Following the 2020 death of 16-year-old Rohan Godhania, who became seriously ill after drinking a protein shake, the Food Standards Agency (FSA) plans to review warning labels on high-protein drinks and supplements.

Godhania was posthumously diagnosed with a rare disorder called ornithine transcarbamylase deficiency (OTC) which causes lethal levels of ammonia to build up in the blood. In some cases, it can be triggered by protein overload; in Godhania’s case, an Ultimate Sports Nutrition protein shake had been consumed three days before the teenager suffered brain damage.

Having received the Coroner’s Report to Prevent Future Deaths, the FSA confirms it intends to pay ‘full consideration to its findings’.

Coroner Tom Osborne says that while OTC isn’t common, cautionary labelling is advisable. “Concerning these protein drinks my preliminary view about them is that … some sort of warning ought to be put on the packaging of these drinks because, although OTC is a rare condition, it can have harmful effects if someone drinks [one] and it causes a protein spike.”

Osborne calls the lack of screening for metabolic conditions such as OTC a ‘lost opportunity’, while charity Metabolic Support UK is backing the Godhania family’s calls for ammonia testing to become standard practice in emergency medicine.

But food lawyer and partner at Legal Foods, Dr Mark Tallon, flags the point that warnings beyond ‘good practice’ (such as ‘seek medical advice if on medication before use’) could cause undue consumer alarm, and would only be of use to those with pre-diagnosed OTC – unlike Godhania, whose onset was late and had not been detected by doctors prior to consuming the protein drink.

“Would a warning related to vomiting be something food businesses want on pack? Where do we stop with warnings, as we have hundreds of such conditions including Lysinuric protein intolerance, Alpha-gal Syndrome, etcetera? How often are people – for multiple reasons – feeling sick and vomiting? As such, would … a warning result in people going to hospital when not really needed or unrelated to food consumption?”