Teens and Caffeine – Is There Cause For Concern?
I did not actually drink coffee until two years into my Pediatric residency training. I never needed it in college or medical school, but once I entered my Pediatric ICU rotations, caffeine became a necessity in order to stay awake and functioning through my shifts. Given the length of time it took for me to need coffee, it always surprises me when teenagers tell me about drinking coffee in the mornings, or grabbing a specialty coffee after school. Many parents ask if coffee is “bad” for their teens, and now that I have a teenager who enjoys sneaking sips of my own coffee drinks, I realized it was a question that needed to be fully addressed.
The question is more complicated than simply, “can teens drink coffee,” however. The root of the issue is really caffeine intake and its potential effects on the developing body and brain.
Negative effects of caffeine
Caffeine is used to increase wakefulness of the brain. Like any substance that has effects on the brain, caffeine is dose-dependent. It is largely accepted that low to moderate intake of caffeine is safe for children and adults. However, higher or larger doses can lead to significant side effects.
Sleep: Many people treat a lack of sleep with caffeine, which makes sense as one of its many benefits is to help individuals wake up. Unfortunately, this can also lead to difficulties obtaining good, restful sleep. Higher doses of caffeine, or ingesting moderate doses later in the day, may lead to decreases in total sleeping time and increased time to fall asleep. This can lead to increased caffeine ingestion the next day…which leads to another night of poor sleep…you get the idea.
Anxiety: caffeine works by blocking the effects of a chemical in the brain that makes you feel tired. At the same time, it triggers the release of adrenaline, which fuels the “fight-or-flight” response in the body. Higher doses of caffeine increase this adrenaline response, which can lead to significant anxiety, restlessness, and nervousness.
Increased blood pressure: though caffeine has not been shown to increase cardiovascular disease, it has been shown to raise blood pressure due to stimulation of the nervous system. This makes sense – in the “fight or flight” response adrenaline increases, and a natural result of that is increases in blood pressure. This effect does seem to be transient and has the largest effect on individuals who do not regularly consume caffeine.
Increased heart rate: similarly to increases in blood pressure, large doses of caffeine stimulates an increased heart rate.
Rebound fatigue: despite its effects on wakefulness, once the caffeine leaves the system it can cause a significant rebound in fatigue and increased sleepiness. This is especially true when consumed in moderate to large doses.
Gastrointestinal upset: caffeine acts as a motility agent for the gut. In other words, it stimulates gut movement and in higher doses can produce diarrhea.
What about growth?
It is a common belief that drinking coffee at a younger age will “stunt your growth.” This has been studied extensively and found to be untrue. Height potential is primarily determined by genetics – in other words, how tall mom and dad are is much more important in final height than anything else. Optimal nutrition is important as well, but drinking coffee (and therefore caffeine) has not been shown to cause an impact on growth.
Caffeine limits?
Consuming up to 400mg of caffeine daily is considered to be safe for adults, but there are no standard guidelines for consumption in children. It is recommended by the American Academy of Pediatrics to keep caffeine intake in adolescents below 100mg daily. There is no recommended intake for children under age 12 years.
Regardless of guidelines, however, it is important to remember that individual caffeine tolerance and responses may vary, and smaller amounts may produce more side effects in certain individuals.
Unfortunately, you may consume more caffeine than you realize throughout the day. The amount of caffeine in particular drinks varies widely.
Soda: citrus-flavored brands have none, while cola brands contain 20-50mg per can
Coffee: average for a cup of brewed coffee is 100mg, however this varies widely based on the type of beans and size of cup. Lighter roasts have more caffeine than darker roasts. Keep in mind that the average of 100mg per cup is for 8oz. Many coffee shops sell 12, 16, 20oz or more “cups” of coffee, providing caffeine doses of 150, 200, or upwards of 300-400mg in one drink!
Espresso typically has about 60mg per serving. Espresso-based drinks (cappuccino, latte, macchiato) usually contain 1-2 servings of espresso.
Tea: The type of tea determines the caffeine content. Herbal teas are essentially caffeine-free. White teas have 10-15mg, green 15-30mg, oolong 30-45mg, and black teat 60-70mg.
Energy drinks: these range from 160mg to over 300mg per bottle. Manufacturers are not required to disclose caffeine amounts on the nutritional information.
A note about energy drinks and teens
There is a very real risk of compounded caffeine ingestion in teens, as they regularly drink coffee, sodas, and energy drinks. Some teens drink multiple energy drinks in a day, providing a caffeine load that is way over any recommended amounts. These drinks specifically appeal to teens – fun names and colors, directed advertising, sweet tastes. This became very evident in 2017 when a previously healthy teen in South Carolina collapsed and died during class due to a caffeine-induced cardiac event. A high dose of caffeine in a short amount of time caused an abnormal heart rhythm, called an arrhythmia, that led to his death. In this particular case, the teenager had consumed a cafe latte, a large Mountain Dew, and an energy drink all within a two hour period. He had no underlying medical conditions, no heart disease, and no signs of other drugs or alcohol in his system.
Just caffeine.
But because caffeine is not thought of as a “drug” most teens – and parents – do not pay attention to how much they are consuming daily. Unfortunately, younger individuals – ie, adolescents – are usually mores sensitive to the negative effects of caffeine. Most notably anxiety, diarrhea, and dehydration.
The risks are even more significant when teens combine energy drinks and alcohol. This leads to a higher level of alertness while drinking, which usually means a higher overall alcohol consumption, poor decision-making, and increased risky behaviors.
Final thoughts
Like any substance that acts on the brain, caffeine can be used in positive ways if done carefully. Promoting alertness and wakefulness are helpful when used in moderation. Staying up late into the night and using a morning cup of coffee or bottle of energy drink is NOT using caffeine safely or in an effective way.
As mentioned, teens are at a higher risk of overdoses of caffeine given the variety of sources they typically obtain it from. Talk to your teens about their caffeine drinking habits. Make them aware of the negative effects of high doses of caffeine and how easily it is for them to consume large doses in a short amount of time. Encourage regular bedtimes, adequate sleep, and daily exercise rather than morning caffeine eye-openers. This doesn’t mean you can’t grab a cup of coffee or specialty drink with your teen at the local coffee shop, if that is something you enjoy doing together. It just means you and they need to pay attention to exactly how much caffeine is IN that cup.
Resources
https://cspinet.org/eating-healthy/ingredients-of-concern/caffeine-chart
https://www.cnn.com/2017/05/15/health/teen-death-caffeine/
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