Intended for healthcare professionals

Feature Sports Drinks

How valid is the European Food Safety Authority’s assessment of sports drinks?

BMJ 2012; 345 doi: (Published 18 July 2012) Cite this as: BMJ 2012;345:e4753

Re: How valid is the European Food Safety Authority’s assessment of sports drinks?

EFSA’s scientific assessment of health claims on ‘sports drinks’ – a clarification
From Juliane Kleiner, European Food Safety Authority

The article by Thompson and colleagues on the European Food Safety Authority’s (EFSA) assessment of two health claims on carbohydrate electrolyte solutions (‘sports drinks’)(1,2),appears to be based on a misunderstanding of what EFSA did.

The article assumed that for the claims on ‘enhancement of water absorption during exercise’ and ‘maintenance of endurance performance’ EFSA based its assessment on all the references submitted to EFSA and published on its website (3). However, EFSA’s opinion (2) makes clear that for these two claims the assessment was based on consensus from authoritative scientific bodies. The other references submitted to EFSA and reviewed in the article were not considered as they were not appropriate for the scientific substantiation of the claim, and thus were not cited in the opinion.

The EU regulatory framework for health claims requires that industry wishing to make a claim related to a food or food component submit to EFSA the evidence necessary to support such claims. EFSA’s assessment of health claims is generally based on the evaluation of the individual scientific studies submitted to EFSA for substantiation of the claim. However, in cases where there is consensus among scientific experts in the field that a claim is substantiated as evidenced by reports from authoritative scientific bodies, EFSA may base its assessment solely on those reports (e.g., claims on the long established physiological functions of vitamins, essential micronutrients, macronutrients, and water).

For example the assessment of the claim on carbohydrate electrolyte solutions related to the ‘maintenance of endurance performance’ was based on a number of such reports, three of which were cited in the opinion – that of the EU Scientific Committee on Food in 2001 (4) and the reports of the American College of Sports Medicine in 2007 and 2009 (5,6). These reports reflect the consensus opinion of experts based on a large body of scientific evidence on the physiological benefits of consuming fluids and carbohydrate during prolonged (endurance) exercise, generally lasting more than one hour.

EFSA’s conclusion that this claim is substantiated is supported by a more recent meta-analysis of 50 randomised controlled trials performed between 1982 and 2011 (7), none of which were among the 54 references submitted to EFSA for this claim.

While EFSA recognises the value of well-conducted systematic reviews for efficacy assessment, these are frequently not available for health claims on foods. However, this does not detract from the scientific rigour of the assessment of the available evidence by the scientists on EFSA’s Panel on Dietetic Products, Nutrition and Allergies (NDA) who assess all relevant evidence in the light of their own extensive expertise.

1) Thompson M, Heneghan C, Cohen D, 2012. How valid is the European Food Safety Authority’s assessment of sports drink. British Medical Journal, 345:e4753

2) EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to carbohydrate-electrolyte solutions and reduction in rated perceived exertion/effort during exercise (ID 460, 466, 467, 468), enhancement of water absorption during exercise (ID 314, 315, 316, 317, 319, 322, 325, 332, 408, 465, 473, 1168, 1574, 1593, 1618, 4302, 4309), and maintenance of endurance performance (ID 466, 469) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2011;9(6):2211. [2 pp.]. doi:10.2903/j.efsa.2011.2211. Available online:


4) SCF (Scientific Committee on Food), 2001. Report on composition and specification of food intended to meet the expenditure of intense muscular effort, especially for sportsmen. SCF/CS/NUT/SPORT/5.

5) Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ and Stachenfeld NS, 2007. American College of Sports Medicine position stand. Exercise and fluid replacement. Medicine and Science in Sports and Exercise, 39, 377-390.

6) Rodriguez NR, Di Marco NM and Langley S, 2009. American College of Sports Medicine position stand. Nutrition and athletic performance. Medicine and Science in Sports and Exercise, 41, 709-731.

7) Temesi J, Johnson NA, Raymond J, Burdon CA, O'Connor HT, 2011. Carbohydrate ingestion during endurance exercise improves performance in adults. Journal of Nutrition, 141, 890-7.

Competing interests: No competing interests

30 July 2012
Juliane Kleiner
Head of Nutrition Unit
European Food Safety Authority (EFSA)
Via Carlo Magno 1A, 43126 Parma, Italy