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Caffeine Content of Energy Drinks, Carbonated Sodas, and Other Beverages

DOI:10.1093/jat/30.2.112
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Rachel R McCusker
Rachel R McCusker
Rachel R McCusker
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Bruce A. Goldberger at University of Florida
Bruce A. Goldberger
Edward J Cone at Johns Hopkins Medicine
Edward J Cone
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Abstract

The caffeine content of 10 energy drinks, 19 carbonated sodas, and 7 other beverages was determined. In addition, the variability of the caffeine content of Coca-Cola® fountain soda was evaluated. Caffeine was isolated from the samples by liquid-liquid extraction and analyzed by gas chromatography with nitrogen-phosphorus detection. The caffeine concentration of the caffeinated energy drinks ranged from none detected to 141.1 mg/serving. The caffeine content of the carbonated sodas ranged from none detected to 48.2 mg/serving, and the content of the other beverages ranged from < 2.7 to 105.7 mg/serving. The intra-assay mean, standard deviation, and % coefficient of variation for the Coca-Cola fountain samples were 44.5, 2.95, and 6.64 mg/serving, respectively.
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Journal of Analytical Toxicology, VoL 30, March 2(]06
[ TechnicalNote
Caffeine Content of Energy Drinks, Carbonated Sodas,
and Other Beverages
Rachel R. McCusker 1, Bruce A. Goldberger 1,2,*, and Edward J. Cone 3
I Department of l~atholog); hnmunology, and Laboratory Medicine and 2Department of Psychiatry, University of Florida
College of Medicino, P.O. Box 100275, Gainesville, Florida 32610-0275 and 3ConeChem Research, LLC, 441 Fairtree Drive,
Severna Park, Maryland 21146
i
Abstract
The caffeine content of 10 energy drinks, 19 carbonated sodas, and
7 other beverages was determined. In addition, the variability of
the caffeine content of Coca-Cola | fountain soda was evaluated.
Caffeine was isolated from the samples by liquid-liquid extraction
and analyzed by gas chromatography with nitrogen-phosphorus
detection. The caffeine concentration of the caffeinated energy
drinks ranged from none detected to 141.1 rag/serving. The
caffeine content of the carbonated sodas ranged from none
detected to 48.2 rag/serving, and the content of the other
beverages ranged from < 2.7 to 105.7 mg/serving. The intra-assay
mean, standard deviation, and % coefficient of variation for the
Coca-Cola fountain samples were 44.5, 2.95, and 6.64 rag/serving,
respectively.
Introduction
Recently there has been an increase in the popularity of caf-
feine-containing "energy drinks" or "functional beverages".
Functional beverages are also known as nutraceutical foods,
which are substances considered to be a food or part of a food
that may provide some health benefit (1). Because of their na-
ture, such beverages are touted as "highly vitalizing", leading to
an "improvement of performance" and a "stimulation of
metabolism". However, there are important health concerns
that cannot be ignored with regards to the amount of caffeine
contained in these drinks.
The American Dietetic Association takes the position that
women of childbearing potential should adopt a health-pro-
moting lifestyle. Their recommendation includes the avoid-
ance of the ingestion of > 300 rag/day of caffeine, citing studies
finding increased risk of spontaneous abortion and low birth
weight children born to women consuming more than 150
rag/day of caffeine (2). Although there are studies demon-
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strating no association between fetal growth retardation and
maternal caffeine consumption (3,4), there are a plethora of
other studies demonstrating a positive association between ma-
ternal caffeine consumption and fetal growth retardation or
decreased birth weight. One such study found that women
whose caffeine intake was 71-140 mg per day had infants
weighing 116 g less than those who consumed 0-10 mg per day
(5). Another study found mothers of small-for-gestational-age
(SGA) infants had a higher mean intake of caffeine in the third
trimester than mothers of non-SGA infants (6). Further, an-
other study linked caffeine consumption to the risk of miscar-
riage, finding that caffeine consumption > 300 rag/day doubled
the risk of miscarriage (7). Though the literature is inconsistent
on fetal growth and spontaneous abortion as it relates to caf-
feine ingestion, there remains a need for caution when caf-
feine is consumed by pregnant women.
Children are another group that should be considered vul-
nerable to excess caffeine. A nationwide caffeine consumption
survey conducted of children aged 5 to 18 years found that 98%
studied consumed caffeine on a weekly basis, derived mostly
from carbonated beverages (8). One study concluded that chil-
dren and adolescents consuming caffeine in high concentra-
tions suffered from caffeine-induced headaches (9). In that study,
36 children were evaluated. They ranged in age from 6 to 18
years and were soda consumers, ingesting on average 192 mg of
caffeine a day. When the subjects ceased drinking soda, 33 ex-
perienced complete cessation of all headaches. In a separate
study involving 191 youths aged 12-15 years, it was found that
an average of 52.7 mg of caffeine was consumed daily and 18.8%
of the total number of subjects consumed 100 mg or more daily
(10). The primary source of caffeine was from consumption of
soft drinks. The study found that the high caffeine consumers ex-
perienced more interrupted sleep during the night.
Materials and Methods
In Phase One of this study, we evaluated the caffeine content
of 10 energy drinks, 19 carbonated sodas, and 7 other beverages.
112
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Journal of Analytical Toxicology, Vol. 30, March 2006
The beverages were purchased from various convenience stores
located in Oainesville, FL. In Phase TWo of this study, we eval-
uated the caffeine content of nine samples of fountain Coca-
Cola which were purchased from various eating establishments
located in Gainesville, FL.
The extraction procedure and instrumental parameters were
previously reported (11). Caffeine was isolated from the bever-
ages by liquid-liquid extraction, and the final extracts were
subjected to a gas chromatographic analysis utilizing nitrogen-
phosphorus detection. Quantitation of caffeine was based on a
calibration curve prepared in a concentration range of 25-250
mg/L for the caffeinated samples and 10-100 mg/L for the de-
caffeinated samples, with the limit of quantitation arbitrarily set
Table I. Caffeine Content of Energy Drinks, Carbonated
Sodas, and Other Beverages
Serving Caffeine
Beverage Size (oz) (mg/serving)
Energy Drinks
Red Devil | 8,4 41.8
SoBe| Adrenaline Rush 8.3 76.7
SoBe| No Fear 16 141.1
Hair of the Dog | 8.4 none detected
Red Celeste
TM
8.3 75.2
E Maxx
TM
8.4 73.6
Amp
TM
8.4 69.6
Red Bull | Sugarfree 8.3 64.7
Red Bull | 8,3 66.7
KMX
TM
8.4 33.3
Carbonated Sodas
Coca-Cola | Classic 12 29,5
Diet Coke | 12 38,2
Diet Coke | wittl Lime 12 39,6
Caffeine Free Diet Coke | 12 none detected
Vanilla Coke | 12 29.5
Pepsi | 12 31.7
Diet Pepsi | 12 27.4
Mountain Dew | 12 45,4
Mountain Dew | Live Wire
TM
12 48.2
Dr Pepper ~ ] 2 36,0
Diet Dr Pepper ~ 12 33.8
Sierra Mist
TM
12 none detected
Celeste
TM
Cola 12 t9.4
Sprite | 12 none detected
Seagram's | Ginger Ale 12 none detected
garq's | Root Beer 12 18.0
Pibb| 12 34.6
A&W | Root Beer 12 none detected
7-UP | 12 none detected
Other Beverages
Nestea | Cool Lemon Iced Tea 12 11.5
Lipton | Brisk Lemon Iced Tea 12 6.5
Yoohoo | Chocolate Drink 9 < 2.7
Starbucks Doubleshot
TM
6.5 105,7
Starbucks Frappuccino ~"~ Mocha 9.5 71.8
Starbucks Frappuccino ~ Vanilla 9.5 63.8
Velda Farms | Chocolate Milk 16 < 3,8
at the concentration of the lowest standard. Control samples
were prepared at 75 mg/L for the caffeinated sample batches
and 50 mg/L for the decaffeinated sample batches.
Results
The results of the caffeine analyses of the energy drinks, car-
bonated sodas, and other beverages (Phase One) are listed in
Table I. Brand names, serving sizes, and measured concentra-
tions of caffeine per serving are provided. The results of the caf-
feine analyses of fountain Coca-Cola samples (Phase Two) are
listed in Table II. The names of the eating establishments where
the samples were purchased, serving sizes, and measured con-
centrations of caffeine per serving are provided.
In Phase One of the study, all beverages purported to be caf-
feine-free contained no caffeine. The caffeine concentration of
the caffeinated carbonated sodas ranged from 18.0 to 48.2
rag/serving. The caffeine concentration of the nine caffeinated
energy drinks ranged from 33.3 to 141.1 mg/serving. The caf-
feine concentration of the remaining seven beverages ranged
from < 2.7 to 105.7 rag/serving.
In Phase Two of the study, the caffeine concentration of the
nine Coca-Cola fountain samples were within the range of 40.9
to 48.4 mg per 16-oz serving. The intra-assay mean (N = 9),
standard deviation, and % coefficient of variation were 44.5
mg/serving, 2.95, and 6.64, respectively.
Discussion
The Food and Drug Administration (FDA) has included caf-
feine in the list of substances that are generally recognized as
safe and has set the maximum concentration of caffeine in
cola beverages at 32.4 mg of caffeine per 6-oz bottle or 65 mg
of caffeine per 12 oz (12). Of the carbonated sodas evaluated, the
caffeine concentrations were in the range of 0-48.2 mS/serving
(12 oz). Such findings are well below the maximum allowable
limits of caffeine concentration per serving as specified by the
FDA.
Table II. Caffeine Content of Fountain Coca-Cola
Serving Caffeine
Establishment Size (oz) (mg/serving)
Burger King | 16 41,5
Wendy's | 16 41.5
McDonald's | 16 44.0
Chick-fiI-A | 16 48.4
Fast Track ] 6 45.5
Steak N Shake | 16 43,5
Atlanta Bread Company | 16 40,9
Checkers | 16 46.9
Citgo | Food Mart 16 48.4
113
Journal of Analytical Toxicology, Vol. 30, March 2006
The caffeine content of energy drinks and cold coffee bever-
ages is not currently regulated by the FDA. Further, these bev-
erages do not fall under the same FDA regulation that limits caf-
feine content of cola beverages. Caffeine content for the
majority of energy drinks included in this study was higher
than the maximum allowed limit for cola beverages (45.3
rag/8.4 oz or 86.4 rag/16 oz). One of the energy drinks packaged
as a 16-oz can contained 141.1 mg of caffeine, well above the
maximum allowed limit for cola beverages. Six of the energy
drinks evaluated contained caffeine concentrations in the range
of 64.7 to 76.7 mg per serving (8.3 or 8.4 oz). The caffeine con-
tent of one of the cold coffee beverages was 105.7 mg per 6.5 oz,
which is approximately three times the maximum allowed limit
for cola beverages (32.4 rag/6 oz).
We decided to assess the variability of Coca-Cola fountain
samples because of potential variation in dispensing. For ex-
ample, some establishments may opt to mix their sodas much
"heavier",
that is, with less carbonated water and more syrup,
thus leading to a more concentrated drink with more caffeine
per serving, whereas some establishments may serve a more di-
lute drink with less caffeine per serving. Surprisingly, we found
little variability in concentration of caffeine in the fountain
samples evaluated.
Because of the previously mentioned health concerns arising
from the consumption of caffeine, it seems appropriate that
warning labels should accompany all caffeinated beverages.
None of the carbonated sodas evaluated in this study were so la-
beled. Of the 10 energy drinks studied, only 4 were labeled with
some form of warning. Three such labels (SoBe Adrenaline
Rush, SoBe No Fear, AMP) advise that the product is not rec-
ommended for children and pregnant women, and the fourth
label (Red Devil) advises that "kids, pregnant women, and caf-
feine-sensitive persons" should not use their product in "large"
amounts. The term "large" was not specified, leaving its inter-
pretation entirely up to the consumer. In addition to warning la-
bels, additional labeling, such as expanding the nutrition facts
panel to include the amount of caffeine per serving, would be
appropriate. The nutrients label currently contains substances
such as total fat, cholesterol, carbohydrates, and sodium rec-
ommended for limited consumption. The modification of the
product label to include caffeine content would be beneficial for
the caffeine-sensitive consumer. Considering the documented
effects of caffeine on children and pregnant women, it would be
prudent for the consumer product labeling of all caffeinated
beverages to indicate the maximum amount of caffeine rec-
ommended for such groups. Of particular concern are those
non-cola beverages that currently contain 150-300% of the
FDA regulated amount per serving for cola beverages. Although
the caffeine content of the energy drinks and cold coffee bever-
ages may seem alarmingly elevated as compared to the caffeine
content of the carbonated sodas, our previous caffeine study
found much higher caffeine concentrations in specialty coffees
with a mean caffeine content of 188 mg per 16-oz serving (11).
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  • Feb 2023
Purpose of Review From the introduction of the popular energy drink “Red Bull” in 1997 to the United States, energy drink consumption has rapidly grown and evolved. In the last decade, in particular, these beverages have been considered a potential health hazard. This is due to their large concentrations of caffeine in addition to other components such as taurine, B vitamins, guarana, l-carnitine, and ginseng that have individual risk as well as potential synergistic risk with other ingredients. Recent Findings This review focuses on the evolving market of energy, typical “active” components of the most used drinks, and their potential effects on health, particularly cardiovascular risk. The most often consumed products are analyzed for their caffeine content and by their key active ingredients. These ingredients are then considered based upon their potential for cardiac risk alone and in combination with others. Summary When used within the recommended dosage, all these components of energy drinks have no to very rare reported adverse health impacts. However, intoxication can occur upon prolonged and excessive consumption of energy drinks and in with consumption of other products. Furthermore, potential vulnerable populations (ex., youth, pregnant women, and those with cardiovascular conditions) should limit consumption of energy drinks, pending further research.
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Psychosocial Determinants of Usage of Energy Drinks among Medical Students
Article
Full-text available
  • Aug 2018
Objective: This study was conducted to determine psychosocial factors leading to energy drinks consumption among medical students. Design: This was observational cross sectional study. Durations and Time: This study was conducted at Services hospital Lahore from July 2017 to December 2017. Materials and Methods: All the students of MBBS or Allied Health Programmes who were enrolled in a medical college were included in our study. The exclusion criteria include all the students who were not registered with the college as medical student of MBBS or any allied health degree. A preformed questionnaire was given to every student. Results: A total of 100 students were recruited for this study. The mean age of the medical students was 22.3+2.2 years with range of 20-25 years. We observed 68(68%) of the students who used energy drinks. Out of these 41 (60.03%) were male and 27(39.07%) were females. 23 (33.82%) students consumed energy drinks for purpose of Energy gaining, 21 (30.88%) for the purpose of reducing sleep 8(11.76%) students consumed energy drinks for purpose of regaining body fluids. All other causes were minimal. Conclusion: We may conclude in our study that the energy drinks consumption is high among medical students.The main purpose of its usage is the regain of energy and to reduce the sleep for study purposes.
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Effect of Caffeine Intake During Pregnancy on Birth Weight
Article
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The aim of this study was to examine the effect of caffeine consumption during pregnancy on birth weight and its possible interaction with smoking. The sample included 1,011 women who were interviewed during their first 3 days after delivery in one of the hospitals of Belgrade, Yugoslavia. A significant reduction in birth weight was found to be associated with an average caffeine intake of >71 mg per day, after adjustment for gestational age, infant sex, parity, and maternal height and weight, but only in infants bom to nonsmoking mothers.Am J Epidemiol 1997; 145: 335–8.
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Caffeine Intake and Low Birth Weight: A Population-based Case-Control Study
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The authors conducted a matched case-control study to investigate the effects of caffeine intake during pregnancy on birth weight. From January to November 1992, in the first 24 hours after delivery, 1,205 mothers (401 cases and 804 controls) were interviewed and their newborns were examined to assess birth weight and gestational age by means of the method of Capurro et al. (J Pediatr 1978;93:120-2). The cases were children with birth weight < 2,500 g and gestational age > or = 28 weeks. Cases and controls were matched for time of birth and hospital of delivery and were recruited from the four maternity hospitals in Pelotas, southern Brazil. Daily maternal caffeine intake during pregnancy for each trimester was estimated. To assess caffeine intake, 10% of the mothers were reinterviewed at their households and samples of reported information on drip coffee and maté (a caffeine-containing drink widely used in South America) were collected and sent to the laboratory for caffeine determination through liquid chromatography. When instant coffee was reported, the weight of powder was measured using a portable scale, and caffeine intake was estimated from a reference table. Caffeine intake from tea, chocolate, soft drinks, and medicines was estimated from a reference table. Analyses were performed by conditional logistic regression. Crude analyses showed no effect of caffeine on low birth weight, preterm births or intrauterine growth retardation. The results did not change after allowing for confounders.
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Comparative Potencies of Nutraceuticals in Chemically Induced Skin Tumor Prevention
Article
Full-text available
  • Feb 2002
Four nutraceuticals, sugar beet roots, cucumber fruits, New Zealand spinach leaves, and turmeric rhizomes, were evaluated for their comparative effectiveness against dimethylbenz[a]anthracene (DMBA)-initiated and croton oil-promoted skin tumors. Three different protocols were used. The most effective protocol (Protocol 2) is the topical application of the nutraceuticals 1 h before croton oil. There was a decrease in the percent skin tumor incidence, a decrease in multiplicity of skin tumors, and a later onset of skin tumors compared with the positive control for all the nutraceuticals tested, with turmeric being the most potent, as evidenced by 30% skin tumor incidence, 87.2% decrease in skin tumors, and a 5-wk delay in skin tumor formation compared with the positive control. Topical application of the nutraceuticals daily for 5 days before DMBA and 1 h before croton oil (Protocol 1) and immediately after croton oil (Protocol 3) did not have an additional protective effect against skin tumors compared with Protocol 2. Kruskal-Wallis analysis of variance by ranks showed that Protocol 2 is the most effective, with the treatment groups belonging to different populations at the 0.05 level of significance compared with alpha = 0.20 for Protocols 1 and 3. Turmeric is the most potent nutraceutical, because the average number of tumors formed after application of tumeric is statistically different from the positive control at alpha = 0.01.
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Caffeine Content of Specialty Coffees
Article
Full-text available
  • Nov 2003
Caffeine is the world's most widely consumed drug with its main source found in coffee. We evaluated the caffeine content of caffeinated and decaffeinated specialty coffee samples obtained from coffee shops. Caffeine was isolated from the coffee by liquid-liquid extraction and analyzed by gas chromatography with nitrogen-phosphorus detection. In this study, the coffees sold as decaffeinated were found to have caffeine concentrations less than 17.7 mg/dose. There was a wide range in caffeine content present in caffeinated coffees ranging from 58 to 259 mg/dose. The mean (SD) caffeine content of the brewed specialty coffees was 188 (36) mg for a 16-oz cup. Another notable find is the wide range of caffeine concentrations (259–564 mg/dose) in the same coffee beverage obtained from the same outlet on six consecutive days.
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Amount and dietary sources of caffeine and saccharin intake by individuals ages 5 to 18 years
Article
  • Jan 1983
A nationwide, 7-day food consumption survey was utilized to assess average daily consumption of saccharin and caffeine by individuals 5 to 18 years old. The total sample's average daily saccharin and caffeine intakes were 4.1 and 37.4 mg, respectively. Only 14% of the individuals consumed saccharin while 98% consumed caffeine. On days when these dietary components were consumed, average saccharin intake was 87.4 mg and average caffeine intake was 47.9 mg. In general, intake levels of both dietary components increased with increasing age. However, on a body weight basis (mg/kg) caffeine intakes did not increase with increasing age. When expressed as milligrams of caffeine intake per kilogram body weight per day, children 5 to 6 years old had significantly higher intakes (1.1 mg/kg/day) than 7 to 8 years olds. No other age differences were noted. Artificially sweetened carbonated beverages contributed the greatest number of milligrams of saccharin to total intake while tea, followed by carbonated beverages, made the most significant impact on caffeine consumption. Considerable variation was found for both saccharin and caffeine consumption levels among the sample members as well as for each individual during the 7 days surveyed.
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Maternal Caffeine Intake and Intrauterine Growth Retardation
Article
This study estimates the effect of maternal caffeine consumption throughout pregnancy on fetal growth. We studied 2,714 women who delivered a liveborn infant between 1988 and 1991. Detailed information regarding coffee, tea, and soda drinking during the first and third trimesters of pregnancy was obtained. Average caffeine intake during month 1 of pregnancy was higher than for month 7 (72.4 vs 54.0 mg per day). Consumption of >300 mg caffeine per day during month 1 (adjusted odds ratio = 0.91; 95% confidence interval = 0.44--1.90) and during month 7 (adjusted odds ratio = 1.00; 95% confidence interval = 0.37--2.70) was not associated with intrauterine growth retardation. There was little evidence for any effect modification due to cigarette smoking on the caffeine associations. This study provides evidence that antenatal caffeine consumption has no adverse effect on fetal growth.
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Position of The American Dietetic Association
Article
It is the position of the American Dietetic Association that women of childbearing potential should maintain good nutritional status through a lifestyle that optimizes maternal health and reduces the risk of birth defects, suboptimal fetal growth and development, and chronic health problems in their children. The key components of a health-promoting lifestyle during pregnancy include appropriate weight gain; consumption of a variety of foods in accordance with the Food Guide Pyramid; appropriate and timely vitamin and mineral supplementation; avoidance of alcohol, tobacco, and other harmful substances; and safe food-handling. Prenatal weight gain within the Institute of Medicine (IOM) recommended ranges is associated with better pregnancy outcomes. The total energy needs during pregnancy range between 2,500 to 2,700 kcal a day for most women, but prepregnancy body mass index, rate of weight gain, maternal age, and physiological appetite must be considered in tailoring this recommendation to the individual. The consumption of more food to meet energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally adequate to meet the needs for most nutrients. However, vitamin and mineral supplementation is appropriate for some nutrients and situations. This statement also includes recommendations pertaining to use of alcohol, tobacco, caffeine, street drugs, and other substances during pregnancy; food safety; and management of common complaints during pregnancy and specific health problems. In particular for medical nutrition therapy, pregnant women with inappropriate weight gain, hyperemesis, poor dietary patterns, phenylketonuria (PKU), certain chronic health problems, or a history of substance abuse should be referred to a qualified dietetics professional.
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Caffeine Consumption and Weekly Sleep Patterns in US Seventh-, Eighth-, and Ninth-Graders
Article
To survey caffeine use by seventh-, eighth-, and ninth-graders and relate its use to age, sex, sleep characteristics, and day of week Students kept a daily, 2-week diary of their sleep times and use of caffeine containing drinks and foods. Data were analyzed by fitted multiple regression models A total of 191 students participated. Caffeine intake ranged between 0 and 800 mg/d. Mean use over 2 weeks ranged up to 379.4 mg/d and averaged 62.7 mg/d (corrected for underrepresentation in our sample of boys, who consumed more caffeine). Higher caffeine intake in general was associated with shorter nocturnal sleep duration, increased wake time after sleep onset, and increased daytime sleep. SLEEP PATTERNS: Mean bedtime was 10:57 PM, and mean wake time was at 7:14 AM. Older children delayed bedtime longer on weekends, and younger ones had longer nightly sleep durations. Sleep duration lengthened on weekends, reflecting the combined effects of the circadian timing system and a mechanism that regulates the duration of sleep. Caffeine (soda) consumption also increased on weekends, for reasons that may be primarily social Regardless of whether caffeine use disturbed sleep or was consumed to counteract the daytime effect of interrupted sleep, caffeinated beverages had detectable pharmacologic effects. Limitation of the availability of caffeine to teenagers should therefore be considered.
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Caffeine-Induced Headache in Children and Adolescents
Article
  • Jul 2003
Caffeine is the most widely used behaviourally active substance. Excessive caffeine consumption, mostly in the form of coffee and tea, is a well-recognized cause of headache or migraine, and withdrawal can cause headache. Nevertheless, caffeine abuse headache is not listed as a separate category in the International Headache Society classification, 1988. We report our experience with children and adolescents with daily or near-daily headache and excessive consumption of caffeine in the form of cola drinks. Over a period of 5 years we have encountered, in a tertiary headache clinic in a general hospital, 36 children and adolescents (17 girls and 19 boys) with daily or near-daily headache related to excessive caffeine intake in the form of cola drinks. The mean age of the subjects was 9.2 years (range 6-18) and mean headache duration was 1.8 years (range 0.6-5). All were heavy cola drinks consumers; at least 1.5 L of cola drinks per day (192.88 mg of caffeine daily), and an average of 11 (range 10.5-21) L of cola drinks a week, which amounts to 1414.5 mg of caffeine (range 1350.1-2700.3). Patients were encouraged to achieve gradual withdrawal from cola drinks, which led to complete cessation of all headaches in 33 subjects, whereas one boy and two adolescent girls continued to suffer from migraine without aura not frequent enough to justify prophylactic medication. Children and adolescents with high daily caffeine consumption in the form of cola drinks may suffer from caffeine-induced daily headache. Gradual withdrawal can be achieved without withdrawal headache and with complete disappearance of the induced chronic daily headache.
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High caffeine consumption in the third trimester of pregnancy: Gender-specific effects on fetal growth
Article
  • Nov 2003
It has been suggested that a high caffeine intake in pregnancy may be a risk factor for fetal growth retardation. We have tested this hypothesis in a population-based case-control study. Caffeine intake among 111 mothers of small-for-gestational-age (SGA) infants (56 boys, 55 girls) was compared with the intake among 747 mothers of non-SGA infants (368 boys, 379 girls). Food records for 3 days were collected in the second (week 17-20) and in the third (week 33) trimester, and caffeine intake from coffee, tea, soft drinks and chocolate was calculated and dichotomised as low or high, based upon the median value. Mothers of SGA infants had higher mean intake of caffeine [281 +/- 210 (SD) mg/day] in the third trimester than mothers of non-SGA infants (212 +/- 150 mg/day; P < 0.001). The risk of SGA birth was nearly doubled if the mother had a high rather than a low caffeine intake in the third trimester [odds ratio (OR) 1.8; 95% confidence intervals (CI) 1.2, 2.5]. The increased risk was mainly found in boys (OR 2.8; 95% CI 1.5, 5.2), and not in girls (OR 1.2; 95% CI 0.7, 2.1). The increased risk for boys persisted after adjustment for cigarette smoking alone, or for smoking and various other SGA risk factors together. Our results suggest that a high caffeine intake in the third trimester may be a risk factor for fetal growth retardation, in particular if the fetus is a boy.
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