Subjective Responses to Caffeine Are Influenced by Caffeine Dose, Sex, and Pubertal Stage

Urinary caffeine and its metabolites in association with advanced liver fibrosis and liver steatosis: a nationwide cross-sectional study

Aim: This study used urinary caffeine and its metabolites to evaluate their relationships with liver steatosis and advanced liver fibrosis. Methods: A total of 2068 adult participants with required data were filtered from the 2009-2014 National Health and Nutrition Examination Survey (NHANES) cycles. Non-invasive scores were applied to define liver steatosis and advanced liver fibrosis. Logistic regression models, weighted quantile sum (WQS) regression models, quantile-based g-computation (QG-Comp) models, and restricted cubic spline (RCS) regression models were used to assess the associations of urinary caffeine and its metabolites with liver steatosis and advanced liver fibrosis. A series of additional analyses were conducted to examine the subgroup-specific differences and test the robustness of the observed results. Results: The major caffeine metabolite mixture and most individual caffeine metabolites were found to be negatively associated with the risk of advanced liver fibrosis with subgroup-specific variations. Only 7-MX consistently showed a negative association with liver steatosis in all analyses, while no association was observed between the major caffeine metabolite mixture and liver steatosis. Conclusion: The major caffeine metabolite mixture and most individual urinary caffeine metabolites exhibited inverse associations with advanced liver fibrosis with subgroup differences. Further prospective and experimental studies are urgently needed to verify our results and further identify the possible mechanisms.

Acute effects of caffeine supplementation on taekwondo performance: the influence of competition level and sex

The purpose of this study was to assess the effects of acute caffeine supplementation on physical performance and perceived exertion during taekwondo-specific tasks in male and female athletes with varying expertise. In a double-blinded, randomized, placebo-controlled crossover study design, 52 young athletes from elite (n = 32; 16 males and 16 females) and sub-elite competitive level (n = 20; 10 males and 10 females) participated. Athletes performed taekwondo-specific tasks including the taekwondo-specific agility test (TSAT), 10 s frequency speed of kick test (FSKT-10 s) and multi-bout FSKT (FSKT-multi) under the following conditions: (1) Caffeine (CAF; 3 mg kg-1), placebo (PLA), and no supplement control (CON). Session rating of perceived exertion (s-RPE) was determined after the tests. Findings show that regardless of condition, males performed better than females (p < 0.05) and elite athletes had superior performance compared to their sub-elite counterparts (p < 0.05). For the TSAT (p < 0.001), FSKT-10s (p < 0.001), and FSKT-multi (p < 0.001), CAF enhanced performance in elite female athletes compared to sub-elite females. Likewise, CAF ingestion resulted in superior performance in elite males compared to sub-elite males for FSKT-10s (p = 0.003) and FSKT-multi (p < 0.01). The ergogenic potential of CAF during taekwondo-specific tasks appears to be related to a competitive level, with greater benefits in elite than sub-elite athletes.

Effects of Caffeine and Caffeinated Beverages in Children, Adolescents and Young Adults: Short Review

The prevalence of ED consumption has increased over the past 10–15 years. Studies describing the effects of caffeine and caffeinated beverages show confusing results, so it seems important to regularly summarize the available facts, and in more detail. By a thorough analysis of more than 156 scientific papers, the authors describe the molecular background of absorption, as well as the positive and negative effects of different dosages of caffeine, just like its effects in physical activity and performance. ED and EDwA consumption is a regular habit of not only adults, but nowadays even of children and adolescents. There are no safe dosages described of caffeine or ED consumption for children. There are no positive short- or long-term effects of these compounds/products concerning developing brain functions, psycho-motor functions, or social development. Instead, there are many unpleasant side effects, and symptoms of regular or higher-dose ED consumption, especially at younger ages. This mini review describes many details of these unpleasant side effects, their severity, and motivations for consuming these compounds/products. In a quantitative research in Hungary (10–26 years, mean age: 15.6 ± 3.8 y, 1459 subjects, randomly chosen population), a survey based on a questionnaire asking people about their ED consumption habits was conducted. According to the data, 81.8% of the participants consumed EDs at least once, and 63.3% tried several products of the kind. A positive correlation was found between age and consumption (p < 0.001). The results show that a high proportion of this group often consumed EDwA, in many cases leading to harmful side-effects of caffeine overdose. In a sample of Hungarian high school and college students (17–26 years), ED consumption matched the international data, and only 19.7% of respondents did not use EDs at all (had never tasted an ED in their life).

Caffeine enhances sustained attention among adolescents

Despite the growing interest in caffeine use and its effects among adolescents, and a large literature on caffeine and attention among adults, there is a lack of experimental work examining the impact of caffeine on sustained attention among adolescents. We evaluated the acute effects of caffeine (vs. placebo) during a long (33-min) classic vigilance task among 31 adolescents (aged 12-17; 15 female; median caffeine use = 28 mg/day). We predicted a dose-dependent effect of caffeine, which would attenuate declines in target detection over time (i.e., a vigilance decrement). In each of 3 visits, participants completed an identical pairs continuous performance task beginning ∼25 min after consumption of noncaloric flavored water containing placebo, 1 mg/kg, or 3 mg/kg caffeine (order counterbalanced). Percent hits for low probability targets across 12 100-trial blocks was the primary outcome measure. As predicted, the linear decline in hits across trial blocks was attenuated by caffeine (Caffeine vs. Placebo × Block Linear, p = .01), with significant improvements in Blocks 9-12 (ps < .03). Compared to 1 mg/kg, 3 mg/kg caffeine resulted in earlier improvement in target detection (Drug Dose × Block Quadratic, p = .001). This study demonstrated that caffeine acutely and dose-dependently improves sustained attention among adolescents. These results were likely due to the attention-enhancing effect of caffeine, rather than withdrawal reversal, as our sample was characterized by light to moderate caffeine use. This study provides the foundation for further work on the impact of chronic caffeine consumption on cognitive function during adolescence. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Energy drink consumption, psychological distress, and suicidality among middle and high school students

BACKGROUND

Previous research has found links between energy drink consumption and mental health outcomes in youth. However, little is known about the factors that could moderate these relationships. The present study examined the associations between energy drink consumption and psychological distress, suicidal thoughts, and suicide attempts among adolescents, and tested whether sex and school type (i.e. middle vs. high school) would moderate these associations.

METHODS

Data on students in grades 7 through 12 was obtained from the 2017 Ontario Student Drug Use and Health Survey (N  =  5,538). Multivariable Poisson regression analyses were used to examine associations between energy drink consumption and mental health outcomes. Analyses were weighted and adjusted for the complex survey design.

RESULTS

Energy drink consumption was associated with greater risk of moderate to serious (adjusted incidence rate ratio (IRR) 1.19, 95% confidence interval (CI) 1.03-1.37) and serious (IRR: 1.45, 95% CI: 1.13-1.86) levels of psychological distress, suicidal thoughts (IRR: 1.98, 95% CI: 1.62-2.42), and suicide attempts (IRR: 3.67, 95% CI: 2.26-5.95). The association between energy drink consumption and mental health outcomes was much stronger among boys and middle school students.

LIMITATIONS

The cross-sectional nature of the data precludes causal inferences and there is possibility of bias related to self-reports.

CONCLUSIONS

Energy drink consumption among adolescents is strongly and differentially associated with mental health problems among male and female middle and high school students. Future research is necessary to replicate and disentangle the observed differences in more detail to inform the development of tailored interventions.

Ergogenic effects of caffeine on peak aerobic cycling power during the menstrual cycle

PURPOSE

Recent investigations have established that the ingestion of a moderate dose of caffeine (3-6 mg kg^-1) can increase exercise and sports performance in women. However, it is unknown whether the ergogenicity of caffeine is similar during all phases of the menstrual cycle. The aim of this investigation was to determine the ergogenic effects of caffeine in three phases of the menstrual cycle.

METHODS

Thirteen well-trained eumenorrheic triathletes (age = 31 ± 6 years; body mass = 58.6 ± 7.8 kg) participated in a double-blind, cross-over, randomised experimental trial. In the (1) early follicular (EF); (2) preovulation (PO); (3) and mid luteal (ML) phases, participants either ingested a placebo (cellulose) or 3 mg kg^-1 of caffeine in an opaque and unidentifiable capsule. After a 60-min wait for substance absorption, participants performed an incremental maximal cycle ergometer test until volitional fatigue (25 W/min) to assess peak aerobic cycling power (Wmax).

RESULTS

In comparison to the placebo, caffeine increased Wmax in the EF (4.13 ± 0.69 vs. 4.24 ± 0.71 W kg^-1, Δ = 2.7 ± 3.3%, P = 0.01), in the PO (4.14 ± 0.70 vs. 4.27 ± 0.73 W kg^-1, Δ = 3.3 ± 5.0%; P = 0.03) and in the ML (4.15 ± 0.69 vs. 4.29 ± 0.67 W kg^-1, Δ = 3.6 ± 5.1%; P = 0.01) phases. The magnitude of the caffeine ergogenic effect was similar during all of the menstrual cycle phases (P = 0.85).

CONCLUSION

Caffeine increased peak aerobic cycling power in the early follicular, preovulatory, and mid luteal phases. Thus, the ingestion of 3 mg of caffeine per kg of body mass might be considered an ergogenic aid for eumenorrheic women during all three phases of the menstrual cycle.

The Effect of Caffeine on the Velocity of Half-Squat Exercise during the Menstrual Cycle: A Randomized Controlled Trial

Recent literature confirms the ergogenic effect of acute caffeine intake to increase muscle strength and power in men. However, the information about the effect of caffeine on muscle performance in women is uncertain and it is unknown whether its ergogenicity is similar during the menstrual cycle. The goal of this investigation was to assess the effect of acute caffeine intake on mean and peak velocity of half-squat exercise during three different phases of the menstrual cycle. Thirteen trained eumenorrheic athletes (age = 31 ± 6 years; body mass = 58.6 ± 7.8 kg) participated in a double-blind, crossover and randomized experimental trial. In the early follicular (EFP), late follicular (LFP) and mid luteal phases (MLP), participants either ingested a placebo (cellulose) or 3 mg/kg/bm of caffeine in an opaque and unidentifiable capsule. In each trial, participants performed a half-squat exercise at maximal velocity with loads equivalent to 20%, 40% 60% and 80% of one repetition maximum (1RM). In each load, mean and peak velocity were measured during the concentric phase of the exercise using a rotatory encoder. In comparison to the placebo, a two-way ANOVA showed that the ingestion of 3 mg/kg/bm of caffeine increased mean velocity at 60% 1RM in EFP (Δ = 1.4 ± 2.7%, p = 0.04; ES: 0.2 ± 0.2) and LFP (Δ = 5.0 ± 10.4%, p = 0.04; ES: 0.3 ± 0.4). No other statistical differences were found for the caffeine-placebo comparison for mean velocity, but caffeine induced an ergogenic effect of small magnitude in all of the menstrual cycle phases. These results suggest that the acute intake of 3 mg/kg/bm of caffeine induces a small effect to increase movement velocity during resistance exercise in eumenorrheic female athletes. The positive effect of caffeine was of similar magnitude in all the three phases of the menstrual cycle.

Acute caffeine supplementation promotes small to moderate improvements in performance tests indicative of in-game success in professional female basketball players

The aim of this study was to determine the effect of acute caffeine supplementation on anaerobic performance in professional female basketball players. A double-blind, placebo-controlled, experimental design was used in a randomized counterbalanced manner. In separate sessions, 10 professional basketball players ingested caffeine (3 mg/kg body mass) or a placebo (dextrose: 3 mg/kg body mass) 60 min before completing countermovement jumps (CMJ) with and without arm swing, a squat jump (SJ), the Lane Agility Drill, 20-m sprints (with 5-m and 10-m split times recorded) with and without dribbling a ball, and a suicide run. Participants provided ratings of perceived exertion (RPE) and ratings of perceived performance 30 min following testing. Data analyses included the use of effect size (ES) and significance. Caffeine supplementation produced small nonsignificant (p > 0.05) increases in CMJ without arm swing (ES = 0.30), CMJ with arm swing (ES = 0.29), SJ (ES = 0.33), and the lane agility drill (ES = -0.27). Caffeine supplementation produced small to moderate significant improvements in 10-m (ES = -0.63; p = 0.05) and 20-m (ES = -0.41; p = 0.04) sprint times without dribbling. Caffeine supplementation promoted a moderate significant reduction in RPE during the test battery (ES = -1.18; p = 0.04) and a small nonsignificant improvement in perceived performance (ES = 0.23; p = 0.53). Acute caffeine supplementation may produce small to moderate improvements in key performance attributes required for basketball while reducing RPE.

Review: Trends, Safety, and Recommendations for Caffeine Use in Children and Adolescents

OBJECTIVE

Caffeine use is common in children and adolescents, but the recommendations for safe consumption are based on decades-old data collected exclusively in adults. Increased availability of caffeine-containing products and a concerted marketing effort aimed at children and adolescents, has increased interest in understanding the physiological, behavioral, and psychological effects of caffeine within this population. This manuscript provides a review of the literature concerning trends and safety of ingested caffeine in children and adolescents.

METHOD

A search of the National Library of Medicine database was conducted using the terms caffeine, children, adolescents, and safety, in addition to tailored searches on specific topics using combinations of search terms such as energy drinks, cardiovascular, mood, cognitive, mental health, sleep, and regulations.

RESULTS

The majority of the literature reviewed here suggests that typical, moderate caffeine consumption in children and adolescents is relatively safe, but that higher doses of caffeine consumption (>400 mg) can cause physiological, psychological, and behavioral harm, in particular in subgroups of children, such as those with psychiatric or cardiac conditions. More attention is being paid to the potential adverse effects of both acute and chronic caffeine use, and additional regulations surrounding the sale and marketing of highly caffeinated beverages are now being considered.

CONCLUSION

More research is needed to fill in gaps in our knowledge, including understanding the relationship between caffeine use and initiation of other substances, such as cigarettes, alcohol, or marijuana, identifying individuals at risk for caffeine toxicity, and developing harm-reduction strategies.

"Let's talk about sleep": a qualitative examination of levers for promoting healthy sleep among sleep-deprived vulnerable adolescents

OBJECTIVE

Deficient sleep is highly prevalent in disadvantaged adolescents and contributes to a range of adverse health and behavioral outcomes. We examined mediating mechanisms and strategies that adolescents adopt to improve sleep, and possible levers for promoting sleep in this population.

METHODS

We conducted three focus groups (N = 27 total, age 14-18 years) in adolescents living in low- and middle-income racially/ethnically diverse neighborhoods of Boston, Massachusetts. Participants completed a survey on their sleep and health habits prior to the moderator-led discussions. Discussions were audio-recorded, transcribed, and thematically analyzed.

RESULTS

The study population did not meet the minimum sleep recommendations, and we found a high prevalence of "social jet-lag." We also identified a disconnect between the acknowledgment of the importance of sleep and actual behavior, especially for electronic use. Phone use and screen time were the most commonly cited barriers to a good night's sleep, along with caffeine consumption, which was also high in this sample. There was also a general lack of awareness of sleep hygiene practices and recommendations. Participants reported regulating food intake and physical activity, using allopathic sleep aids, creating a comfortable sleeping environment, and a routine as some strategies to improve sleep.

CONCLUSION

Results from this study suggest facilitating the linkage between participant-generated mediating factors and strategies for better-designed interventions. These include making the negative impact of sleep on health more explicit, improving youth awareness about sleep hygiene, targeting caffeine consumption and electronic use, and introducing sleep recommendations through appropriate and effective channels.

Sex differences in the effects of pre- and postnatal caffeine exposure on behavior and synaptic proteins in pubescent rats

Few studies have addressed the effects of caffeine in the puberty and/or adolescence in a sex dependent manner. Considering that caffeine intake has increased in this population, we investigated the behavioral and synaptic proteins changes in pubescent male and female rats after maternal consumption of caffeine. Adult female Wistar rats started to receive water or caffeine (0.1 and 0.3g/L in drinking water; low and moderate dose, respectively) during the active cycle at weekdays, two weeks before mating. The treatment lasted up to weaning and the offspring received caffeine until the onset of puberty (30-34days old). Behavioral tasks were performed to evaluate locomotor activity (open field task), anxious-like behavior (elevated plus maze task) and recognition memory (object recognition task) and synaptic proteins levels (proBDNF, BDNF, GFAP and SNAP-25) were verified in the hippocampus and cerebral cortex. While hyperlocomotion was observed in both sexes after caffeine treatment, anxiety-related behavior was attenuated by caffeine (0.3g/L) only in females. While moderate caffeine worsened recognition memory in females, an improvement in the long-term memory was observed in male rats for both doses. Coincident with memory improvement in males, caffeine increased pro- and BDNF in the hippocampus and cortex. Females presented increased proBDNF levels in both brain regions, with no effects of caffeine. While GFAP was not altered, moderate caffeine intake increased SNAP-25 in the cortex of female rats. Our findings revealed that caffeine promoted cognitive benefits in males associated with increased BDNF levels, while females showed less anxiety. Our findings revealed that caffeine promotes distinct behavioral outcomes and alterations in synaptic proteins during brain development in a sex dependent manner.

Reinforcing Value of Caffeinated and Noncaffeinated Beverages After Acute Exposure in Children and Adolescents

Background: When caffeine is added to beverages, it increases beverage liking and the relative reinforcing value (RRV) of these beverages after repeated exposure. The purpose of this study was to test the hypothesis that a single acute exposure to caffeine increases liking and motivation to consume sugar-sweetened beverages (SSBs) relative to placebo. Methods: Participants were children ages 8-9 years (n = 36) and adolescents ages 15-17 years (n = 41) with an approximately equal number of boys and girls. A double-blind, placebo-controlled crossover study was conducted where participants sampled a SSB containing caffeine (1 and 2 mg/kg) on one visit and placebo (quinine 0.01 and 0.02 mg/kg) on a second visit day and then, on a third visit, played a computer game to earn points for the beverages and rated liking and taste sensations. They returned to the laboratory after a 1-week washout and had the alternate dose combination. Results: Acute exposure to the higher dose of caffeine increased the RRV of the SSB relative to placebo, but only when that dose was presented in the first week and only in female participants. The liking of the caffeine-containing SSB at the higher dose was lower than the placebo at all time points. Conclusions: These data suggest that a single exposure to a caffeinated SSB can impact its RRV and liking, but only under certain conditions and only in females. This supports previous work suggesting that caffeine can increase desire to consume SSB.

Caffeinated energy drink consumption among adolescents and potential health consequences associated with their use: a significant public health hazard

Caffeinated energy drinks (EDs) are increasingly popular among adolescents despite growing evidence of their negative health effects. The consumption of EDs has seen a substantial increase during the past few decades, especially in the Western and Asian countries. EDs contain high levels of caffeine, sugar, and novel ingredients, and are often marketed through youth-oriented media and venues. The known and unknown pharmacology of the constituents of EDs poses a risk of caffeine toxicity and other ill effects when consumed by young people. Caffeine intoxication may result in tachycardia, vomiting, cardiac arrhythmias, seizures, and even death. Other health concerns related to consumption of EDs include obesity and dental enamel erosion resulting from the acidity of EDs. Coingestion of caffeine and ethanol has been associated with increased risk-taking behaviors in adolescent users, impaired driving, and increased use of other illicit substances. Several researchers have demonstrated that consuming alcohol mixed with energy drinks leads to altered subjective states including decreased perceived intoxication, enhanced stimulation, and increased desire to drink/increased drinking compared to consuming alcohol alone. Caffeine’s effect on intoxication may be most pronounced when mixers are artificially sweetened, that is, lack sucrose which slows the rate of gastric emptying of alcohol. In conclusion: 1) health care providers should educate youth and their parents about the risks of caffeinated drinks; 2) emergency department clinicians should consider asking patients about ED and traditional caffeine usage and substance use when assessing patient symptoms; 3) policy makers should increase their attention on introducing regulatory policies on television food advertising to which youth are exposed; 4) failure to comply with standards for efficacious product labelling, and absence of broader education regarding guidelines, need to be addressed and 5) further studies must be done to improve our understanding of potential negative consequences of caffeinated energy drinks on health. (www.actabiomedica.it)

The Safety of Ingested Caffeine: A Comprehensive Review

Caffeine is the most widely consumed psychoactive drug in the world. Natural sources of caffeine include coffee, tea, and chocolate. Synthetic caffeine is also added to products to promote arousal, alertness, energy, and elevated mood. Over the past decade, the introduction of new caffeine-containing food products, as well as changes in consumption patterns of the more traditional sources of caffeine, has increased scrutiny by health authorities and regulatory bodies about the overall consumption of caffeine and its potential cumulative effects on behavior and physiology. Of particular concern is the rate of caffeine intake among populations potentially vulnerable to the negative effects of caffeine consumption: pregnant and lactating women, children and adolescents, young adults, and people with underlying heart or other health conditions, such as mental illness. Here, we review the research into the safety and safe doses of ingested caffeine in healthy and in vulnerable populations. We report that, for healthy adults, caffeine consumption is relatively safe, but that for some vulnerable populations, caffeine consumption could be harmful, including impairments in cardiovascular function, sleep, and substance use. We also identified several gaps in the literature on which we based recommendations for the future of caffeine research.

Effects of acute and chronic caffeine on risk-taking behavior in children and adolescents

Consumption of caffeinated beverages is associated with increased risk-taking behavior. The purpose of this study was to determine if acute caffeine administration influences risk-taking behavior in a dose-dependent manner. Participants were pre- (ages 8-9) and post-pubertal (ages 15-17) children who visited the laboratory three times and consumed a beverage containing 0, 1, or 2 mg/kg of caffeine. Thirty minutes later, participants completed the balloon analogue risk task (BART), the Iowa gambling task (IGT), and a delay discounting task. The number of balloons exploded on the BART task was significantly increased after 2 mg/kg of caffeine in moderate caffeine consumers, but was decreased after 2 mg/kg of caffeine in high caffeine consumers. There were no main effects of caffeine dose on the delay discounting task or on the IGT. Post-pubertal participants showed reduced delay discounting compared with pre-pubertal participants. Finally, average daily caffeine use was significantly, positively correlated with scores on a risk-taking questionnaire. These data suggest that caffeine dose-dependently influences decision making and risk taking. More research is needed to determine the mechanism of this difference as well as the extent to which sex and pubertal phase influence these relationships.