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Suggested Citation:"Front Matter." 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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Caffeine in Food and
Dietary Supplements

Examining Safety

WORKSHOP SUMMARY

Leslie Pray, Ann L. Yaktine, and Diana Pankevich, Rapporteurs

Planning Committee for a Workshop on Potential Health Hazards
Associated with Consumption of Caffeine
in Food and Dietary Supplements

Food and Nutrition Board

Board on Health Sciences Policy

INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
×

THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001

NOTICE: The workshop that is the subject of this workshop summary was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This activity was supported by Contract/Grant No. HHSF223200810020I between the National Academy of Sciences and the Department of Health and Human Services, Food and Drug Administration. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.

International Standard Book Number-13: 978-0-309-29749-3
International Standard Book Number-10: 0-309-29749-4

Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at www.iom.edu.

Copyright 2014 by the National Academy of Sciences. All rights reserved.

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The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine). 2014. Caffeine in food and dietary supplements: Examining safety: Workshop summary. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.
”      

                                                —Goethe

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INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. C. D. Mote, Jr., is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. C. D. Mote, Jr., are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." 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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PLANNING COMMITTEE FOR A WORKSHOP ON POTENTIAL HEALTH HAZARDS ASSOCIATED WITH CONSUMPTION OF CAFFEINE IN FOOD AND DIETARY SUPPLEMENTS1

LYNN R. GOLDMAN (Chair), Dean, School of Public Health and Health Sciences George Washington University, Washington, DC

JAMES R. COUGHLIN, President, Coughlin & Associates, San Diego, CA

STEPHEN R. DANIELS, Professor and Chair, Department of Pediatrics, University of Colorado, Aurora

THOMAS J. GOULD, Professor of Psychology, Department of Psychology, Director of the Neuroscience Program, Temple University, Philadelphia, PA

CARL L. KEEN, Professor and Chair, Department of Nutrition, University of California, Davis

STEVEN E. LIPSHULTZ, Professor and Chairman of Pediatrics and Endowed Chair in Pediatric Cardiology, Children’s Hospital of the University of Miami, FL

THERESA ANN NICKLAS, Professor, Department of Pediatrics, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX

BARBARA J. PETERSEN, Principal Scientist, Exponent, Inc., Washington, DC

JOSEPH V. RODRICKS, Principal, Environ International Corp., Arlington, VA

IOM Staff

ANN L. YAKTINE, Study Director

DIANA PANKEVICH, Senior Program Officer

JANET MULLIGAN, Research Associate

FAYE HILLMAN, Financial Associate

GERALDINE KENNEDO, Administrative Assistant

ANN L. YAKTINE, Interim Director, Food and Nutrition Board

ANDREW M. POPE, Director, Board on Health Sciences Policy

___________________

1Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." 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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Suggested Citation:"Front Matter." 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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Reviewers

This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:

ANNE BARNHILL, Perelman School of Medicine at the University of Pennsylvania

CINDY D. DAVIS, National Institutes of Health

JOHANNA T. DWYER, Tufts University Medical Center

CARL L. KEEN, University of California, Davis

NANCY S. WELLMAN, Florida International University

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by EILEEN T. KENNEDY, Tufts University. Appointed by the Institute of Medicine, she was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final

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Suggested Citation:"Front Matter." 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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content of this workshop summary rests entirely with the rapporteurs and the institution.

Suggested Citation:"Front Matter." 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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Suggested Citation:"Front Matter." 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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Suggested Citation:"Front Matter." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
×

Abbreviations and Acronyms

ADHD

attention deficit hyperactivity disorder

CDC

U.S. Centers for Disease Control and Prevention

COMT

catechol-O-methyltransferase

CRN

Council for Responsible Nutrition

DAWN

Drug Abuse Warning Network

DSM

Diagnostic and Statistical Manual

ECF

endothelial cell function

EFSA

European Food Safety Authority

FDA

U.S. Food and Drug Administration

GABA

gamma-aminobutyric acid

GRAS

generally recognized as safe

ILSI

International Life Sciences Institute

IOM

Institute of Medicine

MSN

medium spiny neuron

NHANES

National Health and Nutrition Examination Survey

NOAEL

no-observed-adverse-effect level

NPDS

National Poison Data System

PVC

premature ventricular complex

Suggested Citation:"Front Matter." Institute of Medicine. 2014. Caffeine in Food and Dietary Supplements: Examining Safety: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18607.
×

QT

Q-T wave

RACC

reference amount customarily consumed

SHADE-ONE

Study of Heart Effects from Adults Drinking Energy Beverages: On Endothelial Function

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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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