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Pearce-ings: the 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. If you're thinking I am speaking a foreign language, just ask a teen, who likely will be able to translate for you. This is Starbucks lingo. If you're not a coffee drinker, you're likely completely lost, but for those of us who live by the bean, it's the language of love, caffeine love.

Twenty years ago, the thought of a teen drinking coffee was unheard of. Sure, soda has been there for decades, and in many cultures tea is a common drink, but today many kids are lining up at Starbucks for the caffeine jolt, and the new drinks such as 5-Hour Energy, Jolt, and Red Bull are making this generation the most sleep-deprived ever.

But how bad is caffeine for teens? The average adult consumes about 300 mg of caffeine per day, (1) which is equivalent to 2-4 cups of coffee; this is considered to be a moderate intake. But the average teen intake of caffeine is not limited to just coffee. Many are consuming their favorite drink from Starbucks, then a few cans of soda, chocolate candy, and maybe even an energy drink--all before the school day is over. When we consider the content of caffeine in these products, the intake is staggering.

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. The tallest size of 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. (2,3) Simple math will show that the average teen likely has excessive intake of caffeine, resulting in adverse health effects.

The most concerning adverse effect is sleep deprivation. (4) 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. (2) In people who are predisposed to arrhythmias, excessive intake can result in the onset of arrhythmias. Nervousness and jitteriness are other common effects.

Another consideration beyond the direct effects of caffeine is that it is usually coupled with sugary substances like those found in syrups used in Starbucks drinks, chocolate candy, and energy drinks. This has led to concerns of obesity as well as dental decay.

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. (5,6)

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, (7) 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.

References

(1.) "Trends in Caffeine Intake Among US Children and Adolescents" (Pediatrics. 2014;133:386-93).

(2.) Caffeine Consumption Among Children and Adolescents. National Council on Strength and Fitness.

(3.) Caffeine counts. American Physiological Association (Monitor on Psychology. 2001 June;32[6]).

(4.) J Pediatrics. 2011 March;158(3):508-9.

(5.) What is it about coffee? Harvard Health Letter (www. health.harvard.edu/staying-healthy/what-is-it-about-coffee).

(6.) J Alzheimers Dis. 2010;20(suppl 1):s167-74.

(7.) Pediatrics. 2011 June;127(6):1182-9.

BY FRANCINE PEARCE, M.D.

Dr. Pearce is a pediatrician in Frankfort, Ill. Email her at pdnews@frontlinemedcom.com.
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Title Annotation:OPINION
Author:Pearce, Francine
Publication:Pediatric News
Date:Feb 1, 2016
Words:734
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