A generation ago, kids got their caffeine fix from the usual suspects: sodas and chocolate. Now they have easy access to additional sources for a quick jolt: high-dose energy drinks and rocking coffee beverages. Pediatrician Francine Pearce is lost in translation with today’s “Starbucks generation”:

Iced, Half-Caff, Ristretto, Venti, 4-Pump, Sugar Free, Cinnamon, Dolce Soy Skinny Latte. Or Non-Fat Frappuccino with Extra Whipped Cream and Chocolate Sauce. Sorry, let me simplify: Triple, Venti, Soy, No Foam Latte.

 

Considering that the average adult consumes a moderate amount (300 mg) of caffeine a day (equivalent to 2-4 cups of coffee), children and teenagers often ingest “staggering” amounts of caffeine by consuming sodas, energy drinks, chocolate candy, and their favorite Starbucks beverage:

For example, the average soda contains 35-55 mg of caffeine. Energy drinks such as Red Bull, Amp, and Monster contain approximately 150 mg of caffeine. A tall (small) Starbucks coffee also contains about 150 mg of caffeine, and when we increase the size to a grande, then we are looking at 320 mg.

 

Dr. Pearce runs through the assorted adverse health effects of excessive caffeine consumption, including tooth decay and obesity caused by caffeinated sugar-sweetened beverages and candies:

The most concerning adverse effect is sleep deprivation. Physiologically, the circadian rhythm of adolescents changes and decreases the secretion of melatonin naturally, making it more difficult for them to fall asleep. With the addition of caffeine in high amounts, this is making falling asleep a greater challenge. Sleep deprivation leads to daytime sleepiness and inattention, resulting in learning issues.

Other ill effects found in some studies is that consumption of more than 220 mg of caffeine per day is associated with increased impulsivity, sensation seeking, and risk-taking behaviors. In people who are predisposed to arrhythmias, excessive intake can result in the onset of arrhythmias. Nervousness and jitteriness are other common effects.

 

In the final risk-benefit analysis of caffeine consumption in the pediatric population, Dr. Pearce agrees with the AAP’s decaffeinated guidelines:

Now, when caffeine is taken in small to moderate amounts, less than 300 mg, there are health benefits. It certainly does improve concentration by attaching to the adenosine receptors that block the adenosine effect of sedation on the brain. This leads to improved concentration, memory retention, auditory vigilance, and reaction time.

Recent studies have shown that caffeine in moderate amounts can protect against Alzheimer’s, and is linked to a small decreased risk of cancer and liver disease. Coffee drinkers have also shown a moderate decrease in Parkinson’s disease and stroke.

Regardless of the benefits of caffeine, the American Academy of Pediatrics has been very clear that it does not recommend caffeine in children. In its 2011 guideline, the extra calories, the risk of impulsive behavior, and sleep deprivation far outweighed any benefit that caffeine would have. It is critical that physicians educate their patients about foods that contain caffeine and the cumulative effect these foods have on their well-being, now and in the future.

 

 

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