Caffeine Toxicity: Overconsumption Risks

Takeaways

• Caffeine toxicity can occur from consuming too much caffeine
• Common symptoms include rapid heartbeat, anxiety, and insomnia
• Individual sensitivity varies based on factors like genetics and tolerance
• Treatment involves stopping caffeine intake and managing symptoms
• Prevention focuses on moderating caffeine consumption
• Awareness of caffeine content in foods and drinks is essential

What is Caffeine Toxicity?

Caffeine toxicity occurs when an individual consumes too much caffeine, a stimulant found in coffee, tea, and energy drinks. This condition affects many people due to the widespread use of these beverages. Caffeine works by stimulating the central nervous system, which increases alertness and wakefulness.

Most adults can safely consume up to 400 milligrams of caffeine per day¹, which is roughly four cups of coffee. However, some individuals may experience negative effects at lower amounts. Caffeine toxicity happens when an individual’s caffeine intake exceeds what their body can safely handle.

Caffeine affects the body by blocking adenosine receptors in the brain, which reduces feelings of tiredness. It also increases the release of neurotransmitters, such as dopamine and norepinephrine, leading to increased alertness and focus. However, excessive caffeine can overstimulate the nervous system, resulting in unpleasant symptoms.

Signs and Symptoms

Physical Symptoms

Caffeine toxicity can cause a variety of physical symptoms, typically starting within an hour after consumption. The severity of these symptoms depends on the amount of caffeine ingested and an individual’s tolerance to it.

Common physical symptoms include:

• Rapid or irregular heartbeat
• Tremors or shaking
• Increased blood pressure
• Dehydration
• Headache
• Nausea or stomach upset
• Muscle twitches

These symptoms occur because caffeine stimulates the cardiovascular system, increasing heart rate and blood pressure. Caffeine also acts as a diuretic, which increases urination and can lead to dehydration if fluids are not replenished.

In severe cases, caffeine toxicity can lead to more serious symptoms, including:

• Seizures
• Difficulty breathing
• Chest pain
• Vomiting
• Confusion

It’s important to seek immediate medical help if someone experiences severe symptoms of caffeine toxicity. In extreme instances, this condition can be life-threatening.

Mental and Emotional Symptoms

Caffeine toxicity also has mental and emotional effects, which can be as distressing as the physical ones. These symptoms often occur at the same time as physical symptoms, increasing overall discomfort.

Mental and emotional signs of caffeine toxicity include:

• Anxiety or nervousness
• Irritability
• Restlessness
• Difficulty concentrating
• Insomnia or sleep disturbances
• Panic attacks
• Mood swings

These mental and emotional symptoms arise from caffeine’s effect on the brain. Too much caffeine can overstimulate the central nervous system, leading to feelings of anxiety and restlessness. It can also disrupt sleep patterns, causing insomnia or poor sleep quality.

For some individuals, these mental effects may linger even after the physical symptoms fade. This lasting impact can affect daily activities and productivity. Recognizing these symptoms and reducing caffeine intake when they occur is important.

Causes and Risk Factors

Dietary Habits

Dietary habits are a major factor in the risk of caffeine toxicity. Many people consume caffeine daily without being fully aware of how much they are ingesting. Common sources include coffee, tea, soda, and energy drinks.

Some people might unknowingly consume high levels of caffeine through various means, such as:

• Large serving sizes of caffeinated beverages
• Multiple cups of coffee or tea throughout the day
• Energy drinks or shots with high caffeine content
• Caffeine-containing supplements or medications

Hidden sources of caffeine also contribute to overconsumption. Certain foods and drinks contain caffeine without people always realizing it. These hidden sources include:

• Chocolate
• Some ice creams
• Certain flavored waters
• Pre-workout supplements
• Some pain relievers

Here’s a table showing caffeine content in common items:

Being aware of these caffeine sources helps people monitor their intake, which is crucial for preventing toxicity.

Individual Sensitivity

Caffeine sensitivity varies greatly among individuals. Some people can consume large amounts without issues, while others experience symptoms from small doses. This difference in sensitivity arises from several factors.

Factors affecting individual caffeine sensitivity include:

• Genetics
• Body weight
• Tolerance level
• Liver function
• Age
• Medications

Genetic differences play a role in how quickly the body processes caffeine. Some people have a gene variant that slows down caffeine metabolism, making them more sensitive to its effects².

Body weight affects how concentrated caffeine becomes in the system. Smaller individuals may experience stronger effects from the same dose as larger people. Regular caffeine use also leads to tolerance, where higher doses are needed to achieve the same effects.

Liver function is important for caffeine metabolism. People with liver issues may process caffeine more slowly, which can lead to a build-up in the body and an increased risk of toxicity.

Age also affects caffeine sensitivity. Older adults may be more sensitive due to a slower metabolism. They also might take medications that interact with caffeine.

Understanding personal caffeine sensitivity helps individuals make informed choices about their consumption. This awareness allows them to adjust their intake to avoid negative effects.

Underlying Health Conditions

Certain health conditions can increase the risk of caffeine toxicity. These conditions may make people more sensitive to caffeine’s effects or interact with caffeine in harmful ways.

Health conditions that may increase caffeine sensitivity include:

• Anxiety disorders
• Heart conditions
• High blood pressure
• Liver disease
• Gastroesophageal reflux disease (GERD)
• Sleep disorders

People with anxiety disorders may find that caffeine worsens their symptoms. Caffeine can imitate or increase feelings of anxiety and panic. Individuals with heart conditions or high blood pressure should also be careful, as caffeine can increase heart rate and blood pressure, putting strain on the cardiovascular system.

Liver disease can affect caffeine metabolism, possibly causing a buildup of caffeine in the body. People with GERD (gastroesophageal reflux disease) may experience worse symptoms because caffeine can increase stomach acid production.

Certain medications can interact with caffeine, which can increase the risk of toxicity or other side effects. Examples include:

• Some antibiotics
• Certain antidepressants
• Thyroid medications
• Some pain relievers

Individuals with health conditions should consult their doctor about their caffeine intake. This discussion helps determine safe consumption levels based on their unique circumstances.

Diagnosis and Assessment

Diagnosing caffeine toxicity involves several steps. Doctors consider the individual’s symptoms, medical history, and caffeine intake. They might also perform tests to rule out other potential conditions.

The diagnosis process typically includes:

1. Symptom evaluation
2. Review of caffeine consumption history
3. Physical examination
4. Blood tests (in severe cases)
5. Electrocardiogram (ECG) to check heart function

Doctors begin by asking about the patient’s symptoms and when they started. They will also ask about recent caffeine consumption, including the amounts and sources. This helps establish a link between caffeine intake and the experienced symptoms.

During a physical exam, doctors will check vital signs such as heart rate and blood pressure. These measurements can indicate the effect of caffeine on the body. In severe cases, blood tests may be done to measure caffeine levels in the bloodstream.

Doctors also consider other potential causes of the symptoms. They may perform additional tests to rule out conditions that cause similar effects. This ensures an accurate diagnosis and the proper treatment.

Self-assessment can be helpful in identifying caffeine toxicity. People who track their caffeine intake and notice negative effects can take steps to reduce their consumption. This can prevent the development of more severe symptoms.

Treatment Approaches

Immediate Interventions

When someone experiences caffeine toxicity, taking immediate action is important. The first step is to stop caffeine intake, preventing further absorption and allowing the body to process the existing caffeine.

First aid measures for caffeine toxicity include:

• Stopping all caffeine consumption
• Drinking water to stay hydrated
• Resting in a calm environment
• Practicing deep breathing to reduce anxiety
• Avoiding physical activity

In mild cases of caffeine toxicity, these steps are often enough. Symptoms usually improve as the body metabolizes the caffeine, a process that may take several hours depending on the amount consumed.

In severe cases, medical intervention may be required. Severe symptoms include:

• Irregular heartbeat
• Seizures
• Difficulty breathing
• Extreme confusion

If these severe symptoms develop, seek emergency medical help right away. Treatment in a medical setting may include:

• Activated charcoal to reduce caffeine absorption
• Intravenous fluids for hydration
• Medications to manage specific symptoms
• Monitoring of vital signs

Medical professionals provide care based on the severity of the symptoms. They can also address any complications that may arise.

Long-term Management

Long-term management of caffeine toxicity focuses on prevention through lifestyle changes. Reducing caffeine intake helps prevent future episodes of toxicity.

Steps to reduce caffeine intake gradually include:

1. Tracking current caffeine consumption
2. Setting a goal for reduced intake
3. Gradually decreasing caffeine over several weeks
4. Finding caffeine-free alternatives
5. Addressing underlying reasons for high caffeine use

Tracking caffeine consumption helps identify areas where reduction is needed. Many people may not be aware of how much caffeine they consume daily. Keeping a log can provide valuable insight and motivation to make changes.

Gradually reducing caffeine intake is often more effective than stopping abruptly. This minimizes withdrawal symptoms, and allows the body to adjust to lower caffeine levels over time.

Finding alternatives to caffeinated beverages can be helpful. Some options include:

• Herbal teas
• Decaf coffee or tea
• Fruit-infused water
• Natural energy boosters like exercise or power naps

Addressing the reasons for high caffeine use is also important. Some people use caffeine because they have poor sleep or high stress. Improving sleep habits and managing stress can reduce the need for caffeine.

Long-term management may also involve working with healthcare providers. They can provide guidance on safe caffeine limits. They can also help address any underlying health issues that may contribute to caffeine sensitivity.

Prevention Strategies

Preventing caffeine toxicity involves consuming caffeine mindfully and being aware of your limits. Knowing how much caffeine is in foods and drinks is crucial for making informed decisions about intake.

Effective prevention strategies include:

• Setting a daily caffeine limit
• Reading labels to identify caffeine content
• Choosing lower-caffeine alternatives when possible
• Avoiding caffeine late in the day
• Staying hydrated with water
• Improving sleep habits to reduce reliance on caffeine

Setting a daily limit helps maintain moderate consumption. The FDA suggests up to 400 mg per day for most adults³. However, individual limits may be lower depending on personal sensitivity.

Reading labels is key to tracking caffeine intake. Many products now list their caffeine content. For those that don’t, doing online research or contacting the manufacturer can provide this information.

Choosing lower-caffeine alternatives can help reduce overall intake. For example, switching from coffee to green tea in the afternoon can help maintain some caffeine intake while lowering the total consumption.

Avoiding caffeine late in the day can improve sleep quality. Better sleep reduces the need for caffeine the next day, creating a positive cycle of lower caffeine dependence.

Staying hydrated with water is important as it can reduce the need to use caffeinated drinks for hydration. Water also supports overall health.

Improving sleep habits can naturally boost energy levels. This reduces the need to rely on caffeine for alertness. Good sleep habits include:

• Consistent sleep schedule
• Relaxing bedtime routine
• Comfortable sleep environment
• Limiting screen time before bed

Here’s a table with safe caffeine intake guidelines for different age groups:

These guidelines help prevent overconsumption across different life stages, taking into account varying sensitivities and potential health impacts.

Caffeine Alternatives

For those aiming to reduce caffeine intake, many alternatives exist. These options can provide energy and focus without the risks associated with caffeine. Some alternatives offer health benefits beyond simply replacing caffeine.

Healthy alternatives to caffeinated beverages include:

• Herbal teas (e.g., peppermint, chamomile)
• Fresh fruit juices
• Coconut water
• Kombucha (low-caffeine varieties)
• Golden milk (turmeric latte)
• Sparkling water with fruit essence

These options provide hydration and flavor without caffeine. Some, like herbal teas, may offer additional health benefits. For example, chamomile tea can promote relaxation⁴.

Natural energy boosters can also replace caffeine, supporting overall health while increasing alertness. Options include:

• Regular exercise
• Power naps (15-20 minutes)
• Exposure to natural light
• Healthy, balanced meals
• Deep breathing exercises
• Cold showers

Exercise releases endorphins and increases circulation, naturally boosting energy levels. Short power naps can refresh the mind without grogginess. Exposure to natural light helps regulate the body’s sleep-wake cycle and can improve energy levels throughout the day.

Eating balanced meals provides sustained energy. Foods rich in protein, complex carbohydrates, and healthy fats support stable blood sugar levels. This prevents energy crashes that often lead to caffeine cravings.

Deep breathing exercises increase oxygen flow to the brain, promoting alertness and focus. Cold showers or splashing

cold water on the face can provide a quick energy boost. The shock of cold stimulates the body and increases alertness.

Switching to these alternatives offers several benefits:

• Improved sleep quality
• Reduced anxiety and jitters
• Better hydration
• Fewer caffeine withdrawal symptoms
• Potential health benefits from herbal teas and exercises

Making the switch gradually can ease the transition. Begin by replacing one caffeinated drink per day with an alternative. Slowly increase this over time to reduce dependence on caffeine.

Myths and Misconceptions

Many myths exist about caffeine and its effects, leading to misconceptions about caffeine toxicity. Clearing up these myths can help people make more informed decisions about their caffeine consumption.

Common myths about caffeine include:

• Caffeine sobers you up from alcohol
• All coffee drinks have the same caffeine content
• Caffeine is addictive in the same way as drugs
• Caffeine causes dehydration
• Decaf coffee is completely caffeine-free
• Caffeine stunts growth in children

Let’s debunk these myths:

Caffeine does not sober you up from alcohol. While it may make you feel more alert, it does not reduce blood alcohol levels. Mixing caffeine and alcohol can be dangerous, potentially leading to poor judgment about alcohol consumption⁵.

Caffeine levels in coffee drinks vary widely. Factors such as bean type, roast level, and brewing method can affect caffeine content. A small espresso may contain less caffeine than a large brewed coffee.

While caffeine can cause mild physical dependence, it’s not addictive in the same way as drugs. Caffeine withdrawal symptoms are typically mild and short-lived, not comparable to the severe patterns of drug addiction.

Moderate caffeine intake does not cause dehydration. While caffeine has a mild diuretic effect, the fluid in caffeinated drinks offsets this. Regular coffee drinkers also develop a tolerance to the diuretic effect.

Decaf coffee is not entirely caffeine-free. It contains small amounts of caffeine, usually about 2-12 mg per cup. This is much less than regular coffee, but it is not zero.

No scientific evidence supports the idea that caffeine stunts growth in children. However, caffeine may affect sleep and calcium absorption, which can indirectly affect a child’s growth and development.

Understanding these facts helps people make informed choices about caffeine consumption. It also helps reduce unnecessary worry about moderate caffeine intake.

Caffeine in Different Age Groups

Children and Adolescents

Caffeine affects children and adolescents differently than adults. Their smaller bodies and developing nervous systems make them more sensitive to caffeine’s effects, increasing their vulnerability.

Risks associated with caffeine consumption in younger populations include:

• Sleep disturbances
• Increased anxiety
• Difficulty concentrating
• Headaches
• Increased heart rate
• Elevated blood pressure

Children and adolescents often consume caffeine through sodas and energy drinks. These beverages can contain high amounts of caffeine and sugar, which may lead to health issues such as obesity and tooth decay.

Guidelines for safe caffeine intake in children and teens are more restrictive than for adults. Here is a table with age-specific recommendations:

These guidelines help prevent negative effects on growth and development. They also aim to avoid establishing caffeine dependence at a young age.

Parents and caregivers should monitor caffeine intake in children, being aware of hidden sources such as chocolate and some medications. Encouraging healthy alternatives like water and milk supports overall health.

Adults

Caffeine affects adults differently compared to other age groups. Most healthy adults can safely consume up to 400 mg of caffeine per day⁶. However, individual tolerance and sensitivity vary greatly.

Factors influencing caffeine tolerance in adults include:

• Body weight
• Genetics
• Overall health status
• Medications
• Smoking status
• Pregnancy or breastfeeding

Adults often consume caffeine for perceived benefits such as increased alertness, improved focus, and enhanced physical performance. However, overconsumption can lead to negative effects.

Caffeine sensitivity can change over time. Some adults may find they become more sensitive to caffeine as they age, while others may develop a higher tolerance with regular consumption.

Adults should be aware of their personal caffeine limits. Monitoring intake and noting any negative effects helps in identifying individual thresholds, preventing overconsumption and reducing the risk of toxicity.

Older Adults

Older adults face unique concerns regarding caffeine consumption. Age-related changes affect how the body processes and responds to caffeine, increasing sensitivity and the risk of negative effects.

Special considerations for caffeine intake in older adults include:

• Slower caffeine metabolism
• Increased risk of sleep disturbances
• Potential interactions with medications
• Effects on bone health
• Impact on heart health

As people age, their bodies metabolize caffeine more slowly. This means caffeine remains in the system longer, leading to prolonged effects and increased risk of sleep issues.

Many older adults take medications that may interact with caffeine, increasing side effects or reducing medication effectiveness. Common examples include certain antibiotics and thyroid medications.

Caffeine can affect calcium absorption, which is a concern for older adults at risk of osteoporosis. Limiting caffeine and ensuring adequate calcium consumption helps protect bone health.

Heart health is another consideration. While moderate caffeine intake is generally safe, excessive amounts can strain the heart, especially for older adults with existing heart conditions.

Older adults should consult healthcare providers about safe caffeine intake. This discussion should consider overall health, medications, and individual risk factors.

Caffeine and Specific Health Conditions

Caffeine interacts differently with various health conditions. Understanding these interactions helps individuals make informed consumption choices. It is crucial for people with health concerns to discuss caffeine intake with their doctors.

Health conditions affected by caffeine consumption include:

• Anxiety disorders
• Heart conditions
• Gastroesophageal reflux disease (GERD)
• Sleep disorders
• Migraines
• Pregnancy
• Diabetes

Anxiety disorders can be worsened by caffeine intake. Caffeine may mimic or increase anxiety symptoms, therefore individuals with anxiety might benefit from reducing or avoiding caffeine⁷.

Heart conditions require careful consideration of caffeine consumption. Caffeine can increase heart rate and blood pressure, which may be problematic for some heart patients. However, recent studies suggest moderate coffee consumption may have heart health benefits for many people⁸.

GERD sufferers often find that caffeine worsens their symptoms. Caffeine can relax the lower esophageal sphincter, allowing stomach acid to reflux. Reducing or avoiding caffeine may help manage GERD symptoms.

Sleep disorders can be made worse by caffeine, especially when consumed late in the day. Caffeine’s stimulant effects can interfere with sleep quality and the ability to fall asleep. People with sleep issues might benefit from limiting caffeine to morning hours.

Migraines have a complex relationship with caffeine. Some individuals find caffeine helps relieve migraines, while others report it triggers or worsens headaches. Individual responses vary, so monitoring caffeine’s effects on migraine patterns is helpful.

Pregnancy requires careful caffeine management. The American College of Obstetricians and Gynecologists recommends limiting caffeine to less than 200 mg per day during pregnancy⁹. This precaution helps prevent possible risks to the developing fetus.

Diabetes management can be affected by caffeine, potentially impacting insulin sensitivity and blood sugar levels. People with diabetes should monitor how caffeine affects their blood glucose and adjust their intake accordingly.

For all these conditions, consulting healthcare providers about caffeine intake is important. They can offer personalized advice based on individual health status and medications.

Global Perspective on Caffeine Consumption

Caffeine consumption patterns vary widely across cultures. Different countries have unique preferences for caffeinated beverages. These differences reflect cultural traditions, availability, and social norms.

Here’s a table showing caffeine consumption statistics by country or region:

These numbers are averages and can vary within populations. Cultural factors influence not only the amount of caffeine consumed but also the sources.

In Nordic countries, coffee is the most common source of caffeine. These nations are among the top for per capita coffee intake. Social coffee breaks are an important part of daily life in countries like Finland and Sweden.

The United States has a diverse caffeine culture. While coffee is popular, sodas and energy drinks also contribute significantly. Fast-paced lifestyles often drive caffeine consumption for energy and focus.

In the United Kingdom, tea remains a cultural staple. However, coffee consumption has increased in recent years. This shift reflects changing tastes and global influences.

Asian countries like Japan and China have lower average caffeine intakes. Green tea is a traditional beverage in these cultures, containing less caffeine than coffee but offering other health benefits.

Regulations and guidelines for caffeine vary worldwide. Some countries have strict limits on caffeine content in beverages. Others focus on labeling requirements to inform consumers.

The European Food Safety Authority recommends a daily caffeine intake of no more than 400 mg for adults¹⁰, which aligns with guidelines in many other countries.

Some nations have specific regulations for energy drinks, which often include age restrictions or limits on caffeine content. For instance, Lithuania has banned the sale of energy drinks to people under 18¹¹.

Global trends in caffeine consumption continue to evolve. Coffee culture is spreading to traditionally tea-drinking nations, and energy drinks are gaining popularity among younger demographics worldwide.

Understanding these global patterns provides context for individual consumption habits. It also highlights the need for culturally sensitive approaches to caffeine education and regulation.

Future Research and Trends

Caffeine research continues to progress, providing insights into its effects and potential uses. Current studies focus on both the benefits and risks of caffeine consumption. These investigations shape our understanding and guide future recommendations.

Ongoing research topics related to caffeine toxicity include:

• Long-term effects of high caffeine intake
• Genetic factors influencing caffeine sensitivity
• Caffeine’s impact on sleep architecture
• Potential therapeutic uses of caffeine
• Interactions between caffeine and other substances
• Effects of caffeine on brain development in adolescents

Scientists are exploring the long-term consequences of high caffeine consumption, aiming to understand the potential risks or benefits of sustained intake over years or decades.

Genetic studies seek to identify why caffeine affects people differently. This knowledge could lead to personalized recommendations based on genetic profiles and help predict individual risk for caffeine toxicity.

Sleep researchers are investigating how caffeine alters sleep patterns. They are looking beyond just difficulty falling asleep to examine changes in sleep stages and overall sleep quality¹².

Therapeutic applications of caffeine are under investigation. Researchers are studying its potential in treating conditions such as Parkinson’s disease and certain types of headaches, which may lead to new medical uses for caffeine.

Interactions between caffeine and other substances remain an area of interest, including both recreational drugs and prescription medications. Understanding these interactions can prevent negative effects and improve treatment outcomes.

The impact of caffeine on adolescent brain development is a growing concern. As energy drink consumption rises among teenagers, researchers are studying potential long-term effects. This may inform future guidelines for youth caffeine consumption.

Emerging trends in caffeine use and research include:

• Natural caffeine alternatives
• Controlled-release caffeine products
• Caffeine in fitness and sports nutrition
• Digital tools for tracking caffeine intake
• Sustainable and ethical caffeine sourcing

Natural alternatives to synthetic caffeine are gaining popularity. Companies are exploring plant-based sources beyond coffee and tea, which may offer different effects or health benefits.

Controlled-release caffeine products aim to provide steady energy without sudden spikes and crashes. These formulations could reduce the risk of overconsumption and toxicity.

The fitness industry continues to explore caffeine’s performance-enhancing effects. Research in this area may lead to more targeted use of caffeine in sports nutrition.

Digital tools for tracking caffeine intake are becoming more sophisticated. These apps help users monitor consumption and understand personal caffeine responses, which may help prevent toxicity and optimize intake.

Sustainability and ethical sourcing of caffeine are growing concerns. Consumers are increasingly interested in the origin and production methods of their caffeinated products. This trend may influence future production and consumption patterns.

As research progresses, our understanding of caffeine toxicity and safe consumption will likely evolve. Future guidelines may become more personalized, considering individual factors like genetics and lifestyle.

FAQ

1. United States Food and Drug Administration. (2023). Spilling the Beans: How Much Caffeine is Too Much? https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much

2. Cornelis, M. C., El-Sohemy, A., Kabagambe, E. K., & Campos, H. (2006). Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA, 295(10), 1135-1141. https://pubmed.ncbi.nlm.nih.gov/16522833/

3. United States Food and Drug Administration. (2018). FDA to Investigate Added Caffeine. https://www.fda.gov/food/food-additives-petitions/fda-investigate-added-caffeine

4. Srivastava, J. K., Shankar, E., & Gupta, S. (2010). Chamomile: A herbal medicine of the past with bright future. Molecular medicine reports, 3(6), 895-901. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995283/

5. Centers for Disease Control and Prevention. (2023). Dangers of Mixing Alcohol with Caffeine and Energy Drinks. https://www.cdc.gov/alcohol/fact-sheets/caffeine-and-alcohol.htm

6. European Food Safety Authority. (2015). Scientific Opinion on the safety of caffeine. EFSA Journal, 13(5), 4102. https://efsa.onlinelibrary.wiley.com/doi/10.2903/j.efsa.2015.4102

7. Anxiety and Depression Association of America. (2023). Caffeine and Anxiety. https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/caffeine-anxiety

8. Poole, R., Kennedy, O. J., Roderick, P., Fallowfield, J. A., Hayes, P. C., & Parkes, J. (2017). Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ, 359, j5024. https://www.bmj.com/content/359/bmj.j5024

9. American College of Obstetricians and Gynecologists. (2020). Moderate Caffeine Consumption During Pregnancy. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2010/08/moderate-caffeine-consumption-during-pregnancy

10. European Food Safety Authority. (2015). EFSA explains risk assessment: Caffeine. https://www.efsa.europa.eu/en/corporate/pub/efsaexplainscaffeine150527

11. World Health Organization. (2014). Energy drinks cause concern for health of young people. https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/news/news/2014/10/energy-drinks-cause-concern-for-health-of-young-people

12. Clark, I., & Landolt, H. P. (2017). Coffee, caffeine, and sleep: A systematic review of epidemiological studies and randomized controlled trials. Sleep medicine reviews, 31, 70-78. https://pubmed.ncbi.nlm.nih.gov/26899133/

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