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Public well being recommendation on the secure consumption of glycerol-containing slush ice drinks, also called slushees, may have revising, conclude researchers after finishing up an in depth evaluate of the medical notes of 21 youngsters who grew to become acutely unwell shortly after consuming one in all these merchandise.
Their findings, printed within the journal Archives of Illness in Childhood, present that in every case the kid grew to become acutely unwell with a cluster of signs quickly after consuming a slush ice drink, which the researchers discuss with as glycerol intoxication syndrome.
The medical and biochemical options have been comparable in all of those youngsters and included decreased consciousness, a sudden sharp drop in blood sugar (hypoglycemia), and a build-up of acid within the blood (metabolic acidosis).
Such signs, once they happen collectively, can point out poisoning or inherited metabolic issues, prompting additional investigations.
Brightly coloured slush ice drinks are designed to enchantment to youngsters, word the researchers. Whereas the components fluctuate, most of these out there within the UK and Eire are ‘no-added sugar’ or ‘sugar-free’ merchandise and include glycerol (E422, also called glycerin), they add.
Glycerol stops the ice from totally freezing, so sustaining the slush impact within the absence of a excessive sugar content material, they clarify.
With a view to informing public well being coverage and steerage for fogeys, the researchers scrutinized the medical notes of 21 youngsters who had change into acutely unwell after consuming a slush ice drink and had initially been recognized with hypoglycemia after their arrival in emergency care.
Other than one little one referred in 2009, all of the others have been referred for additional evaluate between 2018 and 2024.
Prognosis was knowledgeable by lab take a look at affirmation of not less than two of the next: hypoglycemia; metabolic acidosis; glyceroluria (excessive ranges of glycerol within the urine), and backed up by detrimental biochemical, enzyme, and/or genetic take a look at outcomes for underlying inherited metabolic issues.
Data on intercourse was out there for 18 of the kids, simply over half of whom (10; 56%) have been male. Their common age was 3.5, however ranged from 2 to just about 7.
How rapidly they grew to become sick was identified for 15: in 14 (93%) this was inside 60 minutes. Equally, the state of consciousness was identified for 17, and in 16 this was considerably and instantly decreased. One little one had a seizure. Pressing neuroimaging was carried out in 4 (33%) out of 12 youngsters.
Twenty youngsters had documented hypoglycemia (blood glucose 2.6 mmol/l or under); however in 13 (65%) this was even decrease, indicating extreme hypoglycemia. Metabolic acidosis was current in 16 of the 17 youngsters for whom this info was out there.
Twelve of 16 youngsters had low ranges of potassium, and eight out of 9 in whom this was measured had falsely excessive blood fats ranges (pseudohypertriglycerideremia). The researchers concluded that the kids had glycerol intoxication syndrome.
All the kids recovered rapidly after preliminary resuscitation and stabilization of their blood glucose. They have been discharged with recommendation to keep away from slush ice drinks. Twenty did so and had no additional episodes of hypoglycemia.
However one drank one other slush ice drink on the age of seven and developed signs inside an hour, quickly progressing to vomiting and drowsiness. The dad and mom gave the kid a glucose drink, and referred to as an ambulance. When the paramedics arrived, the kid’s blood glucose was again to regular and signs have been already resolving.
Many of the circumstances within the collection introduced for emergency care between 2018 and 2024. And the researchers counsel, “A cause of the recent apparent surge in cases may be the reduced sugar content of these drinks, secondary to two main factors: first, public health and parental concerns about high sugar ingestion, and second, the introduction of a ‘sugar tax’ on high sugar (>5%)-containing drinks in Ireland and the UK in 2018 and 2019, respectively.”
These drinks, bought in nations the place there is no sugar tax, include a a lot larger glucose content material and infrequently do not include any glycerol in any respect, they add.
Primarily based on a number of the circumstances on this collection, the UK Meals Requirements Company beneficial that younger youngsters (4 and below) should not be given slush ice drinks containing glycerol, and that these aged 10 or youthful mustn’t have a couple of.The Meals Security Authority of Eire (FSAI) adopted go well with with comparable steerage in 2024.
However the researchers imagine that these suggestions might now not be sufficient.
“There is poor transparency around slush ice drink glycerol concentration; estimating a safe dose is therefore not easy. It is also likely that speed and dose of ingestion, along with other aspects, such as whether the drink is consumed alongside a meal or during a fasting state, or consumed after high-intensity exercise, may be contributing factors,” they write.
“Food Standards Scotland and the FSAI suggested that 125 mg/kg of body weight per hour is the lowest dose that is associated with negative health effects. For a toddler, this may equate to 50–220 ml of a slush ice drink. The standard size drink sold in the UK and Ireland is 500 ml,” they level out.
On condition that these drinks do not confer any dietary or well being advantages, “recommendations on their safe consumption therefore need to be weighted towards safety,” they counsel.
And so they conclude, “To ensure safe population-level recommendations can be easily interpreted at the individual parental level, and given the variability across an age cohort of weight, we suggest that recommendations should be based on weight rather than age. Alternatively, the recommended age threshold may need to be higher (8 years), to ensure the dose per weight would not be exceeded, given normal population variation in weight.”
Extra info:
Glycerol intoxication syndrome in younger youngsters, following the consumption of slush ice drinks, Archives of Illness in Childhood (2025). DOI: 10.1136/archdischild-2024-328109
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British Medical Journal
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Glycerol intoxication syndrome: Public well being recommendation on slush ice drinks may have revision (2025, March 11)
retrieved 11 March 2025
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