particular 12 ), and has often resulted in a proliferation of brands, with frequent launch of new products, many of them with eminently national diffusion. Convenience ED (many of them marketed under private label) and innovative product typologies ( energy shots, pre-mixed alcoholic 12 According to Zenith International data featured in the annual reports of the British Soft Drinks Association (BSDA), ED consumption in the United Kingdom has grown from 175 million litres in 2000 (1,5% of total soft consumption) to 495 million litres in 2011 (3,4% of total soft consumption, for an increase of 183% in terms of volume). Per capita consumption levels have increased from 3 litres per person in 2000 to 7,9 litres per person in In other MS the growth has been less intense, and overall consumption volumes are quite limited; in Italy, for instance, consumption of ED (according to GFK-Eurisko data published on MARK UP magazine, April 2009 and April 2010 issues) has passed from 2,67 million litres in 2006 to 2,97 million litres in 2009 (an increase of 11%). Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

11 ED, etc.) have also appeared in some national markets (Alard, Marìn, Cubillo, 2010; EUCAM, 2008 and 2009). Red Bull is by far the leading brand in virtually all national markets; smaller market shares are held by other international brands (Monster, Burn ), by national brands (of which some are however owned by multinational groups) and by private labels. Outline of the relevant EU labeling legislation A short overview of the most relevant European legislation on food labelling - with particular attention to the rules concerning beverages containing active ingredients is provided hereafter. Directive 2000/13/EC of the European Parliament and of the Council on the approximation of the laws of the MS relating to the labelling, presentation and advertising of foodstuffs. The Directive defines mandatory food information to be provided by producers, in order to assure a high level of protection of consumers health and interests. According to this Directive, among the other features (such as the name of the food) it is mandatory to indicate the list of ingredients and the quantity of certain ingredients, or category of ingredients, on the product label. Directive 2002/67/EC of the European Commission on the labelling of foodstuffs containing quinine, and of foodstuffs containing caffeine. The Directive establishes that beverages containing more than 150 mg of caffeine per litre must be labelled with the term high caffeine content, in a position close to the name of the food. Furthermore a clear indication of the amount of caffeine per 100 ml in the product must be provided in the label. In this Directive ED are explicitly indicated as caffeine containing products which, according to the Scientific Committee for Food opinion of 21 st January 1999, do not represent a cause of concern for their contribution to the total consumption of caffeine (only for adults, pregnant women excluded). Regulation (EU) No 1169/2011 of the European Parliament and of the Council on the provision of food information to consumers. From 14 th December 2014 this Regulation will enforce additional caffeine labelling for high caffeine and foods where caffeine is added for its physiological effects 13. In particular, the following categories of beverages must be labelled with the statement High caffeine content. Not recommended for children or pregnant or breast-feeding women placed near the name of the product and followed by the caffeine content specified in mg per 100 ml: - beverages intended for consumption without modification, containing at least 150 mg/l of caffeine; - beverages in concentrated or dried form which after reconstitution contain caffeine in a proportion in excess of 150 mg/l. The aforementioned provisions will instead not apply for: - based on coffee, tea or coffee or tea extract where the name of the food includes the term coffee or tea ; 13 Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

12 - beverages where caffeine is added as a flavouring rather than for a physiological purpose: in this case the term caffeine must appear in the ingredients list under the section flavouring(s). As for labelling on beverages containing taurine and D-glucurono-y-lactone, there are no specific rules to be enforced to indicate these substances. Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

13 TERMS OF REFERENCE As already outlined, the main purpose of the study is gathering information and data on consumption of ED and of some specific ingredients (specifically caffeine, taurine and D-glucurono-y-lactone) in welldefined consumer groups in a number of EU MS. The targeted groups of consumers include children (from 3 to 10 year old), adolescents (from 10 to 18), and adults (from 18 to 65); a focus is also foreseen on adolescents and adults practising intense physical exercise and co-consuming ED with alcohol. According to the terms of reference, in the context of the study: Consumption of ED is analysed at MS level and expressed per subgroup and per unit of time, in order to reflect acute and chronic exposure. Consumption of and exposure to specific ingredients (caffeine, taurine, D-glucurono-y-lactone) are analysed per subgroup for acute and chronic ED consumers in each MS. As for caffeine consumption, the relative contribution of ED is determined and compared with caffeine consumption from major sources in the diet (coffee, tea, cola and cacao, chocolate products, coffee based beverages, etc) to assess whether ED consumption is adding to exposure to caffeine or whether their consumption is substituting exposure via more traditional foods. This contract was awarded by EFSA to: Consortium Nomisma-Areté Contractor: Consortium Nomisma-Areté Contract title: Gathering consumption data on specific consumer groups of energy Contract number: CFT/EFSA/EMRISK/2011/03 Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

14 1. INTRODUCTION AND OBJECTIVES According to the terms of reference, the main objectives of the study can be identified in the following: - Gathering data about consumption of ED in the EU MS (Objective 1); - Collecting data at MS level about the exposure to specific active ingredients (caffeine, taurine, D-glucurono-y-lactone) due to ED consumption, and estimating the relative contribution of ED to caffeine exposure, compared with caffeine consumption from major sources in the diet (Objective 2). In order to achieve the above mentioned objectives, a specific data collection strategy was defined, based on three main elements: 1. review of the relevant literature dealing with the subjects of interest available in the different MS and published over the last three years; 2. consultation of the relevant stakeholders (experts of EFSA national focal points; officials of competent authorities in the field of public health; representatives of the main beverages industry associations both at European and national levels); 3. ad hoc survey, aimed at gathering primary data on the consumption of ED and on the exposure to specific ingredients. The present document constitutes the final report for the study Gathering consumption data on specific consumer groups of energy, commissioned by EFSA to the Consortium Nomisma-Areté at the end of According to the tender specifications for the study, and taking into account EFSA s guidelines for the submission of official reports, the document is structured as follows: - A description of the methodology applied in the study (chapter 2); - A description of the results of the study (chapter 3), divided into: o A description of the results from the literature review ( 3.1); o A description of the results from the stakeholders consultation ( 3.2); o Final results from the survey ( 3.3), as a summary of data on acute and chronic consumption of ED in the previously mentioned subgroups of the population, including summary statistics for each Member State (MS) and for all MS for which data were available. - Conclusions and recommendations (chapter 4). Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

15 2. MATERIALS AND METHODS Due to the complexity of the study and the kind of information required for the purpose of the analysis, a specific data collection strategy was defined, including a combination of different methods and tools (Figure 1). Figure 1: Data collection strategy As foreseen in the data collection strategy, the preliminary phase of the study included: - Literature review, carried out also with the support and contribution of selected stakeholders. - Identification and contact of stakeholders, aimed at ensuring their contribute to the study via interviews (stakeholders consultation). - Survey. The following paragraphs provide details regarding the methodology and tools adopted for each main phase and specific element of the data collection strategy Literature review The literature review was performed with the main objectives of: - Identifying and collecting relevant studies, papers and articles, as well as previous surveys performed during the last three years with respect to the consumption of ED, the occurrence of specific ingredients and human exposure to active ingredients. - Identifying and collecting information and data useful to correctly define the survey design as well as specific contents for the questionnaires. Activities related to literature review were developed through the following main steps: Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

16 1. Identification of the available literature and information sources, in the light of the previously defined objectives and scope of the study. 2. Analysis of the documents collected during step Synthesis of the most relevant documents. 4. Use of the relevant literature for the purposes of the study (survey design and contents of questionnaires). The first phase of the literature review was mainly based on web-based research (specialized magazines, dedicated web-sites, institutional sources, etc.). After this preliminary phase, stakeholders consultation played a relevant role in supporting the identification of additional sources and studies as well as the selection of the proper and most relevant papers for the purposes of the study. Stakeholders were asked to comment on the preliminary list of references and sources collected by the study team, and to eventually add missing references or sources ( 2.2). Literature review was focused on recent bibliography (published between 2008 and 2011) addressing ED and/or their specific ingredients, in terms of consumption habits and possible health effects caused by these products/ingredients. Due to the specific objectives of the study, however, studies and reports dealing exclusively with health effects of ED were deemed as falling outside the scope of the study itself. From the complete list of the relevant literature, resulting from the stakeholders consultation (Appendix A), a number of references featuring meaningful insights about the research topics were selected ( 3.1.2) Stakeholders consultation Two different rounds of stakeholders consultations were planned: before (pre-survey consultation) and after the survey (post-survey consultation). The main objectives of the pre-survey stakeholders consultation is summarised as follows: a) Supporting literature review, and specifically the identification of relevant sources, studies and surveys dealing with the issue of ED consumption over the last 3 years. b) Supporting the collection of data on ED market. c) Supporting and validating the identification of relevant ED brands for the different MS. d) Supporting the identification, for each MS, of relevant food products in the diet contributing to the exposure to active ingredients (caffeine, taurine, D-glucurono-y-lactone). After the conclusion of the survey, stakeholders who had participated to the first round of consultation were contacted again as part of the post-survey consultation, whose main objective was to share with experts the structure of methodology adopted for the study as well as results emerging from the first round of consultations. On the basis of the aforementioned objectives, the categories of stakeholders involved in the pre- and post-survey consultations include: - Experts from EFSA national focal points Focal Points act as an interface between EFSA and the national food safety authorities, research institutes, consumers and other stakeholders. The Focal Point network is made up of members from all 27 EU Member States, Iceland and Norway, as well as observers from Switzerland and (potential) EU candidate countries. Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

17 - Representatives of the main industry associations, both at European level (Union of European Soft Drinks Associations; Energy Drinks Europe; etc.), and at MS level (national associations of soft producers). - Researchers and experts in soft and ED, in particular project managers of relevant studies on ED and related themes (e.g. University of Wien; European Centre for Monitoring Alcohol Marketing EUCAM, etc.). - Representatives of consumers organizations at EU level (e.g. European Consumers Organization BEUC). The pre-survey consultation was carried out between February and May The post-survey consultation was carried out in November 2012, when the survey activities were approaching completion Pre-survey and post-survey consultations Starting from the identification of the relevant categories of stakeholders to be involved, the study team selected a list of experts in the study subjects, specifically including: - experts from MS national health institutes/organisations; - representatives of EU-level industry organisations; - representatives of national industry organisations; - other experts in the field of ED (academics, consultants, etc.), with special focus on ED consumption and composition. The final list of stakeholders to be contacted and the list of questions to be asked were validated by the Steering Group prior to the start of the consultation. The final list of stakeholders also included ones from MS not covered by the survey, for a total of 40 experts (Appendix B). All the interviewed experts were provided in advance (Appendix C and D) with: - list of questions; - list of relevant literature collected by the study team; - list of relevant information sources identified by the study team; - list of the main ED brands marketed in the EU, compiled by the study team on the basis of the literature review; - list of food products in the diet (other than ED) supposed to play a significant role in the assumption of caffeine, taurine, D-glucurono-y-lactone, theophylline and theobromine, compiled by the study team on the basis of the information retrieved through the literature review. The minutes of the interview were sent to each interviewee for validation. Interviews for the pre-survey consultation were organized around three main topics: literature and sources; ED market; active ingredients. However, the choice of semi-structured interviews, based on open-ended questions, encouraged experts not to limit their contributions to such topics, but to provide also general comments on the study as a whole, as well as additional inputs and ideas. Some stakeholders were also involved in the post-survey consultations, in which the structure of the methodology adopted for the survey, as well as results emerging from the first round of consultations were shared with them. Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

18 2.3. Survey Gathering consumption data on specific consumer groups of energy The literature review and the pre-survey stakeholders consultation enabled the study team to better define the reference frame for the survey, which actually represented the main source of data and information for the study. As already outlined, the survey aimed at collecting primary data on different population targets, and specifically: 1) children (3-10 years old); 2) adolescents (10-18 years old); 3) adults (18-65 years old); as well as: a) adolescents and adults practising intense sport activities; b) adolescents and adults consuming ED mixed with alcohol. For each target group mentioned at points from 1 to 3 above, a dedicated questionnaire was prepared and translated in all the languages of the MS covered by the survey. In the specific case of children aged 3-5 an additional questionnaire addressed to parents was also prepared. The survey was structured to collect data and information to achieve both Objective 1 and 2 (chapter 1). Questions related to each objective covered a specific section in the questionnaire. Each questionnaire started with an introductive section aimed at gathering some preliminary information on the respondent (gender, age, education level, etc.), followed by two dedicated sections, for each of the two objectives. Additional consumer profile information (e.g. on lifestyle, such as smoker or not ) was collected through specific questions. Objective 1: Data on ED consumption Study design A. This section featured a number of questions mainly aimed at investigating: - Frequency and volume of consumption. - Reasons for consumption and consumption habits. - Main typologies, size formats and brands consumed. - ED consumption and sport activities (in adults and adolescents). - Co-consumption of ED and alcohol (in adults and adolescents). Objective 2: Data on consumption of other food products containing caffeine, taurine, D-glucurono-ylactone Study design B. This section featured a number of questions mainly aimed at investigating: - Relevant food products in the diet that constitute a source of caffeine, taurine and D-glucuronoy-lactone. - Consumption frequency and products content in caffeine, taurine and D-glucurono-y-lactone. Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

19 Selection of MS involved in the survey Gathering consumption data on specific consumer groups of energy The survey covered 16 MS out of 27, selected in order to guarantee an adequate coverage of the whole EU population and of the different consumption styles. The following selection criteria were adopted: - Size of ED potential market in terms of population in the relevant age group (from 3 to 65 years). - Balance among different geographical areas supposed to have potentially different consumption habits (Western vs. Eastern countries, Northern vs. Southern countries). - Balance among different food consumption patterns (e.g. Mediterranean countries vs. Nordic countries). On the basis of these criteria (also taking into account preliminary findings emerging from the literature review), and after final validation by the Steering Group, the following 16 MS were selected for the survey: 1. Austria 2. Belgium 3. Cyprus 4. Czech Republic 5. Germany 6. Greece 7. Finland 8. France 9. Hungary 10. Italy 11. Poland 12. Romania 13. Spain 14. Sweden 15. The Netherlands 16. United Kingdom Study design In order to guarantee a wide coverage of each targeted group, the survey was differently defined on the basis of the target. A description of the survey structure and for each targeted group is provided below. 1. Children A. Children 3-5 years old Survey carried out with schools' support ("school survey"). Paper questionnaires, featuring images aimed at helping children to correctly understand each question and call back to mind food products and beverages. Questionnaires to be filled in by children, at school, with the help of their teachers. Additional questionnaires to be filled in by parents, aimed at collecting more accurate information on the children s consumption habits and at confirming/adjusting what declared by children in the respective questionnaire. B. Children 6-10 years old School survey. Paper questionnaires, featuring images aimed at helping children to correctly understand each question and call back to mind food products and beverages. Questionnaires to be filled in by children, at school, with the help of their teachers. For a small sample of children, questionnaires to be filled in also by parents (specifically required for schools covering both the target groups). Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be considered as an output adopted by the Authority. The European food Safety Authority reserves its rights, view and position as regards the issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

20 2. Adolescents A. Adolescents years old School survey. Web questionnaires or alternatively paper questionnaires to be filled in by students. B. Adolescents years old School survey. Web questionnaires or alternatively paper questionnaires to be filled in by students. 3. Adults (18-65 years old) Mixed mode survey CAWI (Computer Assisted Web Interview) e CATI (Computer Assisted Telephone Interview). Maximum share of telephone interviews = 20%. 4. Adolescents and adults practising Intense Physical Exercise (IPE) Covered through the questionnaires already addressed to adolescents and adults (points 2 and 3 above). Practice of sport and/or physical exercise at least twice a week. Target covered by Adolescent and Adults Survey (points 2 and 3 above). 5. Adolescents and adults Co-Consuming ED with alcohol (CC) Covered via questionnaires already addressed to adolescents and adults (points 2 and 3 above). At least one situation of co-consuming during the last year. Target covered by Adolescents and Adults Survey (points 2 and 3 above). For children and adolescents, the sample of schools for MS was determined on the basis of each target group (Tables 4 and 5). Official registries containing the complete list of schools, with related contact details, were requested to the Ministries of Education and other competent Authorities of the MS covered by the survey. On this basis, sampling activities were carried out on the complete lists of schools for each level involved (pre-primary, primary, secondary). For the survey on adults (18-65 years), a mixed mode was preferred, integrating CAWI and CATI methods. The questionnaires (adults, adolescents, children and parents) were translated in all the relevant languages for the MS covered by the survey, in order to promote people s cooperation and participation. Supporting Publications 2013:EN

21 Details on the minimum sample dimension defined for each country, in terms of schools to be contacted, are provided in Table 4. Supporting Publications 2013:EN

22 Table 4: Sample design Number of schools included in the sample by country SCHOOL SAMPLE AND POTENTIAL CONTACTS PRE-SCHOOL (20x3) (a) PRIMARY SCHOOL (20x5) (a) LOWER SECONDARY (25x3x2) (a) UPPER SECONDARY (22x5x3) (a) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United Kingdom TOTAL (a) Average number of pupils/students per class (class size) multiplied for the average number of school year levels. The number of contacts with schools in each MS was defined by means of a specific sampling methodology: the total number of potential contacts was distributed among the 16 MS according to the total population; the numbers obtained were then adjusted in order to guarantee a minimum number of contacts in the less compared to the more populous MS. The methodology adopted for the definition of sample size is therefore proportional with adjustments. The sample of schools to be contacted in each MS was defined by random sampling methodology, aimed at guaranteeing nation-wide coverage and representativeness of the group of interviews in terms of geographical areas for each target group. During the survey activities, the initially planned number of schools to be contacted was significantly increased, in order to guarantee a sufficient coverage also in those countries where the actual participation rate resulted to be much lower than initially expected (50%). The replacement procedure was based on the representativeness of the sample, including three more schools from the same region, with similar characteristics (level of education, area, number of students, etc.). Even if the sample was built on these premises, the results cannot be deemed as fully matching the scheme initially proposed, as the participation rate in the survey strongly depended on the schools availability. Therefore, a more intense effort was driven towards replacements and recalls in the MS where the number of potential ED consumers resulted to be lower. Details regarding the expected number of consumers (consumption of ED at least once over the last year) to be reached for each target category are reported in Table 5. Supporting Publications 2013:EN

23 Table 5: Sample design Expected number of consumers to be reached through the survey CONSUMERS (a) 3-10 years old years old years old of which: IPE (b) CC (b) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United Kingdom TOTAL (a) At least one intake over the last year. (b) Samples for IPE and CC are referred to both adolescents and adults Pilot study and quality checks The tools used in the survey, including questionnaires, were validated following a specific procedure. All the documents were drafted on the basis of the study team s expertise in surveys on food consumption habits, with particular respect to the target groups covered by the study. Relevant literature in the dietary assessment methodology field has been reviewed in order to use upto-date methods to assess the consumption habits on a target population 15. Moreover, a review of empirical studies on consumption habits was also made 16, in order to grasp the critical aspects of the tools already used in other surveys and to avoid as much as possible bias in the outcomes of the survey. 15 One of the reference papers used was Dietary Assessment Methodology F. E. Thompson, A. F. Subar, National Cancer Institute, Bethesda, Maryland, Specific reference was made to Safefood (A review of health effect of stimulant ), Expochi (Dietary exposure assessments for children in Europe), Food4You project (Healthy Lifestyle in Europe by Nutrition in Adolescence, European food information council) and Catch kids club (survey on consumption habits in youngsters). Edmunds, L.D. and Ziebland, S. (2002) Validation of a fruit and vegetable questionnaire for 7 9 year olds. Health Education Research 17: Supporting Publications 2013:EN

24 Professional translators were used to translate documents into the relevant languages; the use of simple wording and a close cooperation between the translators and the study team also ensured that all the survey questions and annexed documents were easy to understand. National experts the pre-survey consultations allowed to tailor the questionnaires to national characteristics concerning the main ED brands and/or other common food products/beverages containing caffeine. Questionnaires for surveys in schools were tested through a pilot survey in 3 MS (Italy, France and UK). A sample of schools for each level was contacted to complete the pilot questionnaires and to gather comments/suggestions on the structure and wording. Also head teachers or educational experts of some schools not involved in the pilot survey provided useful remarks and suggestions on the survey approach and questionnaires. Comments and suggestions gathered during the pilot phase were used for fine-tuning methodology and related tools prior starting the survey. Checks on the documents were initially based on the content validity, which was already part of the tender specifications and which was tested with the Steering Group. The specificity validity was achieved through adjustment of the standard methodology for investigating food consumption habits to the specific kind of product considered, i.e. ED: in particular, the consumption time reference scale and the occasions of consumption were based on each specific type of product. Moreover, a validation of the sensitivity was achieved through three check questions regarding ED consumption, to have further confirmation of the same and to avoid non-consumers. These check questions also allowed the selection of subgroups of consumers in the population and the investigation of their specific consumption habits. The external validity was assured by the outcomes of the pilot survey and by the stakeholders consultations, with the aim of allowing generalization of the survey results to the entire reference population. As for qualitative checks on the filled in questionnaires, accuracy in compiling the questionnaire was assured by the constrains foreseen in the online questionnaires (adults and adolescents), which enabled to continue with the compilation only if all the previous questions had been answered, and blocked the compilation in case of unrealistic answers regarding age, weight, slept hours, etc. With specific reference to ED consumption, in all those cases where the respondent had indicated a product which is not an ED (e.g. sport drink), the respondent was reclassified as non-ed consumer, and all the answers concerning ED consumption and related habits were consequently excluded from the analysis. As far as outliers are concerned, in all those answers where a number specification was required (e.g. number of cans consumed in an average week ), a reclassification or elimination was always made for clearly extreme - and hence probably unrealistic - figures (e.g. 100 cans/week). An additional reclassification was made with specific regards to coffee consumption, in order to assure coherence in the overall consumption of the three product typologies: specifically, when respondents declared to consume more than 15 cups per day 17 of beverages with coffee - combining declared consumption data espresso, coffee (instant, ground, ice-coffee) and cappuccino - the number of cups consumed daily has been reclassified as maximum 5 cup per day for each typology. 17 Over 15 cups of coffee per day have been considered an unrealistic consumption data. Supporting Publications 2013:EN

25 Finally, the validity of results was also guaranteed by the choice to carry out the survey over a quite long time period (from March to November), thus avoiding - or at least sharply reducing - possible distortions due to seasonal trends in consumption Data processing methods for calculating the exposure to active ingredients Processing methods used for calculating the exposure to active ingredients (caffeine, taurine and D- glucurono-y-lactone) for each subject interviewed ( row analysis of the data) were applied to data on: The exposure was derived: 1. ED consumption; 2. consumption of other food products and beverages containing the active substances object of the analysis. Such calculations were made for both ED consumers and all respondents 18, and allowed to define the relative contribution of ED consumption as a source of caffeine, taurine and D-glucurono-y-lactone through the diet. Throughout the analysis, calculations were always based on the data of the single respondent, while average data were used solely to give the final outputs/elaborations or to define the threshold for further breakdowns of the analysis (i.e. acute or chronic consumption). Final results on the exposure to active substances were expressed in mg/day and in mg/kg bw/day Caffeine exposure from ED consumption Calculation started from ED consumption data retrieved via survey. Data on number of cans of ED consumed in an average month were combined with data on: a. the size of cans usually consumed; b. the top-three ED brands usually consumed; c. the relative importance of the favourite ED brand among the top-three products; d. caffeine content of the ED brands concerned (table 6 and 7); in order to calculate the overall caffeine exposure from ED consumption, weighted according to the relative importance of the top-three ED brands consumed (each respondent was asked to indicate the three main ED brands consumed, in decreasing order of importance, and to specify the per cent share of his/her favourite brand in his/her total ED consumption). In the specific case of children, a different method had to be used, as no question about the top-three ED brands was asked. In this case, the average content of caffeine as well as concerning D- glucurono-y-lactone and taurine - of the first 3 brands of ED comprehensively indicated by children has been used. With regards to the format of ED, a specific analysis was performed for the energy shots format: in this case, the occurrence of active substances results to be remarkably different (and normally higher) from that of the standard EDs, and to sharply vary from one energy shot brand to another. Table 7 provides the contents of active ingredients for the energy shots brands cited by respondents and 18 The calculation of the total exposure (ED and other foods/beverages) is not available for all the respondents in the target group of adults, since in this case respondents who declared not to consume ED were not asked additional information on the consumption of other food and beverages containing active ingredients. Supporting Publications 2013:EN

26 analysed in the study. When the exact occurrence of active ingredients was not available or considered not fully reliable, a standardized content of active substances was applied 19 ( 2.3.6). 19 The contents adopted for the calculations are: mg/l for caffeine, mg/l for taurine and mg/l for glucurono-y-lactone. The size is 63 ml. Supporting Publications 2013:EN

27 Table 6: Content of active ingredients in different ED brands included in the questionnaire (1) D-glucurono-y-lactone Brand name Caffeine (mg/l) Taurine (mg/l) (mg/l) Atomic Bad Dog Not present Battery Not present Big Energy Shock (b) Not present Blu 300 (a) 4000 b Not present Bomba Not present Booster energy drink 300 (a) 4000 (b) 2400 (b) Brava Italia Not present Bullet 300 (a) 4000 (b) Not present Burn Carrefour 300 (a) 4000 (b) 2400 (b) Chillo 300 (a) 4000 (b) 2400 (b) Clever (b) Control 300 (a) 4000 (b) 2400 (b) Crazy horse Not present Dark dog Not present Effect Fireball 300 (a) 4000 (b) 2400 (b) Flying horse 300 (a) 4000 (b) 2400 (b) Full Throttle Not present Green go Not present Grizzly 300 (a) 4000 (b) 2400 (b) Hell (b) Not present KX (Tesco) Long Horn 320 Not present Not present Mad bat 300 (a) 4000 (b) 2400 (b) Mixxed up (b) Not present Mad croc Monster Not present MX Maximim 300 (a) 4000 (b) 2400 (b) Nalu 320 Not present Not present Natural Magic 300 (a) 4000 (b) 2400 (b) Power horse Premium XO 300 (a) 4000 (b) Not present Raw 300 (a) 4000 (b) 2400 (b) Real Power 300 (a) 4000 (b) 2400 (b) Red Bull Red Devil Not present Relentless Supporting Publications 2013:EN

28 Brand name Caffeine (mg/l) Taurine (mg/l) D-glucurono-y-lactone (mg/l) Rhino's (b) 2400 (b) Rienergy Refresher Rockstar Not present Rodeo Semtex Not present Sexy Italia 300 (a) 4000 (b) 2400 (b) Shark (b) Tiger Not present Tonino Lamborghini V V Power 300 (a) 4000 (b) 2400 (b) V (a) 4000 (b) 2400 (b) White Tiger 320 Not present Not present 28 Black Acai 320 Not present Not present Note: values highlighted by the light grey background were assumed, as no information on actual content could be retrieved. (a) assumed as equal to the value in König, (b) assumed as equal to the modal value. (1) Contents of relevant substances in different ED brands indicated as other by respondents in the questionnaire are provided in Appendix F. Table 7: Content of active ingredients in different energy shots brands Brand name Caffeine (mg/l) Taurine (mg/l) D-glucurono-y-lactone (mg/l) size (ml) Battery 1345 (a) 4000 b 2400 (b) 63 (a) Burn energy shot Dark Dog x10 Shot Not present 63 (a) Mad Croc energy shot (a) 4000 b 2400 (b) 60 (a) Monster Hitman Energy Shot Not present 89 Red Bull energy shot Relentless energy shot 1600 (a) 4000 b 2400 (b) 50 (a) Rhino's energy shot 1345 (a) 4000 b 2400 (b) 63 (a) Rockstar energy shot 1345 (a) 4000 b 2400 (b) 63 (a) Shark energy shot Not present 75 Tiger energy shot Not present 60 Note: values highlighted by the light grey background were assumed, as no validated information on actual content could be retrieved. (a) assumed as equal to the average of other energy shots indicated in the survey (b) assumed as equal to the modal value of occurrence in standard ED Supporting Publications 2013:EN

29 Calculation of the daily exposure to caffeine deriving from ED consumption was made through the following formula: ED_caffeine_daily exposure = (ED_monthly volume * ED_caffeine_content) / 30 where: ED_caffeine_daily exposure = daily exposure to caffeine deriving from ED consumption (mg) ED_monthly volume = volume of ED consumed in a month (l), calculated by combining the number of cans consumed in an average month with the size of the cans ED_caffeine_content = content of caffeine in ED (mg/l), weighted according to the brands consumed Caffeine exposure from consumption of other food products and beverages Caffeine exposure from consumption of other food products and beverages was calculated by combining data: a. on consumption frequency (daily or weekly, according to the type of product concerned); b. on quantities consumed in a single occasion (taking into account container size or item weight, whenever relevant); c. on caffeine content of each product. The parameters considered in the calculations are reported in table 7. Supporting Publications 2013:EN

30 Table 8: Caffeine occurrence in other food products and beverages: relevant parameters considered in the calculations Type of product Container Size with caffeine (mg/l or mg/kg) decaffeinated (mg/l or mg/kg) Espresso Coffee cup 0,03 l Coffee (instant, ground, ice coffee ) mug 0,24 l ,7 Cappuccino cup 0,15 l Tea (instant, tea bag, ice tea ) cup/glass 0,25 l Hot chocolate cup 0,25 l 150 Chocolate bars* 0,10 kg 180 Dark chocolate 0,10 kg 340 Milk chocolate 0,10 kg 183 White chocolate 0,10 kg 0 Chocolate snacks (e.g. Mars, KitKat a 0,05 kg 140 Dark chocolate 0,05 kg 264 Milk chocolate 0,05 kg 142 White chocolate 0,05 kg 0 Colas (e.g. Coca Cola, Pepsi) glass 0,25 l 79,2 0 (a) = whenever no distinction was made between dark, milk and white chocolate, values for generic chocolate products as featured in König J.) were used for calculations. Sources: König J., 2011., Final report: Assessment of caffeine intake in a representative sample of the Austrian population (age years). NZFSA - New Zealand Food Safety Authority (2010), Risk profile: caffeine in energy and energy shots. Report prepared by the Institute of Environmental Science and Research Limited (ESR). Food Safety Promotion Board (2002), A review of the health effects of stimulant Final Report, Safe Food, Cork, Ireland. Web page on caffeine - University of Washington: Websites of individual producers. Supporting Publications 2013:EN

31 The general calculation method can be illustrated through an example referred to espresso coffee. Total consumed volume in a week was calculated through the formula: tot_espresso_week = number of cups per day * content of a cup (l) * weekly consumption frequency Daily exposure was then calculated by applying the formula: espresso_daily_exposure = (tot_espresso_week * caffeine content espresso mg/l) / 7 The above method was applied (mutatis mutandis) for the various types of coffee, tea and hot chocolate. In the case of chocolate bars, chocolate snacks and colas, no questions about daily consumption frequency were asked, as such products are not always consumed on a regular daily basis 20. Daily exposure for such products was hence calculated ex-post, through the formulas: tot_product_week = (product content or size in l or kg * weekly consumption volume) product_daily_exposure = (tot_product_week * product caffeine content mg/l or mg/kg) / 7 In these specific cases, consumption volumes of each item were associated to the respective content of caffeine, and consumption frequency (already specified in the question not in the answer) was reclassified on a daily basis, thus obtaining the exposure to caffeine in mg/day for each specific food/beverage for each respondent Contribution of ED to total caffeine exposure Total daily caffeine exposure was calculated as the sum of both daily exposure from ED consumption ( ) and daily exposure from consumption of all other food products and beverages ( ). Daily exposure from ED consumption was then referred to the above total, to express ED contribution to caffeine exposure as % of total daily exposure. Forthe relative contribution of ED to the total exposure to active substances, the mean value presented in this analysis is calculated as a ratio between the mean exposure to the ingredient (e.g. caffeine) deriving from ED and the total exposure to the ingredient (e.g. caffeine), on the other Contribution of ED to total exposure to taurine and D-glucurono-y-lactone The calculation of daily exposure to taurine and D-glucurono-y-lactone from ED consumption was carried out by applying the same method used for calculating daily exposure of caffeine from ED consumption for the three targets involved in the survey ( ). On the contrary, lack of data on content of taurine and D-glucurono-y-lactone in specific food products and beverages (except for limited spot information) did not allow to apply the analytical method of calculation of daily exposure used for caffeine ( ). As a consequence, data on daily exposure to taurine and D-glucurono-y-lactone from consumption of other food products and beverages other than ED were not possible to be included in analysis for adolescents and children. 20 For these specific items a weekly frequency has been used, also taking into account indications from the relevant literature references; the adoption of a week as the reference time frame also allowed to include in the analysis all respondents consuming less frequently than once a day. Supporting Publications 2013:EN

32 Concerning adults, this analysis was carried out based on consistent data, derived from EFSA s scientific opinion The use of taurine and D-glucurono-γ-lactone as constituents of the so-called energy (adopted on January 15, 2009). More specifically, daily exposure from consumption of other food products and beverages other than ED was assumed: For taurine, equal to 58 mg (mean daily exposure to taurine from omnivore diets). For D-glucurono-y-lactone, equal to 1,5 mg (estimated daily exposure from naturally occurring sources in the diet). The calculation of the contribution of ED to total exposure to taurine and D-glucurono-y-lactone was carried out by: 1. summing daily exposure from ED consumption to daily exposure from consumption of other food products and beverages, to obtain the total daily taurine and D-glucurono-y-lactone exposure; 2. referring daily exposure from ED consumption to total daily exposure (point 1), to express ED contribution to the exposure to taurine and D-glucurono-y-lactone as % of total daily exposure. As for caffeine, the relative contribution of ED to the total exposure to active substances, the mean values presented in the analysis were calculated as a ratio between the mean exposure to the ingredient deriving from ED and the total exposure to the ingredient for each subgroup considered in the analysis Criteria for defining patterns of ED consumption (acute and chronic consumers) The identification of respondents that could be defined as high acute or high chronic ED consumers was performed on the basis of the frequency distribution of the variables specifically linked to volume and frequency of ED consumption respectively 21. This means that consumption habits that stand above or below the average were identified by using the upper decile of frequency distribution of the correspondent variables as threshold value. Specifically, high acute ED consumers were defined by making reference to the volume consumed in a single session 22. In particular, the calculation derives from the variable liters of ED in a single session, that combines the number of cans consumed per single session with the size format indicated by each respondent in the questionnaire. The threshold beyond which ED consumers were considered high acute was set at the 90 th percentile 23 of frequency distribution for that variable (excluding outliers 24 ), corresponding to a consumption of 1 litre of ED per single session in the case of adults and of 1,065 litres in the case of adolescents. 21 The methodology used to define acute and chronic consumers refers to the approach presented in the Opinion of the Scientific Committee on Food on Additional information on energy, European Commission health & consumer protection Directorate-General, Scientific Committee on Food, According to the present study, single session is a period of time of a couple of hours (e.g. a night out, a study or sport session). 23 High acute consumers defined as 90 th percentile % of respondents who declared a consumption of more than 4 cans in a single session actually declared completely unrealistic consumption volumes (e.g cans in a single session): for such reason, values declared by these respondents were considered as outliers and were excluded from the analysis. Supporting Publications 2013:EN

33 For children, the identification of high acute consumers has not been assessed, because it was not foreseen to make specific question on volume of ED consumed in a single session for this target group. As for chronic ED consumers, two different categories were defined for both adults and adolescents, referring to weekly ED consumption frequency: 1. Mean chronic ED consumers were identified in relation to a frequency distribution for ED consumption comprised between the 75 th and 90 th percentile 25 (respondents who on average consumed ED 2-3 days a week in the case of adults, and from 1 to 3 days a week 26 in the case of adolescents). 2. High chronic ED consumers were identified in relation to a frequency distribution for ED consumption greater than or equal to the 90 th percentile (respondents who regularly consumed ED 4-5 days a week or more). When frequency distribution for ED consumption was below the threshold set at the 75 th percentile, ED consumers were considered non-chronic. a. In the specific case of children, the rationale adopted for identifying chronic ED consumers is similar, with a significant difference: high chronic ED consumers were identified in relation to the frequency distribution for the variable weekly ED consumption frequency beyond the 90 th percentile (respondents who regularly consumed ED 3-5 days a week or about every day ). This subgroup actually corresponds, in this case, to the one identified by the threshold set for mean chronic ED consumers in the other two groups (75 th percentile). Table 9: Parameters for the identification of chronic and acute consumers Consumer category ED consumption threshold (percentile) Corresponding volume/frequency of ED consumption Adults Adolescents Children High acute 90 th 1 L/single session High chronic 90 th 4-5 times/week or more Mean chronic 75 th - 90 th (excluded) 2-3 times/week 1,065 L/single session 4-5 times/week or more once a week and 2-3 times/week n.a. 3-5 times a week Results are presented specifically focussing on the comparison between high acute consumers and non-high acute consumers, and between high chronic and non-high chronic consumers: such comparisons are provided for each MS (based on the data collected through the survey) as well as for the 16 MS as a whole (based on weighted average data). 25 The 90 th percentile has to be intended as excluded (<90 th ) 26 Thus covering the two answer choices on frequency: 2-3 days a week and once a week. Supporting Publications 2013:EN

34 Problems encountered, related solutions and limitations of the study The complexity of the study and a number of problems encountered in its carrying out required a number of ad hoc solutions. Some limitations deriving from the adopted solutions need to be considered when interpreting the results of the present study. Such limitations stem from issues of different nature: 1. Issues regarding difficulties encountered during the survey conduction. 2. Issues concerning data and information collected. 3. Issues concerning the methodology for data elaboration (mainly assumptions). Concerning problems encountered carrying out the study, a number of unforeseen events occurred during the survey, causing a substantial delay in the data collection process. Different procedures to allow the involvement of schools caused difficulties in some MS. In some cases, complex and timeconsuming procedures were required to obtain the official list of schools, or to obtain official authorization to contact pre-primary, primary and secondary schools for the purposes of the survey. Quite often schools contact details, as presented in the official registries provided by Ministries, resulted to be incomplete or incorrect. Finally, in some MS, cooperation by the contacted schools was actually low. Nevertheless, to overcome these difficulties in some MS, additional efforts were made, by contacting a higher number of schools than originally planned ( 2.3.2), by frequent recalls, and by intensifying efforts to sensitize the involved institutions (also with the support from EFSA national contact points). Anyway, the approach adopted for the survey can be considered highly effective, taking into account a total number of around respondents ( adults, adolescents, children) were reached in the 16 MS covered, and in the specific case of children - such coverage was achieved in spite of the final participation rate was lower than initially expected. In most of the MS covered by the study, the number of respondents was high enough to make the samples representative of the population. Only in France, Germany, Belgium and United Kingdom the number of respondents was lower than estimated in the survey design 27. For the reliability and validity of survey results, it is important to highlight some methodological aspects in order to correctly interpret the findings of the study. In the case of children, the questionnaire was addressed to very young kids (from 3 to 10 years old) and specific technical measures were adopted both to improve children s capacity of recalling their food consumption habits, and to minimize the risk of errors and misunderstandings: lower number of questions compared to the version for adolescents and adults 28 ; very simple wording for the questions; introduction of images to help children to correctly understand each question; recommendation of filling in the questionnaire with the help of a teacher. 27 In order to take into account differences in composition of the sample among individual MS (see also providing a full picture of the sample dimension for each MS and each target group), a specific system of weights was adopted, structured to guarantee the weighted average data could correctly represent both the total population and the ED consumers for the 16 MS. 28 For example, for children, a simplified version of the questions regarding ED brands were adopted: children were asked to indicate just the most consumed brands, without providing information regarding the relative amount of the favorite brand compared to the total consumption. Similarly, as far as caffeine-containing products were concerned, children were not asked to make distinctions between caffeinated and decaffeinated products. For each food product cited in the questionnaire, the content of caffeine was calculated as a weighted average of the content of caffeinated and decaffeinated product according to the answers provided, with regards to this specific issue, by parents. Supporting Publications 2013:EN

35 Despite these measures adopted, it has anyway been considered the possible difficulty, for young children, to provide reliable data regarding specific consumption habits: for this reason, in order to avoid losing information, data on more complex figures (i.e. single session consumption, specification of caffeinated or decaffeinated products, etc.) were gathered through the direct survey to parents. The two questionnaires and surveys for children and for parents were thus complementary and used to guarantee a higher reliability of data on children s consumption habits. For specific issues on the methodology for data elaboration, some of these are linked to the selection of products to include in the questionnaires, for both ED and other than ED product categories. Limitations are the following: 1. Due to high number and variety of caffeine-containing products, the selection of such products to be included in the questionnaires was bound to be non-exhaustive. 2. Due to the extreme variability in caffeine content for individual product categories (even if defined in a very narrow way), average caffeine contents had to be assumed for the purposes of the study. For the selection of products other than ED to be included in the questionnaires, considering the rather extensive geographical coverage and the complexity of the research, the study team decided to follow the selection criteria reported below: only the most popular caffeine containing products had to be considered, with the aim of making the resulting selection sufficiently representative of the products present and consumed in every MS involved in the study; only categories of products with a standard content of caffeine had to be considered, in order to make the calculation of caffeine exposure comparable throughout the 16 MS covered by the survey. In this context, two potentially relevant categories of products for quantifying the total exposure to caffeine were not included in the questionnaire: Products with chocolate content, as caffeine concentration was too variable to find an average value for each MS. For example, the category chocolate biscuits was not included because no standard typology of such products could be identified which could be deemed as widely consumed and with comparable caffeine content in every MS. Only categories of products with a standard content of chocolate - and caffeine - were considered, in order to make the quantification of caffeine exposure comparable throughout the MS. Drugs, because it was not possible to consider a standard caffeine content for these products valid for all the MS considered. Furthermore, due to constraints related to safeguard of privacy, collecting consumption data for these products from individual respondents would have been not feasible. In this framework, another critical issue was the selection of coffee beverages to be included in the questionnaire. The study team included only three categories of coffee beverages - espresso coffee, coffee (including instant, ground and ice coffee) and cappuccino - mainly for the following reasons: The choice of clustering coffee beverages in these quite broad categories aimed at representing the most widely consumed products with the highest concentration of caffeine in all the MS covered by the study. As the present study covers 16 MS, there was the necessity of Supporting Publications 2013:EN

36 standardizing as much as possible the caffeine content of different coffee beverages to gather reliable data on their consumption throughout different MS. For this reason, since there was no possibility of collecting punctual data on caffeine content for each kind of coffee beverages in single MS, the study team adopted for each category of homogenous products an average value of caffeine concentration 29 (more details on the assumptions made will be provided in the following sections). Instant, ground and ice coffee were included in the general category of coffee because they are the most popular non-espresso coffees, with a similar content of caffeine throughout Europe and with a caffeine concentration that sharply differs from espresso. The range of products described in the questionnaire could not be too wide and detailed, as the questionnaire had to be simple and quick to fill in 30. Furthermore, due to the complexity of the survey design, the study team deemed not possible to gather information about the coffee preparation methods from the questionnaires. Aside from the above limitations, it should be noted that the identification of peculiar coffee-based beverages which are widely consumed only in specific MS was possible, from stakeholders suggestions and information deriving from the pilot survey. In some cases these peculiar beverages were included in the questionnaire for the survey, with the two-fold aim of making the questions more understandable and the answers more reliable (e.g. in the questionnaire for children of Greece and Cyprus the specification frappe coffee was included as an additional example within the option cappuccino, because in those countries frappe coffee is a very popular beverage containing coffee and milk, just like cappuccino, and with a very similar caffeine content). Finally, it is important to underline the assumptions related to the data processing methods applied in the present study. An estimated amount of caffeine, taurine and D-glucurono-y-lactone for some ED brands was considered, in order to quantify the exposure to these substances from ED consumption. In some cases the quantities of these ingredients are claimed on the labels or in the producers websites, so the values used for the elaboration were derived directly from these sources. In few other cases the list of ingredients was provided directly by ED producers 31. Due to the very high number of brands covered (a total number of 223 different brands of ED were considered among the 16 MS) and to the quite low number of information directly provided by producers (by labels, official websites, or direct consultation), concerning the brands for which no information was available the amount of caffeine was considered equal to the average quantity identified by König (2011) in his study about caffeine 29 Also König in his study Final report: Assessment of caffeine intake in a representative sample of the Austrian population (2011) identified different categories of coffee-based products to investigate caffeine exposure: coffee strong, coffee medium, coffee light, instant coffee, cappuccino, café latte, ice coffee. In the same way, he associated to each category a mean caffeine concentration, taking into account that this value varies for different products in the same class. 30 The methodological approach was based on gathering data on a wider sample of interviewees and on collecting information on a smaller amount of ordinary products, instead of achieving a narrower number of deep interviews on a wider range of products. 31 For a number of relevant brands for which the quantity of one or more specific ingredients was not indicated on labels or on the official website of the producing company, data were asked directly to producers. Supporting Publications 2013:EN

37 exposure in a sample of Austrian population (mean caffeine concentration = 300 mg/l) 32. Concerning D-glucurono-y-lactone and taurine, in ED brands for which it was not possible to retrieve official data, the amount of these ingredients was assumed equal to the modal value of their concentration in other ED brands. Similar difficulties affected the collection of data on the content of active ingredients for energy shots. Due to the frequent unavailability of official data, in these cases a standardised content of active ingredients was used grounding on information retrieved via official sources 33. Specifically, for caffeine the value was assumed to be equal to the average reliable contents - after eliminating outlier data 34. For taurine and D-glucurono-y-lactone, the modal occurrence in standard ED was used, due to a lack of consistency of average data. Within the category of energy shots, in all cases in which also the size of the can resulted to be unknown or more than one energy shot had been indicated, an average size (63 ml) was adopted for the calculation. Further assumptions were made for the quantification of caffeine exposure and contribution of coffee beverages to total caffeine exposure itself. As previously underlined, three categories of coffee-based products were defined, on the basis of the homogeneity of caffeine content. An average content of caffeine was then associated to each category of products, as follows: Espresso: mg/l of caffeine; Coffee (including instant, ground, ice-coffee): 400 mg/l of caffeine; Cappuccino: 250 mg/l of caffeine. Two main limitations arising from this approach must be underlined: Caffeine content varies for products in the same category. For instance, in this study drip coffee, brewed coffee and instant coffee are all included in the same category (coffee). However, considering a standard cup (225ml), drip coffee has the highest caffeine content, with 115 to 175 mg per cup; brewed coffee is the next most potent at 80 to 135 mg per cup; and instant coffee contains 65 to 100 mg per cup (Chou, 1992). As explained later in this chapter, this variability must be taken into account also for the other categories of caffeine containing products, such as teas or chocolates. Caffeine concentration may vary for the same typology of product (i.e. ground coffee) in different countries, because of different ways of preparing and/or consuming coffee. Indeed in every geographic area there is a traditional way to prepare and consume coffee that can influence the average amount of caffeine exposure of the population. Unfortunately, there is scarcity of academic studies investigating this phenomenon. As for possible differences in caffeine concentration for the same typology of product in different countries, a large body of literature assess substantial variations in caffeine content from the variety of coffee, the preparation and from geographical source of the coffee bean (McCusker et al., 2003; Mandel, 2002). For instance, ground coffee identifies a wide range of traditional products which may 32 In the case of caffeine, specific data were found for 160 brands, while average data from Konig s study were applied to the remaining 63 brands. 33 Specifically, the contents for energy shots used in the elaborations are 1345 mg/l for caffeine, 4000 mg/l for taurine and 2400 mg/l for glucuronolactone. 34 Energy shots with caffeine content of mg/l and mg/l were not considered in the calculation of the average. Supporting Publications 2013:EN

38 differ a lot in terms of caffeine content. Swedish/Scandinavian brewed coffee, used in Sweden as in other parts of the Nordic region, tends to be very strong. Greek coffee is prepared much like Turkish coffee, i.e. a very strong coffee served in 60 ml or 90 ml cups with sugar. Overall, drip filtered are the most prevalent type of coffee beverage, but espresso and mocha were consumed by 100% of Italian coffee drinkers. Variability on caffeine concentrations must be considered also for the other categories of caffeine containing products, such as teas, chocolates and colas. Indeed, black tea is the most caffeinated of the tea varieties, followed by oolong and green teas (Chou, 1992). Different ranges of caffeine concentrations are reported in literature for different types of tea: for instance, in Heckman et al. (2001) a 240 ml cup of black tea was found to contain mg of caffeine, while 240 ml of green tea were found to contain mg of caffeine. Also due to such divergence in data on caffeine content of tea from different authors, the study team decided to associate an average value of caffeine concentration to the general category of tea (including instant tea, bag tea, ice tea): after comparing different sources, 100 mg of caffeine per litre was deemed to be the most reliable value (König, 2011).Concerning chocolate products, in the present study two categories were considered: chocolate bars and chocolate snacks. Each of them was split in three subcategories on the basis of the type of chocolate they can be made of (dark chocolate, milk chocolate and white chocolate). These three different categories of products have different caffeine concentrations, as reported in a number of studies (Food Safety Promotion Board, 2002; Gilbert et al., 1976; Heckam et al, 2001; Mayo Clinic article 35 ; NZFSA - New Zealand Food Safety Authority, 2010). After a careful process of literature consultation and online research (snack producers web sites;), average values of caffeine concentration to be adopted in the present study for the calculation of caffeine exposure from chocolate products were identified 36. The details of the references and the ranges of caffeine concentration evaluated for the study are provided in Appendix G. Another assumption to be taken into consideration is the daily exposure to taurine and D-glucurono-ylactone. As the questionnaire for the survey did not allow to collect consumption data of all food products in an omnivore diet, the average daily exposures to taurine and D-glucurono-y-lactone (which were needed to calculate the contribution of ED to total exposure of such substances in the diet) were derived from literature. According to EFSA s scientific opinion The use of taurine and D- glucurono-γ-lactone as constituents of the so-called energy (adopted on January 15, 2009), the daily exposure to taurine can be assumed equal to 58 mg (mean daily exposure to taurine from omnivore diets); while 1,5 mg is the estimated daily exposure from naturally occurring sources in the diet for D-glucurono-y-lactone. In this framework, in absence of solid indications in literature about daily exposure to taurine and D-glucurono-y-lactone for children and adolescents, the calculation of the contribution of ED to total daily exposure was not carried out for this specific age group. Finally, assumptions were also made to manage missing data concerning the variable weight of respondent in the questionnaire, as they were necessary to represent the daily exposure to active ingredients (mg/kg bw/day). Following the indication of the Steering Group, in case of missing information about weight, the values indicated in the EFSA scientific opinion Guidance on selected Chocolate bar 180 mg/kg (dark 340 mg/kg; milk 183 mg/kg; white 0 mg/kg); chocolate snack 140 mg/kg (dark 264 mg/kg; milk 142 mg/kg; white 0 mg/kg). After a similar evaluation process of the different data sources, the average caffeine content associated to the category of colas in this research was assumed equal to 79,2 mg/l (König, 2011). Supporting Publications 2013:EN

39 default values to be used by the EFSA Scientific Committee, Scientific Panels and Units in the absence of actual measured data (2012) were adopted. In any case, these standard values were also crosschecked and compared to the average and median values of the relative age group in the MS concerned. Supporting Publications 2013:EN

40 3. RESULTS A short description of the main findings emerging from literature review and pre-survey stakeholders consultation is provided at 3.1 and 3.2, respectively. Details in this respect are provided in the annexes (Appendices A and E for further details). Final results from the survey, for each target subgroup, are instead outlined at Literature review Overview Results from the literature review is outlined as follows. - The issue of ED is highly debated from a scientific point of view, especially for health effects related to the consumption and over-consumption of these products. Several studies (Alford et al., 2011; Reissig et al., 2009; SHC, 2012; Arria et al., 2011; Marin Institute, 2011; Oteri et al., 2007) focus: o on potential and/or evidenced effects of active ingredients (caffeine, taurine, D- glucurono-y-lactone, etc.) on highly sensitive subjects, such as children, pregnant women, heart-patients, etc.; o on potential and/or evidenced effects of co-consuming of ED with alcohol or with other products containing active ingredients. There is great availability of advisory reports produced by national food safety authorities (SHC, 2008, 2009; Meltzer et al. 2008) and academic papers (Seifert et al., 2011; Reissig et al., 2009) aiming at assessing the exposure of caffeine through food other than food supplements (e.g. via coffee, tea, cola beverages and ED), including specific reference to well-defined population groups, such as children, teenagers and young adults. Most studies also provide analysis and evaluations on the adverse effects and possible risks from caffeine (BfR, 2009; James et al., 2011). There is also evidence for increased ED consumption trend in excessive quantities and in combination with alcoholic beverages by young people (Miller, 2008; SHC, 2009). Indeed a number of recent academic studies (Arria et al., 2010; Alford et al. 2011; Brache and Stockwell, 2011; Oteri et al., 2007) and technical reports (BfR, 2008; EUCAM, 2008, 2009) focused on the issue of health effects of co-consumption of alcohol and ED on young people. - On the contrary, on consumption habits are much less frequent than those focusing on health issues. US literature in this sense seems to be wider than the EU one, and studies have recently been conducted also in Canada and New Zealand (Heckman et al., 2010; Miller, 2008; O Brien et al., 2008), even though a number of advisory reports on this issue were recently published in some MS where the phenomenon seems to have higher relevance (BfR, 2008; Norwegian Scientific Committee for Food Safety, 2009; SHC, 2009). - With reference to studies and surveys providing data on ED consumption and human exposure to caffeine in specific MS, one of the most relevant is the König s study on caffeine exposure assessment in a sample of the Austrian population (König, 2011). Moreover, in 2002 a comprehensive study has been carried out in Ireland and Northern Ireland with the aim of reviewing the health effects of stimulant, through a survey of the consumption of these beverages in a representative sample of year olds in the Republic of Ireland and in Northern Ireland. Results of the research demonstrated that the main concerns related to stimulant Supporting Publications 2013:EN

41 were co-consumption with alcohol, the high caffeine content and the uncertainty among consumers regarding the actual content in other ingredients (Food Safety Promotion Board, 2002) Focus on the most relevant references The final version of the literature review defined with the support from stakeholders - includes around 40 references (Appendix A for full references and table 10 for summary).some of the most relevant references were selected according to their consistency with the study, their content, and reference geographical area. Supporting Publications 2013:EN

42 Table 10: Abstracts of relevant references König J, 2011 Paper Objective Methodology Results Heckman MA, Sherry K, Gonzalez de Mejia E, 2010 Gambon DL, Brand HS, Boutkabout C, Levie D, Veerman EC, 2011 Oteri A, Salvo F, Caputi AP, Calapai G, 2007 To determine total caffeine exposure from all foods in the average healthy population and the contribution of ED to this exposure. To analyse the current situation of U.S. ED market with emphasis on market size, social aspects of consumers, active ingredients, potential benefits, safety and regulations. To determine the frequency of occurrence and patterns in consumption of potentially erosive beverages in school children in the Netherlands. Gathering information about food habits and behaviours of the students of the School of Medicine of Messina (Italy) A group of 700 subjects (aged years) was selected in Austria. A food frequency questionnaire was developed for the purpose of caffeine exposure estimation. A total of 124 samples of different foods and beverages were analysed in their caffeine concentration. Socio-economic market analysis. A cross-sectional, single centre study was performed among 502 school children in Rotterdam, in age varying between 12 and 19 years. Data on consumption of soft, ED, sports and alcopops were obtained through a self-reported questionnaire. Dedicated questionnaire focusing on ED in order to gather information about consumption patterns of these products, consumed alone or in association with alcoholic beverages. Five hundred students of the School of Medicine of the University of Messina were interviewed, and 450 filled the questionnaire. The vast majority of caffeine exposure resulted from coffee, providing 60,8% of total caffeine exposure. ED, as second highest contributor, provided 11,9% and colas provided 9,5%. ED have experienced exponential growth since their launch in the US. The market is becoming flooded with new ED, many with unusual names and claims of a higher energy boost compared to the previous ones. Research needs to continue regarding the potential benefits of these products to support the claims. Consumption of soft, ED, sports and alcoholic products by school children is related to age and gender. Evidence from the study suggests that a subgroup of school children with a high cumulative exposure to these potentially erosive does exist. Association of ED + alcohol is very popular among students. Users of ED + alcoholic beverages might not feel the signs of alcohol intoxication, thus increasing the probability of accidents and/or favouring the possibility of development of alcohol dependence. Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

43 Paper Objective Methodology Results Higgins, JP, Phil M, Tuttle TD, Higgins CL, 2010 To picture the situation of energy beverages (EBs) market, describing their ingredients, discussing safety aspects, and providing recommendations regarding their use. The research query included studies and information involving non-athlete consumers. Also, the review offers recommendations which are specific to each group. A search of the English-language scientific literature was performed primarily by searching the MEDLINE and EMBASE databases and using the Google Internet search engine for the period January 1976 through May Ingestion of EBs before an event or during training can have serious adverse effects. Limited ingestion of EBs by healthy people is not likely to cause major adverse effects, but binge consumption or consumption with alcohol may lead to adverse effects. Individuals with medical illnesses, especially underlying heart disease, should check with their physician before using EBs. Meltzer HM, Nordisk Ministerråd N, Råd Nordisk, 2008 To develop a risk assessment of caffeine in children and adolescents in Nordic countries. The report focuses on effects of caffeine on the central nervous system. An overview of consumption data on caffeinecontaining foods, among children and adolescents in the Nordic countries, is presented in the exposure characterisation. Authors transformed the total caffeine exposure in the various age-groups and exposure levels into exposure per kg. This enabled them to compare more directly Nordic exposure levels with exposure levels provided in international literature. Many Nordic teenagers have an exposure to caffeine which can be associated with tolerance development and withdrawal symptoms, while approximately 20% of the teenagers might be exposed to levels of caffeine from caffeinecontaining soft inducing anxiety and jitteriness. If other sources of caffeine such as chocolate, tea and coffee were also considered, these figures might be higher.. Alard J, Marìn C, Cubillo JM, 2010 To analyse different types of promotion strategies used by the leading brands (including private labels) of ED in each country, as well as their long-run effects on sales for both categories. The survey, based on scanner data at store-level in a series which covers 7 years, provides almost all of the history of the category. The effect of promotions results to be less intense for Private Label than for the other brands. Impacts of different promotional activities are presented and commented. Food Safety Promotion Board, 2002 The Food Safety Promotion Board (FSPB) convened an expert Committee to review the health effects of stimulant. A survey of the consumption of stimulant in a representative sample of year olds in the Republic of Ireland (total sample number (n) = 625)and in Northern Ireland (n = 635). Results of the research demonstrated that the main concerns vis à vis stimulant were its consumption with alcohol, the perceived high caffeine content and the sense of ambiguity and uncertainty regarding the other ingredients. Supporting Publications 2013:EN by the author(s) in the context of a contract between the European Food Safety Authority and the author(s), awarded following a tender procedure. The present document is published complying with the transparency principle to which the Authority is subject. It may not be issues addressed and the conclusions reached in the present document, without prejudice to the rights of the authors.

44 3.2. Stakeholders consultation: emerging issues The pre-survey consultation of stakeholders was carried out to identify useful sources and suggestions for the study, in order to fine-tune the survey design. The post-survey consultation aimed instead at gathering comments from stakeholders on the analysis developed in the study as well as on results emerging from the first round of consultations. During the pre-survey consultation, the rationale and the purpose of the study was introduced by sent to 41 subjects, as identified in the list of relevant stakeholders agreed with EFSA. Following this preliminary contacts, and according to the stakeholders availability to cooperate, a total number of 17 interviews (13 phone interviews and 4 based on written contributes) were made between February and May 2012 (table 11). As for the post-survey consultation, a selection of the stakeholders already interviewed during the first round of consultations were contacted by . Written comments were collected by 9 experts on November 2012 (table 11). Table 11: List of the contacted stakeholders: pre-survey and post-survey consultation EU Country Stakeholder Pre-survey Post - Survey EUCAM European Centre for Monitoring Alcohol Marketing Phone interview Contacted EU UNESDA Union of European Beverages Associations - Contacted Belgium Cyprus FIEB/VIWF - Fédération des Industries des Eaux et des Boissons Rafraîchissantes Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology Phone interview Written comments Phone interview - EU EDE Energy Drinks Europe Phone interview Netherlands France NVWA Netherlands Food and Consumer Product Safety Authority ANSES - French Agency for Food, Environmental and Occupational Health & Safety Phone interview /written answers Phone interview Written comments - Written comments Austria University of Vienna - Department of Nutritional Sciences Phone interview Contacted Greece Czech Republic Italy Germany EFET - Hellenic Food Authority, Nutrition Policy & Research Directorate Ministry of Agriculture of the Czech Republic - Food Production and Legislation Department INRAN Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione WAFG - Wirtschaftsvereinigung Alkoholfreie Getränke e.v. Phone interview Written comments Phone interview - Phone interview Phone interview Cyprus Ministry of Health - State General Laboratory Phone interview Written comments Written comments Written comments Belgium SHC - Superior Health Council Phone interview - Latvia Assessment and Registration Agency of Food and Veterinary Service of Latvia Phone interview/ written answers Hungary Hungarian Food Safety Office Phone interview Iceland MAST Icelandic Food and Veterinary Authority Phone interview Germany BfR - Federal Institute for Risk Assessment Phone interview/ written answers Contacted Written comments Written comments - Supporting Publications 2013:EN

45 A short description of the main issues emerging from the stakeholders consultation is provided at 3.2.1, and (details in Appendix E) Literature and sources Stakeholders contribution to literature review was useful for the identification of relevant scientific studies, and above all for the collection of reports investigating national features related to the ED sector in specific MS. Stakeholders also provided interesting remarks on the selection of study references ED market Interviewees were asked to provide data and information about the situation of the market both at EU level and for their MS. Before the interviews, the study team sent the stakeholders a list of the main brands of ED for each MS; these lists had been compiled mostly using relevant online sources (i.e. ED websites, blogs, web magazines, etc.). Stakeholders were then asked to comment and - if deemed opportune - modify such list of brands, on the basis of their knowledge of the market. In most cases, stakeholders were unable to provide any additional information regarding ED brands and market shares, but they generally confirmed the validity of information on the 4-5 leading brands in each national market. In some cases, useful information was provided by stakeholders on the growing importance of private labels (especially among youngsters), as well as on the significant presence, in some MS, of pre-mixed alcoholic ED. With specific reference to the list of ED brands marketed in each MS, most stakeholders confirmed its validity and representativeness Active ingredients On the basis of outcomes from the literature review, a list of the most relevant food products containing caffeine, taurine and D-glucurono-y-lactone had been identified for each MS and provided to the stakeholders. Experts were then asked to comment this list, especially for the role of the listed products as potential sources of active ingredients considered in the study. In some cases the stakeholders contribution was extremely helpful to identify a number of food products containing caffeine which were widely consumed in some MS only 37. In some cases, experts highlighted that caffeine content in specific products belonging to the same category may vary significantly 38. As a consequence, some experts suggested the adoption of questionnaires with reference to local foods/beverages and brands for each MS considered in the study, and the evaluation of caffeine content for any specific product. 37 This was the case of Frappè coffee, which is an extremely popular coffee-based drink in Greece and Cyprus. 38 For instance, a cappuccino in a bar may contain 70 mg of caffeine whilst a large cappuccino from a coffee house such as Starbucks may contain mg of caffeine. Supporting Publications 2013:EN

46 A substantial share of interviewees also highlighted the relevant role played by drugs and medicines in determining the total exposure to active ingredients in the diet, especially for some specific groups of consumers, thus suggesting the inclusion of these product categories in the questionnaires Survey: results General overview The survey activities were started in February and closed in November Table 12 below provides the total number of respondents by target group and by MS at the date when the survey was officially closed (12 th November 2012). Table 12: Number of total validated respondents (a) Country Adults Adolescents Children TOTAL Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United kingdom Validated respondents Total respondents Source: Survey Nomisma Areté for EFSA (a) The total number of respondents, including not validated respondents, amount at A total number of respondents were eliminated after applying quality check procedures. Survey data are presented as average values of the 16 MS as a whole, or for individual MS in specific cases. Additional elaborations by gender (for all the target groups) and by age (only for adults) were made with the aim of investigating potential differences. 39 In the light of considerations concerning both protection of the respondents privacy and operational difficulties posed by the extremely wide variety of drugs and medicines marketed in the 16 MS covered by the survey, the study team agreed with the steering group the exclusion of any question on drugs and medicine consumption from the questionnaire. Supporting Publications 2013:EN

47 With reference to the results of the analysis in the different samples and subsamples, it is important to clarify that the figures provided in the following chapters refer to actual sample sizes observed in the survey - which indicate the actual number of interviews - whilst incidence figures in relation to the analysis on the 16 MS as a whole are based on weighted data, in order to have more accurate data replicating the differences in sample composition among individual MS. The system of weights adopted in the analysis was structured to guarantee that the weighted data correctly represent the proportion both of the total population and the ED consumers for the 16 MS as a whole. Supporting Publications 2013:EN

48 Adults The sample of adults ( total respondents) was composed for 55% by women and 43% 40 by men, the 43% were of the age group years and around 72% of total respondents lived in urban areas. Most respondents declared to have completed the upper secondary school (37%) or to have university degree 29%). The 63% were workers ED consumption Around 30% of the total respondents ( total respondents) declared to have consumed ED at least once in the last year, and this value varied from around 14% in Cyprus to 50% in Austria (figure 2). This percentage increased to 53% in the age group 18-29, and decreased to around 17% for respondents older than 50 (figure 3). As for ED consumers (4.180 ED consumers), the sample was composed for 53% by men and 47% by women, and around 75% of them lived in urban areas. Most respondents declared to have completed the upper secondary school (39%) or to have a university degree (29%). Regular smokers accounted for around 35% of the sample. Figure 2: Adults Prevalence 41 of ED consumption by country (Sample size: Total respondents) 40 Being this information N.A. for 2% of respondents. 41 In the present study ED consumers are defined as subjects who have been drinking ED at least once over the last year, so prevalence of ED consumption was calculated on the basis of this assumption. Supporting Publications 2013:EN

49 Figure 3: Adults Prevalence of ED consumption for each age group (Sample size: Total respondents) Considering the prevalence of ED consumption by gender, around 26% of females and 37% of males declared to have consumed ED at least once in the last year. Around 25% of total adult consumers affirmed to have been drinking ED once or twice a month, while 21% of consumers to have done it once a week. Higher consumption frequencies (at least twice a week) concern around 33% of consumers. The most common format consumed was the 250 ml can, while around 6% of consumers declared to consume energy shots 42. Around 22% of consumers resulted to be used to drink more than 10 cans in a month, while for most consumers the volume was 2-4 cans per month (33%) or 5-10 cans per month (23%). Around 52% of adult consumers declared to have drunk only 1 can of ED in a single session, and only 3% to consume more than 4 cans in the same occasion (Figure 4). As for volumes, the average volume consumed by adults was approximately 2 L/month for ED consumers, ranging from 1,3 L/month in Italy and 2,9 L/month in Romania. 42 Even if energy shots just cover 6,4% of adult consumers, a particular attention is suggested to be paid to this product category, due to peculiarities in the content of active substances. Indeed, focusing the analysis on the specific energy shots brands indicated by respondents, the occurrence of active substances reveals to sharply differ among energy shots brands: in most cases the absolute content of active substances in mg per serving is approximately equal to that of the standard ED (i.e. 80 mg of caffeine in a 60 ml can), but the concentration of these substances is consequently much higher. See also details in the chapter materials and methods, Supporting Publications 2013:EN

50 Figure 4: Adults - ED consumption related features (Sample size: ED consumers) Supporting Publications 2013:EN

51 According to the final results of the survey, around 25% of adult consumers stated to usually consume ED in association with sport and physical exercise; for an additional 39% consumption is sometimes associated to such activities. The most common situations of ED consumption resulted to be at home in ordinary situations and at home with friends during parties (both accounting for around 65% of consumers). Also sport and physical exercise registered high percentages (around 63% of consumers), followed by bar/pubs (52%) and discos (47%). As for reasons for consumption, most adult consumers (around 40%) declared to consume ED mainly as a source of energy, or less frequently to stay awake (18%), simply because of their taste (16%) or to drive for a long time (around 8%). It is however worth highlighting the presence of other secondary reasons, such as enhancing sport performance, concentration augmenting or stimulating metabolism (figure 5). Red Bull resulted to be the most common ED brand: it was included as first choice among the topthree brands by nearly 89% of consumers. Red Bull is followed by Monster (first choice for 45% of consumers) and Burn (first choice for 42% of consumers). Figure 5: Adults Motivations for ED consumption (first choice) (Sample size: ED consumers) Supporting Publications 2013:EN

52 Survey data were elaborated according to a specifically defined methodology ( 3.3.5) in order to identify high acute and high chronic consumers. On this basis, high acute consumers accounted for a 3% of the total respondents, while high chronic consumers represented around 4% (figure 6). Figure 6: Adults - Prevalence of ED consumption for ED consumers, high acute consumers and high chronic consumers on total respondents (Sample size: Total respondents) Adults identified to be both high acute and high chronic consumers accounted for 3,4% of ED consumers, (corresponding to 1% of total respondents): this share was anyway much smaller than the ones for the purely high chronic and high acute consumer groups. The high acute consumer profile is provided at Table 13: Adults Overlap between high chronic and high acute ED consumers (Sample size: ED consumers) % on total ED consumers High acute Non high acute Total High chronic 3,4% 8,4% 11,8% Non high chronic 7,6% 80,6% 88,2% Total 11,0% 89,0% 100,0% Supporting Publications 2013:EN

53 High chronic ED consumers resulted to account for around 12% of adult consumers. This average value varied from around 21% of adult consumers in United Kingdom, and 5% Italy and Hungary (figure 7). Figure 7: Prevalence of high chronic ED consumption by country (Sample size: ED consumers) Supporting Publications 2013:EN

54 The prevalence of high chronic consumers was 13,3% in young adult consumers. Table 8 provides the distribution of ED consumers and high chronic ED consumers among different age groups. Among high chronic consumers the percentage of years rose from 27% to 31% of the target group. High chronic consumption resulted to be higher among consumers who declared to smoke regularly: 15% against 10% of non-smokers. Figure 8: Adults - Distribution of high chronic ED consumption by age groups (Sample size: ED consumers) Around 95% of high chronic consumers declared to have consumed ED in the three days before the survey, while this share decreased to 60% considering total consumers. The share of consumers who declared to drink ED at least 4 times a week was higher for high chronic consumers than for total consumers (73% and 9%, respectively). As for consumed volumes, only 21% of total consumers resulted to drink more than 10 cans of ED per month, against a share of 61% of high chronic consumers (figure 9). The average consumed volume was 4,47 L/month in the case of adult high chronic consumers. Supporting Publications 2013:EN

55 Figure 9: Adults ED consumption patterns: characteristics for high chronic and ED consumers (Sample size: ED consumers; High chronic consumers) Supporting Publications 2013:EN

56 Supporting Publications 2013:EN

57 Co-consumption of ED and alcohol Survey results highlighted the co-consumption habit (ED and alcohol) 43 among adults. Around 56% of ED consumers declared to consume ED and alcohol, ranging from 24% in Cyprus to 67% in Germany. With reference to the total respondents, this percentage decreased to 17%, and ranged from 3% in Cyprus to 29% in Austria, while percentages for ED consumers varied from 24% in Cyprus and 67% in Germany (figure 10). Figure 10: Adults - Prevalence of co-consumption of ED and alcohol by country (Sample size: Total respondents; ED consumers) 43 In this study, co-consumers of ED and alcohol are defined as subjects who have been drinking ED and alcohol in a single session at least once over the last year. Supporting Publications 2013:EN

58 Concerning the different age groups identified within the target group adults, the highest prevalence of co-consumption of ED and alcohol was reported in the age group 18-29, as around 71% of ED consumers and 38% of total respondents in this group declared to consume ED with alcohol in the same session (figure 11). Focusing on ED consumers, there were no differences in co-consumption habits by gender. On the other hand, only 14% of female declared to consume ED and alcohol, while prevalence of such habit increased for male (21%). Figure 11: Adults - Prevalence of co-consumption of ED and alcohol by age groups Comparison between total respondents (Sample size: Total respondents; ED consumers) Supporting Publications 2013:EN

59 Around 60% of respondents declared to co-consume ED and alcohol mostly mixing them at the moment of consumption. Co-consumption resulted to occur at least once a week for 38% of ED consumers drinking ED and alcohol. Around 57% of ED consumers stated that they mix ED and alcohol at least twice in a single session of consumption (figure 12). Figure 12: Adults - Co-consumption of ED and alcohol and related features (Sample size: ED consumers) (Sample size: Consumers drinking ED and alcohol) (Sample size: Consumers drinking ED and alcohol) (Sample size: Consumers drinking ED and alcohol) Supporting Publications 2013:EN

60 As illustrated in figure 13, co-consumption was identified to occur at least twice a week for 56% of high chronic consumers, against 20% of consumers. The share of high chronic consumers combining ED with alcohol about every time was 23% (against an average 9% for consumers). Figure 13: Adults Monthly frequency of co-consumption of ED and alcohol: high chronic and average consumers drinking ED and alcohol (Sample size: Consumers drinking ED and alcohol; 486 High chronic consumers) Supporting Publications 2013:EN

61 Consumption of ED during sport activities Around 52% of adult ED consumers declared to usually drink ED before/in association with/after sport activities 44. Remarkably, this percentage increased for ED consumers practising sport activities. Around 49% of consumers stated to practise sport or physical exercise at least twice a week (figure 14). Figure 14: Adults Consumption of ED during sport activities (Sample size: ED consumers) 44 In the context of the study respondents who declare to practice physical activities at least once a week are considered as subjects practicing sport activities. Supporting Publications 2013:EN

62 Around 75% of ED consumers who practise sport activities at least once a week declared to drink ED at least sometimes during such activities, with 14% drinking ED about every time they practise such activities. Around 53% of consumers declared to drink 2 cans or more in a single sport/physical exercise session (figure 15). Figure 15: Adults - Consumption of ED during sport activities and related features (Sample size: ED consumers practicing sport activities) (Sample size: ED consumers drinking ED during sport activities) The average prevalence of ED consumption during sport activities masks some differences at MS level (figure 16): the lowest prevalence was recorded in Hungary (around 41% of ED consumers), while the highest in the United Kingdom and Greece (around 88% of ED consumers). With regards to the total respondents and ED consumers, the highest prevalence of ED consumption during physical activities was registered respectively in Poland (26%) and in Spain (62%). Supporting Publications 2013:EN

63 Figure 16: Adults - Prevalence of ED consumption during sport activities by country (Sample size: Total respondents; ED consumers; ED consumers practicing sport activities) The main reasons for ED consumption during sport practice were endurance time at the maximum intensity (40%) and vitality (26%), but also aerobic endurance and concentration were mentioned (figure 17). Supporting Publications 2013:EN

64 Figure 17: Adults Motivations for consumption of ED during sport practice (Sample size: ED consumers drinking ED during sport activities) Concerning respondents who practise physical activities, the share of high chronic consumers who declared to consume ED about every time they engage in sport activities (figure 18) was much higher (45%) than the share of total respondents (14%). Figure 18: Adults Prevalence and frequency of consumption of ED during sport activities: high chronic and average consumers practicing sport (Sample size: ED consumers practicing sport activities; 486 High chronic consumers) Supporting Publications 2013:EN

65 ED contribution to total exposure to relevant substances Tables 14 and 15 provide absolute values of chronic exposure 45 to caffeine for total respondents, ED consumers and high chronic consumers, calculated on the basis of the methodology ( ). For adults, chronic exposure to caffeine from ED varied from around 7 mg/day for total respondents to around 48 mg/day for high chronic consumers. Accordingly, total caffeine exposure (from ED and other products in the diet) varied from 272 mg/day (ED consumers) to around 382 mg/day (high chronic consumers). Consequently, chronic exposure to caffeine from ED ranged from 0,10 mg/kg bw/day for total respondents to 0,70 mg/kg bw/day for high chronic consumers. Table 14: Adults Chronic exposure to caffeine from ED and from all products (a) (values in mg/day) (Sample size: Total respondents; ED consumers; 486 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED: Total respondents 6,82 0,00 0,00 229,33 2,78 20,00 39,79 19,10 ED consumers 22,43 11,15 0,53 229,33 28,17 50,63 77,30 29,14 High chronic consumers 48,32 39,80 2,50 228,98 56,80 107,72 158,65 43,12 Total exposure: Total respondents NA NA NA NA NA NA NA NA ED consumers 271,73 237,67 2, ,36 365,83 528,36 670,39 202,09 High chronic consumers 381,91 334,01 11, ,36 503,71 688,96 855,94 252,33 (a) Including ED Table 15: Adults Chronic exposure to caffeine from ED and from all products (a) (values in mg/kg bw/day) (Sample size: Total respondents; ED consumers; 486 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED: Total respondents 0,10 0,00 0 6,15 0,05 0,29 0,53 0,29 ED consumers 0,32 0,15 0 6,15 0,38 0,71 1,02 0,46 High chronic consumers 0,70 0,51 0 6,15 0,80 1,59 2,32 0,76 Total exposure: Total respondents NA NA NA NA NA NA NA NA ED consumers 3,87 3, ,60 5,05 7,54 9,60 4,08 High chronic consumers 5,78 4, ,09 7,17 10,60 13,90 6,66 (a) *Including ED 45 The calculations of exposure to the different active ingredients were based on usual consumption patterns: hence, the volume of consumption for each food/beverage investigated in the survey was linked to the average consumption frequency, e.g. average month over the last year. Therefore the exposure here represented has to be considered as chronic exposure. Supporting Publications 2013:EN

66 On average, ED consumption contributed for 8% of the overall daily exposure to caffeine (figure 19), a figure increasing to 13% for high chronic consumers (to 12% considering daily caffeine exposure per kg bw). Figure 19: Adults ED contribution to the total daily exposure to caffeine (%): high chronic and ED consumers (Sample size: ED consumers; High chronic consumers) Supporting Publications 2013:EN

67 Concerning total respondents at MS level, chronic exposure to caffeine from ED ranged from around 14 mg/day (0,20 mg/kg bw/day) in Austria to around 3 mg/day (0,04 mg/kg bw/day) in Cyprus (tables 16 and 17). Table 16: Adults Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/day) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 13,99 2, ,98 19,54 40,00 66,67 30,21 Belgium 3,53 0, ,20 0,00 7,95 20,00 15,55 Cyprus 2,67 0, ,42 0,00 7,63 19,10 12,04 Czech Republic 8,81 0, ,20 8,01 21,26 39,80 20,68 Finland 5,20 0, ,00 2,67 10,99 28,40 17,16 France 6,09 0, ,33 0,00 11,47 38,90 22,30 Germany 6,33 0, ,41 2,67 19,83 39,20 16,93 Greece 5,83 0, ,24 3,78 20,13 39,15 15,19 Hungary 6,80 0, ,00 7,52 20,00 39,88 17,35 Italy 4,46 0, ,03 2,66 11,39 23,31 12,56 Netherlands 4,34 0, ,19 0,00 8,34 28,35 14,52 Poland 10,57 0, ,06 8,00 39,59 40,64 23,14 Romania 12,10 0, ,18 17,38 39,81 56,46 25,42 Spain 7,53 0, ,20 7,75 26,77 39,89 20,08 Sweden 3,46 0, ,38 0,00 8,00 19,90 12,27 United Kingdom 6,36 0, ,27 2,66 20,00 39,75 17,44 Table 17: Adults Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/kg bw /day) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 0,20 0,03 0 3,63 0,17 0,54 0,95 0,48 Belgium 0,05 0,00 0 2,78 0,00 0,11 0,31 0,21 Cyprus 0,04 0,00 0 1,93 0,00 0,11 0,24 0,17 Czech Republic 0,11 0,00 0 3,07 0,11 0,33 0,53 0,27 Finland 0,07 0,00 0 1,99 0,03 0,12 0,45 0,23 France 0,09 0,00 0 3,72 0,00 0,18 0,47 0,34 Germany 0,08 0,00 0 3,25 0,04 0,28 0,47 0,23 Greece 0,08 0,00 0 3,92 0,06 0,27 0,44 0,23 Hungary 0,11 0,00 0 5,51 0,07 0,26 0,51 0,37 Italy 0,06 0,00 0 2,65 0,04 0,20 0,34 0,18 Netherlands 0,06 0,00 0 3,15 0,00 0,14 0,35 0,23 Poland 0,14 0,00 0 2,97 0,13 0,45 0,67 0,31 Romania 0,17 0,00 0 2,82 0,19 0,60 0,85 0,35 Spain 0,11 0,00 0 4,94 0,09 0,34 0,57 0,29 Sweden 0,04 0,00 0 1,79 0,00 0,12 0,25 0,15 United Kingdom 0,10 0,00 0 6,15 0,03 0,30 0,57 0,35 Supporting Publications 2013:EN

68 Comparing the average values in the 16 MS for adult ED consumers, the highest level of chronic exposure to caffeine from ED was around 32 mg/day for Romanian consumers (against a total daily exposure to caffeine of 277 mg) (table 18). Table 18: Adults Chronic exposure to caffeine from ED and from all products (a) in the 16 MS covered by the survey (values in mg/day) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev % from ED/Total exposure from ED 27,82 19,28 2,51 228,98 39,75 66,67 126,32 37,86 Austria 11,3% total exposure 246,91 225,56 3,56 891,67 351,40 472,67 611,95 169,71 exposure from ED 23,38 8,00 2,51 227,20 28,40 41,84 91,55 33,80 Belgium 7,2% total exposure 324,30 258,46 16, ,94 466,42 713,23 819,21 257,56 exposure from ED 19,35 8,75 2,50 160,42 21,88 43,72 85,84 27,23 Cyprus 9,4% total exposure 204,89 156,66 11,43 680,59 270,35 390,59 507,00 141,34 exposure from ED 19,23 8,05 2,08 227,20 20,09 39,95 56,71 27,11 Czech Republic 7,7% total exposure 248,24 211,28 7,50 958,42 355,30 467,71 544,04 171,95 exposure from ED 18,11 7,98 1,33 151,00 15,99 55,92 80,00 28,19 Finland 5,3% total exposure 343,98 323,24 11, ,85 493,99 684,03 704,80 232,00 exposure from ED 27,30 11,13 2,01 229,33 28,11 65,63 133,33 40,67 France 9,9% total exposure 276,66 225,19 3, ,49 399,58 540,47 687,25 215,31 exposure from ED 21,01 10,98 1,51 162,41 27,31 52,90 64,34 25,37 Germany 6,7% total exposure 311,82 268,20 2, ,02 431,06 630,46 718,75 222,63 exposure from ED 18,48 11,07 2,52 227,24 27,99 40,03 55,14 22,35 Greece 8,9% total exposure 207,15 183,94 9,48 669,52 279,86 404,48 490,10 132,18 exposure from ED 16,97 7,99 0,53 160,00 19,99 40,00 69,67 24,08 Hungary 7,6% total exposure 224,13 211,45 4, ,50 292,54 434,10 493,38 168,63 exposure from ED 15,76 8,00 1,33 159,03 20,00 39,92 41,33 19,48 Italy 6,8% total exposure 231,95 234,50 9,41 736,46 307,93 416,19 477,80 138,23 exposure from ED 20,92 8,00 2,50 159,19 28,17 52,50 76,56 25,94 Netherlands 6,4% total exposure 327,69 274,90 8,98 926,06 511,48 708,96 776,56 242,39 exposure from ED 23,34 11,31 2,50 218,06 28,40 41,73 71,85 29,76 Poland 8,7% total exposure 269,27 255,45 3,81 960,64 366,40 460,04 565,63 162,59 exposure from ED 31,71 20,00 2,54 183,18 39,87 78,17 109,70 32,77 Romania 11,5% total exposure 276,93 242,76 8, ,05 369,82 525,05 638,10 196,45 exposure from ED 24,39 15,42 2,50 227,20 29,20 55,43 79,42 29,92 Spain 11,3% total exposure 215,04 167,26 8, ,87 307,84 454,29 589,73 177,36 exposure from ED 15,79 7,98 1,31 158,38 19,74 39,76 54,04 22,23 Sweden 5,0% total exposure 318,60 273,98 5, ,61 432,67 696,14 738,81 236,01 exposure from ED 22,96 11,36 1,27 228,27 28,40 55,91 63,25 26,80 United Kingdom 7,4% total exposure 308,27 251,59 4, ,36 435,30 637,94 786,37 255,29 (a) Including ED Supporting Publications 2013:EN

69 Exposure to caffeine from ED ranged from 0,20 mg/kg bw/day for Swedish ED consumers to 0,44 mg/kg bw/day for Romania (table 19). Table 19: Adults Chronic exposure to caffeine from ED and from all products (a) in the 16 MS covered by the survey (values in mg/kg bw/day) ED Consumers (Sample size: 4.180) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED 0,40 0,16 0,03 3,63 0,43 0,95 1,68 0,62 total exposure 3,34 3,03 0,06 12,49 4,52 6,66 7,42 2,32 exposure from ED 0,32 0,13 0,03 2,78 0,37 0,70 1,39 0,45 total exposure 4,53 3,47 0,22 16,61 5,98 9,90 13,28 3,77 exposure from ED 0,28 0,14 0,03 1,93 0,28 0,56 1,46 0,38 total exposure 2,91 2,23 0,16 9,07 4,15 6,04 7,24 2,00 exposure from ED 0,25 0,13 0,00 3,07 0,30 0,55 0,78 0,36 total exposure 3,17 2,76 0,00 14,30 4,36 6,47 8,11 2,35 exposure from ED 0,24 0,09 0,00 1,99 0,23 0,68 1,17 0,39 total exposure 4,33 3,94 0,00 34,98 6,12 8,36 10,03 3,93 exposure from ED 0,40 0,16 0,03 3,72 0,41 0,99 1,76 0,62 total exposure 4,12 3,18 0,06 24,53 5,47 8,68 10,80 3,51 exposure from ED 0,28 0,14 0,00 3,25 0,34 0,62 0,86 0,35 total exposure 4,17 3,48 0,00 16,59 5,64 8,46 10,78 3,15 exposure from ED 0,24 0,14 0,02 3,92 0,32 0,50 0,66 0,35 total exposure 2,72 2,44 0,14 9,75 3,94 5,15 5,60 1,83 exposure from ED 0,27 0,11 0,00 5,51 0,26 0,57 1,35 0,55 total exposure 3,37 2,65 0,00 47,53 4,36 6,18 8,03 4,09 exposure from ED 0,22 0,13 0,00 2,65 0,28 0,50 0,71 0,29 total exposure 3,23 3,10 0,00 14,34 4,43 5,56 6,97 2,06 exposure from ED 0,30 0,13 0,02 3,15 0,35 0,69 1,03 0,44 total exposure 4,28 3,26 0,14 14,72 6,19 8,84 10,80 3,23 exposure from ED 0,31 0,16 0,00 2,97 0,39 0,70 0,98 0,40 total exposure 3,71 3,45 0,00 14,18 5,06 6,84 8,10 2,38 exposure from ED 0,44 0,29 0,00 2,82 0,62 0,95 1,31 0,45 total exposure 3,90 3,27 0,00 19,05 5,42 7,72 10,01 2,88 exposure from ED 0,34 0,20 0,00 4,94 0,42 0,73 1,02 0,45 total exposure 3,01 2,38 0,00 13,93 4,22 6,52 8,20 2,53 exposure from ED 0,20 0,11 0,02 1,79 0,24 0,49 0,72 0,27 total exposure 4,18 3,35 0,10 15,86 5,89 8,96 11,25 3,28 exposure from ED 0,37 0,17 0,00 6,15 0,42 0,78 1,09 0,59 United Kingdom total exposure 5,25 3,14 0,00 79,60 5,90 9,76 14,91 8,66 (a) Including ED % from ED/Total As for the differences between genders, chronic caffeine exposure from ED consumption was equal to nearly 21 mg/day for female consumers and to about 23 mg/day for male ones. The values of total daily caffeine exposure were similar between genders. The highest value of caffeine exposure deriving from ED consumption was around 23 mg/day reported in the age group, whereas the highest value of total caffeine exposure concerned the age group, with an average value of 310 mg/day. 11,9% 7,0% 9,5% 7,8% 5,6% 9,8% 6,6% 8,8% 8,1% 6,9% 6,9% 8,5% 11,2% 11,4% 4,9% 7,0% Supporting Publications 2013:EN

70 Concerning the contribution of ED to chronic exposure to taurine and D-glucurono-y-lactone, differences between total respondents, ED consumers and high chronic consumers showed to be much higher than those observed for caffeine. Tables 20 and 21 show that average taurine exposure in high chronic consumers resulted to be nearly twice the average value for all consumers, and seven times higher than the average value for total respondents. Table 20: Adults Chronic exposure to taurine from ED (values in mg/day) (Sample size: Total respondents; ED consumers; 486 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 82,71 0,00 0, ,33 250,00 500,00 236,26 ED consumers 271,88 120,71 0, ,00 500,00 915,40 363,42 High chronic consumers 585,79 500,00 7, , , ,00 544,46 Table 21: Adults Chronic exposure to taurine from ED (values in mg/kg bw/day) (Sample size: Total respondents; ED consumers; 486 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 1,16 0, ,92 0,55 3,47 6,46 3,58 ED consumers 3,82 1, ,92 4,46 8,76 12,50 5,65 High chronic consumers 8,49 6, ,92 9,96 19,08 29,24 9,42 The relative contribution from ED to the total exposure to taurine resulted to be 82% in ED consumers, picking up to 91% in high chronic consumers. Supporting Publications 2013:EN

71 Tables 22 and 23 report the daily exposure to taurine from ED for total respondents (respectively in mg/day and in mg/kg bw/day) in the 16 MS covered by the survey. Table 22: Adults Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/day) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 157,25 5, ,00 108,44 500,00 767,14 359,25 Belgium 36,92 0, ,00 0,00 68,80 178,75 180,55 Cyprus 31,49 0, ,33 0,00 100,00 250,00 139,63 Czech Republic 109,80 0, ,00 100,00 308,50 500,00 259,17 Finland 64,46 0, ,00 33,33 134,13 355,00 216,24 France 71,25 0, ,00 0,00 142,00 355,00 266,35 Germany 80,81 0, ,00 33,33 250,00 500,00 219,22 Greece 70,64 0, ,00 41,95 250,00 355,00 188,63 Hungary 85,03 0, ,00 77,40 250,00 500,00 217,95 Italy 51,45 0, ,00 33,33 142,00 250,00 150,61 Netherlands 49,85 0, ,00 0,00 100,00 355,00 168,11 Poland 130,14 0, ,00 100,00 500,00 500,00 290,49 Romania 150,07 0, ,67 142,00 500,00 710,00 322,97 Spain 89,56 0, ,00 57,48 250,00 500,00 246,55 Sweden 42,86 0, ,00 0,00 100,00 250,00 155,06 United Kingdom 77,80 0, ,00 33,33 250,00 500,00 217,09 Table 23: Adults Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/day) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 2,27 0, ,08 1,72 5,63 11,58 5,79 Belgium 0,51 0, ,45 0,00 0,86 2,29 2,42 Cyprus 0,45 0, ,09 0,00 1,30 2,85 1,98 Czech Republic 1,41 0, ,38 1,37 4,44 6,72 3,39 Finland 0,85 0, ,00 0,36 1,50 4,75 2,94 France 1,05 0, ,33 0,00 2,03 5,55 3,98 Germany 1,06 0, ,60 0,53 3,53 6,10 2,99 Greece 0,92 0, ,97 0,64 3,13 5,41 2,81 Hungary 1,37 0, ,00 0,86 3,33 6,49 4,71 Italy 0,72 0, ,33 0,41 2,00 3,99 2,18 Netherlands 0,70 0, ,67 0,00 1,54 4,13 2,69 Poland 1,76 0, ,10 1,67 5,56 8,33 3,91 Romania 2,06 0, ,41 2,11 7,20 11,11 4,41 Spain 1,25 0, ,74 0,83 3,99 7,12 3,60 Sweden 0,55 0, ,67 0,00 1,45 3,21 1,92 United Kingdom 1,24 0, ,92 0,41 3,49 6,95 4,33 Supporting Publications 2013:EN

72 Focusing only on ED consumers, the highest exposure to taurine from ED was evidenced for Romania (around 393 mg/day, corresponding to 5,41 mg/kg bw/day) (tables 24 and 25), while the relative contribution from ED to the total exposure to taurine varied from 75,8% in Italy and 87,1% in Romania. Chronic taurine exposure from ED showed the highest value in the age group of consumers, even though differences among values for the different age groups were limited. The average exposure to taurine for male consumers resulted slightly higher than the one for female consumers. Table 24: Adults Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/day) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev % taurine ED/total taurine Austria 312,81 100,00 5, ,00 369,69 757, ,79 456,61 84,4% Belgium 244,40 99,51 0, ,00 250,00 500,00 972,50 407,42 80,8% Cyprus 228,62 100,00 33, ,33 250,00 500, ,00 313,11 79,8% Czech Republic 239,56 100,00 13, ,00 250,00 500,00 710,00 340,19 80,5% Finland 224,31 100,00 0, ,00 200,00 710, ,00 356,93 79,5% France 319,63 100,00 6, ,00 355,00 710, ,09 489,10 84,6% Germany 268,15 142,00 0, ,00 355,00 710,00 833,33 330,71 82,2% Greece 223,97 142,00 0, ,00 315,44 500,00 710,00 280,59 79,4% Hungary 212,13 100,00 5, ,00 250,00 500,00 880,00 302,95 78,5% Italy 181,73 100,00 6, ,00 250,00 500,00 500,00 237,76 75,8% Netherlands 240,23 100,00 0, ,00 250,00 500,00 933,33 301,43 80,6% Poland 287,24 142,00 6, ,00 355,00 500,00 928,33 375,87 83,2% Romania 393,11 250,00 7, ,67 500, , ,00 421,96 87,1% Spain 290,03 142,00 8, ,00 355,00 674,50 988,75 372,70 83,3% Sweden 195,30 100,00 5, ,00 250,00 500,00 710,00 283,14 77,1% United Kingdom 281,04 142,00 0, ,00 355,00 710,00 733,33 336,54 82,9% Supporting Publications 2013:EN

73 Table 25: Adults Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/day) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 4,51 1, ,08 4,78 11,52 18,34 7,52 Belgium 3,35 1, ,45 3,92 7,40 16,93 5,41 Cyprus 3,26 1, ,09 3,27 6,90 16,95 4,44 Czech Republic 3,08 1, ,38 3,85 6,90 9,77 4,47 Finland 2,97 1, ,00 2,83 8,78 14,66 4,89 France 4,70 1, ,33 4,90 11,73 19,72 7,35 Germany 3,53 1, ,60 4,18 7,89 11,40 4,58 Greece 2,91 1, ,97 3,70 6,25 8,19 4,38 Hungary 3,43 1, ,00 3,32 7,49 16,94 6,96 Italy 2,56 1, ,33 3,21 5,93 8,33 3,49 Netherlands 3,36 1, ,67 3,85 7,97 12,46 5,09 Poland 3,88 1, ,10 4,81 8,77 12,24 5,06 Romania 5,41 3, ,41 7,47 12,12 16,51 5,74 Spain 4,05 2, ,74 5,10 8,84 12,00 5,53 Sweden 2,52 1, ,67 2,89 6,01 9,12 3,45 United Kingdom 4,46 2, ,92 5,07 10,00 13,33 7,30 The average chronic exposure to D-glucurono-y-lactone in high chronic consumers was 269 mg/day, around twice the average value for all consumers (126 mg/day). The average value for total respondents was 38 mg/day (tables 26 and 27). The relative contribution from ED to the total exposure to D-glucurono-y-lactone was 98,8% among ED consumers and 99,4% in high chronic consumers. Table 26: Adults Chronic exposure to D-glucurono-y-lactone exposure from ED (values in mg/day) (Sample size: Total respondents; ED consumers; 486 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 38,31 0, ,64 120, ,65 ED consumers 125,95 60, ,00 300, ,65 High chronic consumers 268,84 200, ,80 633, ,32 Table 27: Adults Chronic exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/day) (Sample size: Total respondents; ED consumers; 486 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 0,54 0, ,15 0,24 1,53 3,00 1,82 ED consumers 1,78 0, ,15 2,08 4,27 6,20 2,95 High chronic consumers 3,91 2, ,15 4,90 7,90 13,33 5,04 Tables 28 and 29 illustrate the daily exposure to D-glucurono-y-lactone from ED (in mg/day and in mg/kg bw/day) for total respondents, comparing the 16 MS covered by the survey. In both cases the highest data were registered in Romania (83 mg/day corresponding to 1,14 mg/ kg bw/day respectively). Supporting Publications 2013:EN

74 Table 28: Adults Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/day) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 79, ,00 60,00 255,00 340,35 189,84 Belgium 19, ,00 0,00 26,99 60,00 105,70 Cyprus 17, ,00 0,00 20,00 85,20 82,88 Czech Republic 31, ,00 20,00 85,20 146,63 108,25 Finland 15, ,00 0,10 19,00 64,75 78,91 France 33, ,00 0,00 60,00 159,75 129,91 Germany 38, ,00 19,00 127,68 213,00 112,16 Greece 32, ,00 19,38 113,85 201,82 99,33 Hungary 23, ,52 10,00 52,50 116,25 76,12 Italy 27, ,00 17,00 72,26 150,00 81,43 Netherlands 22, ,00 0,00 58,68 142,50 86,30 Poland 50, ,60 51,00 150,00 262,50 118,26 Romania 83, ,00 60,00 300,00 420,25 180,48 Spain 44, ,00 20,00 146,25 255,00 128,28 Sweden 19, ,00 0,00 57,00 90,00 71,25 United Kingdom 37, ,00 18,00 127,50 240,00 112,77 Table 29: Adults Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/day) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 1, ,05 0,97 3,10 5,44 2,95 Belgium 0, ,27 0,00 0,35 1,01 1,40 Cyprus 0, ,25 0,00 0,35 1,36 1,18 Czech Republic 0, ,03 0,30 1,00 2,08 1,52 Finland 0, ,25 0,00 0,22 0,82 1,03 France 0, ,22 0,00 1,00 2,35 1,98 Germany 0, ,56 0,24 1,50 2,69 1,57 Greece 0, ,38 0,28 1,35 2,52 1,54 Hungary 0, ,00 0,14 0,68 1,85 2,24 Italy 0, ,61 0,21 1,08 2,19 1,19 Netherlands 0, ,50 0,00 0,75 1,79 1,44 Poland 0, ,26 0,63 2,13 3,64 1,66 Romania 1, ,14 1,13 4,20 6,26 2,44 Spain 0, ,04 0,34 1,97 3,50 1,91 Sweden 0, ,28 0,00 0,71 1,39 0,83 United Kingdom 0, ,15 0,14 1,59 3,22 2,27 Supporting Publications 2013:EN

75 Tables 30 and 31 provide the daily exposure to D-glucurono-y-lactone from ED (in mg/day and in mg/kg bw/day) for ED consumers, comparing the 16 MS covered by the survey. Exposure to D-glucurono-y-lactone from ED showed the highest value in Romania, where the average daily exposure for ED consumers was around 218 mg (3 mg/kg bw/day). The lowest value was recorded in Finland (69 mg/day corresponding to 0,70 mg/kg bw/day). Similarly, the relative contribution from ED to the total exposure to D-glucurono-y-lactone varied from 97,2% in Finland and 99,3% in Romania. Table 30: Adults Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/day) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev % ED glucuronolactone / total glucuronolactone Austria 158,51 60, ,00 150,00 334,80 671,65 243,56 99,1% Belgium 129,78 50, ,00 115,50 300,00 570,00 244,92 98,9% Cyprus 126,51 60, ,00 150,00 300,00 600,00 191,50 98,8% Czech Republic 69,33 24, ,00 75,00 150,00 270,00 151,73 97,9% Finland 52,83 10, ,00 40,47 120,10 271,65 140,60 97,2% France 148,55 60, ,00 142,50 300,00 776,00 242,19 99,0% Germany 126,24 60, ,00 150,00 300,00 426,00 175,08 98,8% Greece 102,40 59, ,00 142,50 237,50 300,00 155,54 98,6% Hungary 58,17 15, ,52 52,50 193,53 300,00 111,63 97,5% Italy 96,58 57, ,00 135,00 255,00 300,00 129,45 98,5% Netherlands 109,68 57, ,00 138,75 271,56 355,73 162,74 98,7% Poland 110,42 57, ,60 135,00 270,00 383,40 155,66 98,7% Romania 218,29 150, ,00 300,00 447,60 800,00 236,61 99,3% Spain 143,91 63, ,00 181,05 300,00 431,60 197,56 99,0% Sweden 88,19 54, ,00 80,94 210,00 300,00 130,94 98,3% United Kingdom 135,21 60, ,00 181,05 300,00 390,00 181,00 98,9% Supporting Publications 2013:EN

76 Table 31: Adults Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/day) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 2,25 0, ,05 2,33 5,43 8,51 3,85 Belgium 1,77 0, ,27 1,72 4,44 9,63 3,23 Cyprus 1,82 0, ,25 1,89 4,14 10,17 2,72 Czech Republic 0,93 0, ,03 0,92 2,14 3,39 2,15 Finland 0,70 0, ,25 0,44 1,71 3,41 1,84 France 2,20 0, ,22 2,13 5,18 10,05 3,72 Germany 1,67 0, ,56 2,11 3,79 5,53 2,49 Greece 1,36 0, ,38 1,73 3,17 3,80 2,51 Hungary 1,04 0, ,00 0,68 2,92 3,88 3,45 Italy 1,36 0, ,61 1,66 3,33 5,00 1,92 Netherlands 1,58 0, ,50 1,78 3,57 5,25 2,83 Poland 1,51 0, ,26 1,91 3,94 4,95 2,20 Romania 3,00 1, ,14 4,33 6,99 9,41 3,18 Spain 2,02 1, ,04 2,54 4,60 6,24 2,99 Sweden 1,11 0,66 0 9,28 1,30 2,59 4,48 1,48 United Kingdom 2,14 0, ,15 2,50 4,56 6,39 3,91 Supporting Publications 2013:EN

77 ED acute consumption: analysis on high acute consumers Prevalence of high acute consumption on the population was around 8% (figure 6). High acute consumers were approximately 11% of total adult ED consumers, ranging from 19% in Germany, to 0% in Cyprus (figure 20). Figure 20: Adults Prevalence of high acute ED consumption by country (Sample size: ED consumers) Supporting Publications 2013:EN

78 Concerning the different age groups of ED consumers (figure 21), the highest prevalence of high acute consumption was in young adults (13% in years). The distribution of high acute consumers among age groups evidenced a higher percentage of aged consumers (49%). Prevalence of high consumption of ED was about 11% among ED consumers, and approximately 16% among regular smoking consumers. Figure 21: Adults - Prevalence of high acute ED consumption by age (Sample size: ED consumers) Supporting Publications 2013:EN

79 Approximately 96% of high acute consumers declared to drink at least 3 cans of ED in a single session, against about 18% of ED consumers (figure 22). Figure 22: Adults - Recent ED consumption acts: high acute and total consumers (Sample size: ED consumers; High acute consumers) As illustrated in figure 23, around 61% of high acute consumers resulted to drink 3 or more cocktails of ED and alcohol in a single session, compared to 30% for ED consumers. Supporting Publications 2013:EN

80 Figure 23: Adults Acute consumption of ED in association with alcohol: high acute and average consumers drinking ED and alcohol (Sample size: ED consumers drinking ED and alcohol; 448 High acute consumers) Concerning acute consumption of ED during sport activities, 57% of high acute consumers resulted to drink 3 or more cocktails of ED and alcohol in a single session; 27% of total consumers consumed the same quantity in a single session of physical activity (figure 24). Figure 24: Adults Acute consumption of ED during sport practice: high acute and average consumers practicing sport (Sample size: ED consumers practicing sport activities; 448 High acute consumers) Supporting Publications 2013:EN

81 Exposure to active ingredients in high acute adult consumers Tables 32 and 33 provide the average values of exposure to caffeine in a single session of consumption for total respondents, ED consumers and high acute consumers. Acute exposure form ED ranged from about 47 mg/single session for total respondents to around 374 mg for high acute consumers. Considering exposure to caffeine expressed in mg/kg bw/single session, the highest value was around 5 mg/kg bw/single session for high acute consumers. Table 32: Adults Acute exposure to caffeine from ED (values in mg/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 47,17 0,00 0, ,59 160,00 237,53 89,45 ED consumers 155,07 113,60 16, ,40 316,19 344,25 97,84 High acute consumers 373,70 340,35 175, ,00 464,35 565,24 76,80 Table 33: Adults Acute exposure to caffeine from ED (values in mg/kg bw/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 0,66 0,00 0,00 10,90 1,03 2,33 3,37 1,27 ED consumers 2,16 1,64 0,29 10,90 2,75 4,13 5,08 1,44 High acute consumers 5,14 4,91 2,43 10,90 6,00 7,15 8,15 1,48 Supporting Publications 2013:EN

82 Tables 34 and 35 provide results for acute exposure to caffeine from ED in a single session (in mg/single session and in mg/kg bw/single session) for total respondents, comparing the 16 MS covered by the survey. Values expressed in mg/single session ranged from around 12 in Cyprus to around 81 in Austria. Table 34: Adults Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/single session) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 80, ,40 152,00 240,00 320,00 107,11 Belgium 24, ,00 0,00 80,00 160,00 70,01 Cyprus 12, ,00 0,00 83,07 87,50 30,66 Czech Republic 77, ,90 122,09 239,52 321,10 109,49 Finland 39, ,00 79,50 113,60 219,51 86,39 France 32, ,69 0,00 153,78 194,29 71,61 Germany 53, ,04 78,76 204,76 310,10 103,35 Greece 49, ,02 80,00 160,81 243,06 93,48 Hungary 61, ,00 80,00 225,82 319,63 101,94 Italy 36, ,69 79,40 158,38 160,75 71,00 Netherlands 30, ,43 0,00 151,72 160,76 71,58 Poland 67, ,68 87,34 224,43 240,00 95,82 Romania 58, ,00 80,00 160,00 238,85 94,72 Spain 48, ,25 79,68 159,68 234,20 89,07 Sweden 34, ,10 0,00 113,60 226,03 81,56 United Kingdom 43, ,98 78,52 159,19 228,10 88,80 Table 35: Adults - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 1,12 0,62 0 7,65 1,69 3,05 4,69 1,57 Belgium 0,34 0, ,90 0,00 1,23 2,44 1,02 Cyprus 0,17 0,00 0 2,63 0,00 1,05 1,33 0,46 Czech Republic 1,03 0,00 0 7,61 1,46 3,16 4,35 1,52 Finland 0,51 0,00 0 9,39 0,89 1,67 2,42 1,12 France 0,48 0,00 0 9,12 0,00 1,80 2,97 1,10 Germany 0,73 0,00 0 9,29 1,03 2,66 3,78 1,42 Greece 0,66 0,00 0 8,83 1,06 2,27 3,66 1,26 Hungary 0,87 0, ,33 1,22 2,67 4,38 1,54 Italy 0,52 0,00 0 6,98 0,95 1,88 2,64 1,01 Netherlands 0,41 0,00 0 6,81 0,00 1,67 2,48 0,98 Poland 0,94 0,00 0 9,70 1,46 2,86 3,53 1,34 Romania 0,83 0,00 0 8,89 1,27 2,65 3,85 1,39 Spain 0,69 0,00 0 9,22 1,14 2,36 3,37 1,29 Sweden 0,45 0,00 0 9,69 0,00 1,68 2,76 1,09 United Kingdom 0,60 0, ,18 0,93 2,19 3,41 1,26 Supporting Publications 2013:EN

83 With regards to ED consumers, acute exposure to caffeine from ED ranged from around 88 mg/single session in Cyprus to around 180 mg/single session for Austrian consumers. At the same time, acute exposure per body weight in a single session ranged from 1,27 mg /kg bw/single session in Cyprus to 2,42 mg/kg bw/single session in Germany (tables 36 and 37). Table 36: Adults - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/single session) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 160,58 152,00 75,00 454,40 230,18 320,00 397,54 99,95 Belgium 160,47 113,87 60,21 568,00 227,95 319,64 340,80 103,05 Cyprus 87,69 87,50 75,00 150,00 87,50 104,60 122,30 13,38 Czech Republic 168,17 157,20 62,50 480,90 233,40 323,52 400,15 104,06 Finland 138,94 80,00 39,75 800,00 160,00 290,21 360,99 110,66 France 144,45 112,91 60,21 565,69 163,75 240,00 320,00 82,44 Germany 179,07 155,46 49,70 574,04 230,63 337,37 401,13 114,21 Greece 156,07 110,92 69,50 571,02 226,16 321,78 345,10 105,11 Hungary 153,88 80,00 16,00 568,00 211,39 320,00 396,38 108,37 Italy 129,63 82,06 39,92 565,69 159,84 237,04 319,35 75,90 Netherlands 148,59 150,68 75,00 449,43 160,00 281,23 331,75 84,91 Poland 150,05 113,60 75,00 562,68 164,80 245,29 320,00 89,14 Romania 152,54 113,60 64,00 568,00 175,10 312,18 346,31 95,47 Spain 156,48 154,15 39,63 771,25 220,74 243,83 339,21 93,63 Sweden 155,09 113,60 39,25 636,10 192,07 301,35 396,94 107,57 United Kingdom 157,70 113,01 38,19 583,98 221,34 320,00 350,39 102,50 Table 37: Adults - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 2,22 1,67 0,62 7,65 2,78 4,69 6,22 1,56 Belgium 2,26 1,68 0,61 10,90 2,94 4,81 5,17 1,58 Cyprus 1,27 1,17 0,73 2,63 1,48 1,60 2,08 0,35 Czech Republic 2,24 1,62 0,65 7,61 2,93 4,40 5,74 1,53 Finland 1,79 1,21 0,35 9,39 1,99 3,70 4,96 1,45 France 2,16 1,63 0,69 9,12 2,86 3,74 4,93 1,35 Germany 2,42 1,98 0,66 9,29 3,08 4,86 5,93 1,62 Greece 2,08 1,51 0,65 8,83 2,81 4,32 4,87 1,43 Hungary 2,18 1,38 0,29 10,33 2,67 4,62 6,48 1,74 Italy 1,83 1,43 0,57 6,98 2,20 3,17 4,35 1,08 Netherlands 1,98 1,58 0,71 6,81 2,43 3,82 4,47 1,23 Poland 2,06 1,59 0,70 9,70 2,75 3,78 4,63 1,28 Romania 2,17 1,59 0,66 8,89 2,70 4,19 5,44 1,47 Spain 2,22 1,78 0,59 9,22 2,71 4,09 5,08 1,41 Sweden 2,05 1,58 0,51 9,69 2,64 4,08 4,89 1,45 United Kingdom 2,18 1,60 0,58 10,18 2,79 4,26 5,19 1,51 Supporting Publications 2013:EN

84 Concerning the analysis of acute exposure to taurine, data expressed in mg/single session varied from around 568 mg for total respondents, for ED consumers, and around mg for high acute consumers (tables 38). Values are also provided in mg/ kg bw/single session (table 39). Table 38: Adults Acute exposure to taurine from ED (values in mg/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 568, ,87 ED consumers 1.869, ,80 High acute consumers 4.654, ,20 Table 39: Adults Acute exposure to taurine from ED (values in mg/kg bw/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 7,89 0, ,00 12,35 28,19 40,82 15,65 ED consumers 25,95 19, ,00 33,33 50,58 63,58 18,35 High acute consumers 64,04 61, ,54 74,93 88,96 101,43 19,54 Supporting Publications 2013:EN

85 With reference to the variations registered among the 16 MS, acute exposure to taurine from ED ranged from around 145 mg/day in Cyprus to around 972 mg/day in Czech Republic (table 40). Calculations in terms of mg/kg bw/single session are provided in table 41. Table 40: Adults - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/single session) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 881,45 158, , , , ,43 Belgium 248,60 0, ,00 950, ,75 778,23 Cyprus 145,12 0, , , ,00 369,49 Czech Republic 971,88 0, , , , ,54 Finland 493,54 0, , , , ,00 France 378,77 0, , , ,00 871,05 Germany 680,01 0, , , , ,51 Greece 584,66 0, , , , ,63 Hungary 766,84 0, , , , ,15 Italy 421,11 0, , , ,00 854,41 Netherlands 362,56 0, , , ,00 864,70 Poland 824,78 0, , , , ,32 Romania 706,77 0, , , , ,44 Spain 571,44 0, , , , ,02 Sweden 410,10 0, , , , ,32 United Kingdom 532,26 0, , , , ,88 Table 41: Adults - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 12,31 1, ,04 18,18 34,48 47,99 17,99 Belgium 3,51 0, ,54 0,00 12,47 25,00 11,25 Cyprus 2,11 0, ,09 0,00 12,69 15,63 5,55 Czech Republic 12,97 0, ,00 18,62 40,61 55,10 20,02 Finland 6,35 0, ,65 10,53 20,95 29,91 14,07 France 5,66 0, ,33 0,00 20,88 35,77 13,44 Germany 9,18 0, ,33 13,16 33,33 48,39 18,11 Greece 7,77 0, ,23 12,63 24,39 44,43 15,08 Hungary 10,89 0, ,09 15,15 33,33 54,80 19,36 Italy 5,91 0, ,65 9,41 20,67 30,91 12,01 Netherlands 4,77 0, ,06 0,00 19,28 28,59 11,62 Poland 11,35 0, ,41 17,86 35,50 43,48 16,57 Romania 10,05 0, ,28 15,50 33,33 46,59 17,00 Spain 8,09 0, ,11 13,33 28,57 40,00 15,60 Sweden 5,39 0, ,03 0,00 20,29 33,90 13,00 United Kingdom 7,37 0, ,09 10,48 26,33 41,92 15,50 Concerning ED consumers, acute exposure to taurine showed the highest value in Germany (around mg/single session and 30 mg/kg bw/single session), and the lowest in Cyprus (tables 42 and 43). Supporting Publications 2013:EN

86 Table 42: Adults - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/single session) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 1.753, , , ,30 Belgium 1.645, , , ,52 Cyprus 1.053, , , ,54 Czech Republic 2.120, , , ,54 Finland 1.717, , , ,59 France 1.699, , , ,44 Germany 2.256, , , ,51 Greece 1.853, , , ,73 Hungary 1.913, , , ,94 Italy 1.487, , , ,51 Netherlands 1.747, , , ,55 Poland 1.820, , , ,04 Romania 1.851, , , ,81 Spain 1.850, , , ,77 Sweden 1.868, , , ,66 United Kingdom 1.922, , , ,46 Table 43: Adults - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 24,48 18,18 1,15 98,04 29,80 47,59 69,97 18,60 Belgium 23,22 16,26 0,00 136,54 31,79 53,79 61,88 19,54 Cyprus 15,30 14,29 9,52 35,09 17,32 19,89 26,06 4,66 Czech Republic 28,29 20,41 5,00 140,00 37,50 56,80 72,88 21,00 Finland 22,11 15,15 0,00 117,65 24,87 48,62 63,62 18,48 France 25,41 18,87 2,55 118,33 34,48 45,74 60,60 17,58 Germany 30,45 25,00 0,00 118,33 38,46 62,56 75,30 20,99 Greece 24,63 17,92 0,00 109,23 32,94 50,06 58,51 17,51 Hungary 27,16 17,28 1,88 129,09 33,33 58,91 82,86 22,21 Italy 20,88 15,87 2,13 87,65 25,97 37,80 53,64 14,03 Netherlands 22,97 18,87 0,00 86,06 28,45 44,44 51,89 15,26 Poland 25,05 19,23 2,86 122,41 34,04 46,88 57,56 16,20 Romania 26,32 19,23 2,03 116,28 33,33 51,81 66,02 18,14 Spain 26,19 21,88 2,68 116,11 31,91 47,73 61,62 17,72 Sweden 24,57 18,68 2,38 91,03 31,40 47,62 61,25 17,31 United Kingdom 26,62 20,00 0,00 129,09 34,48 53,25 64,55 18,85 Supporting Publications 2013:EN

87 The average exposure to D-glucurono-y-lactone in acute consumers ranged from 263 mg/single session for total respondents, to 864 mg for ED consumers, and mg for high acute consumers (tables 44 and 45). Table 44: Adults Acute exposure to D-glucurono-y-lactone from ED (values in mg/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 262, ,48 ED consumers 864, ,82 High acute consumers 2.118, ,27 Table 45: Adults Acute exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 3,66 0, ,83 4,62 12,92 19,88 7,77 ED consumers 12,03 9, ,83 15,62 24,88 32,77 9,89 High acute consumers 29,15 29, ,83 38,13 47,31 53,32 14,52 Supporting Publications 2013:EN

88 Concerning the differences among MS, the highest values of acute exposure to D-glucurono-y-lactone for total respondents were registered in Austria (around 488; tables 46 and 47). Table 46: Adults - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/single session) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 488, ,60 600, , ,00 700,01 Belgium 126, ,00 0,00 450,00 858,00 420,56 Cyprus 78, ,00 0,00 600,00 600,00 212,38 Czech Republic 296, ,20 450,00 960, ,29 547,54 Finland 109, ,00 3,00 320,58 600,00 373,08 France 178, ,00 0,00 639, ,00 423,56 Germany 324, ,00 420, , ,00 679,98 Greece 269, ,00 420,00 828, ,00 567,09 Hungary 199, ,00 180,00 600, ,00 456,19 Italy 222, ,00 255,60 722, ,00 463,54 Netherlands 169, ,60 0,00 600, ,46 426,63 Poland 324, ,00 540, , ,00 522,28 Romania 394, ,00 600, , ,42 656,70 Spain 279, ,00 450, , ,52 544,53 Sweden 199, ,00 0,00 600, ,00 512,44 United Kingdom 252, ,00 300,00 852, ,42 542,78 Table 47: Adults - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 6, ,55 9,74 20,14 26,79 10,07 Belgium 1, ,83 0,00 5,72 10,91 6,05 Cyprus 1, ,05 0,00 7,04 9,35 3,20 Czech Republic 4, ,39 4,99 13,09 21,71 7,82 Finland 1, ,88 0,03 4,18 9,01 4,98 France 2, ,84 0,00 10,36 16,47 6,50 Germany 4, ,16 5,52 16,20 23,72 9,32 Greece 3, ,43 4,87 10,96 20,80 7,62 Hungary 2, ,22 2,38 8,57 14,49 6,81 Italy 3, ,56 4,11 11,07 16,24 6,50 Netherlands 2, ,00 0,00 9,38 14,25 5,97 Poland 4, ,43 7,29 13,92 19,81 7,32 Romania 5, ,77 8,57 17,94 25,85 9,70 Spain 3, ,22 6,00 14,19 20,48 7,97 Sweden 2, ,62 0,00 9,50 15,85 6,53 United Kingdom 3, ,34 3,57 12,40 19,94 7,70 Supporting Publications 2013:EN

89 Regarding ED consumers (tables 48 and 49), acute exposures ranged from around 380 mg/single session in Finland to over mg in Germany. Table 48: Adults - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/single session) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 970,99 600, , , ,20 711,30 Belgium 836,00 570, , , ,00 761,75 Cyprus 569,76 600, , ,80 852,00 218,17 Czech Republic 646,25 511, , , ,00 654,66 Finland 380,25 150, , , ,00 618,82 France 799,42 600, , , ,00 555,41 Germany 1.077,05 809, , , ,00 851,13 Greece 854,62 585, , , ,20 721,72 Hungary 497,01 300, , , ,00 609,95 Italy 786,60 600, , , ,25 561,80 Netherlands 819,04 600, , , ,00 588,69 Poland 715,24 570, , , ,30 567,81 Romania 1.032,52 809, , , ,00 686,12 Spain 906,32 681, , , ,49 626,67 Sweden 910,43 600, , , ,50 742,71 United Kingdom 912,70 600, , , ,00 679,82 Table 49: Adults - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) ED Consumers (Sample size: 4.180) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 13,35 9, ,55 17,44 26,70 36,80 10,64 Belgium 11,69 8, ,83 14,40 30,26 34,31 11,24 Cyprus 8,30 8, ,05 10,29 11,36 15,63 3,88 Czech Republic 8,75 5, ,39 11,49 22,61 29,26 9,59 Finland 4,92 1, ,88 5,57 13,17 22,89 8,32 France 11,96 9, ,84 15,43 24,00 29,86 8,85 Germany 14,51 11, ,16 18,99 31,13 40,85 11,89 Greece 11,43 8, ,43 13,90 26,67 32,38 9,73 Hungary 7,10 4, ,22 8,52 17,50 27,83 9,25 Italy 11,06 8, ,56 13,90 20,34 28,29 7,85 Netherlands 11,04 9, ,00 13,85 22,48 30,38 8,68 Poland 9,85 7, ,43 12,98 21,12 25,69 8,07 Romania 14,70 10, ,77 18,32 29,77 36,46 10,62 Spain 12,87 10, ,22 16,67 24,84 33,40 9,55 Sweden 11,86 8, ,62 14,55 23,75 33,06 9,22 United Kingdom 12,71 9, ,34 17,14 26,98 32,98 9,86 Supporting Publications 2013:EN

90 Adolescents As already mentioned at 2.3.6, the sample of schools for the survey on adolescents was considerably enlarged with respect to the original sample design, especially for all the MS where the progress of survey activities was slower than expected. A total number of filled-in questionnaires (of which validated) were collected in the 16 MS covered by the survey. It is worth highlighting that the average results presented in this paragraph often hide relevant differences at MS level, which are highlighted wherever opportune. The sample appeared to be well balanced between boys and girls, with an average age of 16 years. 58% of the total respondents resided in urban areas and 90% lived with parents. Regular smokers accounted for 17% of the total number of respondents ED consumption With reference to the prevalence of ED consumption, around 68% of the total respondents ( Total respondents) declared to have consumed ED at least once during the last year, while around 28% of total respondents declared to have consumed ED in the three days before the survey (figure 25). Figure 25: Adolescents ED consumption and related features (Sample size: Total respondents) Supporting Publications 2013:EN

91 As highlighted by figure 26, prevalence of ED consumption varied from around 48% in Greece to 82% in Czech Republic 46. Figure 26: Adolescents - Prevalence of ED consumption by country (Sample size: Total respondents) 46 The highest prevalence of ED consumption among total respondents was observed in Belgium (85%). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred to indicate the highest value as observed in Czech Republic. Supporting Publications 2013:EN

92 ED consumers had higher prevalence in the age group (73% of total population; figure 27) than in the age group (55% of total population). Among male respondents a higher prevalence of ED consumption was reported (74 %) than among female ones (63%). Share of ED consumers increased among respondents who smoke regularly: around 85% of regular smokers consumed ED, against 64% of non-smokers. Figure 27: Adolescents - Prevalence of ED consumption by age groups and by gender (Sample size: Total respondents) Supporting Publications 2013:EN

93 Around 26% of total consumers has been usually drinking ED twice a week or more (with around 5% drinking ED every day and around 6% drinking them 4-5 times a week). The most consumed size format was by far the 250 ml can (around 60% of total consumers), while around 11% of consumers declared to consume energy shots 47. Around 19% of ED consumers stated to have been drinking more than 10 can per month; around 49% of ED consumers declared to drink two or more cans in a single occasion (figure 28). As for volumes, adolescent ED consumers declared to drink on average around 2 L/month, varying from 1,3 L/month in Italy to 3,1 L/month in the UK. Figure 28: Adolescents - Features of ED consumption (Sample size: ED consumers) 47 See also considerations on energy shots at Supporting Publications 2013:EN

94 As for the reasons behind ED consumption (figure 29), the most important ( first choice ) among adolescents resulted to be the taste of the product (for around 40% of ED consumers), the need for energy (21%) and the need to stay awake (17%); also mentioned were consumption to enhance sport performance (7%) and to treat hangover (4%). The most common situations of ED consumption resulted to be at home with friends during parties (for around 65% of consumers) and at home in ordinary situations (for around 56% of consumers). Also discos and bar/pubs resulted to be quite common consumption situations, together with sport and physical exercise (these three were mentioned by at least 40% of consumers). Red Bull was by far the most popular brand among adolescents (it was mentioned as first choice among the top-three ED brands by 48% of consumers), followed by Monster (22%). No other ED brands were mentioned as first choice among the top-three ones by more than 5% of consumers. Figure 29: Adolescents - Motivations for ED consumption (First choice) (Sample size: ED consumers) Supporting Publications 2013:EN

95 As previously seen for adults ( ), also in the case of adolescents data were elaborated according to a specifically defined methodology ( 2.3.5), in order to identify high acute and high chronic consumers. With reference to total respondents, prevalence of ED high acute consumption was about 8% and the same share is recorded for the prevalence of high chronic consumption (figure 30). As highlighted in figure 31, high chronic consumers represent around 17% of total ED consumers. Figure 30: Adolescents - Prevalence of ED consumption for ED consumers, high acute consumers and high chronic consumers on total respondents (Sample size: Total respondents) Similarly to adults, an overlap between high acute and high chronic profiles was observed in adolescents, accounting for 4,5% of ED consumers (corresponding to 3% of total respondents). Again, being this percentage smaller than the overall incidence of purely high acute and high chronic consumers on total ED consumers, a dedicated analysis for high acute consumers will be provided at Table 50: Adolescents Overlap between high chronic and high acute groups of ED consumers % on total ED consumers High acute Non high acute Total High chronic 4,5% 7,2% 11,7% Non high chronic 7,2% 81,1% 88,3% Total 11,7% 88,3% 100,0% Supporting Publications 2013:EN

96 Considering the 16 MS involved in the survey, high chronic consumers had the lowest prevalence in Italy and France (7% of total ED consumers) and the highest one in the Netherlands (27%) (figure 31). Among ED consumers who declared to regularly smoke the percentage of high chronic ED consumers was about 21%, while among total consumers this share decreases at 12%. Concerning the different age groups of the target group adolescents, the highest prevalence of high chronic ED consumers was recorded among consumers aged (15% against 11% in years group). Figure 31: Prevalence of high chronic ED consumption by country (Sample size: ED consumers) Supporting Publications 2013:EN

97 Around 88% of high chronic consumers declared to have consumed ED in the three days before the survey, compared to around 42% of total ED consumers. As for the frequency of consumption, around 47% of high chronic consumers drank ED every day. About 69% of high chronic consumers declared to drink more than 10 cans of ED in an average month and with an average ED volume of around 7 L/month, against 18% of total consumers (figure 32). Figure 32: Adolescents Recent consumption acts: high chronic and total consumers (Sample size: ED consumers; High chronic consumers) Supporting Publications 2013:EN

98 Supporting Publications 2013:EN

99 Co-consumption of ED with alcohol In the case of adolescents, the phenomenon of co-consumption of ED and alcohol involved, on average, around 36% of the total population (figure 33) and around 53% of ED consumers. Figure 33: Adolescents - Co-consumption of ED and alcohol (Sample size: Total respondents) Supporting Publications 2013:EN

100 Prevalence of co-consumption among ED consumers ranged from 29% in the Netherlands to 71% in Austria 48 (figure 34). When referring to total respondents, the prevalence ranged from 20% in the Netherlands to 57% in Czech Republic. Figure 34: Adolescents Co-consumption of ED and alcohol by country (Sample size: Total respondents; ED consumers) 48 The highest prevalence of co-consumption of ED and alcohol was observed in Belgium (81%). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

101 Prevalence of co-consumption among ED consumers was higher in the age group (59%: figure 35) than in the one (32%). Even if the prevalence of co-consumption was slightly higher in the male population (38% vs. 35%), prevalence among male ED consumers was lower than prevalence among female ones (51% vs. 55% respectively). Figure 35: Adolescents - Prevalence of co-consumption of ED and alcohol by age groups and gender (Sample size: Total respondents; ED consumers) Supporting Publications 2013:EN

102 Consumers drinking ED and alcohol about every time or often accounted for 29% of the total number of co-consumers. Co-consumption occurred every day for a relatively small share of coconsumers (7%); most consumers experienced co-consumption less frequently (16% once a week, 24% once-twice a month, 31% with lower frequency). Around 39% of co-consumers mixed ED and alcohol more than twice in a single session (figure 36). Figure 36: Adolescents - Co-consumption of ED and alcohol and related features (Sample size: ED consumers) (Sample size: ED consumers drinking ED and alcohol) (Sample size: ED consumers drinking ED and alcohol) (Sample size: ED consumers drinking ED and alcohol) Supporting Publications 2013:EN

103 Among co-consumers, 31% of high chronic ones mixed ED and alcohol every day, while just 12% of total co-consumers do the same. About 36% of high chronic consumers declared to drink ED in association with alcohol about every time they drink ED (figure 37). Figure 37: Adolescents Monthly frequency of co-consumption of ED with alcohol: high chronic and total co-consumers (Sample size: ED consumers drinking ED and alcohol; High chronic consumers) Supporting Publications 2013:EN

104 Consumption of ED during sport activities Around 77% of ED consumers were found to usually practise sport or physical exercise, while around 41% of total ED consumers declared to consume ED before, during, or just after practising sport or physical activities (figure 38). Figure 38: Adolescents - Consumption of ED during sport activities (Sample size: ED consumers) Supporting Publications 2013:EN

105 Around 37% of ED consumers usually practising sport declared to associate ED consumption with sport practice about every time or often. Around 14% of ED consumers usually practising sport drank four or more cans of ED in a single sport session; 48% of them limited instead themselves to one can only (figure 39). Figure 39: Adolescents Consumption of ED during sport practice and related features (Sample size: ED consumers practicing sport) (Sample size: ED consumers drinking ED during sport activities) Supporting Publications 2013:EN

106 Prevalence of ED consumption during sport activities showed substantial differences at MS level (figure 40): the lowest prevalence was recorded in Sweden (around 14% of ED consumers and 10% of total respondents), while the highest prevalence was recorded in the United Kingdom (around 65% of ED consumers and 45% of total respondents, reaching 81% of ED consumers practicing sport activities). Figure 40: Adolescents - Prevalence of ED consumption during sport activities by country (Sample size: Total respondents; ED consumers; ED consumers practicing sport activities) Supporting Publications 2013:EN

107 The most common motivations behind ED consumption during sport activity (first choice: figure 41) were ED capacity to increase endurance time at a high intensity (43%) and power (21%); also cited as the most important reason were ED capacity to improve vitality (12%), concentration (11%), and aerobic endurance (8%). Figure 41: Adolescents - Motivations for consumption of ED during sport activity (Sample size: ED consumers drinking ED during sport activities) Around 65% of high chronic consumers drank ED during sport activities, while the prevalence was 41% among total consumers (figure 42). Figure 42: Adolescents - Prevalence and frequency of consumption of ED during sport activities: high chronic and total consumers (Sample size: ED consumers; High chronic consumers) Supporting Publications 2013:EN

108 Around 62% of high chronic consumers drank ED in association with sport practice about every time or often (figure 43), whereas this happened for just around 21% of ED consumers usually practising sports. Figure 43: Adolescents - Frequency of consumption of ED during sport practice: high chronic and ED consumers practicing sport activities (Sample size: ED consumers practicing sport activities; High chronic consumers) Supporting Publications 2013:EN

109 ED contribution to total exposure to relevant substances Tables 51 and 52 report data on chronic exposure to caffeine for the different categories of consumers, calculated on the basis of the methodology ( ). Average caffeine exposure from ED varied from around 16 mg/day for total respondents to around 75 mg/day for high chronic consumers. Accordingly, total caffeine exposure (from ED and other products in the diet) varied from around 150 mg/day (total respondents) to around 477 mg/day (high chronic consumers), with an average caffeine exposure for ED consumers of around 185 mg/day. Average caffeine exposure from ED in high chronic consumers was nearly three times the average value for total ED consumers and was seven times higher than the average value for total respondents. ED contribution to total caffeine exposure in high chronic consumers was around 16%, and not remarkably higher than the average one (13%) applying for all ED consumers (table 51). Table 51: Adolescents Chronic exposure to caffeine from ED and from all products (a) (values in mg/day) (Sample size: Total respondents; ED consumers; High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED: Total respondents 15,91 3,63 0,00 340,70 17,67 41,08 79,39 32,45 ED consumers 23,51 8,00 0,01 340,70 20,31 58,10 106,64 37,08 High chronic consumers 75,08 57,98 2,05 340,70 110,73 155,67 195,06 61,89 Total exposure: Total respondents 149,20 74,51 0, ,54 170,52 329,87 505,87 239,68 ED consumers 184,92 101,85 0, ,54 215,21 404,85 636,09 265,84 High chronic consumers 476,99 267,79 2, ,54 574, , ,09 536,38 (a) Including ED Data for the chronic exposure to caffeine in mg//kg bw/day are provided in table 52. The total exposure varied from 2,45 mg in total respondents to around 3 in ED consumers and 7,3 in high chronic consumers. The average ED contribution to total caffeine exposure was 13% in ED consumers and 16% in in high chronic consumers (figure 44). Table 52: Adolescents Chronic exposure to caffeine from ED and from all products (a) (values in mg/kg bw/day) (Sample size: Total respondents; ED consumers; High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED: Total respondents 0,26 0,06 0,00 6,95 0,25 0,71 1,20 0,53 ED consumers 0,38 0,15 0,00 6,95 0,41 0,94 1,59 0,60 High chronic consumers 1,18 0,89 0,02 6,40 1,76 2,66 3,09 1,01 Total exposure: Total respondents 2,45 1,28 0,00 50,17 2,93 5,58 8,59 3,71 ED consumers 3,01 1,73 0,01 50,17 3,53 6,74 10,27 4,12 High chronic consumers 7,30 4,11 0,05 49,54 9,75 18,60 25,78 8,07 (a) Including ED Supporting Publications 2013:EN

110 Figure 44: Adolescents - ED contribution to total daily exposure to caffeine (%) (Sample size: ED consumers) As for the variations registered among different MS, it can be observed that: chronic exposure to caffeine from ED for total respondents varied from around 6,9% (9 mg/day and 0,24 mg/kg bw/day) in Italy, to around 14,2% (22,3 mg/day and 0,39 mg/kg bw/day) in the UK (tables 53 and 54); chronic exposure to caffeine from ED for ED consumers varied from around 9% (around 16 mg/day) in the case of Italy to nearly 17% (around 32 mg/day) in the case of United Kingdom (tables 55 and 56); As for variations among different age groups, chronic exposure to caffeine from ED varied from around 12% (corresponding to 23 mg/day) in adolescents aged 15-18, to around 15% (corresponding to 26 mg/day) in the age group years; Some differences were also registered according to gender: the ED contribution was around 11% (corresponding to 16 mg/day) for female consumers, around 14% (corresponding to 28 mg/day) for male ones. Supporting Publications 2013:EN

111 Table 53: Adolescents Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/day) Total respondents (Sample size: ) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United Kingdom Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED 16,53 7, ,00 19,80 41,33 79,55 30,52 total exposure 122,45 65, ,65 140,57 266,09 391,83 192,36 exposure from ED 25,14 8, ,50 20,00 76,52 148,16 43,83 total exposure 264,64 148, ,77 284,61 885, ,75 386,71 exposure from ED 10,36 2, ,70 8,30 21,73 44,27 27,62 total exposure 107,34 51, ,23 113,98 247,46 389,53 182,62 exposure from ED 15,42 7, ,27 19,24 40,96 66,11 26,16 total exposure 134,73 80, ,07 162,83 303,37 424,64 179,18 exposure from ED 15,29 2, ,20 11,36 40,00 82,67 33,33 total exposure 167,58 79, ,59 210,85 406,56 525,67 258,63 exposure from ED 13,89 2, ,00 10,22 39,73 58,25 31,30 total exposure 141,36 86, ,04 177,81 316,10 488,11 168,92 exposure from ED 13,19 2, ,60 11,13 39,03 57,50 28,94 total exposure 129,48 54, ,14 142,91 305,28 477,69 221,42 exposure from ED 9,34 0, ,00 7,90 20,08 40,99 27,91 total exposure 95,91 40, ,32 101,53 230,05 336,17 172,17 exposure from ED 18,59 7, ,00 19,96 41,33 80,00 34,25 total exposure 153,50 84, ,71 188,90 351,40 497,89 216,03 exposure from ED 8,94 2, ,49 7,99 20,00 41,12 21,27 total exposure 130,48 70, ,54 159,20 298,98 426,84 199,76 exposure from ED 13,04 2, ,13 10,94 40,49 57,98 26,62 total exposure 98,91 56, ,21 113,11 214,66 302,91 171,12 exposure from ED 16,20 3, ,00 19,35 41,33 76,83 32,71 total exposure 171,44 101, ,57 195,83 373,18 534,73 237,54 exposure from ED 17,79 7, ,13 20,00 41,76 101,39 29,96 total exposure 143,15 78, ,16 163,02 334,09 463,51 220,24 exposure from ED 12,60 2, ,89 11,09 38,60 57,98 25,98 total exposure 95,92 41, ,74 111,10 254,59 363,82 161,53 exposure from ED 13,63 2, ,07 11,13 39,45 58,70 29,87 total exposure 122,15 46, ,34 129,03 302,69 461,71 227,97 exposure from ED 22,29 7, ,00 19,63 66,69 123,45 40,90 total exposure 156,48 63, ,67 165,13 323,28 672,59 288,98 % from ED/Total 13,5% 9,5% 9,7% 11,4% 9,1% 9,8% 10,2% 9,7% 12,1% 6,9% 13,2% 9,4% 12,4% 13,1% 11,2% 14,2% Supporting Publications 2013:EN

112 Table 54: Adolescents Chronic exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/kg bw/day) - Total respondents (Sample size: ) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United Kingdom Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED 0,28 0,12 0 4,94 0,31 0,75 1,33 0,52 total exposure 2,14 1, ,47 2,48 4,62 7,00 3,42 exposure from ED 0,44 0,14 0 3,97 0,43 1,23 3,04 0,82 total exposure 4,19 2, ,78 4,28 15,09 19,12 5,74 exposure from ED 0,18 0,04 0 5,41 0,16 0,45 0,77 0,45 total exposure 1,88 0, ,17 2,06 4,42 6,71 3,14 exposure from ED 0,25 0,11 0 3,77 0,28 0,66 1,00 0,42 total exposure 2,17 1, ,47 2,65 4,90 7,15 2,88 exposure from ED 0,23 0,05 0 4,92 0,19 0,61 1,20 0,49 total exposure 2,56 1, ,89 3,39 6,30 8,22 3,87 exposure from ED 0,23 0,06 0 5,02 0,18 0,61 0,97 0,48 total exposure 2,42 1, ,02 3,26 5,53 8,11 2,79 exposure from ED 0,22 0,05 0 6,95 0,20 0,62 1,04 0,48 total exposure 2,18 1, ,54 2,50 5,10 7,83 3,68 exposure from ED 0,14 0,00 0 4,48 0,12 0,34 0,61 0,40 total exposure 1,47 0, ,24 1,63 3,58 5,51 2,44 exposure from ED 0,29 0,11 0 5,61 0,34 0,77 1,23 0,53 total exposure 2,46 1, ,85 3,08 5,62 8,39 3,32 exposure from ED 0,14 0,04 0 4,26 0,14 0,37 0,67 0,34 total exposure 2,15 1, ,41 2,62 4,88 7,16 3,16 exposure from ED 0,24 0,06 0 3,59 0,20 0,67 1,09 0,46 total exposure 1,82 1, ,87 2,14 3,93 5,63 3,01 exposure from ED 0,26 0,07 0 6,40 0,25 0,69 1,07 0,53 total exposure 2,79 1, ,14 3,24 6,26 9,04 3,76 exposure from ED 0,32 0,11 0 4,69 0,39 0,89 1,43 0,55 total exposure 2,63 1, ,56 3,09 5,99 8,67 3,91 exposure from ED 0,21 0,05 0 4,59 0,20 0,59 1,02 0,43 total exposure 1,62 0, ,63 1,99 4,31 6,09 2,53 exposure from ED 0,20 0,05 0 4,14 0,16 0,52 1,02 0,44 total exposure 1,86 0, ,00 1,97 4,72 6,83 3,54 exposure from ED 0,39 0,12 0 4,83 0,40 1,23 2,02 0,73 total exposure 2,64 1, ,77 2,95 6,18 10,33 4,26 % from ED/Total 13,2% 10,6% 9,3% 11,3% 8,8% 9,4% 10,0% 9,4% 11,9% 6,7% 13,1% 9,2% 12,2% 13,2% 10,9% 14,9% Supporting Publications 2013:EN

113 Table 55: Adolescents Chronic exposure to caffeine from ED and from all products (a) covered by the survey (values in mg/day) ED Consumers (Sample size: ) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United Kingdom Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED 22,05 8,00 1,07 320,00 20,00 57,78 105,76 33,49 total exposure 140,77 80,77 2, ,65 159,37 296,11 438,42 207,41 exposure from ED 29,55 11,18 2,51 218,50 27,83 112,90 152,49 46,17 total exposure 304,22 178,24 5, ,77 334, , ,61 405,93 exposure from ED 19,64 8,20 0,26 340,70 20,08 43,21 75,70 35,57 total exposure 153,11 82,25 1, ,23 175,13 329,22 519,11 227,52 exposure from ED 18,88 7,97 0,10 210,27 19,92 41,36 79,74 27,80 total exposure 148,73 91,10 2, ,07 181,31 328,25 445,48 186,23 exposure from ED 23,58 8,00 0,11 227,20 21,06 66,02 106,67 38,97 total exposure 210,24 118,32 1, ,59 282,76 467,21 594,25 287,96 exposure from ED 21,07 8,00 0,11 326,00 20,00 45,23 80,75 36,55 total exposure 172,36 110,41 2, ,04 213,29 415,17 580,33 190,08 exposure from ED 21,90 8,00 0,79 305,60 20,00 55,48 81,65 34,65 total exposure 173,20 88,68 2, ,14 205,20 400,95 629,39 257,82 exposure from ED 19,33 7,96 0,10 314,00 19,63 41,20 80,25 37,69 total exposure 143,20 75,57 2, ,32 158,92 312,80 551,38 213,67 exposure from ED 23,74 8,00 0,26 320,00 26,87 56,95 105,07 37,09 total exposure 176,18 104,63 2, ,71 217,11 395,24 546,67 228,89 exposure from ED 15,97 7,94 0,02 226,49 19,76 40,91 58,39 26,38 total exposure 172,45 102,45 2, ,54 214,07 367,92 503,06 232,94 exposure from ED 19,57 7,97 0,81 317,13 20,00 41,33 79,36 30,59 total exposure 121,02 70,59 2, ,21 138,09 237,99 348,36 199,48 exposure from ED 22,24 8,00 0,01 320,00 20,00 56,00 104,57 36,53 total exposure 198,81 118,71 2, ,57 232,73 416,74 629,56 259,30 exposure from ED 25,51 9,24 0,11 211,13 39,14 76,26 106,66 33,03 total exposure 183,76 110,91 2, ,16 215,77 391,80 580,77 248,81 exposure from ED 20,36 8,00 0,10 224,89 19,96 56,31 80,48 30,54 total exposure 127,60 63,63 0, ,74 150,93 307,36 432,39 188,00 exposure from ED 19,79 7,92 0,21 296,07 19,84 42,96 90,12 34,26 total exposure 155,78 70,57 0, ,34 184,15 343,83 553,15 258,15 exposure from ED 32,11 11,22 2,07 304,00 39,00 99,31 145,67 45,77 total exposure 189,86 91,83 2, ,67 209,13 422,31 796,85 309,77 (a) Including ED in the 16 MS % from ED/Total 15,7% 9,7% 12,8% 12,7% 11,2% 12,2% 12,6% 13,5% 13,5% 9,3% 16,2% 11,2% 13,9% 16,0% 12,7% 16,9% Supporting Publications 2013:EN

114 In table 56, data on exposure to caffeine are expressed in mg/kg bw/day. The highest exposure to caffeine deriving from ED was reported for United Kingdom s consumers (0,57 mg/kg bw/day), while the lowest value was registered in Italy (0,26 mg/kg bw/day). Table 56: Adolescents Chronic exposure to caffeine from ED and from all products (a) covered by the survey (values in mg/kg bw/day) ED Consumers (Sample size: ) Austria Belgium Cyprus Czech Republic Finland France Germany Greece Hungary Italy Netherlands Poland Romania Spain Sweden United Kingdom Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED 0,38 0,15 0,02 4,94 0,38 0,91 1,65 0,58 total exposure 2,41 1,40 0,03 46,47 2,76 5,08 7,42 3,62 exposure from ED 0,52 0,18 0,02 3,97 0,45 1,95 3,05 0,87 total exposure 4,80 2,93 0,10 25,78 4,66 15,76 20,06 6,00 exposure from ED 0,33 0,15 0,00 5,41 0,35 0,75 1,31 0,57 total exposure 2,64 1,43 0,02 50,17 2,90 5,95 9,02 3,93 exposure from ED 0,30 0,13 0,00 3,77 0,33 0,74 1,18 0,44 total exposure 2,39 1,47 0,03 43,47 2,92 5,28 7,46 3,01 exposure from ED 0,35 0,13 0,00 4,92 0,36 0,95 1,61 0,57 total exposure 3,16 1,81 0,01 40,89 4,17 7,06 9,63 4,21 exposure from ED 0,35 0,15 0,00 5,02 0,36 0,81 1,44 0,56 total exposure 2,90 1,91 0,04 20,02 3,74 6,26 9,24 3,10 exposure from ED 0,36 0,16 0,02 6,95 0,39 0,92 1,34 0,57 total exposure 2,84 1,51 0,04 49,54 3,32 6,42 10,55 4,27 exposure from ED 0,29 0,12 0,00 4,48 0,27 0,63 1,04 0,54 total exposure 2,14 1,18 0,03 42,24 2,39 4,89 7,79 3,01 exposure from ED 0,38 0,15 0,01 5,61 0,42 0,90 1,46 0,57 total exposure 2,82 1,72 0,02 42,85 3,46 6,45 9,21 3,54 exposure from ED 0,26 0,12 0,00 4,26 0,28 0,62 0,98 0,42 total exposure 2,76 1,68 0,03 47,41 3,44 6,17 8,37 3,57 exposure from ED 0,36 0,16 0,01 3,59 0,41 0,89 1,44 0,52 total exposure 2,20 1,31 0,05 45,87 2,58 4,47 6,43 3,47 exposure from ED 0,35 0,15 0,00 6,40 0,37 0,84 1,44 0,59 total exposure 3,20 1,91 0,02 48,14 3,76 7,16 10,28 4,13 exposure from ED 0,46 0,19 0,00 4,69 0,62 1,24 1,85 0,60 total exposure 3,33 2,09 0,05 44,56 4,07 7,33 10,28 4,40 exposure from ED 0,35 0,16 0,00 4,59 0,40 0,89 1,34 0,51 total exposure 2,13 1,11 0,01 29,63 2,56 5,22 7,47 2,90 exposure from ED 0,30 0,11 0,00 4,14 0,30 0,75 1,43 0,50 total exposure 2,36 1,08 0,01 47,00 2,58 5,54 8,71 4,04 exposure from ED 0,57 0,21 0,02 4,83 0,63 1,59 2,33 0,82 total exposure 3,21 1,64 0,02 31,77 3,55 7,23 13,36 4,62 (a) Including ED in the 16 MS % from ED/Total 15,7% 10,9% 12,6% 12,6% 11,0% 11,9% 12,7% 13,4% 13,3% 9,3% 16,3% 11,0% 13,8% 16,2% 12,5% 17,7% Supporting Publications 2013:EN

115 Figure 45 focuses on the average values of ED contribution to total caffeine exposure for the 16 MS covered by the study, considering both total respondents and ED consumers. The relative contribution from ED in total respondents varies from around 6% in Greece to 14% in Austria, while referring only to ED consumers the relative contribution varies from 9% in Italy to around 17% in the UK. Figure 45: Adolescents - ED contribution to total daily exposure to caffeine (%) by country (Sample size: Total respondents; ED consumers) Supporting Publications 2013:EN

116 Also in the case of adolescents, as already seen for adults ( ), differences in the total exposure to active ingredients other than caffeine (i.e. taurine and D-glucurono-y-lactone) among total respondents, ED consumers, and high chronic consumers were higher than the differences already described for the case of caffeine. Exposure to taurine from ED varied from an average value of 192 mg/day in total respondents, to around 283 mg/day in ED consumers, till around 924 in high chronic consumers (tables 57 and 58). Table 57: Adolescents Chronic exposure to taurine from ED (values in mg/day) (Sample size: Total respondents; ED consumers; High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 192,01 33,33 0, ,25 516,67 994,00 405,19 ED consumers 283,88 100,00 0, ,00 733, ,33 465,05 High chronic consumers 924,34 733,67 0, , , ,67 795,41 Table 58: Adolescents Chronic exposure to taurine from ED (values in mg/kg bw/day) (Sample size: Total respondents; ED consumers; High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 3,14 0,67 0,00 90,91 2,91 8,61 14,72 6,60 ED consumers 4,63 1,82 0,00 90,91 4,90 11,48 18,81 7,56 High chronic consumers 14,53 10,33 0,00 80,00 21,42 33,81 41,16 13,09 Supporting Publications 2013:EN

117 With regards to differences among MS, it is worth noting that: for total respondents, average value of exposure to taurine ranged from around 100 mg/day (corresponding to 1,62 mg/kg bw/day) in Italy, to around 284 mg/day (corresponding to 5 mg/kg bw/day) in United Kingdom (tables 58 and 59); for ED consumers the highest value in absolute terms around 410 mg/day in the United Kingdom (corresponding to around 7mg/kg bw/day) was more than twice the lowest one (around 180 mg/day corresponding to around 3 mg/kg bw/day in Italy: tables 60 and 61). With regards to differences between genders, exposure was around 345 mg/day in male ED consumers, versus around 213 mg/day in female ones. Table 59: Adolescents Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/day) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 178,93 64, ,00 180,63 516,67 833,33 349,48 Belgium 302,22 85, ,00 250,00 960, ,33 564,87 Cyprus 120,32 13, ,00 100,00 250,00 516,67 327,04 Czech Republic 191,02 100, ,67 250,00 516,67 833,33 332,58 Finland 191,75 33, ,00 142,00 500, ,33 420,09 France 157,14 33, ,00 100,00 362,92 733,67 372,85 Germany 165,07 33, ,00 142,00 500,00 733,67 368,19 Greece 106,66 0, ,00 100,00 250,00 516,67 326,05 Hungary 229,50 100, ,00 250,00 516, ,00 433,88 Italy 100,98 13, ,00 100,00 250,00 516,67 260,87 Netherlands 160,62 33, ,00 100,00 516,67 733,67 332,94 Poland 195,81 47, ,00 200,00 516,67 800,00 405,17 Romania 209,31 40, ,67 250,00 516, ,33 369,52 Spain 148,54 33, ,00 142,00 355,00 733,67 324,06 Sweden 163,04 33, ,00 142,00 465,00 733,67 358,17 United Kingdom 284,45 100, ,00 250,00 850, ,67 526,56 Supporting Publications 2013:EN

118 Table 60: Adolescents Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/day) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 3,06 1, ,45 3,00 8,13 14,16 6,05 Belgium 5,35 1, ,64 4,46 15,40 38,77 10,64 Cyprus 2,05 0, ,11 1,87 5,46 8,88 5,39 Czech Republic 3,03 1, ,33 3,38 8,34 12,55 5,31 Finland 2,83 0, ,74 2,37 7,69 15,11 6,18 France 2,57 0, ,54 2,13 6,78 10,78 5,79 Germany 2,73 0, ,91 2,50 7,72 13,34 6,13 Greece 1,58 0, ,79 1,35 3,95 7,38 4,64 Hungary 3,63 1, ,73 4,17 9,41 15,43 6,73 Italy 1,62 0, ,33 1,54 4,24 7,62 4,11 Netherlands 2,94 0, ,33 2,50 8,08 13,34 5,75 Poland 3,09 0, ,00 2,96 7,96 13,34 6,49 Romania 3,76 0, ,26 4,44 10,51 17,47 6,76 Spain 2,52 0, ,96 2,22 7,10 12,34 5,41 Sweden 2,43 0, ,64 2,00 6,42 11,29 5,26 United Kingdom 5,03 1, ,49 5,00 15,78 26,04 9,42 Table 61: Adolescents Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/day) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 238,76 100, ,00 250,00 516, ,33 385,63 Belgium 355,24 130, ,00 253, , ,00 597,40 Cyprus 228,14 100, ,00 250,00 516,67 733,67 422,26 Czech Republic 233,83 100, ,67 250,00 516, ,00 354,10 Finland 295,75 100, ,00 250,00 833, ,33 491,42 France 238,39 100, ,00 250,00 516,67 944,94 437,78 Germany 274,17 100, ,00 250,00 733, ,33 441,98 Greece 220,84 100, ,00 225,00 516,67 800,00 441,62 Hungary 293,08 100, ,00 250,00 733, ,33 470,94 Italy 180,40 100, ,00 173,59 512,60 733,67 327,49 Netherlands 241,04 100, ,00 250,00 516, ,00 383,44 Poland 268,79 100, ,00 250,00 700, ,33 453,59 Romania 300,26 100, ,67 355,00 733, ,33 410,64 Spain 240,07 100, ,00 250,00 718, ,33 384,44 Sweden 236,69 100, ,00 250,00 516, ,33 410,91 United Kingdom 409,73 142, ,00 500, , ,33 590,05 Supporting Publications 2013:EN

119 Table 62: Adolescents Chronic exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/day) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 4,08 1, ,45 4,31 9,94 17,56 6,68 Belgium 6,29 2, ,64 5,12 24,27 39,41 11,29 Cyprus 3,89 1, ,11 4,02 8,63 13,54 6,93 Czech Republic 3,71 1, ,33 4,17 9,39 14,44 5,65 Finland 4,37 1, ,74 4,55 11,83 20,11 7,22 France 3,90 1, ,54 4,31 9,39 14,71 6,76 Germany 4,54 1, ,91 5,00 11,47 17,05 7,36 Greece 3,27 1, ,79 3,08 7,38 11,81 6,24 Hungary 4,63 1, ,73 5,10 11,23 18,50 7,30 Italy 2,89 1, ,33 2,91 6,88 11,48 5,15 Netherlands 4,41 1, ,33 5,04 10,86 18,38 6,57 Poland 4,24 1, ,00 4,55 10,33 16,67 7,28 Romania 5,40 2, ,26 7,40 14,54 21,10 7,53 Spain 4,07 1, ,96 4,55 11,03 16,47 6,40 Sweden 3,53 1, ,64 3,52 8,69 15,54 6,03 United Kingdom 7,25 2, ,49 7,95 21,21 30,30 10,58 Supporting Publications 2013:EN

120 Contribution from ED to chronic exposure to D-glucurono-y-lactone in high chronic consumers was more than three times the average value for all ED consumers, and over four times the average value for total respondents (tables 63 and 64). Table 63: Adolescents Chronic exposure to D-glucurono-y-lactone from ED (values in mg/day) (Sample size: Total respondents; ED consumers; High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 67,72 14, ,00 159, ,29 ED consumers 100,14 32, ,00 248, ,09 High chronic consumers 311,60 156, ,00 875, ,58 Table 64: Adolescents Chronic exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/day) (Sample size: Total respondents; ED consumers; High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 1,12 0, ,64 0,96 2,82 5,22 2,73 ED consumers 1,65 0, ,64 1,67 4,13 6,77 3,18 High chronic consumers 4,98 2, ,64 6,73 14,20 18,26 6,11 Supporting Publications 2013:EN

121 Focussing on the differences registered among MS, with reference to the chronic exposure to D- glucurono-y-lactone, it can be highlighted that: with regards to total respondents, average exposure to D-glucurono-y-lactone ranged from around 41 mg/day (0,60 mg/kg bw/day) in Greece, to around 104,5 mg/day (1,91 mg/kg bw/day) in Romania 49 (tables 65 and 66); with regards to ED contribution in ED consumers, values varied from around 51 mg/day in Czech Republic to around 150 mg/day in Romania; Similarly to what observed for taurine, some differences also appeared between genders: ED contribution to total exposure was around 117 mg/day for male ED consumers, versus around 80 mg/day for female ones. Table 65: Adolescents Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/day) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 95,94 24, ,00 85,20 279,00 440,20 196,48 Belgium 105,21 40, ,00 120,00 213,00 662,00 208,98 Cyprus 46,04 0, ,00 30,00 105,00 191,70 149,52 Czech Republic 41,73 6, ,00 30,00 105,00 205,37 112,40 Finland 59,04 6, ,00 33,00 139,52 300,00 168,77 France 62,59 15, ,00 57,00 150,00 265,01 163,55 Germany 54,39 6, ,48 42,00 149,19 270,69 151,08 Greece 40,86 0, ,00 20,08 80,94 150,00 151,00 Hungary 41,51 4, ,00 26,25 93,00 186,00 132,10 Italy 46,05 5, ,00 42,00 120,00 213,00 127,48 Netherlands 69,85 19, ,25 60,00 186,00 310,00 156,82 Poland 51,84 8, ,00 42,00 124,00 253,65 143,11 Romania 104,45 20, ,00 136,25 310,00 500,00 191,94 Spain 46,10 4, ,00 36,00 124,72 217,00 126,36 Sweden 67,39 16, ,00 59,64 155,00 310,00 162,44 United Kingdom 81,08 15, ,00 66,56 215,00 397,14 181,62 49 The highest chronic exposure to glucuronolactone on total respondents was observed in Belgium (105 mg/day corresponding to 1,95 mg/kg bw/day). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

122 Table 66: Adolescents Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/day) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 1,64 0, ,86 1,42 4,46 7,08 3,34 Belgium 1,95 0, ,70 1,76 3,60 11,82 4,42 Cyprus 0,77 0, ,87 0,54 1,88 3,48 2,42 Czech Republic 0,66 0, ,72 0,50 1,61 3,13 1,80 Finland 0,87 0, ,34 0,51 2,06 4,25 2,50 France 1,01 0, ,92 0,97 2,72 4,57 2,43 Germany 0,89 0, ,43 0,67 2,45 4,44 2,30 Greece 0,60 0, ,61 0,36 1,24 2,50 2,06 Hungary 0,64 0, ,88 0,43 1,50 3,10 1,95 Italy 0,74 0, ,98 0,65 1,90 3,30 2,00 Netherlands 1,25 0, ,82 1,13 3,56 5,64 2,50 Poland 0,81 0, ,64 0,65 2,00 3,88 2,26 Romania 1,91 0, ,56 2,28 5,58 9,10 3,60 Spain 0,78 0, ,08 0,60 2,12 3,78 2,08 Sweden 1,01 0, ,24 0,86 2,54 5,21 2,37 United Kingdom 1,44 0, ,09 1,33 3,68 7,53 3,23 Table 67: Adolescents Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/day) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 128,02 56, ,00 135,00 310,00 567,00 217,74 Belgium 123,67 48, ,00 129,78 247,44 817,76 221,69 Cyprus 87,30 28, ,00 75,00 186,00 328,14 197,00 Czech Republic 51,09 14, ,00 45,00 127,20 248,00 122,42 Finland 91,06 20, ,00 68,20 226,84 440,20 202,56 France 94,96 42, ,00 93,00 217,00 374,17 193,73 Germany 90,33 30, ,48 85,20 240,00 358,43 186,24 Greece 84,61 22, ,00 60,00 150,00 310,00 208,66 Hungary 53,01 10, ,00 40,30 124,00 248,00 147,23 Italy 82,27 28, ,00 68,62 185,82 310,00 161,42 Netherlands 104,83 48, ,25 132,47 279,00 419,46 182,35 Poland 71,16 18, ,00 60,00 174,69 308,40 163,53 Romania 149,83 60, ,00 170,50 323,75 704,32 214,63 Spain 74,50 21, ,00 60,86 175,51 310,00 153,94 Sweden 97,83 30, ,00 90,00 270,75 426,44 187,99 United Kingdom 116,78 45, ,00 120,00 310,00 528,24 208,24 Supporting Publications 2013:EN

123 The highest contribution from ED to D-glucurono-y-lactone exposure was recorded in Romania (2,74 mg/kg bw/day, against an average value of 1,65 mg/day/kg for total ED consumers). Table 68: Adolescents Chronic exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/day) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 2,18 0, ,86 2,32 5,52 8,82 3,70 Belgium 2,29 0, ,70 2,19 3,95 15,82 4,71 Cyprus 1,46 0, ,87 1,26 3,40 5,49 3,18 Czech Republic 0,81 0, ,72 0,69 2,02 3,70 1,96 Finland 1,34 0, ,34 1,09 3,43 6,55 3,00 France 1,54 0, ,92 1,63 3,67 5,64 2,85 Germany 1,47 0, ,43 1,50 4,01 6,12 2,81 Greece 1,24 0, ,61 1,07 2,59 4,43 2,83 Hungary 0,82 0, ,88 0,64 2,02 3,82 2,17 Italy 1,32 0, ,98 1,25 3,00 5,17 2,53 Netherlands 1,88 0, ,82 2,34 4,98 7,71 2,87 Poland 1,12 0, ,64 0,99 2,72 4,94 2,58 Romania 2,74 1, ,56 3,49 6,77 10,79 4,04 Spain 1,27 0, ,08 1,14 3,26 5,46 2,53 Sweden 1,46 0, ,24 1,32 3,88 6,52 2,73 United Kingdom 2,07 0, ,09 2,17 5,54 9,57 3,71 Supporting Publications 2013:EN

124 ED acute consumption: analysis on high acute consumers As previously seen for adults ( ), also in the case of adolescents data were elaborated according to a specifically defined methodology, in order to identify high acute consumers ( 2.3.5). High acute consumers represented around 12% of total ED consumers; prevalence of high acute consumers ranged from 7% of total ED consumers in Romania and the Netherlands to 17% in Germany and Sweden 50 (figure 46). Figure 46: Adolescents Prevalence of high acute ED consumption by country (Sample size: ED consumers) Prevalence of high acute consumption was slightly higher in the years age group towards the younger one (12% and 11% respectively). It reached a share of 23% among smokers (ED consumers who declare to regularly smoke), while among non-smoker consumers it was around 9%. Around 54% of high acute consumers declared to have consumed more than 4 cans of ED in a single session of consumption over the last year. About 50% of high acute consumers among the adolescents involved in the survey have drunk 4 or more cocktails of ED and alcohol in a single session. Then, 22% of high acute consumers declared of having drunk more than 4 cans of ED during sport activities (figure 47). 50 The highest prevalence of high acute ED consumption was observed in Belgium (26%). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

125 Figure 47: Adolescents - ED consumption: high acute and total consumers (Sample size: ED consumers; High acute consumers; ED consumers drinking ED and alcohol; ED consumers practicing sport activities) Supporting Publications 2013:EN

126 Supporting Publications 2013:EN

127 Exposure to active ingredients in high acute adolescent consumers Tables 69 and 70 illustrate the average values of acute exposure to caffeine of total respondents, ED consumers and high acute consumers. Values in mg/single session varied from around 119 mg for total respondents, to 175 for ED consumers till around 458 for high acute consumers. Table 69: Adolescents Acute exposure to caffeine from ED (values in mg/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 118,63 79,84 0, ,25 159,96 316,10 397,56 135,76 ED consumers 175,62 149,00 0, ,25 229,80 340,80 449,51 131,45 High acute consumers 457,98 426,67 197, ,25 546,26 614,85 760,00 119,59 Table 70: Adolescents Acute exposure to caffeine from ED (values in mg/kg bw/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 1,97 1,44 0,00 17,78 2,84 4,92 6,43 2,24 ED consumers 2,92 2,13 0,00 17,78 3,67 5,82 7,24 2,16 High acute consumers 7,21 6,76 2,06 17,78 8,66 10,83 11,87 2,39 Also with respect to acute exposure to caffeine from ED, some differences were observed at MS level: as for total respondents, acute exposure to caffeine ranged from around 83 mg/single session (1,32 mg/kg bw/single session) in the case of Greece, to nearly 146 mg/single session (2,34 mg/kg bw/single session) in the case of Czech Republic 51 (tables 71 and 72); as for ED consumers, the highest value of acute exposure to caffeine was registered in Germany 52, with around 202 mg/single session (3,44 mg/kg bw/single session) Belgium, with around 226 mg/single session (3,77 mg/kg bw/single session) (tables 73 and 74). As for differences among age groups, the average value of acute exposure to caffeine for total respondents was around 130 mg/single session in adolescents aged 15-18, versus around 92 mg/single session in the age group between 10 and 14 years; With regards to differences between genders, male respondents presented an average acute exposure to caffeine equal to about 140 mg/single session, against 100 mg/single session registered for female respondents. 51 The highest acute exposure to caffeine on total respondents was observed in Belgium (192 mg/single session corresponding to 3,21 mg/kg bw/single session). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. 52 The highest acute exposure to caffeine on ED consumers was observed in Belgium (226 mg/single session and 3,77 mg/kg bw/single session). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

128 Table 71: Adolescents Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/single session) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 143,38 80, ,00 237,08 337,93 400,00 133,05 Belgium 192,38 159, ,38 240,00 449,88 540,75 171,77 Cyprus 99,15 76, ,75 160,85 309,80 352,90 133,37 Czech Republic 145,96 109, ,00 220,17 320,24 398,59 130,75 Finland 113,50 80, ,00 159,50 320,00 400,00 144,17 France 105,81 79, ,00 159,19 239,30 338,24 118,60 Germany 121,88 77, ,05 159,89 322,44 447,21 155,29 Greece 82,84 0, ,00 113,60 237,53 343,95 122,43 Hungary 136,65 80, ,00 160,01 320,00 400,00 130,66 Italy 87,36 79, ,84 153,44 236,29 329,87 113,11 Netherlands 105,56 79, ,15 158,35 240,00 320,00 117,32 Poland 110,44 80, ,00 158,38 240,00 340,80 117,49 Romania 103,67 79, ,00 156,13 240,00 323,88 115,82 Spain 97,02 78, ,50 153,15 237,08 329,28 119,35 Sweden 138,36 80, ,25 224,87 339,42 449,87 153,31 United Kingdom 125,66 79, ,00 159,00 316,70 409,31 142,44 Supporting Publications 2013:EN

129 Table 72: Adolescents - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 2,47 1,78 0,00 15,42 3,75 5,85 7,01 2,32 Belgium 3,21 2,37 0,00 11,58 4,90 7,88 9,59 2,97 Cyprus 1,73 1,12 0,00 13,74 2,73 4,97 6,27 2,31 Czech Republic 2,34 1,75 0,00 16,34 3,24 5,16 6,45 2,09 Finland 1,71 1,33 0,00 16,00 2,27 4,27 6,15 2,14 France 1,81 1,43 0,00 11,24 2,67 4,41 5,80 2,01 Germany 2,07 1,35 0,00 15,35 3,05 5,78 7,59 2,63 Greece 1,31 0,00 0,00 14,88 1,83 3,81 5,20 1,96 Hungary 2,23 1,54 0,00 17,78 3,14 5,31 6,68 2,17 Italy 1,44 1,13 0,00 17,77 2,10 3,74 5,23 1,90 Netherlands 1,98 1,51 0,00 16,76 2,86 5,17 6,38 2,22 Poland 1,79 1,38 0,00 15,99 2,35 4,25 5,62 1,92 Romania 1,92 1,59 0,00 17,59 2,61 4,64 6,27 2,14 Spain 1,69 1,33 0,00 16,35 2,34 4,45 5,78 2,07 Sweden 2,07 1,43 0,00 11,88 3,19 5,33 6,88 2,24 United Kingdom 2,24 1,67 0,00 14,55 3,21 5,52 7,12 2,50 Table 73: Adolescents - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/single session) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 191,32 159,68 32,00 800,00 240,00 397,20 400,00 120,20 Belgium 226,13 160,00 67,57 779,38 340,75 454,36 548,73 164,33 Cyprus 188,02 159,96 7,72 851,75 245,91 349,80 435,64 130,46 Czech Republic 178,67 155,60 3,07 805,00 235,13 335,90 400,78 122,80 Finland 175,06 113,60 3,20 800,00 164,50 340,80 490,80 145,89 France 160,52 113,14 3,23 652,00 224,43 318,70 397,53 112,04 Germany 202,44 153,89 21,00 920,05 302,70 426,73 546,70 154,10 Greece 171,53 116,62 3,07 785,00 223,35 359,67 445,08 125,80 Hungary 174,51 154,80 3,20 800,00 236,10 375,00 400,00 123,26 Italy 156,06 112,22 0,61 799,84 165,85 319,91 398,38 110,15 Netherlands 158,41 113,60 16,17 781,15 217,26 316,10 394,28 110,82 Poland 151,61 85,66 0,32 800,00 160,00 320,00 395,13 112,72 Romania 148,72 85,66 3,20 800,00 160,00 314,22 383,32 112,00 Spain 156,81 109,91 3,07 822,50 217,84 319,83 397,93 116,81 Sweden 200,86 158,38 6, ,25 249,00 400,00 513,98 146,85 United Kingdom 181,00 150,00 60,00 800,00 227,20 340,80 468,00 138,58 Supporting Publications 2013:EN

130 Table 74: Adolescents - Acute exposure to caffeine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 3,30 2,75 0,53 15,42 4,53 6,35 7,27 2,11 Belgium 3,77 2,75 0,68 11,58 5,65 8,67 10,07 2,87 Cyprus 3,27 2,63 0,12 13,74 4,34 6,17 7,59 2,25 Czech Republic 2,86 2,31 0,08 16,34 3,69 5,64 6,90 1,96 Finland 2,64 1,88 0,05 16,00 2,91 5,34 7,38 2,15 France 2,74 2,00 0,06 11,24 3,54 5,14 6,32 1,89 Germany 3,44 2,57 0,42 15,35 4,52 6,82 9,20 2,61 Greece 2,71 1,92 0,06 14,88 3,42 5,24 6,88 2,04 Hungary 2,85 2,13 0,07 17,78 3,66 5,85 7,11 2,06 Italy 2,57 1,85 0,01 17,77 3,16 4,99 6,40 1,87 Netherlands 2,97 2,21 0,16 16,76 3,73 5,87 7,23 2,11 Poland 2,45 1,67 0,00 15,99 3,02 4,88 6,28 1,85 Romania 2,75 1,88 0,06 17,59 3,33 5,34 7,05 2,07 Spain 2,73 1,93 0,05 16,35 3,41 5,33 6,77 2,03 Sweden 3,00 2,32 0,14 11,88 4,06 6,06 7,51 2,12 United Kingdom 3,23 2,37 0,64 14,55 4,08 6,54 8,47 2,41 Acute exposure to taurine from ED in high acute consumers was more than two times the average value for all ED consumers, and over four times the average value for total respondents (tables 75 and 76). Table 75: Adolescents Acute exposure to taurine from ED (values in mg/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 1.414, ,44 ED consumers 2.094, ,13 High acute consumers 5.821, ,68 Table 76: Adolescents Acute exposure to taurine from ED (values in mg/kg bw/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 23,47 16, ,22 33,33 61,54 80,00 28,44 ED consumers 34,70 23, ,22 44,44 72,73 90,91 28,35 High acute consumers 91,58 86, ,22 109,23 136,29 154,35 31,19 Tables from 77 to 80 provides data on acute exposure to taurine from ED (in mg/single session and mg/kg bw/single session) in the 16 MS considered in the study (total respondents and ED consumers).concerning differences among MS, the highest values of acute exposure to taurine for total respondents (tables 77 and 78) were registered in Czech Republic 53 with mg/single session (28,62 mg/kg bw/single session). 53 The highest acute exposure to taurine on total respondents was observed in Belgium (2.222 mg/single session corresponding to 37,1 mg/kg bw/single session). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

131 Table 77: Adolescents - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/single session) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 1.558, , , , ,45 Belgium 2.222, , , , ,24 Cyprus 1.155,69 375, , , ,02 Czech Republic 1.790, , , , ,00 Finland 1.414, , , , ,57 France 1.202, , , , ,84 Germany 1.514, , , , ,93 Greece 942,75 0, , , ,85 Hungary 1.653, , , , ,26 Italy 952,01 375, , , ,07 Netherlands 1.297, , , , ,73 Poland 1.322, , , , ,94 Romania 1.192, , , , ,53 Spain 1.119,39 992, , , ,39 Sweden 1.685, , , , ,17 United Kingdom 1.590, , , , ,52 Table 78: Adolescents Acute exposure to taurine from ED acute consumption in the 16 MS covered by the survey (values in mg/kg bw/single session) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 26,80 18, ,19 40,00 67,12 83,33 27,43 Belgium 37,10 27, ,35 55,10 98,66 124,51 38,08 Cyprus 20,08 7, ,50 31,56 60,00 76,07 28,06 Czech Republic 28,62 20, ,77 40,54 66,67 81,63 26,93 Finland 21,35 16, ,00 28,40 54,56 76,92 27,07 France 20,48 15, ,00 29,94 54,55 71,43 25,24 Germany 25,71 15, ,00 37,83 73,29 95,81 34,07 Greece 14,83 0, ,67 20,73 44,44 62,50 23,31 Hungary 26,88 18, ,22 38,46 66,67 83,53 27,70 Italy 15,59 6, ,22 21,74 43,69 61,74 22,85 Netherlands 24,31 18, ,39 35,71 64,59 80,35 27,98 Poland 21,32 16, ,00 28,17 51,56 66,67 23,76 Romania 21,90 17, ,22 30,15 53,77 76,92 26,76 Spain 19,43 14, ,77 26,30 52,94 71,43 26,03 Sweden 25,13 17, ,45 38,99 65,54 83,34 27,78 United Kingdom 28,36 21, ,82 41,29 71,00 88,99 32,16 Supporting Publications 2013:EN

132 With regards to ED consumers, the highest values of acute exposure to taurine among MS (tables 79 and 80) were registered in Germany 54 with mg/single session (42.71 mg/kg bw/single session). Table 79: Adolescents - Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/single session) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 2.079, ,00 75, , , ,66 Belgium 2.612, ,00 252, , , ,36 Cyprus 2.191, ,00 0, , , ,40 Czech Republic 2.191, ,00 7, , , ,13 Finland 2.181, ,00 0, , , ,39 France 1.824, ,00 40, , , ,75 Germany 2.514, ,00 0, , , ,03 Greece 1.951, ,00 0, , , ,79 Hungary 2.111, ,00 0, , , ,13 Italy 1.700, ,00 0, , , ,79 Netherlands 1.946, ,00 0, , , ,13 Poland 1.815, ,00 0, , , ,55 Romania 1.710, ,00 40, , , ,82 Spain 1.809, ,81 0, , , ,28 Sweden 2.446, ,00 0, , , ,15 United Kingdom 2.291, ,00 180, , , ,01 Table 80: Adolescents Acute exposure to taurine from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 35,76 28,57 0,63 185,19 48,98 74,67 88,75 26,15 Belgium 43,61 30,77 2,86 154,35 61,56 109,68 130,40 37,68 Cyprus 38,07 30,77 0,00 177,50 50,00 74,74 90,50 28,43 Czech Republic 35,03 27,78 0,13 212,77 46,15 71,43 86,21 25,75 Finland 32,93 23,67 0,00 200,00 36,36 67,42 92,55 27,36 France 31,07 21,28 0,70 142,00 42,39 63,11 78,89 25,25 Germany 42,71 31,25 0,00 200,00 57,14 89,13 119,95 34,67 Greece 30,71 21,28 0,00 166,67 40,00 63,54 82,79 25,24 Hungary 34,33 24,48 0,00 222,22 44,78 72,96 88,89 26,91 Italy 27,85 19,72 0,00 222,22 35,71 59,70 76,92 24,31 Netherlands 36,49 26,30 0,00 217,39 46,15 73,90 90,30 27,04 Poland 29,27 20,00 0,00 200,00 36,36 59,06 76,92 23,28 Romania 31,41 22,22 0,71 222,22 37,74 64,94 88,54 26,98 Spain 31,40 21,85 0,00 212,77 40,82 65,54 86,54 26,82 Sweden 36,49 27,84 0,00 145,45 50,00 72,73 94,60 26,57 United Kingdom 40,86 30,77 3,03 181,82 51,64 83,33 109,23 31,29 54 The highest acute exposure to taurine on ED consumers was observed in Belgium (2.612 mg/single session corresponding to 43,61 mg/kg bw/single session). Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

133 With regards to the acute exposure to D-glucurono-y-lactone from ED, data in mg/single session vary from around 512 mg for total respondents, to around 759 for ED consumers and around in high acute consumers (tables 81 and 82). Table 81: Adolescents Acute exposure to D-glucurono-y-lactone from ED (values in mg/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 512,62 240, ,18 ED consumers 759,24 540, ,64 High acute consumers 1.934, , ,83 Table 82: Adolescents Acute exposure to D-glucurono-y-lactone from ED (values in mg/kg bw/single session) (Sample size: Total respondents; ED consumers; High acute consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Total respondents 8,58 4, ,67 11,54 24,34 33,96 12,56 ED consumers 12,70 8, ,67 16,73 29,51 39,71 13,44 High acute consumers 30,93 28, ,67 44,84 62,65 73,85 22,80 For what concerns differences among MS, it can be noted that: with regards to total respondents, acute exposure to D-glucurono-y-lactone ranges from around 306 mg/single session (4,96 mg/kg bw/single session) in Hungary, to around 828 mg/single session (14,28 mg/kg bw/single session) in the case of Austria 55 (tables 83 and 84); with regards to ED consumers, the highest value of acute exposure to D-glucurono-y-lactone is registered in Austria, with around mg/single session (19 mg/kg bw/single session) (tables 85 and 86); As for differences among age groups of total respondents, the average value of acute exposure to D- glucurono-y-lactone is around 566 mg/single session in adolescents aged 15-18, versus around 375 mg/single session in the age group between 10 and 14 years; Passing to variations between genders, the average acute exposure to D-glucurono-y-lactone results to be around 582 mg/single session for males and 455 mg/single session for females. 55 The highest acute exposure to glucuronolactone on total respondents was observed in Belgium (890 mg/single session and 15,25 mg/kg bw/single session. Nevertheless, due do the small dimension of the sample for Belgium, for which the sampling error of estimates exceeds 5%, it was preferred not to cite this figure. Supporting Publications 2013:EN

134 Table 83: Adolescents - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/single session) Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 828,01 600, , , ,00 872,91 Belgium 890,91 532, , , ,80 962,77 Cyprus 447, , , ,00 738,25 Czech Republic 390,66 150, , , ,00 610,37 Finland 412,30 120, , , ,36 720,62 France 517,10 240, , , ,68 726,62 Germany 481,75 120, , , ,90 763,44 Greece 359, , , ,00 663,14 Hungary 306,41 60, ,00 900, ,00 558,92 Italy 442,91 127, , , ,00 686,26 Netherlands 569,67 429, , , ,80 711,40 Poland 352,16 135, ,00 960, ,80 565,27 Romania 600,36 480, , , ,80 752,96 Spain 341,22 90, ,00 960, ,50 561,83 Sweden 691,80 450, , , ,00 875,85 United Kingdom 488,23 207, , , ,00 743,48 Table 84: Adolescents - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) - Total respondents (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 14,28 10, ,15 21,82 37,19 46,15 15,18 Belgium 15,25 9, ,61 21,60 34,51 55,48 17,46 Cyprus 7,67 0, ,67 10,84 25,04 33,94 12,62 Czech Republic 6,28 2, ,20 8,71 18,62 26,18 9,95 Finland 6,19 1, ,20 8,11 16,94 27,83 10,49 France 8,76 4, ,20 12,00 25,54 35,10 12,21 Germany 8,23 2, ,51 11,16 25,16 37,02 13,14 Greece 5,67 0, ,20 8,33 17,53 26,63 10,47 Hungary 4,96 1, ,00 6,00 14,20 23,41 9,08 Italy 7,28 2, ,67 10,34 20,69 29,47 11,44 Netherlands 10,58 7, ,29 15,00 28,15 39,13 13,15 Poland 5,66 2, ,09 7,75 15,27 23,95 9,08 Romania 11,18 8, ,71 15,00 27,69 40,47 14,22 Spain 5,92 1, ,67 8,88 16,83 25,66 9,64 Sweden 10,38 6, ,38 15,33 28,44 38,07 12,97 United Kingdom 8,74 3, ,09 11,44 24,89 33,67 13,51 Supporting Publications 2013:EN

135 Table 85: Adolescents - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/single session) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 1.104,88 852, , ,10 843,10 Belgium 1.047,21 840, , ,00 962,21 Cyprus 848,59 596, , ,00 832,65 Czech Republic 478,20 240, , ,00 643,57 Finland 635,92 390, , ,00 811,71 France 784,48 540, , ,00 769,01 Germany 800,18 540, , ,00 844,68 Greece 744,36 540, , ,00 790,14 Hungary 391,30 180, , ,00 604,77 Italy 791,23 600, , ,00 752,16 Netherlands 854,92 600, , ,00 718,09 Poland 483,42 300, , ,00 612,52 Romania 861,22 600, , ,00 767,24 Spain 551,49 420, , ,00 627,91 Sweden 1.004,30 600, , ,00 894,33 United Kingdom 703,25 480, , ,00 803,22 Table 86: Adolescents - Acute exposure to D-glucurono-y-lactone from ED in the 16 MS covered by the survey (values in mg/kg bw/single session) ED Consumers (Sample size: ) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev Austria 19,05 14, ,15 26,53 41,67 49,09 14,71 Belgium 17,93 12, ,61 24,22 40,68 58,44 17,62 Cyprus 14,55 10, ,67 21,31 33,33 42,60 14,22 Czech Republic 7,69 4, ,20 10,34 20,69 29,95 10,51 Finland 9,54 6, ,20 11,52 22,04 33,76 11,73 France 13,30 9, ,20 17,04 31,03 38,57 12,88 Germany 13,66 9, ,51 18,46 34,29 43,92 14,57 Greece 11,74 8, ,20 15,00 27,00 35,50 12,48 Hungary 6,33 2, ,00 7,89 17,14 26,67 9,83 Italy 13,00 9, ,67 16,67 27,88 37,87 12,63 Netherlands 15,87 11, ,29 21,05 34,16 44,67 13,24 Poland 7,77 5, ,09 9,82 18,87 26,67 9,84 Romania 16,04 12, ,71 20,00 33,09 46,41 14,57 Spain 9,56 6, ,67 12,12 22,50 31,51 10,74 Sweden 15,07 10, ,38 21,05 34,09 43,64 13,18 United Kingdom 12,59 9, ,09 16,09 29,45 37,50 14,65 Supporting Publications 2013:EN

136 Children Gathering consumption data on specific consumer groups of energy The sample of children featured a marked prevalence of male respondents (4.960 Total respondents). Children living in urban areas accounted for around 53% of the sample; around 99% of respondents attended primary schools, while around 1% attended pre-schools. Children aged 3-5 accounted for around 1% of the sample; children aged 6-10 accounted for the remaining share (around 99%) ED consumption On average, around 18% of children stated to have consumed ED at least once in the last year; the figure presents differences at MS level (from a prevalence of around 6% in Hungary to a prevalence of around 40% in the Czech Republic) (figure 48). Prevalence of ED consumption was around 19% in the age group 6-10 years, and decreased to around 2% in the age group 3-5 age. Prevalence was higher among male: around 22%, versus around 14% among female (figure 49) Figure 48: Children Prevalence of ED consumption by country (Sample size: Total respondents) Supporting Publications 2013:EN

137 Figure 49: Children Prevalence of ED consumption by age groups and gender (Sample size: Total respondents) Among ED consumers (930 ED consumers), around 16% stated to have been drinking ED 3 times a week or more during the last months before the survey (figure 50). As for the consumption location, most children consumed ED at home (35%), during sport and physical exercise (27%) and at parties (26%). Consumption frequency resulted to be one glass per week for around 56% of consumers, and 2 glasses per week for around 24%, with an average ED consumption volume of 0,49 L/week for ED consumers, ranging from 0,25 L/week in Belgium to 0,63 L/week in Germany. Children declared that they drank ED for their taste (around 60% of consumers) or as a source of energy (around 31% of consumers). When asked whether they considered drinking ED the same as drinking colas, around 55% of consumers declared that they were aware of the difference between the two product categories, while around 23% of consumers declared that they simply did not know. Around 19% of consumers considered ED and colas equivalent. Supporting Publications 2013:EN

138 Figure 50: Children ED consumption and related features (Sample size: 930 ED consumers) Supporting Publications 2013:EN

139 Also in the case of children, data were elaborated in order to identify high chronic consumers ( for details on methodology). Among children, high chronic consumers accounted for around 16% of ED consumers (figure 51) and had an average consumption volume of ED of around 0,95 L/week. Figure 51: Children - Prevalence of high chronic ED consumption (Sample size: 930 ED consumers) Supporting Publications 2013:EN

140 Around 39% of high chronic consumers drank ED about every day (compared to just 6% of total consumers; figure 52). Around 69% of high chronic consumers drank 3 or more glasses of ED per week (compared to just 21% of total consumers). Figure 52: Children Monthly frequency of ED consumption and weekly consumed volumes: high chronic and total consumers (Sample size: 930 ED consumers; 154 High chronic consumers) Supporting Publications 2013:EN

141 Focusing on situations of ED consumption, there were some differences between high chronic and total consumers (figure 53): consumption at home occurred for around 50% of high chronic consumers, compared to around 35% on the other ones; consumption during parties was instead more common among consumers (around 26%, versus around 14% of high chronic consumers). Figure 53: Children Situations of ED consumption: high chronic and total consumers (Sample size: 930 ED consumers; 154 High chronic consumers) Supporting Publications 2013:EN

142 With regards to the motivations behind consumption, most children declared to consume ED because they like their taste, both in the case of total consumers (60%) and high chronic consumers (54%; figure 54). Figure 54: Children Motivations for ED consumption: high chronic and total consumers (Sample size: 930 ED consumers; 154 High chronic consumers) Supporting Publications 2013:EN

143 ED contribution to total exposure to relevant substances Tables 87 and 88 provide data on chronic exposure to caffeine for the different categories of consumers, calculated on the basis of the methodology ( ). In the case of children, chronic caffeine exposure from ED varied from 3,98 mg/day for total respondents to around 43 mg/day for high chronic consumers. Accordingly, total caffeine exposure (from ED and other products in the diet) varied from 23 mg/day (total respondents) to around 90 mg/day (high chronic consumers). Table 87: Children Chronic exposure to caffeine from ED and from all products (a) (values in mg/day) (Sample size: Total respondents; 930 ED consumers: 154 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED: Total respondents 3,98 0,00 0,00 112,74 0,00 11,27 22,55 11,46 ED consumers 21,97 11,27 11,27 112,74 22,55 45,10 67,64 18,18 High chronic consumers 42,90 33,82 11,27 112,74 45,10 78,92 112,74 26,98 Total exposure: Total respondents 23,35 16,07 0,00 292,21 31,57 51,06 66,68 24,93 ED consumers 51,38 41,61 11,27 288,09 60,66 98,76 110,39 36,28 High chronic consumers 90,24 75,51 12,97 288,09 109,97 183,88 206,22 56,23 (a) Including ED Table 88: Children Chronic exposure to caffeine from ED and from all products (a) (values in mg/kg bw/day) (Sample size: Total respondents; 930 ED consumers: 154 High chronic consumers) Mean Median Min Max 75th perc. 90th perc. 95th perc. StdDev exposure from ED: Total respondents 0,18 0,00 0,00 5,20 0,00 0,52 1,04 0,53 ED consumers 1,01 0,52 0,52 5,20 1,04 2,08 3,12 0,84 High chronic consumers 1,98 1,56 0,52 5,20 2,08 3,64 5,20 1,24 Total exposure: Total respondents 1,08 0,74 0,00 13,47 1,45 2,35 3,07 1,15 ED consumers 2,37 1,92 0,52 13,28 2,80 4,55 5,09 1,67 High chronic consumers 4,16 3,48 0,60 13,28 5,07 8,47 9,50 2,59 (a) Including ED Supporting Publications 2013:EN

144 Differences in ED contribution to total caffeine exposure between all consumers and high chronic consumers are reported in figure 55: ED consumption accounted for around 43% of total daily exposure of all consumers, compared to around 48% in the case of high chronic consumers. Differences in the importance of ED s contribution to caffeine exposure according to gender are relatively limited: ED contributed to 42% of total daily exposure in the case of male consumers, and 44% in the case of female ones. Also differences in the importance of ED s contribution to caffeine exposure in the two age groups considered were relatively limited: ED contributed to around 43% of total daily exposure in the age group 6-10, and around 46% in the age group 3-5. Figure 55: Children - ED contribution to total daily exposure to caffeine (%): high chronic and total consumers (Sample size: Total respondents; 154 High chronic consumers) Supporting Publications 2013:EN