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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 167
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 168
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 169
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 170
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 171
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 172
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 173
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
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Page 174

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A Workshop Agenda Caffeine in Food and Dietary Supplements: Examining Safety Planning Committee on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements The National Academies Lecture Room 2101 Constitution Avenue NW Washington, DC 20418 August 5–6, 2013 WORKSHOP OBJECTIVES  Evaluate the epidemiological, toxicological, clinical, and other relevant literature to describe important health hazards associated with caffeine consumption  Delineate vulnerable populations who may be at risk from caf- feine exposure  Describe caffeine exposure and risk of cardiovascular and other health effects on vulnerable populations, including additive effects with other ingredients and effects related to preexisting conditions  Explore safe caffeine exposure levels for general and vulnerable populations  Identify data gaps on caffeine stimulant effects including but not limited to cardiovascular, central nervous system, or other health outcomes 167

168 CAFFEINE IN FOOD AND DIETARY SUPPLEMENTS August 5, 2013 8:00–8:45 a.m. Registration INTRODUCTION AND OPENING REMARKS 8:50 a.m. Welcome Lynn Goldman, George Washington University, Chair, Planning Committee on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements 9:00 a.m. Opening Remarks Margaret Hamburg, Commissioner of Food and Drugs, Food and Drug Administration SESSION 1: INTAKE AND EXPOSURE TO CAFFEINE Moderated by Barbara Petersen, Exponent 9:15 a.m. Examining Exposure to Caffeine in Foods, Beverage, and Supplements Caffeine Intakes from Beverages in the United States Diane Mitchell, Penn State University Trends in Caffeine Consumption Victor Fulgoni III, Nutrition Impact, LLC 10:00 a.m. Panel Discussion with Speakers 10:30 a.m. Break

APPENDIX A 169 SESSION 2: SAFETY SIGNALS AND SURVEILLANCE OF POPULATIONS Moderated by Steve Lipshultz, University of Miami 10:50 a.m. Type and Frequency of Caffeine Toxicity: U.S. and International Surveillance Alvin Bronstein, Rocky Mountain Poison Center 11:10 a.m. Safety Assessment of Caffeine in Foods and Beverages Ashley Roberts, Intertek Cantox Consulting (by WebEx) 11:30 a.m. Panel Discussion with Speakers 12:00 p.m. Break for Lunch SESSION 3: CAFFEINE EFFECTS ON THE CARDIOVASCULAR SYSTEM Moderated by Stephen Daniels, Children’s Hospital, University of Colorado, Denver 1:00 p.m. Vascular Effects of Caffeine John Higgins, University of Texas Medical School 1:20 p.m. Caffeine and Risk of Arrhythmia Jeffrey Goldberger, Northwestern University 1:40 p.m. Caffeine and Risk of Hypertension Ahmed El-Sohemy, University of Toronto (by WebEx) 2:00 p.m. Panel Discussion with Speakers

170 CAFFEINE IN FOOD AND DIETARY SUPPLEMENTS SESSION 4: CAFFEINE EFFECTS ON THE CENTRAL NERVOUS SYSTEM Moderated by Thomas Gould, Temple University 2:20 p.m. Neuropharmacologic Effects of Caffeine Exposure Sergi Ferré, National Institutes of Health, National Institute on Drug Abuse 2:40 p.m. Developmental Neurological Effects of Caffeine Exposure Jennifer Temple, University of Buffalo (by WebEx) 3:00 p.m. Panel Discussion with Speakers 3:20 p.m. Break SESSION 5: PANEL DISCUSSION: BEHAVIORAL EFFECTS ASSOCIATED WITH CAFFEINE CONSUMPTION Moderated by Richard Adamson, TPN Associates 3:30 p.m. Dependence/Tolerance Roland Griffiths, Johns Hopkins University Addiction Charles O’Brien, University of Pennsylvania Risk Taking Amelia Arria, University of Maryland, College Park 4:30 p.m. Public Comments

APPENDIX A 171 PUBLIC COMMENTS AND CONCLUDING REMARKS 5:00 p.m. Concluding Remarks for Day 1 Lynn Goldman, George Washington University, Chair, Planning Committee on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements 5:10 p.m. Adjourn Meeting August 6, 2013 8:50 a.m. Welcome and Summary from Day 1 Lynn Goldman, George Washington University, Chair, Planning Committee on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements 9:00 a.m. Opening Remarks Michael Taylor, Deputy Commissioner for Foods and Veterinary Medicine, Food and Drug Administration SESSION 1: OTHER COMPOUNDS IMPACTING CAFFEINE EFFECTS Moderated by James Coughlin, Coughlin & Associates 9:15 a.m. Facilitated Discussion: Other Components Im- pacting Caffeine Effects Led by Stephen Schaffer, University of South Alabama Summary of the Issues Stephen Schaffer Panel Discussion Speakers from Day 1

172 CAFFEINE IN FOOD AND DIETARY SUPPLEMENTS SESSION 2: USE OF CAFFEINATED PRODUCTS Moderated by: James Coughlin, Coughlin & Associates 10:15 a.m. Trends in Usage and Potential Benefits from Caffeine Andrew Smith, Cardiff University, UK (by WebEx) 10:35 a.m. Q&A SESSION 3: EXPLORING SAFE CAFFEINE EXPOSURE LEVELS 10:45 a.m. Panel Discussion: Exploring Safe Caffeine Exposure Levels for Vulnerable Populations Panel Moderator Mark Feeley, Health Canada Pregnancy/Infants Christina Chambers, University of California, San Diego Children/ Young Adults Steve Lipshultz, University of Miami 11:30 a.m. Break for Lunch SESSION 4: DATA GAPS Moderated by Joe Rodricks, Environ International 12:30 p.m. Panel Discussion on Data Gaps and Future Research Stephen Schaffer, University of South Alabama Christina Chambers, University of California, San Diego

APPENDIX A 173 Steve Lipshultz, University of Miami Regan Bailey, National Institutes of Health, Office of Dietary Supplements Amelia Arria, University of Maryland, College Park Alvin Bronstein, Rocky Mountain Poison Center 1:45 p.m. Chair’s Summary and Final Thoughts Lynn Goldman, George Washington University, Chair, Planning Committee on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements 2:00 p.m. Adjourn Meeting

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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.

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