MONTHLY

NEWSLETTER Dietetic and Catering Department

AUGUST 2008
EDITION
Hospital Sultan Abdul Halim
Inside this issue:
Caffeine
Caffeine 1
When most people think of caffeine, they think of
coffee—and for good reason, as it is certainly one
But isn't it natural? 1 of the most common sources of caffeine in our
diets. But caffeine can be also be found in many
The Metabolism of caf- 1 other drinks and foods, most notably tea made
feine from black tea leaves.
The positive effect of caf- 2 While tea and coffee have been consumed foe well
feine over a thousand years, it is only in the last three or
four decades that the health effects of caffeine have
So, when does the positive 2
become a negative? been debated.

How do I know how 3

much caffeine I’m consum- But isn’t it natural?
ing?
Caffeine is naturally found nut or from cacao (cocoa). The amount of caffeine in
Caffeine conclusion 4
in various quantities in the You can also find caffeine in food products varies de-
leaves, seeds, beans or fruit some places you wouldn't pending upon the serving
over 60 plants. It is defined expect. For instance, some size, type of product and
Caffeine is a bitter
as a drug because it is a cen- of the caffeine in energy method of preparation (see
white crystalline xan- tral nervous system stimu- drink may come from herbs, table 1). With teas and cof-
thine alkaloid that acts lant. such as guarana and yerba fees, the plant variety also
as a psychoactive stimu-
While caffeine is most com- mate and may not be listed affect the caffeine content.
lant drug and a mild diu-
retic (speeds up urine
monly consumed in infu- in the ingredients as caf-
production) in humans sions extracted from the feine . These products, in-
and other animals. beans of coffee plant and tended for occasional use
leaves of the tea bush, it is only, may contain levels of
Caffeine was discovered
by a German chemist,
also absorbed from various caffeine as high as 1000mg
F rie dr ich F er dina nd foods and drinks containing in a daily dose.
Runge, in 1819. He products derived from kola
coined the term
"kaffein",
compound
a
in
chemical
coffee, The Metabolism of caffeine
which in English became
caffeine. Caffeine is metabolized in the liver by the cytochrome P450 oxidase enzyme system into
three metabolic dimethylxanthines, which each have their own effects on the body:
Caffeine is also called
guaranine when found in
guarana, mateine when • Paraxanthine (84%): Has the effect of increasing lipolysis, leading to elevated glycerol
found in mate, and and free fatty acid levels in the blood plasma.
theine when found in • Theobromine (12%): Dilates blood vessels and increases urine volume. Theobromine
tea; all of these names is also the principal alkaloid in cocoa, and therefore chocolate.
are synonyms for the • Theophylline (4%): Relaxes smooth muscles of the bronchi, and is used to treat
same chemical com-
asthma. The therapeutic dose of theophylline, however, is many times greater than the
pound.
levels attained from caffeine metabolism.
Page 2 Caffeine AUGUST 2008

The Positive effects of caffeine

History It has been shown that a demonstrated increases in that moderate caffeine con-
moderate intake of about key aspects of cognitive sumption (around 300mg/
200—300mg of caffeine a function related to alertness. day) from coffee and other
Coffee use can be traced day (about two to three cups Caffeine has also been beverages decreased the risk
at least to as early as the of brewed coffee), isn't shown to enhance self-rated of Parkinson’s Disease in
9th century, when it harmful to most healthy moods such as vigour, effi- men, as well as in women
appeared in the
adults. Indeed, it may even ciency, energy and clear- who have never used post-
highlands of Ethiopia.
have some positive effects. headedness. These effects menopausal hormone re-
According to legend, were present at consump- placement therapy. An anti-
Ethiopian shepherds
were the first to observe
tion levels as low as 32mg inflammatory effect has also
For adults, a small amount per day. been observed in a numbers
the influence of the
caffeine in coffee beans of caffeine can increase of studies on caffeine’s im-
when the goats appeared alertness and the ability to pact on the immune system.
to "dance" and to have concentrate. And recent Additionally, several cohort
an increased level of
studies have consistently studies have found evidence
energy after consuming
wild coffee berries.

The legend names the

shepherd "Kaldi." From
Ethiopia, coffee spread
So, when does the positive become a negative?
to Egypt and Yemen. It
was in Arabia that coffee Many studies have been
beans were first roasted done over the years on the • Nausea, diarrhea or feine daily (approximately
and brewed similarly as two cups of brewed coffee).
potential adverse effects of other gastrointestinal
they are today. By the
15th century, it had caffeine in areas such as problems Consuming more than
“To catch the reader's attention, place an interesting

reached sentence theor quoterest of the

from the story here.”
general toxicity, cardiovas- 300mg a day during preg-
• Abnormal heart
Middle East, Persia, cular effects, calcium bal- nancy has also been previ-
Turkey, and northern
rhythms
ance and bone health and ously linked to low birth
Africa. While some studies have
potential links to cancer. weights and smaller head
Most concur that negative shown that caffeine may circumferences.
effects from caffeine for increase some cardiovascu-
healthy adults are not appar- lar risk factors such as blood
pressure, heart rate and cho- Some people show a greater
ent with moderate con-
lesterol, overall there ap- sensitivity to caffeine’s ef-
sumption of 300mg/day or
pears to be no association fect and may experience a
less.
with increased cardiovascu- reaction (eg. Increased heart
lar disease or stroke. beat) after smaller quantities
Heavy caffeine use—more of caffeine have been con-
than 500 to 600mg a day— sumed. This may be due to
can cause: Of particular concern to individual metabolism, a
women are reports that high smaller body mass or vari-
• Restlessness caffeine consumption dur- ous type of stress, smoking
• Anxiety ing pregnancy can increase habits and some health con-
the risk of miscarriage and a ditions. Those with hyper-
• Muscle tremors
recent study recommends tension and the elderly may
• Sleeplessness pregnant women consume also be more vulnerable.
• Headaches no more than 200mg caf-
Caffeine AUGUST 2008 Page 3

How do I know how much caffeine I’m consuming?

We’ve already talked about the average cup get the ‘hidden’ caffeine in energy drink and
of brewed coffee containing approximately the like.
100mg caffeine, but what about tea, soft
drink and chocolate? How can you be sure
how much caffeine you’re consuming? Coffee and tea, while containing caffeine,
also contain many health-promoting antioxi-
dants. While consuming coffee or tea for
The caffeine Content Chart below provide a their health benefits is not recommended, if Caffeine is similar to the
good guide as to how much caffeine is in you’re a coffee or tea drinker, doing so in drug theophylline, and
common foods and beverages. To determine moderation might contribute to your overall low doses seem to lead
to some improvement in
your caffeine intake, make a note of your good health. lung function, but more
consumption over a few days to get an aver- research is needed.
age daily amount. If you are concerned, ad-
In an asthma attack, the
just your intake accordingly. And don’t for-
airways (passages to the
lungs) narrow from mus-
Table 1: Caffeine Content Chart 1 cle spasms. Caffeine is a
Milligrams of Caffeine methylxanthine drug
Typically Ranges* (like theophylline, an
asthma drug), which
Coffee (240mL cup) may affect the muscles
Brewed (drip method) 85 65 – 120 in the airways.

Instant 75 60 – 85 There is caffeine in cof-

fee, tea, cola drinks and
Decaffeinated 3 2–4 cocoa. The review of
Espresso (30mL cup) 40 30 – 50 trials found that even
Tea (240mL cup) low amounts of caffeine
can improve lung func-
Brewed (US brands) 40 20 – 90 tion for up to four hours,
Brewed (Non-US brand) 60 25 – 110 but it is not known if this
leads to improvements
Instant 28 24 – 31 in symptoms.
Iced 25 9 – 50
It may be that caffeine is
Soft-drink (375mL can) 40 30 – 60 needed in such large
amounts that the drug's
Energy drinks (~ 250mL) 80 50 – 160 adverse effects become
a problem, so more re-
Cocoa drink (240mL) 6 3 – 32 search is needed.

Chocolate milk drink 5 2–7

Solid milk chocolate (30g) 6 1 – 15

Solid dark chocolate (30g) 20 5 – 35

Baker’s chocolate (30g) 26 26

* Amounts vary due to brewing method, plant variety, brand, formulation etc. Adapted from Caf-
feine & Health: Clarifying the Controversies. IFIC Review, October 2007.
Caffeine conclusions
Based on the current evidence, a
moderate caffeine intake of around
200—300mg/day is unlikely to have
any harmful effect for healthy indi-
viduals and may even have some po-
tential health benefits.

Pregnant women should limit their

consumption to 200mg/day. How-
ever, other people who may be more
vulnerable to the effects of caffeine,
such as children, the elderly and
those with a history of heart disease,
should also limit their caffeine consump-
tion to less than 200mg/day. 1,2

References:
1. Caffeine & Health: Clarifying the Controversies. IFIC Review, October 2007. International Food Information Council Foundation.
2. Weng X, Odouli R and Li D-K. Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study. Am J
Obstet Gynecol 2008.
3. Caffeine: How much is too much? Mayo Foundation for Medical Education and Research (Mayo Clinic) 2007.
4. Caffeine and your health. Health Canada, Food & Nutrition 2003.

Dietetic & Catering Department

Ask a Dietitian:
Extension number:
• 1000 Puan Meriam
• 1002 Mr. Loh
• 1003 Puan Norzaila
• 3250 Diet Clinic