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.

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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

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

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Willing is not enough; we must do.”      

                                                —Goethe

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              OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

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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.

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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

content of this workshop summary rests entirely with the rapporteurs and the institution.

Contents

ABBREVIATIONS AND ACRONYMS

1   INTRODUCTION

Background and Workshop Objectives

About This Report

The Past, Present, and Future of Caffeine Regulation in the United States

References

2   INTAKE AND EXPOSURE TO CAFFEINE

Caffeine Intake from Beverages in the United States

Various Aspects of Caffeine Intake in America: Analysis of NHANES

Panelist Discussion with the Audience

References

3   SAFETY SIGNALS AND SURVEILLANCE

Caffeine and Energy Drink Exposure Call Surveillance

Safety Assessment of Caffeine in Foods and Beverages

Panelist Discussion with the Audience

References

4   EXPLORING SAFE CAFFEINE EXPOSURE LEVELS FOR VULNERABLE POPULATIONS

Health Canada’s Approach

Safe Caffeine Exposure Levels in Vulnerable Populations: Pregnant Women and Infants

Risk of Adverse Effects of Caffeine and Caffeinated Products in Children and Other Vulnerable Groups

Panelist Discussion with the Audience

References

5   CAFFEINE EFFECTS ON THE CARDIOVASCULAR SYSTEM

Vascular Effects of Caffeine

Caffeine and Risk of Arrhythmia

Caffeine and Potential Risk of Hypertension

Panelist Discussion with the Audience

References

6   CAFFEINE EFFECTS ON THE CENTRAL NERVOUS SYSTEM AND BEHAVIORAL EFFECTS ASSOCIATED WITH CAFFEINE CONSUMPTION

Mechanisms of the Central Nervous System Effects of Caffeine

Developmental and Psychopharmacological Effects of Caffeine

Addictive Properties of Caffeine

DSM-5: Substance-Related and Addiction Disorders

Energy Drink Use and Risk Taking During Adolescence and Young Adulthood

Caffeine, Performance, and Well-Being

Panelist Discussion with the Audience

References

7   OTHER COMPOUNDS IMPACTING CAFFEINE EFFECTS

Interaction Between Energy Drink Ingredients and Caffeine

Panelist Remarks

Panelist Discussion with the Audience

References

8   PUBLIC COMMENTS

Richard H. Adamson, Ph.D., TPN Associates, LLC

Bob Arnot, M.D., Medical Advisor to Monster Beverage, Inc.

Joel Geerling, M.D., Ph.D., Harvard Medical School, Boston

John P. Higgins, M.D., M.B.A., University of Texas Medical School, Houston

Richard Kingston, Pharm.D., SafetyCall International, Bloomington, Minnesota

Emilia C. Lonardo, Ph.D., Grocery Manufacturers Association, Washington, DC

Rend Al-Mondhiry, J.D., Council for Responsible Nutrition, Washington, DC

J. Philip Saul, M.D., University of South Carolina, Mount Pleasant, and Consultant to the American Beverage Association

John R. White, Jr., Pharm.D., Washington State University, Spokane

References

9   MOVING FORWARD: FILLING THE DATA GAPS

Panelist Remarks

Panelist Discussion with the Audience

Reference

APPENDIXES

A   Workshop Agenda

B   Workshop Attendees

C   Biographical Sketches of Workshop Speakers and Moderators

D   Workshop Statement of Task

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Boxes, Figures, and Tables

BOXES

FIGURES

TABLES

Abbreviations and Acronyms