“Contains Phenylalanine” – Advisory and Warning Statements on Australian Food – Podcast Report

Those warnings in bold capital letters on food labels beneath lists of ingredients – “CONTAINS PHENYLALANINE”, “CONTAINS QUININE”, “UNPASTEURISED”. Why are they there, who are they directed at and what are the health ramifications of these ingredients?

Contains Caffeine, Contains Phenylalanine

Earlier this month, I gave a report on advisory and warning statements on Australian food labels on The Skeptic Zone Podcast,  you can listen to it on episode #298 {Permalink}, and I have included the transcript below.

I would like to apologise for writing so infrequently here of late – I now have a regular segment on The Skeptic Zone (also titled Evidence, Please) and have been off learning the podcasting ropes. I do have several topics that I’d like to cover over here though – between planned posts (augmented perhaps with a few transcripts), more regular content should be appearing again soon.


Please note: Transcripts are published as-is, please excuse the lack of referencing.

Further Reading: Warning and Advisory Statements – Food Authority New South Wales

Hello, this is Jo Alabaster.

Here in Australia, food authorities have deemed that common allergens such as crustaceans, eggs, fish, milk, peanuts, soybeans, tree nuts, sesame seeds and their products must be declared in product ingredient lists clearly, in order to allow consumers to be aware of their presence and avoid them as they need to. Royal Jelly is another allergen which, while uncommon, must be noted on labels as an ingredient due to the seriousness of allergic reactions. Gluten and sulphites must also feature on ingredient lists, for the sake of people with medically diagnosed conditions such as coeliac disease and sulphite intolerance.

Alongside these better known and understood ingredients of potential concern to people with medical conditions involving allergies and sensitivities, Australia also has a list of five ingredients which must be noted on a separate “Advisory and warning statement”. Often found in a large typeface near the ingredient list, the five items are:

Aspartame – ‘contains phenylalanine’
Added caffeine in cola drinks – ‘contains caffeine’
Guarana – ‘contains caffeine’
Quinine – ‘contains quinine’
Unpasteurised egg and milk products – ‘unpasteurised’

Today I’d like to take a look at these ingredients, whether we should be concerned by their presence in the products that we eat and drink and why it is that we label them.


Of the substances which require mandatory advisory and warning statements here in Australia, none are surrounded by as much controversy and misinformed concern as the artificial sweetener, Aspartame. It was first synthesised in 1965 and sold under the brand name NutraSweet, though the patent expired in 1992.

Many claims have been made over the years about the dangers of aspartame and as a result, it is one of the most highly scrutinised food additives – the subject of numerous animal studies, clinical and epidemiological research – as well as post marketing surveillance. And yet, the anti-aspartame claims don’t go away… Google aspartame and the second search result is Mercola’s website, in which he claims that aspartame causes everything from slurred speech to numbness to depression – and chronic illnesses such as mental retardation, birth defects, Lymphoma, Parkinson’s Disease and Multiple Sclerosis can be triggered or worsened by the ingestion of aspartame. Yet another case of “Anything Syndrome”.

The aspartame controversy, as it’s dubbed, has been around since it was first approved for human consumption by the FDA, fueled by dodgy media reports (the most famous being a US 60 Minutes episode in which it was suggested that there was a causal link between brain tumors and aspartame… no such link has ever been found), an unsourced hoax email written by a non-existent “Nancy Markle”, which claims a conspiracy between Monsanto and the FDA, and a seemingly endless run of anti-aspartame memes spread via social media.

Public pressure driven by fear and misinformation has had an effect on the market – several supermarket chains worldwide have removed aspartame from their own-brand products. Likewise, concerns about aspartame have driven food safety authorities worldwide to conduct studies, more studies and re-evaluations of studies on the safety of aspartame – alongside MSG, aspartame is one of the world’s most studied food additives. The results? Aspartame poses no toxicity concerns for consumers at current levels of exposure.

FDA officials have described aspartame as “one of the most thoroughly tested and studied food additives the agency has ever approved” and its safety as “clear cut”.

So, why has aspartame earned a spot on the advisory and warning statements list? While aspartame presents no health concerns for the vast majority of consumers, there is a medical condition which requires an awareness of its presence.

The genetic disorder phenylketonuria, or PKU, occurs when two mutated copies of the PKU gene fail to produce the enzyme which metabolises the amino acid phenylalanine – a component of aspartame. PKU is a serious condition and in many countries, it is screened for with a heel prick test at birth – in Australia, the incidence of PKU in newborns is around one in ten thousand. With detection and treatment, children with PKU can grow and develop normally, but left undetected and untreated, excess levels of phenylalanine accumulate in the blood and cause brain damage – an infant can develop severe intellectual disability, abnormalities in brain function, mood disorders, irregular motor function, microcephaly and behavioral issues. As such, people diagnosed with PKU must be carefully monitored and diligently follow a phenylalanine restricted diet, while supplementing with a medical formula containing amino acids and other nutrients.

It is vital to the health of people with PKU and their carers they they be aware of any phenylalanine contained within foods and beverages consumed, hence the labeling of aspartame.


Another substance on the advisory and warning statements list is caffeine – be it added to cola, or in the form of guarana, the seeds of which contain around twice the concentration of coffee beans. Caffeine is also found in teas, energy drinks, chocolate products and believe it or not – there are trace amounts still found in decaf coffee.

While caffeine isn’t necessarily bad in and of itself, people may wish to pay attention to how much they’re consuming – caffeine is a stimulant which acts on the brain and nervous system and it is possible to develop caffeine dependency – withdrawal symptoms can include tiredness, crankiness, headaches, sweating and muscle pain. Depending on an individual’s sensitivity, caffeine can interfere with sleep, cause anxiety and in excessive doses, palpitations and trembling. Pregnant women should discuss their caffeine intake with their doctor and while there are no official guidelines regarding children’s caffeine intake, parents should be aware that it can cause symptoms such as irritability, sleeplessness and stomach upset. The labeling of caffeine allows us to monitor our intake as we see fit.

Perhaps I should declare a potential invested interest here – much caffeine has gone into the writing of this report. I haven’t yet been offered a sponsorship deal from a coffee company, but I suspect it’s only a matter of time.


Next, quinine. Quinine is a substance with a fascinating history – it has fever reducing, analgesic, anti-inflammatory and antimalarial properties and occurs naturally in the bark of the chinchona tree. Chinchona bark was used as a traditional medicine in Peru and Bolivia, before being brought to Europe in the 17th century, and remained a primary anti-malarial drug of choice until the 1940s. Quinine has a distinct bitter flavour, most recognisable in tonic water – which was indeed developed as a tonic, intended for use as a prophylactic against malaria.

In the early 1800s, a British officer in colonial India came up with the idea of adding gin to tonic water – in an effort to make the tonic water more palatable!

Modern tonic water tends to have a lower quinine content than original medicinal tonic water and is often sweetened with sugar or artificial sweeteners. Indeed, the FDA in the USA have limited the quinine content of tonic water to 83 mg per litre – therapeutic doses are in the range of 500 – 1000mg. Quinine itself is often synthesised these days, but there are still natural quinine products (which have precisely the same chemical makeup as synthesised quinine) on the market.

In the past, quinine was listed on the Australian pharmaceutical benefits scheme as a medication for reducing the severity and frequency of night time leg cramps. This recommendation was revoked in 2004, due to its efficacy being marginal at best and an unfavourable harm-benefit profile. Quinine is still prescribed as part of some antimalarial treatments… the use of therapeutic doses of quinine is associated with many risks however, and patients should be monitored carefully for signs and symptoms of adverse events.

Consumer products containing very low amounts of quinine carry few risks – when used as a mixer for alcoholic beverages, the alcohol is likely of greater concern. However, there are people with medically diagnosed quinine sensitivities, who should avoid or restrict quinine intake, as per their doctor’s advice. Quinine should also be avoided by people diagnosed with the metabolic disorder glucose-6-phosphate dehydrogenase deficiency, which affects red blood cell metabolism.


Finally on the advisory and warning statements list are unpasteurised egg and milk products.

The sale of raw milk from cows for human consumption is illegal in Australia, but it can still be sold, if labeled as a ‘beauty product’… and there are some consumers out there who are willing to seek it out, under the misheld belief that pasteurisation of milk renders it less healthy to consume, when quite the opposite it true. It is, however, possible to purchase raw goat’s milk for human consumption, some cheeses made with unpasteurised cow’s milk have been approved for production by Food Standards Australia New Zealand, following risk assessment. Of course, raw eggs are the norm on our shelves, though pasteurised egg products for cooking purposes can be found in some supermarket dairy cabinets.

Unpasteurised eggs and milk run a high risk of contamination with pathogens – salmonella can be present in uncooked eggs; salmonella, campylobacter jejuni, listeria and e.coli in raw milk and soft cheeses, toxoplasmosis – the cat poo pathogen! – in raw goat’s milk. People who choose to consume unpasteurised dairy and eggs should be aware of the risk of serious poisoning that comes with their decision – particularly if they are elderly, in any way infirm, or planning on giving such foods to children under their care – none of these groups of people are able to handle the resulting illness well.

Guidelines recommend that pregnant women should take special care to avoid consuming unpasteurised egg and milk products, as salmonella, listeria and toxoplasmosis can all have detrimental effects on pregnancies.


Food labeling is a tricky topic to navigate – without understanding the context by which it is required, consumers can experience undue alarm due to a mandated warning that a product contains aspartame. Equally, we can misled by claims placed on products by manufacturers, such as “Contains no MSG”, “Natural”, “Light” or “Organic”. Perhaps the best we can do is to improve our understanding of the risks, benefits and dodgy claims made about varying ingredients and food additives – and I hope that this report been informative! If you have any concerns about the ingredients that I’ve mentioned, have a chat with your GP or a qualified dietitian.


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