A majority of children aged 2 years and older are consuming caffeine in food and beverages such as soda and energy drinks, with the greatest intake among 12- to 19-year-olds, indicated the first study to report on the amounts of caffeine consumed by youths in the United States.

In the paper published in American Journal of Clinical Nutrition (2014;100[4]:1124-1132), Namanjeet Ahluwalia, PhD, and colleagues cautioned that caffeine intake in children has been associated with adverse effects that range from nervousness, jitteriness, and fidgetiness to tachycardia, central nervous system agitation, gastrointestinal disturbance, and diuresis.

“Because of the continued brain development involving myelination and pruning processes, children may be particularly sensitive to caffeine,” the authors wrote.

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The group analyzed dietary information collected from 3,280 children aged 2 years to 19 years who were part of the National Health and Nutrition Examination Survey (NHANES) over 10 years (2001-2010). From 2009 to 2010, 71% of U.S. children consumed caffeine on a given day.

The median daily caffeine intake was 1.3 mg for all subjects aged 2 years to 5 years; 4.5 mg for those aged 6 years to 11 years; and 13.6 mg for those aged 12 years to 19 years. When the analyses were restricted to the children who consumed caffeine, the median intake jumped to 4.7 mg for 2- to 5-year-olds, 9.1 mg for 6- to 11-year-olds, and 40.6 mg for 12- to 19-year-olds. 

The researchers determined that on a given day, nearly 25% of children aged 12 to 19 years who reported consuming caffeine exceeded an intake of 2.5 mg/kg, which they cited as the suggested maximum by Health Canada, a federal department of that country that promotes health. The United States has no guidelines for caffeine intake for children.

Combining energy drinks with alcohol has become a popular but dangerous practice, as the caffeine can mask the depressant effects of alcohol: In more than 4,800 calls to the U.S. National Poison Data System related to the consumption of energy drinks, the incidence of moderate to major adverse effects was 15.2% for nonalcoholic energy drinks and 39.3% for alcoholic energy drinks, as reported in the journal Clinical Toxicology (Philadelphia) (2013;51[7]:566-574). Major adverse effects included seizure, tachypnea, and nonventricular and ventricular dysrhythmia.