Caffeine in Food and Dietary Supplements Examining Safety: Workshop Summary (2014) / Chapter Skim
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4 Exploring Safe Caffeine Exposure Levels for Vulnerable Populations
4 Exploring Safe Caffeine Exposure Levels for Vulnerable Populations
Pages 51-66
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From page 51... ...
BOX 4-1 Key Points Made by Individual Speakers As noted by Mark Feeley, on the basis of an extensive scientific eval uation conducted about 10 years ago, Health Canada recommended that individuals consume no more than 400 mg of caffeine daily. Since then, Health Canada has identified two potentially vulnerable subpopulations, women of reproductive age and children, and has further recommended that children consume no more than 2.5 mg of caffeine per kilogram body weight per day and that women of reproductive age consume no more than 300 mg a day.
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From page 52... ...
Steven Lipshultz described the efforts of a working group in South Flori da that was formed in 2007–2008 to see whether the safety signals being observed in children who had consumed caffeinated energy drinks were of concern. He identified children and children with underlying cardiac condi tions as two potentially vulnerable populations.
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From page 53... ...
Health Canada is currently exploring options for product labeling and consumer education as ways to control the intakes of caffeine below the recommended daily intakes. SAFE CAFFEINE EXPOSURE LEVELS IN VULNERABLE POPULATIONS: PREGNANT WOMEN AND INFANTS Presented by Christina Chambers, Ph.D., M.P.H., University of California, San Diego Christina Chambers listed several end points of interest with any exposure during pregnancy (i.e., not just caffeine)
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From page 54... ...
Finally, an important problem, especially with studying spontaneous abortion, is the change in usual caffeine consumption because of the symptoms of pregnancy. More than half of pregnant women experience nausea and vomiting, which, in turn, may lead to reduced caffeine consumption.
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From page 55... ...
They concluded that there was no evidence of an increased risk for spontaneous abortion with caffeine consumption at any level within the range of the study and that the association found among women who had already experienced spontaneous abortions was a spurious association resulting from recall bias. Despite these conflicting results, concern for risk of spontaneous abortion led the American College of Obstetrics and Gynecology to issue guidelines recommending that pregnant women restrict their caffeine intake to less than 200 mg per day.
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From page 56... ...
In sum, in Chambers' opinion, the evidence is not compelling enough to suggest that there is an increased risk for any specific pattern of congenital anomalies in humans with caffeine consumption in the range that women would typically consume. Nor have researchers found a consistent association between caffeine consumption during pregnancy and various measures of fetal growth, including increased risk for growth, small for gestational age, and low birth weight.
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From page 57... ...
Are wom en who consume energy drinks binge drinking? Is high caffeine consumption in an unrecognized pregnancy associated with poor dietary habits?
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From page 58... ...
emergency department visits involving caffeinated energy drink consumption in patients 12 years old and older. Those data, which were published in a 2011 DAWN report (SAMHSA, 2013)
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From page 59... ...
Furthermore, Lipshultz said, from 2005 to 2009, the New Zealand poison center reported 20 energy drink– or energy shot–related adverse events, including vomiting, nausea, abdominal pain, jitteriness, racing heart, agitation, and myocardial infarction. Between 2004 and 2010, the New South Wales Australian Poison Information Center reported increases in both recreational ingestions and accidental pediatric ingestions of caffeinated energy drinks (Gunja and Brown, 2012; see Figure 4-2)
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From page 60... ...
60 Recreational: intentional ingestion for the purpose of gaining euphoria or other psychotropic effect 50 Accidential paediatric: non-deliberate ingestion by a person under 18 years of age Number of Exposures 40 30 Recreational Accidental paediatric 20 10 0 2004 2005 2006 2007 2008 2009 2010 Year FIGURE 4-2 Calls regarding the intentional or accidental consumption of energy drinks to individual New South Wales, Australia, poison control centers, 2004–2010. SOURCE: Gunja and Brown, 2012.
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From page 61... ...
These specialists believed that children on either type of therapy should probably be advised not to consume caffeine from any source. High blood pressure, Lipshultz said, occurs in 3 to 5 percent of children in the United States, with 2.5 percent of NPDS calls for caffeinated energy drink consumption toxicity in the 2000–2013 period related to
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From page 62... ...
In addition, among adolescents with eating disorders, caffeine can potentially lead to adverse health outcomes. For children with underlying heart disease, any stimulant is of concern, whether it be a prescription medication or a caffeinated energy drink.
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From page 63... ...
The National Poison Data System: An Imperfect System An audience member commented on Dr. Lipshultz's observation that 51 percent of all reported energy drink poisonings involved children Slope before vs.
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From page 64... ...
Calls are being received by a variety of people that relate to temporal associations with these products. The next step is to verify those signals at "the next level of higher-quality science." When asked about the need for a national registry to track adverse events associated with caffeinated energy drink consumption or the need
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From page 65... ...
The commenter referred to a study showing that women who met diagnostic criteria for caffeine dependence were less likely to reduce caffeine consumption below the Health Canada recommended 300 mg daily. Although not familiar with any data on compliance, Chambers suspected that most pregnant women are not compliant.
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From page 66... ...
report: Update on emergency de partment visits involving energy drinks: A continuing public health concern. http://www.samhsa.gov/data/2k13/DAWN126/sr126-energy-drinks-use.pdf (accessed November 25, 2013)
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