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Caffeine in Food and Dietary Supplements is the summary of a workshop convened by the Institute of Medicine in August 2013 to review the available science on safe levels of caffeine consumption in foods, beverages, and dietary supplements and to identify data gaps. Scientists with expertise in food safety, nutrition, pharmacology, psychology, toxicology, and related disciplines; medical professionals with pediatric and adult patient experience in cardiology, neurology, and psychiatry; public health professionals; food industry representatives; regulatory experts; and consumer advocates discussed the safety of caffeine in food and dietary supplements, including, but not limited to, caffeinated beverage products, and identified data gaps.

Caffeine, a central nervous stimulant, is arguably the most frequently ingested pharmacologically active substance in the world. Occurring naturally in more than 60 plants, including coffee beans, tea leaves, cola nuts and cocoa pods, caffeine has been part of innumerable cultures for centuries. But the caffeine-in-food landscape is changing. There are an array of new caffeine-containing energy products, from waffles to sunflower seeds, jelly beans to syrup, even bottled water, entering the marketplace. Years of scientific research have shown that moderate consumption by healthy adults of products containing naturally-occurring caffeine is not associated with adverse health effects. The changing caffeine landscape raises concerns about safety and whether any of these new products might be targeting populations not normally associated with caffeine consumption, namely children and adolescents, and whether caffeine poses a greater health risk to those populations than it does for healthy adults. This report delineates vulnerable populations who may be at risk from caffeine exposure; describes caffeine exposure and risk of cardiovascular and other health effects on vulnerable populations, including additive effects with other ingredients and effects related to pre-existing conditions; explores safe caffeine exposure levels for general and vulnerable populations; and identifies data gaps on caffeine stimulant effects.

Product Details

ISBN-13: 9780309297493
Publisher: National Academies Press
Publication date: 05/23/2014
Pages: 212
Product dimensions: 6.00(w) x 9.00(h) x 0.60(d)

Table of Contents

Abbreviations and Acronyms xv

1 Introduction 1

Background and Workshop Objectives 1

About This Report 2

The Past, Present, and Future of Caffeine Regulation in the United States 4

References 10

2 Intake and Exposure to Caffeine 11

Caffeine Intake from Beverages in the United States 11

Various Aspects of Caffeine Intake in America: Analysis of NHANES 20

Panelist Discussion with the Audience 26

References 30

3 Safety Signals and Surveillance 31

Caffeine and Energy Drink Exposure Call Surveillance 31

Safety Assessment of Caffeine in Foods and Beverages 38

Panelist Discussion with the Audience 43

References 47

4 Exploring Safe Caffeine Exposure Levels for Vulnerable Populations 51

Health Canada's Approach 52

Safe Caffeine Exposure Levels in Vulnerable Populations: Pregnant Women and Infants 53

Risk of Adverse Effects of Caffeine and Caffeinated Products in Children and Other Vulnerable Groups 58

Panelist Discussion with the Audience 63

References 66

5 Caffeine Effects on the Cardiovascular System 67

Vascular Effects of Caffeine 67

Caffeine and Risk of Arrhythmia 73

Caffeine and Potential Risk of Hypertension 78

Panelist Discussion with the Audience 84

References 86

6 Caffeine Effects on the Central Nervous System and Behavioral Effects Associated with Caffeine Consumption 89

Mechanisms of the Central Nervous System Effects of Caffeine 89

Developmental and Psychopharmacological Effects of Caffeine 96

Addictive Properties of Caffeine 102

DSM-5: Substance-Related and Addiction Disorders 108

Energy Drink Use and Risk Taking During Adolescence and Young Adulthood 110

Caffeine, Performance, and Well-Being 114

Panelist Discussion with the Audience 118

References 123

7 Other Compounds Impacting Caffeine Effects 129

Interaction Between Energy Drink Ingredients and Caffeine 129

Panelist Remarks 134

Panelist Discussion with the Audience 138

References 141

8 Public Comments 145

Richard H. Adamson, Ph.D., TPN Associates, LIC 145

Bob Arnot, M.D., Medical Advisor to Monster Beverage, Inc 146

Joel Geerling, M.D., Ph.D., Harvard Medical School, Boston 146

John P. Higgins, M.D., M.B.A., University of Texas Medical School, Houston 147

Richard Kingston, Pharm.D., SafetyCall International, Bloomington, Minnesota 147

Emilia C. Lonardo, Ph.D., Grocery Manufactures Association, Washington, DC 148

Rend A1-Mondhiry, J.D., Council for Responsible Nutrition, Washington, DC 149

J. Philip Saul, M.D., University of South Carolina, Mount Pleasant, and Consultant to the American Beverage Association 150

John R. White, Jr., Pharm.D., Washington State University, Spokane 150

References 151

9 Moving Forward: Filling the Data Gaps 153

Panelist Remarks 155

Panelist Discussion with the Audience 160

Reference 166


A Workshop Agenda 167

B Workshop Attendees 175

C Biographical Sketches of Workshop Speakers and Moderators 185

D Workshop Statements of Task 195

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