Energy on the Rise – Caffeine Intake in Children and Adolescents

By Jessica Lieb, RD, LDN, Children’s Hospital of Pittsburgh of UPMC

Jessica_Lieb_0200Sleek colorful cans. Celebrity endorsements. And promises to “Give you Wiiings,” “Party like a Rockstar,” “Unleash the Beast,” “Elevate your Performance,” and “Go Fast.” Or how about a nice warm espresso macchiato while studying for finals or an iced caffé mocha on a hot day while socializing with friends at the nearest Starbucks or Crazy Mocha?

It’s no wonder caffeine, one of the most popular drugs in our country, has become so enticing for kids.

A study released earlier this year by the American Academy of Pediatrics (AAP) looked at trends in caffeine intake among children and adolescents in the Unites States, finding that 73 percent of children consume caffeine on a given day. That equals three out of every four children. Soda still makes up the majority of this intake, but coffee and energy drinks are quickly on the rise.

Caffeine is a central nervous system and heart muscle stimulant. Excess consumption of caffeine has been found to result in increased blood pressure, decreased heart rate, insomnia, hyperactivity, inability to focus, anxiety and decreased appetite. Although considered a safe substance by the FDA, adverse side effects and dosage limits remain unknown, especially for the pediatric population.

Another recent study published by the AAP, and now being talked about in the news, found gender differences in cardiovascular response to caffeine, even with moderate doses, in post-pubertal boys and girls, showing boys having a greater response than girls. It also revealed differences in cardiovascular response to caffeine across the menstrual cycles of post-pubertal girls. This study affirms the already known response caffeine has on children in general (increasing blood pressure and decreasing heart rate) even with doses equivalent to just one 12 ounce can of soda or two cups of regular coffee. It also sheds light on new findings that hormonal changes of puberty and sexual maturity may affect the way boys and girls metabolize caffeine. Further research is needed to determine why these differences occur; but how will these results affect recommendations of pediatric health care professionals? Should they at all?

There are currently no guidelines from the Dietary Guidelines for Americansor the Institute of Medicine for caffeine intake as a nutrient. This could be because there is no nutritional need for caffeine with regards to healthy growth and development of a child. For the pediatric population, the risks far outweigh the presumed benefits.

From a medical standpoint, the risks of heart muscle stimulation are apparent. But from a nutritional standpoint, caffeine-containing beverages pose hidden risks that parents and even healthcare professionals may not be aware of.

Caffeine-containing beverages like soda, coffee and energy drinks are loaded with added7816398_web sugar, offering kids empty calories. They are void of essential nutrients like protein, calcium, vitamins D, A and B12, zinc and riboflavin. When caffeinated beverages make their way into a child or adolescent’s diet, intake of beneficial fluids like water, milk and a limited amount of 100 percent juice declines. This increases the risk of both obesity and overall malnutrition. Caffeine also suppresses the appetite, placing children at risk for skipping meals and suboptimal intake of nutrient rich foods.

Children and adolescents with cardiovascular issues like hypertension or those with sleep problems should abstain from all forms of caffeine intake. Further, it is my professional recommendation that all children and adolescents abstain from caffeine-containing beverages like soda, coffee and energy drinks until they are well beyond puberty. For adults, as with all things, caffeine should be consumed in moderation.

Although it may be a challenge, it is certainly never too late to change the diet of a growing and developing child. Caffeine intake should be weaned gradually over a period of a few weeks to prevent unpleasant side effects of withdrawal that can include headache, irritability, lethargy, constipation and depression.

Decrease your child or patient’s intake of caffeinated beverages by one beverage per week, replacing fluid intake with water, milk and a limited amount of 100 percent juice. It is also important to encourage a consistent sleep schedule to allow for optimal rest and energy replenishment.

For more information or to make an outpatient appointment for nutrition counseling, please visit: www.chp.edu/CHP/nutritionalclinic