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Caffeine (cont.)

Medical Editor:

Should caffeine be consumed by children?

With the increased popularity of coffee shops, a new generation of caffeine consumers was born. Children are being exposed to caffeine with products designed specifically to target them as early as 4 years of age. With the increase in caffeine-containing products, children can now be consuming as much caffeine as some adults. Could this trend be harming children?

Children and adolescents are the fastest growing population of caffeine users, with a large increase in the amount that they consume over the past 30 years. It is estimated that the average caffeine intake for children 2-11 years of age is 0.4 mg per kg of body weight each day, and those 12-17 years of age consume 0.55 mg/kg per day. This is almost half of what adults consume (1.3 mg/kg). These numbers are averages, so there are children and adolescents who are consuming even more than adults. The difference with adults and children is that there is research to show how much is acceptable for adults and what impact it will have on them when they go above that, but that is not the case with children. We can't be sure of the short-term or long-term effects of this kind of exposure to caffeine.

The Centers for Disease Control and Prevention's School Health Policies and Practices Study (SHPPS) 2000 survey concluded that 43% of elementary schools, 89.4% of middle/junior high, and 98.2% of senior high schools had a vending machine or a school store, canteen, or snack bar where students could purchase foods or beverages. The trend in milk consumption has declined over time, while soft drink consumption has risen. Studies have shown that children 2-18 years of age who consume over 9 oz of soda per day drink less milk and juice and end up consuming about 200 calories more each day compared to infrequent soda drinkers. Fortunately, this problem has gained a great deal of recognition, and some states have now enacted legislation to replace existing food and drinks of minimal nutritional value for healthier options or to restrict student access to the machines.

Companies are aware of the growing population of young caffeine drinkers. There are now products being marked directly to them. Energy drinks are the fastest growing segment of the beverage industry, and their marketing is often geared toward children and adolescents. Their caffeine content can be up to five times the amount of caffeine in one cup of coffee! Caffeine is also being added to water, gum, candy bars, potato chips, and oatmeal. A web site for a caffeine-containing gum makes this marketing statement:

"Each pack contains 12 pieces -- the energy/alertness boost of six coffees. Doing the math for you, a dozen packs contain a "makes-you-the-most-popular-kid-on-the block" 144 pieces of gum (72 cups of coffee). And you may be able to get Art History 101 credit by chewing Spearmint Gum. Each piece is a brilliant shiny white with green Jackson Pollock-ish speckles."

With all of these products, just imagine how easy it would be for a child to consume dangerous amounts of caffeine without anyone even realizing it. We have evidence for how much is fatal for an adult but do not know what that would be for a child.

The effect of caffeine on children's moods and behavior is another concern. In a study done by the National Institute of Mental Health, 8- to 13-year-olds who regularly consumed high doses of caffeine were judged to be more restless by teachers, and one-third were hyperactive enough to meet the criteria for attention deficit disorder with hyperactivity (ADHD). A Stanford study of fifth- and sixth-graders deprived of daily caffeine reported them as having symptoms that included trouble thinking clearly, not feeling energetic, and getting angry. These symptoms were even reported by children who typically consume 28 mg of caffeine a day. The research in this area is somewhat limited, but the studies that have been conducted are compelling enough to warrant restricting caffeine intake in children to as little as possible. If there is no nutritional need for caffeine, why take the risk and allow children to consume it?


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