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CORK Bibliography: Caffeine

61 citations. January 2011 to present

Prepared: September 2011

Arria AM; O'Brien MC. The "high" risk of energy drinks. (editorial). Journal of the American Medical Association 305(6): 600-601, 2011. (10 refs.)

The article reflects on the threat posed by regular energy drinks to individual and public health and safety in the U.S. Energy drinks refer to beverages containing modest to relatively high levels of caffeine. According to research, consumption of energy drink is potentially harmful because caffeine has been linked with adverse health effects and the practice of mixing energy drinks with alcohol has been associated to drinking high volumes of alcohol per session. The neuropharmacologic effects of caffeine are also discussed.

Astorino TA; Martin BJ; Schachtsiek L; Wong K; Ng K. Minimal effect of acute caffeine ingestion on intense resistance training performance. Journal of Strength and Conditioning Research 25(6): 1752- 1758, 2011. (42 refs.)

Astorino, TA, Martin, BJ, Schachtsiek, L, Wong, K, and Ng, K. Minimal effect of acute caffeine ingestion on intense resistance training performance. J Strength Cond Research 25(6): 1752-1758, 2011-The primary aim of the study was to determine the efficacy of acute caffeine intake to enhance intense resistance training performance. Fourteen resistance-trained men (age and body mass = 23.1 +/- 1.1 years and 83.4 +/- 13.2 kg, respectively) who regularly consumed caffeine ingested caffeine (6 mg.kg(-1)) or placebo 1 hour before completion of 4 sets of barbell bench press, leg press, bilateral row, and barbell shoulder press to fatigue at 70-80% 1-repetition maximum. Two minutes of rest was allotted between sets. Saliva samples were obtained to assess caffeine concentration. The number of repetitions completed per set and total weight lifted were recorded as indices of performance. Two-way analysis of variance with repeated measures was used to examine differences in performance across treatment and sets. Compared to placebo, there was a small but significant effect (p < 0.05) of acute caffeine intake on repetitions completed for the leg press but not for upper-body exercise (p > 0.05). Total weight lifted across sets was similar (p > 0.05) with caffeine (22,409.5 +/- 3,773.2 kg) vs. placebo (21,185.7 +/- 4,655.4 kg), yet there were 9 'responders' to caffeine, represented by a meaningful increase in total weight lifted with caffeine vs. placebo. Any ergogenic effect of caffeine on performance of fatiguing, total-body resistance training appears to be of limited practical significance. Additional research is merited to elucidate interindividual differences in caffeine-mediated improvements in performance.

Astorino TA; Terzi MN; Roberson DW; Burnett TR. Effect of caffeine intake on pain perception during high-intensity exercise. International Journal of Sport Nutrition and Exercise Metabolism 21(1): 27-32, 2011. (19 refs.)

Caffeine has been shown to reduce leg-muscle pain during submaximal cycle ergometry, as well as in response to eccentric exercise. However, less is known about its analgesic properties during non-steady-state, high-intensity exercise. The primary aim of this study was to examine the effect of 2 doses of caffeine on leg pain and rating of perceived exertion (RPE) during repeated bouts of high-intensity exercise. Fifteen active men (age 26.4 +/- 3.9 yr) completed 2 bouts of 40 repetitions of "all-out" knee extension and flexion of the dominant leg at a contraction velocity equal to 180 degrees/s. Before each trial, subjects abstained from caffeine intake and intense exercise for 48 hr. Over 3 days separated by 48 hr, subjects ingested 1 of 3 treatments (5 mg/kg or 2 mg/kg of anhydrous caffeine or placebo) in a randomized, single-blind, counterbalanced, crossover design. Leg-muscle pain and RPE were assessed during and after exercise using established categorical scales. Across all treatments, pain perception was significantly increased (p < .05) during exercise, as well as from Bout 1 to 2, yet there was no effect (p > .05) of caffeine on pain perception or RPE. Various measures of muscle function were improved (p < .05) with a 5-mg/kg caffeine dose vs. the other treatments. In the 5-mg/kg trial, it is plausible that subjects were able to perform better with similar levels of pain perception and exertion.

Babu KM; Zuckerman MD; Cherkes JK; Hack JB. First-onset seizure after use of 5-hour Energy. Pediatric Emergency Care 27(6): 539-540, 2011. (17 refs.)

The health consequences of energy drink use in adolescents are unknown. We discuss an adverse event in an adolescent who presented to the emergency department with his first-ever seizure after consumption of 5-Hour Energy. We review the typical presentation of caffeine toxicity, as well as the importance of screening for energy drink use in adolescents with appropriate clinical findings. We pay particular attention to the identification of energy drink-related adverse events in the emergency department and the need for subsequent reporting to the Food and Drug Administration. To our knowledge, this is the first reported case of an adolescent presenting with a new-onset seizure associated with energy drink use.

Boleda MR; Galceran MT; Ventura F. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments. Environmental Pollution 159(6): 1584- 1591, 2011. (66 refs.)

The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies >= 94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse.

Browne ML; Hoyt AT; Feldkamp ML; Rasmussen SA; Marshall EG; Druschel CM et al. Maternal caffeine intake and risk of selected birth defects in the National Birth Defects Prevention Study. Birth Defects Research. Part A: Clinical and Molecular Teratology 91(2): 93-101, 2011. (29 refs.)

BACKGROUND: Caffeine intake is common during pregnancy, yet few epidemiologic studies have examined the association between maternal caffeine consumption and birth defects. Using data from the National Birth Defects Prevention Study (NBDPS), we examined the association between maternal caffeine consumption and anotia/microtia, esophageal atresia, small intestinal atresia, craniosynostosis, diaphragmatic hernia, omphalocele, and gastroschisis. METHODS: The NBDPS is a multi-site population-based case-control study. The present analysis included 3,346 case infants and 6,642 control infants born from October 1997 through December 2005. Maternal telephone interview reports of demographic characteristics and conditions and exposures before and during pregnancy were collected. Odds ratios and 95% confidence intervals, adjusted for relevant covariates, were calculated to estimate the associations between maternal dietary caffeine intake (coffee, tea, soda, and chocolate) and maternal use of caffeine-containing medications and each defect. RESULTS: We observed small, statistically significant elevations in adjusted odds ratios ranging from 1.3 to 1.8 for total maternal dietary caffeine intake or specific types of caffeinated beverages and anotia/microtia, esophageal atresia, small intestinal atresia, and craniosynostosis; however, dose-response patterns were absent. Periconceptional use of caffeine-containing medications was infrequent and estimates were imprecise. CONCLUSIONS: We did not find convincing evidence of an association between maternal caffeine intake and the birth defects included in this study. The increasing popularity of caffeine-containing energy drinks and other caffeinated products may result in higher caffeine intake among women of childbearing age. Future studies should consider more detailed evaluation of such products.

Buscemi S; Mattina A; Tranchina MR; Verga S. Acute effects of coffee on QT interval in healthy subjects. Nutrition Journal 10: e-article 15, 2011. (5 refs.)

The coronary endothelial function is recognized to have an important role in the physiology of the diastolic ventricular relaxation, a phase of the heart cycle that influences the electrocardiographic QT interval. Endothelial function is investigated in vivo by flow mediated dilation (FMD) in the brachial artery and has proven to be a strong predictor of both coronary endothelial function and cardiovascular events. It has been reported that coffee acutely induces FMD changes. In particular, the brachial artery FMD seems to decrease after caffeinated coffee (CC) and to increase after decaffeinated coffee (DC) ingestion. Since the cardiovascular effects of coffee are still a debated matter, this study aimed at investigating with a randomized, double-blind crossover design, if the QT interval of adult healthy subjects (19 males and 21 females) changes in the hour following CC or DC ingestion. Both systolic and diastolic blood pressure were higher in the hour following the ingestion of CC; the heart rate significantly increased 30 minutes after CC ingestion. A significant increase of the QT duration was observed one hour after DC ingestion (398.9 +/- 3.8 vs 405.3 +/- 3.7 msec; P < 0.05), not after CC. The QT interval corrected for heart rate did not significantly change following CC or DC ingestion. In conclusion, despite CC and DC previously demonstrated to influence the FMD they do not seem to induce a significant unfavourable acute change of the left ventricular repolarization. Further investigations are required to elucidate the effects of coffee in subjects with cardiovascular diseases.

Cartiser N; Bevalot F; Chatenay C; Le Meur C; Gaillard Y; Malicier D et al. Postmortem measurement of caffeine in bone marrow: Influence of sample location and correlation with blood concentration. Forensic Science International 210(1-3): 149-153, 2011. (29 refs.)

Bone marrow (BM) analysis is of forensic interest in postmortem toxicological investigation in case of limited, unavailable or unusable blood samples. However, it remains difficult to determine whether a drug BM concentration is therapeutic or represents overdose, due to the lack of studies on this alternative matrix. Given the variations in BM composition in the body, sample location was suggested to be a relevant factor in assessing BM concentration. The aim of the present study was to compare postmortem caffeine concentrations in various BM sample locations and secondly to consider the correlation between BM and blood concentrations. Six BM samples (right and left side: proximal and medial femur and 5th rib) and a blood sample were collected from 21 forensic autopsies. Gas chromatography coupled to tandem mass spectrometry was performed. Blood caffeine concentrations ranged from 60 to 7591 ng/mL. Femoral and rib BM concentrations ranged from 51 to 6171 ng/g and 66 to 7280 ng/g, respectively. Blood concentrations were always higher than BM concentrations. As a good correlation was demonstrated between blood and rib BM and between blood and the average of the four femoral BM concentrations, blood caffeine concentrations could be correctly extrapolated from BM concentrations. BM caffeine concentration was found to depend on sample location. Rib BM caffeine concentrations appeared to be systematically greater than averaged femur values and concentrations were much more variable between the 4 femur BM samples than between the 2 ribs. From a practical point of view, for caffeine analysis, rib BM appeared more relevant than femoral BM, which requires multisampling to overcome the concentration variability problem.

Cole C; Jones L; McVeigh J; Kicman A; Syed Q; Bellis M. Adulterants in illicit drugs: A review of empirical evidence. (review). Drug Testing and Analysis 3(2): 89-96, 2011. (90 refs.)

Widespread public perception is that illicit drugs contain substances that are a serious risk to health, even though adulterants are often not considered in clinical or forensic toxicology. This review attempts to present an evidence-based overview of adulterants in illicit drugs, and their associated toxicity. Adulterants are deliberately added to increase bulk, enhance or mimic a pharmacological effect, or to facilitate drug delivery. Those present unintentionally are as a result of poor manufacturing techniques. From the reports gathered, adulterants are predominantly substances which are readily available, commonly being caffeine, procaine, paracetamol, and sugars. These are likely to have minimal impact on users' health at low dosages. Other adulterants, particularly in injectable drugs, have the potential to cause serious health issues, but the quantities reported, such as strychnine in heroin, are not life-threatening. The most commonly identified bacterial contaminants identified are Bacillus and Clostridium species. When death or serious illness due to adulteration occurs, circulation of information is particularly vital, such as in the USA regarding heroin and cocaine adulterated with fentanyl, and in Scotland recently regarding anthrax contaminated heroin. The complex interactions of supply, demand, and control of illicit drugs have a tangible impact on their adulteration. Continuing vigilance and the circulation of information is, therefore, desirable as a public health issue. As part of that strategy, analyses performed for adulterants needs to be encouraged, which are considerably limited in number and scope at the moment.

Conger SA; Warren GL; Hardy MA; Millard-Stafford ML. Does caffeine added to carbohydrate provide additional ergogenic benefit for endurance? (review). International Journal of Sport Nutrition and Exercise Metabolism 21(1): 71-84, 2011. (86 refs.)

Context: Carbohydrate (CHO) and caffeine (CAF) both improve endurance performance. Purpose: To determine by systematic literature review coupled with meta-analysis whether CAF ingested with CHO (CHO+CAF) improves endurance performance more than CHO alone. Methods: Databases were searched using the keywords caffeine, endurance, exercise, carbohydrate, and performance. Criteria for inclusion were studies that used human subjects performing an endurance-exercise performance task and included both a CHO and CHO+CAF condition. Effect sizes (ESs) were calculated as the standardized mean difference. Results: Twenty-one studies met the criteria for analysis. ESs for individual studies ranged from -0.08 (trivial effect favoring CHO) to 1.01 (large effect favoring CHO+CAF). The overall ES equaled 0.26 (95% Cl 0.15-0.38,p < .001), indicating that CHO+CAF provides a small but significant performance benefit over CHO. ES was not significantly (p > .05) related to CAF dose, exercise duration, or performance-assessment method. To determine whether ES of CHO+CAF vs. CHO was different than CAF compared with water (placebo), a subgroup meta-analysis compared 36 CAF vs. placebo studies against the 21 CHO+CAF vs. CHO studies. The overall ES for the former group of studies (ES = 0.51, 95% Cl 0.40-0.61) was nearly 2-fold greater than in CHO+CAF vs. CHO studies (p = .006). Conclusions: CHO+CAF ingestion provides a significant but small effect to improve endurance performance compared with CHO alone. However, the magnitude of the performance benefit that CAF provides is less when added to CHO than when added to placebo.

Crowe SF; Barot J; Caldow S; D'Aspromonte J; Dell'Orso J; Di Clemente A et al. The effect of caffeine and stress on auditory hallucinations in a non-clinical sample. Personality and Individual Differences 50(5): 626-630, 2011. (27 refs.)

Both the diathesis-stress model and the continuum theory of schizophrenia attempt to explain the mechanism by which stress may facilitate the expression of the symptoms of schizophrenia in non-clinical samples. Caffeine has also recently been reported to increase proneness to hallucinate. In this study, 92 non-clinical participants were assigned to either a high or a low stress condition and a high or a low caffeine condition on the basis of self-report. After they had been primed, the participants were asked to listen to white noise and to report each time they heard the song "White Christmas" during the white noise. The song was never played. The results indicated that the interaction of stress and caffeine had a significant effect on the reported frequency of hearing "White Christmas". The results demonstrated that high caffeine levels in association with high levels of stressful life events interacted to produce higher levels of "hallucination" in non-clinical participants, indicating that further caution needs to be exercised with the use of this overtly "safe" drug.

De Bruin EA; Rowson MJ; Van Buren L; Rycroft JA; Owen GN. Black tea improves attention and self-reported alertness. Appetite 56(2): 235-240, 2011. (41 refs.)

Tea has previously been demonstrated to better help sustain alertness throughout the day in open-label studies. We investigated whether tea improves attention and self-reported alertness in two double-blind, randomised, placebo-controlled, crossover studies. Participants: received black tea (made from commercially available tea bags) in one condition and placebo tea (hot water with food colours and flavours) similar in taste and appearance to real tea in the other condition. Attention was measured objectively with attention tests (the switch task and the intersensory-attention test) and subjectively with a self-report questionnaire (Bond-Lader visual analogue scales). In both studies, black tea significantly enhanced accuracy on the switch task (study 1 p < .002, study 2 p = .007) and self-reported alertness on the Bond-Lader questionnaire (study 1 p < .001. study 2 p = .021). The first study also demonstrated better auditory (p < .001) and visual (p = .030) intersensory attention after black tea compared to placebo. Simulation of theanine and caffeine plasma time-concentration curves indicated higher levels in the first study compared to the second, which supports the finding that tea effects on attention were strongest in the first study. Being the second most widely consumed beverage in the world after water, tea is a relevant contributor to our daily cognitive functioning.

Du F; Qiukui H; Birong D; Changquan H; Hongmei W; Yanling Z et al. Association of osteoporotic fracture with smoking, alcohol consumption, tea consumption and exercise among Chinese nonagenarians/centenarians. Journal of Nutrition, Health & Aging 15(5): 327-331, 2011. (37 refs.)

To observe the association of osteoporotic fracture with habits of smoking, alcohol consumption, tea consumption and exercise among very old people. A cross sectional study conducted in Dujiangyan Sichuan China. 703 unrelated Chinese nonagenarians and centenarians (67.7(1% women, mean age 93.48 years) resident in Dujiangyan. Medical history of osteoporosis and the statement of fracture and habits (current and former) of smoking, alcohol consumption, tea consumption and exercise were collected. In women, subjects with current or former habit of alcohol consumption had significantly higher prevalence osteoporotic fracture than those without this habit; but subjects with former habit of exercise had significantly lower prevalence osteoporotic fracture than those without tills habit. However, in men, there was no significant difference in prevalence of these habits between subjects with and without osteoporotic fracture. After adjust for age, gender, sleep habits educational levels, religion habits and temperament, we found that former habit of alcohol consumption had a significant odds ratio (OR=2.473 95% CI (1.074, 5.526)) for osteoporotic fracture. In summary, among nonagenarians and centenarians, among habits (current and former) of smoking, alcohol consumption, tea consumption and exercise, there seems to be significant association of osteoporotic fracture only with current or former habits of alcohol consumption, former habit of exercise. The habit of alcohol consumption might be associated with a greater risk of osteoporotic fracture, but the former habit of exercise might be associated with a lower risk of osteoporotic fracture.

Duncan MJ; Oxford SW. The effect of caffeine ingestion on mood state and bench press performance to failure. Journal of Strength and Conditioning Research 25(1): 178-185, 2011. (41 refs.)

Research has suggested that caffeine enhances aerobic performance. The evidence for high-intensity, short-term exercise, particularly resistance exercise is mixed and has not fully examined the psychological changes that occur after this mode of exercise with caffeine ingestion. This study examined the effect of caffeine (5 mg.kg(-1)) vs. placebo on bench press exercise to failure and the mood state response pre to postexercise. Thirteen moderately trained men (22.7 +/- 6.0 years) completed 2 laboratory visits, after determination of 1 repetition maximum (1RM) on the bench press, where they performed bench press repetitions to failure at a load of 60% 1RM. Mood state was assessed 60 minutes pre and immediately post-substance ingestion. Borg's rating of perceived exertion (RPE) and peak blood lactate (PBla) were assessed after each test, and peak heart rate (PHR) was determined using heart rate telemetry. Participants completed significantly more repetitions to failure (p = 0.031) and lifted significantly greater weight (p = 0.027) in the caffeine condition compared to the placebo condition. The PHR (p = 0.0001) and PBla (p = 0.002) were higher after caffeine ingestion. The RPE was not different across conditions (p = 0.082). Mood state scores for vigor were greater (p = 0.001) and fatigue scores lower (p = 0.04) in the presence of caffeine. Fatigue scores were greater postexercise (p = 0.001) compared to scores pre exercise across conditions. Caffeine ingestion enhances performance in short-term, resistance exercise to failure and may favorably change the mood state response to exercise compared to a placebo.

Duvnjak-Zaknich DM; Dawson BT; Wallman KE; Henry G. Effect of caffeine on reactive agility time when fresh and fatigued. Medicine and Science In Sports and Exercise 43(8): 1523-1530, 2011. (39 refs.)

Purpose: This study examined the effects of acute caffeine ingestion on agility performance and decision-making accuracy after simulated team-sport exercise. Methods: Using a randomized, double-blinded, counterbalanced design, 10 moderately trained male team-sport athletes ingested either caffeine (6 mg.kg(-1)) or placebo (dextrose) 60 min before completing an 80-min (4 x 20 min) simulated team-game, intermittent running protocol. Interspersed between each exercise quarter was a reactive agility test (RAT) consisting of five trials where measures of total time (TT), reactive agility (RA) time, decision time (DT), movement time (MT), and decision-making accuracy were obtained. Results: Although there were no significant differences between trials for TT (P = 0.54), RAtime (P = 0.84), MT (P = 0.89), or DT (P = 0.91), caffeine ingestion resulted in consistently faster TT (2.3%), RA time (3.9%), MT (2.7%), and DT (9.3%) scores compared with placebo (significant main effect for condition for RA time, TT, DT, and MT; P < 0.05). These faster times were supported by qualitative analyses of "almost certain benefit" and large effect size (ES) for RA (quarter 3) and "likely" to "very likely benefits" and moderate to large ES for TT (precircuit and quarters 1, 2, and 4) and RA time (precircuit and quarters 1, 2 and 4). A "likely benefit" and moderate ES was found for MT (quarters 1 and 3), but the effect of caffeine on DT was largely "unclear," with small ES and only a "likely" chance of benefit (quarters 2 and 3). Improved decisionmaking accuracy (3.8%) after caffeine ingestion was supported by a "likely benefit" (quarter 1) and large ES (quarters 1 and 4). Conclusion: Caffeine ingestion may be beneficial to RA performance when athletes are fresh and fatigued.

Ely BR; Ely MR; Cheuvront SN. Marginal effects of a large caffeine dose on heat balance during exercise-heat stress. International Journal of Sport Nutrition and Exercise Metabolism 21(1): 65-70, 2011. (37 refs.)

The use of caffeine supplements in athletic and military populations has increased in recent years. Excessive caffeine consumption in conjunction with exercise in a hot environment may predispose individuals to heat illness. Purpose: To examine heat balance induced by a large dose of caffeine during exercise in a hot environment. Methods: Ten men, not heat acclimated and not habitual caffeine users, consumed either caffeine (CAF; 9 mg/kg) or placebo (PLA) before performing cycle-ergometer exercise for 30 min at 50% VO2peak in a 40 degrees C, 25% relative humidity environment while body temperature (core and skin) and ratings of thermal comfort (TC) were monitored. Heat-exchange variables were calculated using partitional calorimetry and thermometry. Results: Mean body temperature (T-b) was higher (p < .05) with CAF (37.18 +/- 0.15 degrees C) than with PLA (36.93 +/- 0.15 degrees C) at the start of exercise. Heat production was slightly higher (similar to 8 W, p < .05) with CAF. There were no differences in heat storage, dry heat gains, TC, or T-b during exercise. Conclusions: A caffeine dose of 9 mg/kg does not appreciably alter heat balance during work in a hot environment. The small increase in T-b observed with CAF was undetected by the participants and is unlikely to increase physiological strain sufficiently to affect endurance performance or risk of heat illness.

Fagherazzi G; Touillaud MS; Boutron-Ruault MC; Clavel-Chapelon F; Romieu I. No association between coffee, tea or caffeine consumption and breast cancer risk in a prospective cohort study. Public Health Nutrition 14(7): 1315-1320, 2011. (26 refs.)

Objective: Numerous mechanisms for the effects of coffee, tea and caffeine on the risk of breast cancer have been suggested. Caffeine intake has already been associated with high plasma levels of female hormones, but associations have not been clearly demonstrated in epidemiological studies. Design: We examined prospectively the association of coffee, tea and caffeine consumption with breast cancer risk in a French cohort study. Setting: Dietary information was obtained from a 208-item diet history questionnaire self-administered in 1993-1995. Multivariable Cox proportional hazards regression models were used to estimate hazards ratios and 95% confidence intervals. Subjects: The study was conducted on 67 703 women with available dietary information. During a median follow-up of 11 years, 2868 breast cancer cases were diagnosed. Results: Median intake was 280 ml/d (2.2 cups/d) for coffee and 214 ml/d (1.7 cups/d) for tea. Median caffeine intake was 164 mg/d. No association was found between consumption of coffee, tea or caffeine and breast cancer risk. Sub-analyses by tumour receptor status, menopausal status, type of coffee (regular or decaffeinated) and meals at which beverages were drunk led to the same conclusion. Conclusions: Results from this prospective study showed no relationship between coffee, tea or caffeine intake and breast cancer risk overall or by hormone receptor status.

Froehner S; Piccioni W; Machado KS; Aisse MM. Removal capacity of caffeine, hormones, and bisphenol by aerobic and anaerobic sewage treatment. Water Air and Soil Pollution 216(1-4): 463-471, 2011. (37 refs.)

The number of chemical compounds in sewage and consequently their release into the environment is increasing. Some of them are toxic and many of them are considered endocrine disrupters. Here, the capacity of three wastewater treatment plants (WWTPs) to remove caffeine, hormones and bisphenol-A was investigated. Bisphenol-A and caffeine are highly water-soluble compounds, as opposed to hormones (estradiol, estriol, and ethynilestradiol) which are hydrophobic compounds. In the Sewage Treatment Plant (SWT)1 the sewage is treated by activated sludge process, in the second plant, SWT2, sewage is treated by upflow anaerobic sludge blanket reactors followed by dissolved air flotation, and in the third, SWT3 sewage is treated by stabilization lagoons. The first lagoon is 3.5 m deep, thus facultative and polishment processes occur. It was speculated that there was a difference in efficiency between the three plants in removing micropollutants. Small differences were found in the amounts removed, probably accounted for by retention time. The caffeine and bisphenol-A were almost completely removed, higher than 90% for both compounds (bisphenol-A and caffeine) in all WWTPs. The hormones, however, had a smaller rate of removal, between 70% and 87%. It is suspected that retention time is essential for removal efficiency, together with type of treatment. In fact, the hormones, caffeine, and bisphenol-A found in the environment definitely come from untreated sewage.

Ganio MS; Johnson EC; Klau JF; Anderson JM; Casa DJ; Maresh CM et al. Effect of ambient temperature on caffeine ergogenicity during endurance exercise. European Journal of Applied Physiology 111(6): 1135- 1146, 2011. (54 refs.)

It is well established that caffeine ingestion during exercise enhances endurance performance. Conversely, the physiological and psychological strain that accompanies increased ambient temperature decreases endurance performance. Little is known about the interaction between environmental temperature and the effects of caffeine on performance. The purpose of this study was to compare the effects of ambient temperature (12 and 33 degrees C) on caffeine ergogenicity during endurance cycling exercise. Eleven male cyclists (mean +/- SD; age, 25 +/- 6 years; (V) over dotO(2max); 58.7 +/- 2.9 ml kg(-1) min(-1)) completed four exercise trials in a randomized, double blind experimental design. After cycling continuously for 90 min (average 65 +/- 7% (V) over dotO(2max)) in either a warm (33 +/- 1 degrees C, 41 +/- 5% rh) or cool (12 +/- 1 degrees C, 60 +/- 7%rh) environment, subjects completed a 15-min performance trial (PT; based on total work accumulated). Subjects ingested 3 mg kg(-1) of encapsulated caffeine (CAF) or placebo (PLA) 60 min prior to and after 45 min of exercise. Throughout exercise, subjects ingested water so that at the end of exercise, independent of ambient temperature, their body mass was reduced 0.55 +/- 0.67%. Two- way (temperature x treatment) repeated-measures ANOVA were conducted with alpha set at 0.05. Total work (kJ) during the PT was greater in 12 degrees C than 33 degrees C [P < 0.001, eta(2) = 0.804, confidence interval (CI): 30.51-62.30]. When pooled, CAF increased performance versus PLA independent of temperature (P = 0.006, eta(2) = 0.542 CI: 3.60-16.86). However, performance differences with CAF were not dependent on ambient temperature (i.e., non-significant interaction; P = 0.662). CAF versus PLA in 12 and 33 degrees C resulted in few differences in other physiological variables. However, during exercise, rectal temperature (T-re) increased in the warm environment (peak T-re; 33 degrees C, 39.40 +/- 0.45; 12 degrees C, 38.79 +/- 0.42 degrees C; P < 0.05) but was not different in CAF versus PLA (P > 0.05). Increased ambient temperature had a detrimental effect on cycling performance in both the CAF and PLA conditions. CAF improved performance independent of environmental temperature. These findings suggest that caffeine at the dosage utilized (6 mg/kg body mass) is a, legal drug that provides an ergogenic benefit in 12 and 33 degrees C.

Gavrieli A; Yannakoulia M; Fragopoulou E; Margaritopoulos D; Chamberland JP; Kaisari P et al. Caffeinated coffee does not acutely affect energy intake, appetite, or inflammation but prevents serum cortisol concentrations from falling in healthy men. Journal of Nutrition 141(4): 703-707, 2011. (29 refs.)

Our aim in this crossover study was to investigate the acute effects of caffeinated and decaffeinated coffee consumption on appetite feelings, energy intake, and appetite-, inflammation-, stress-, and glucose metabolism-related markers. Sixteen healthy men (age range, 21-39 y; BMI range, 19.7-28.6 kg/m(2)) received in a random order on 3 separate occasions a standard breakfast snack with 200 mL of either caffeinated coffee (3 mg caffeine/kg body weight), decaffeinated coffee, or water (control). Before intervention (-15 min) and at standard time points following breakfast consumption (0, 15, 30, 60, 90, 120, 150, and 180 min), participants recorded their appetite feelings and we collected blood samples for measurements of circulating glucose, insulin, cortisol, and appetite- and inflammation-related markers. At 180 min, participants consumed a meal ad libitum. The appetite-related ratings, the appetite plasma hormonal responses as well as the plasma glucose, serum insulin, and plasma and serum inflammatory marker responses did not show an overall intervention effect or a time x intervention interaction. Ad libitum energy intake did not differ among the 3 interventions. However, a significant intervention effect (P = 0.04) and a time x intervention interaction (P-interaction = 0.02) were found for serum cortisol; cortisol concentrations were significantly higher following the caffeinated coffee intervention, compared to control, at 60 mm and thereafter. In conclusion, the usually consumed amount of caffeinated coffee does not have short-term effects on appetite, energy intake, glucose metabolism, and inflammatory markers, but it increases circulating cortisol concentrations in healthy men.

Gelber RP; Petrovitch H; Masaki KH; Ross GW; White LR. Coffee intake in midlife and risk of dementia and its neuropathologic correlates. Journal of Alzheimer's Disease 23(4): 607-615, 2011. (29 refs.)

While animal data suggest a protective effect of caffeine on cognition, studies in humans remain inconsistent. We examined associations of coffee and caffeine intake in midlife with risk of dementia, its neuropathologic correlates, and cognitive impairment among 3494 men in the Honolulu-Asia Aging Study (mean age 52 at cohort entry, 1965-1968) examined for dementia in 1991-1993, including 418 decedents (1992-2004) who underwent brain autopsy. Caffeine intake was determined according to self-reported coffee, tea, and cola consumption at baseline. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for overall dementia, Alzheimer's disease (AD), vascular dementia (VaD), cognitive impairment (Cognitive Abilities Screening Instrument score <74), and neuropathologic lesions at death (Alzheimer lesions, microvascular ischemic lesions, cortical Lewy bodies, hippocampal sclerosis, generalized atrophy), according to coffee and caffeine intake. Dementia was diagnosed in 226 men (including 118 AD, 80 VaD), and cognitive impairment in 347. There were no significant associations between coffee or caffeine intake and risk of cognitive impairment, overall dementia, AD, VaD, or moderate/high levels of the individual neuropathologic lesion types. However, men in the highest quartile of caffeine intake (>277.5 mg/d) were less likely than men in the lowest quartile (<= 115.5 mg) to have any of the lesion types (adjusted-OR, 0.45; 95% CI, 0.23-0.89; p, trend = 0.04). Coffee and caffeine intake in midlife were not associated with cognitive impairment, dementia, or individual neuropathologic lesions, although higher caffeine intake was associated with a lower odds of having any of the lesion types at autopsy.

Gollenberg AL; Mumford SL; Cooney MA; Sundaram R; Louis GMB. Validity of retrospectively reported behaviors during the periconception window. Journal of Reproductive Medicine 56(3-4): 130-137, 2011. (31 refs.)

OBJECTIVE: To assess the validity of retrospectively reported maternal behaviors while attempting pregnancy. STUDY DESIGN: Participants in a prospective pregnancy cohort study with periconception enrollment were queried about. use of cigarettes, alcohol, vitamins and caffeine and the consumption of sport fish while attempting pregnancy. Prospective longitudinal data reported in daily diaries (gold standard) were compared with data obtained a decade later using a self-administered questionnaire. Agreement was assessed by percent agreement and Kappa coefficients. RESULTS: Among the 82 participating women, percent agreement ranged from 54-74% for the 5 behaviors. Validity was highest for smoking (Kappa = 0.43, 95% confidence interval [CI]: 0.22, 0.65) followed by fish consumption (Kappa = 0.32, 95% CI: 0.09, 0.55), caffeine (Kappa = 0.21, 95% CI: 0.09, 0.51) and alcohol (Kappa = 0.20, 95% CI: 0.08, 0.33). There were no systematic differences in agreement by time to pregnancy or pregnancy outcome. Associations between smoking and alcohol consumption and pregnancy outcomes were highly sensitive to the levels of misclassification observed in this study. CONCLUSION: Validity was poor to moderate for the 5 behaviors, though higher for more regular behaviors such as smoking and caffeine consumption. The potential for misreporting of periconception behaviors can affect inferences, and thus efforts to capture information prospectively should be promoted.

Gonzalez AM; Walsh AL; Ratamess NA; Kang J; Hoffman JR. Effect of a pre-workout energy supplement on acute multi-joint resistance exercise. Journal of Sports Science and Medicine 10(2): 261-266, 2011. (38 refs.)

The effect of a pre-workout energy supplement on acute multi-joint resistance exercise was examined in eight resistance-trained college-age men. Subjects were randomly provided either a placebo (P) or a supplement (S: containing caffeine, taurine, glucuronolactone, creatine, beta-alanine, and the amino acids; leucine, isoleucine, valine, glutamine and arginine) 10 minutes prior to resistance exercise. Subjects performed 4 sets of no more than 10 repetitions of either barbell squat or bench press at 80% of their pre-determined 1 repetition-maximum (1RM) with 90 seconds of rest between sets. Dietary intake 24 hours prior to each of the two training trials was kept constant. Results indicate that consuming the pre-workout energy drink 10 minutes prior to resistance exercise enhances performance by significantly increasing the number of repetitions successfully performed (p = 0.022) in S (26.3 +/- 9.2) compared to P (23.5 +/- 9.4). In addition, the average peak and mean power performance for all four sets was significantly greater in S compared to P (p < 0.001 and p < 0.001, respectively). No differences were observed between trials in subjective feelings of energy during either pre (p = 0.660) or post (p = 0.179) meaures. Similary, no differences between groups, in either pre or post assessments, were observed in subjective feelings of focus (p = 0.465 and p = 0.063, respectively), or fatigue (p = 0.204 and p = 0.518, respectively). Results suggest that acute ingestion of a high-energy supplement 10 minutes prior to the onset of a multi-joint resistance training session can augment training volume and increase power performance during the workout.

Heatherley SV. Caffeine withdrawal, sleepiness, and driving performance: What does the research really tell us? Nutritional Neuroscience 14(3): 89-95, 2011. (38 refs.)

As a psychostimulant, caffeine is thought to reduce road accidents by keeping drivers alert and wakeful. Studies have found that caffeine can improve performance on vigilance tasks and in driving simulators under normal sleeping conditions and after sleep restriction or deprivation. However, there is increasing evidence that these beneficial effects of caffeine are due to withdrawal reversal. Studies comparing the effects of caffeine versus placebo on driving performance have tested habitual caffeine consumers deprived of caffeine from the evening before the test day. The conclusion from this review is, therefore, that improvements in driving performance and alertness after caffeine are likely to represent withdrawal reversal rather than a net beneficial effect of caffeine. Further research using designs that control for caffeine withdrawal are necessary and, accordingly, advice given to the public on use of caffeine as an antidote to tiredness and impaired performance should be reviewed.

Howland J; Rohsenow DJ; Calise TV; MacKillop J; Metrik J. Caffeinated alcoholic beverages an emerging public health problem. American Journal of Preventive Medicine 40(2): 268-271, 2011. (44 refs.)

Hutchison R. Bites, nibbles, sips and puffs: New exotic goods in Norway in the 18th and the first half of the 19th century. Scandinavian Journal of History 36(2): 156-185, 2011. (91 refs.)

The slow but significant changes in the material culture of European households that took place in the pre-industrial period are visible in several ways, such as in the changing patterns of housing, furnishing and clothing which have been illustrated in several studies. However, most of these studies focus on the pre-industrial economic leaders, often ignoring the changes taking place on the margins of the economic growth centres. This article seeks to rectify this by looking at changes in the material culture in one such 'marginal' country, namely Norway. The goods focused upon in this case are sugar, tobacco and coffee, which are often termed as exotic goods. These were new commodities in the 18th century and precisely because of their novelty and foreign origin, it is in many cases possible to trace how they spread in rural society, as well as how they impacted it. The emphasis has been put on rural areas for the simple reason that this was where the overall majority of Norwegians lived at the time.

Imatoh T; Tanihara S; Miyazaki M; Momose Y; Uryu Y; Une H. Coffee consumption but not green tea consumption is associated with adiponectin levels in Japanese males. European Journal of Nutrition 50(4): 279- 284, 2011. (31 refs.)

Coffee is among the most widely consumed beverages in the world. Numerous epidemiological studies have reported a significant inverse association between coffee consumption and risk of type 2 diabetes mellitus, but the underlying mechanisms are still not fully understood. Therefore, we conducted an epidemiological study to clarify the relationship between coffee consumption and adiponectin levels in Japanese males. We also evaluated whether green tea consumption affected adiponectin levels. We carried out a cross-sectional study. The subjects were 665 male employees in Japan. Coffee consumption was assessed, using a self-administered questionnaire, as the number of times per week and cups per day respondents drank, and subjects were grouped into four levels (non, 1-5 times/week, 1-2 cups/day and a parts per thousand yen3 cups/day). The means of adiponectin levels were positively associated with coffee consumption. A dose-response relationship was found between coffee consumption and circulating adiponectin levels. The relationship remained significant after adjustment for potential confounding factors (P for trend < 0.05). However, green tea consumption was not significantly associated with adiponectin levels (P for trend = 0.90). We not only revealed that habitual coffee consumption is associated with higher adiponectin levels in Japanese males but also found a dose-dependent association between coffee consumption and adiponectin levels. Therefore, our study suggested that coffee components might play an important role in the elevation of adiponectin level.

Irwin C; Desbrow B; Ellis A; O'Keeffe B; Grant G; Leveritt M. Caffeine withdrawal and high-intensity endurance cycling performance. Journal of Sports Sciences 29(5): 509-515, 2011. (19 refs.)

In this study, we investigated the impact of a controlled 4-day caffeine withdrawal period on the effect of an acute caffeine dose on endurance exercise performance. Twelve well-trained and familiarized male cyclists, who were caffeine consumers (from coffee and a range of other sources), were recruited for the study. A double-blind placebo-controlled cross-over design was employed, involving four experimental trials. Participants abstained from dietary caffeine sources for 4 days before the trials and ingested caspulses (one in the morning and one in the afternoon) containing either placebo or caffeine (1.5mg center dot kg-1 body weight center dot day-1). On day 5, capsules containing placebo or caffeine (3mg center dot kg-1 body weight) were ingested 90min before completing a time trial, equivalent to one hour of cycling at 75% peak sustainable power output. Hence the study was designed to incorporate placebo-placebo, placebo-caffeine, caffeine-placebo, and caffeine-caffeine conditions. Performance time was significantly improved after acute caffeine ingestion by 1:49 +/- 1:41min (3.0%, P=0.021) following a withdrawal period (placebo-placebo vs. placebo-caffeine), and by 2:07 +/- 1:28min (3.6%, P=0.002) following the non-withdrawal period (caffeine-placebo vs. caffeine-caffeine). No significant difference was detetcted between the two acute caffeine trials (placebo-caffeine vs. caffeine-caffeine). Average heart rate throughout exercise was significantly higher following acute caffeine administration compared with placebo. No differences were observed in ratings of perceived exertion between trials. A 3mg center dot kg-1 dose of caffeine significantly improves exercise performance irrespective of whether a 4-day withdrawal period is imposed on habitual caffeine users.

Johnson S; Koh WP; Wang RW; Govindarajan S; Yu MC; Yuan JM. Coffee consumption and reduced risk of hepatocellular carcinoma: Findings from the Singapore Chinese Health Study. Cancer Causes & Control 22(3): 503-510, 2011. (39 refs.)

Background: Coffee consumption has been associated with reduced markers of hepatic cell damage, reduced risk of chronic liver disease, and cirrhosis across a variety of populations. Data on the association between coffee consumption and risk of hepatocellular carcinoma (HCC), especially in high-risk populations, are sparse. Methods: This study examines the relationship between coffee and caffeine consumption, and the risk of developing HCC within the Singapore Chinese Health Study, a prospective cohort of 63,257 middle-aged and older Chinese men and women, a relatively high-risk population for HCC. Baseline data on coffee consumption and other dietary and lifestyle factors were collected through in-person interviews at enrollment between 1993 and 1998. Results: As of 31 December 2006, 362 cohort participants had developed HCC. High levels of coffee or caffeine consumption were associated with reduced risk of HCC (p for trend < 0.05). Compared with non-drinkers of coffee, individuals who consumed three or more cups of coffee per day experienced a statistically significant 44% reduction in risk of HCC (hazard ratio 0.56, 95% confidence interval, 0.31-1.00, p = .049) after adjustment for potential confounders and tea consumption. Conclusion: These data suggest that coffee consumption may reduce the risk of developing HCC in Chinese in Singapore.

Khajeamiri AR; Kobarfard F; Ahmadkhaniha R; Mostashari G. Profiling of ecstasy tablets seized in Iran. Iranian Journal of Pharmaceutical Research 10(2): 211-220, 2011. (9 refs.)

In this study 50 samples of ecstasy tablets seized in Iran during the period of 2007 through 2008 were examined and their physical characteristics (appearance, marking, scored/not scored, color, weight, diameter, thickness) were determined. In order to determine the chemical characteristics of these tablets, color tests (Marquis test, Simon's test, Chen's test and Gallic acid test), Thin Layer Chromatography (TLC), anion test, residual solvents, Gas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Mass Spectrometry (LC-MS) were carried out on the tablets. The range of tablets weight was 96-308 mg and the range of 3,4-methylenedioxymethamphetamine (MDMA) hydrochloride content in these tablets was 60180 mg. No good correlation was found between the tablets weight and their MDMA contents. All of the tablets containing MDMA had this compound in hydrochloride form. Ketamine, phenmetrazine and ephedrine (or pseudoephedrine) were found in some of the tablets along with MDMA. No MDMA was found in 10% of the tablets. Some of these tablets contained compounds such as caffeine or tramadol as their active ingredient.

Levitan EB; Ahmed HN; Mittleman MA; Wolk A. Coffee consumption and incidence of heart failure in women. Circulation. Heart Failure 4(4), 2011. (26 refs.)

Background-Previous studies of the relationship between coffee consumption and incidence of heart failure (HF) have not been consistent, with both potential benefit and potential harm reported. We therefore examined the association between coffee consumption and HF hospitalization or mortality in women. Methods. and Results-We conducted a prospective, observational study of 34 551 participants of the Swedish Mammography Cohort who were 48 to 83 years old and did not have HF, diabetes, or myocardial infarction at baseline. Diet was measured using food-frequency questionnaires. Cox models were used to calculate hazard ratios of HF hospitalization or death from HF as the primary cause, as determined through the Swedish inpatient and cause-of-death registers between January 1, 1998, and December 31, 2006. Over 9 years of follow-up, 602 HF events occurred. Women who consumed >= 5 cups of coffee per day did not have higher rates of HF events than those who consumed <5 cups per day (multivariable-adjusted hazard ratio, 0.93; 95% confidence interval, 0.72 to 1.20). Compared with women who consumed <= 1 cup of coffee per day, hazard ratios were 1.01, 0.82, 0.94, and 0.87 for women who consumed 2, 3, 4, and >= 5 cups per day, respectively (P for trend =0.23). Further adjustment for self-reported hypertension did not change the results. Conclusions-In this population of middle-aged and older women, we did not find an association between coffee consumption and incidence of HF events.

Lin WY; Pi-Sunyer FX; Chen CC; Davidson LE; Liu CS; Li TC; Wu MF. Coffee consumption is inversely associated with type 2 diabetes in Chinese. European Journal of Clinical Investigation 41(6): 659- 666, 2011. (35 refs.)

Background: Coffee consumption has been shown to be inversely associated to type 2 diabetes mellitus (T2DM), but evidence in Chinese populations is limited. We investigated the relationship between coffee consumption and T2DM in a population-based cohort of middle-aged Chinese. Materials and methods: We studied 2332 subjects who participated in the Taichung Community Health Study in Taiwan in 2004. The relationships between coffee consumption, T2DM and fasting glucose were assessed. Results: The prevalence of T2DM was 14 center dot 0% and 10 center dot 4% in men and women. After adjustment for age, body mass index, blood pressure, smoking, alcohol drinking, betel nut chewing, physical activity, income, education level, fat%, protein%, carbohydrate% and magnesium, coffee intake was inversely associated with T2DM. Habitual coffee drinkers had 38-46% lower risk of T2DM than nondrinkers. Compared to nondrinkers, the adjusted odds ratios (ORs) for T2DM according to subjects with habitual coffee consumption (< 1, 1-6, >= 7 times per week) were 0 center dot 77 (0 center dot 52-1 center dot 13), 0 center dot 46 (0 center dot 28-0 center dot 76) and 0 center dot 37 (0 center dot 16-0 center dot 83), respectively. The decreasing ORs indicate a dose-response effect of coffee consumption on the likelihood of having T2DM (P < 0 center dot 001). A similar relationship was also evident in newly diagnosed T2DM (P < 0 center dot 05). The adjusted mean fasting glucose levels gradually decreased as the frequency of coffee consumption increased (P < 0 center dot 05). Conclusions: Coffee intake is inversely associated with T2DM in Chinese. Coffee may be a protective agent for T2DM in Chinese.

Lopez-Garcia E; Rodriguez-Artalejo F; Li TY; Mukamal KJ; Hu FB; van Dam RM. Coffee consumption and mortality in women with cardiovascular disease. American Journal of Clinical Nutrition 94(1): 218-224, 2011. (35 refs.)

Background: Coffee is commonly consumed among populations of all ages and conditions. The few studies that have examined the association between coffee consumption and mortality in patients with cardiovascular disease (CVD) have obtained conflicting results. Objective: The objective was to assess the association between filtered caffeinated coffee consumption and all-cause and CVD mortality during up to 24 y of follow-up in women with CVD from the Nurses' Health Study. Design: The Nurses' Health Study included 11,697 women. Coffee consumption was first assessed in 1980 with a food-frequency questionnaire (FFQ) and then repeatedly every 2-4 y. Cumulative consumption was calculated with all available FFQs from the diagnosis of CVD to the end of the follow-up in 2004 to assess long-term effects. In addition, the most recent coffee measurement was related to mortality in the subsequent 2 y to assess shorter-term effects. Analyses were performed by using Cox regression models. Results: We documented 1159 deaths, of which 579 were due to CVD. The relative risks [RRs (95% CI)] of all-cause mortality across categories of cumulative coffee consumption [<1 cup (240 mL or 8 oz)/mo, 1 cup/mo to 4 cups/wk, 5-7 cups/wk, 2-3 cups/d, and >= 4 cups/d] were 1, 1.04 (0.86, 1.27), 1.13 (0.95, 1.36), 1.01 (0.86, 1.18), and 1.18 (0.89, 1.56), respectively (P for trend = 0.91). The RRs of CVD mortality across the same categories of coffee intake were 1, 0.99 (0.75, 1.31), 1.03 (0.80, 1.35), 0.97 (0.78, 1.21), and 1.25 (0.85, 1.84), respectively (P for trend = 0.76). Similarly, caffeine intake was not associated with total or CVD mortality. Finally, we observed no association of the most recent coffee and caffeine intakes with total and CVD mortality in the subsequent 2 y. Conclusion: Consumption of filtered caffeinated coffee was not associated with CVD or all-cause mortality in women with CVD.

Mahapatra S; Belgrad JL; Adeoye MA. Psychotropic drug-related eosinophilia with systemic symptoms after acute caffeine ingestion. Pediatrics 127(1): E235-E238, 2011. (12 refs.)

Drug-related eosinophilia with systemic symptoms (DRESS) is a potentially life-threatening, multiorgan condition that can result from drug treatment. Antiepileptic medications have provided the best-studied link of any class of medications. Here, we report the case of a 16-year-old boy with long-standing bipolar disorder who was chronically treated with aripiprazole and fluoxetine and developed DRESS syndrome after ingestion of high doses of caffeine. His classic presentation with fever, morbilliform rash, lymphadenopathy, and visceral involvement, including leukocytosis, eosinophilia, and hepatitis, was consistent with this diagnosis. Furthermore, the patient's symptoms dramatically improved after corticosteroid therapy and discontinuation of all psychotropic medications. We propose that the development of DRESS syndrome is a net result of inconsistent medication adherence coupled with the ingestion of near-toxic doses of caffeine, which can lead to rhabdomyolysis and, through renal impairment, lead to the accumulation of toxic oxidative metabolites of either or both psychotropic medications. We also present one of the few reported cases of caffeine-induced rhabdomyolysis and propose its role in the development of DRESS in this patient.

Mahoney CR; Brunye TT; Giles G; Lieberman HR; Taylor HA. Caffeine-induced physiological arousal accentuates global processing biases. Pharmacology, Biochemistry and Behavior 99(1): 59-65, 2011. (81 refs.)

The effects of caffeine-induced arousal on global versus local object focus were investigated in non-habitual consumers using a double-blind, within-subjects, repeated-measures design. Following an overnight fast, low caffeine consumers (N = 36; M = 42.5 mg/day caffeine) completed 5 counterbalanced test sessions (normal consumption, 0 mg, 100 mg, 200 mg, and 400 mg) separated by at least 3 days. During each session, volunteers either consumed their normal amount of caffeine or were administered 1 of 4 treatment pills. One hour later they completed two tasks assessing visual attention, in counterbalanced order. Measures of mood, salivary caffeine and cortisol were taken at multiple time points. Dose-dependent elevation of caffeine in the saliva demonstrated the experimental manipulation was effective. Furthermore, analyses of the mood and arousal measures detected consistent changes on arousal subscales and caffeine administration elevated saliva cortisol. Analyses of the visual attention tasks revealed that caffeine-induced physiological arousal produced global processing biases, after as little as 100 mg caffeine. These data suggest caffeine consumption may influence how individuals attend to and process information in their environment and could influence daily tasks such as face recognition, learning new environments and navigation, especially for those who normally consume little caffeine.

Mart SM. Alcohol marketing in the 21st Century: New methods, old problems. Substance Use & Misuse 46(7): 889-892, 2011. (19 refs.)

Marketing and advertising for alcoholic beverages is abundant throughout the United States and the rest of the world. Despite the fact that alcohol advertising is related to earlier initiation of drinking, higher rates of consumption, and positive expectancies among youth populations, alcohol companies continue to design new products and related campaigns with youth-friendly attributes. Alcopops and caffeinated alcoholic beverages are two particularly dangerous types of products, and new social networking technologies make direct promotion easy and voluminous. In order to stop the harm from these alcohol products and promotion, advocacy from the research community is imperative.

Mcmahon T; Newman DG. Caffeine chewing gum as an in-flight countermeasure to fatigue. (editorial). Aviation, Space and Environmental Medicine 82(4): 490-491, 2011. (6 refs.)

Mineharu Y; Koizumi A; Wada Y; Iso H; Watanabe Y; Date C; p. Coffee, green tea, black tea and oolong tea consumption and risk of mortality from cardiovascular disease in Japanese men and women. Journal of Epidemiology and Community Health 65(3): 230-240, 2011. (39 refs.)

Background: The effects of coffee and green, black and oolong teas and caffeine intake on cardiovascular disease (CVD) mortality have not been well defined in Asian countries. Methods To examine the relationship between the consumption of these beverages and risk of mortality from CVD, 76 979 individuals aged 40-79 years free of stroke, coronary heart disease (CHD) and cancer at entry were prospectively followed. The daily consumption of beverages was assessed by questionnaires. Results: 1362 deaths were documented from strokes and 650 deaths from CHD after 1 010 787 person-years of follow-up. Compared with non-drinkers of coffee, the multivariable HR and 95% CI for those drinking 1-6 cups/week, 1-2 cups/day and >= 3 cups/day were 0.78 (0.50 to 1.20), 0.67 (0.47 to 0.96) and 0.45 (0.17 to 0.87) for strokes among men (p=0.009 for trend). Compared with non-drinkers of green tea, the multivariable HR for those drinking 1-6 cups/week, 1-2 cups/day, 3-5 cups/day and >= 6 cups/day were 0.34 (0.06-1.75), 0.28 (0.07-1.11), 0.39 (0.18-0.85) and 0.42 (0.17-0.88) for CHD among women (p=0.038 for trend). As for oolong tea, the multivariable HR of those drinking 1-6 cups/week and >= 1 cups/day were 1.00 (0.65-1.55) and 0.39 (0.17-0.88) for total CVD among men (p=0.049 for trend). Risk reduction for total CVD across categories of caffeine intake was most prominently observed in the second highest quintile, with a 38% lower risk among men and 22% among women. Conclusions: Consumption of coffee, green tea and oolong tea and total caffeine intake was associated with a reduced risk of mortality from CVD.

Mueller U; Sauer T; Weigel I; Pichner R; Pischetsrieder M. Identification of H2O2 as a major antimicrobial component in coffee. Food & Function 2(5): 265-272, 2011. (31 refs.)

Coffee shows distinct antimicrobial activity against several bacterial genera. The present study investigated molecular mechanisms and active ingredients mediating the antimicrobial effect of coffee. Depending on concentration, roasted, but not raw coffee brew inhibited the growth of Escherichia coli and Listeria innocua. Several coffee ingredients with known antibacterial properties were tested for their contribution to the observed effect. In natural concentration, caffeine, ferulic acid and a mixture of all test compounds showed very weak, but significant activity, whereas trigonelline, 5-(hydroxymethyl) furfural, chlorogenic acid, nicotinic acid, caffeic acid, and methylglyoxal were not active. Antimicrobial activity, however, was completely abolished by addition of catalase indicating that H2O2 is a major antimicrobial coffee component. In accordance with this assumption, bacterial counts during 16 h of incubation were inversely related to the H2O2 concentration in the incubation solution. Pure H2O2 showed slightly weaker activity. The H2O2 dependent antimicrobial activity of coffee could be mimicked by a reaction mixture of D-ribose and L-lysine (30 min 120 degrees C) indicating that H2O2 is generated in the coffee brew by Maillard reaction products. Identification of H2O2 as major antimicrobial coffee component is important to evaluate the application of coffee or coffee extracts as natural preservatives.

Nebes RD; Pollock BG; Halligan EM; Houck P; Saxton JA. Cognitive slowing associated with elevated serum anticholinergic activity in older individuals is decreased by caffeine use. American Journal of Geriatric Psychiatry 19(2): 169-175, 2011. (32 refs.)

Objectives: This study examined whether some of the age-associated decrements in basic cognitive resources (information-processing speed and working memory) result from anticholinergic medication use (as measured by serum anticholinergic activity [SAA]) and whether such decrements are lessened by caffeine. Design: Cross-sectional observational study. Setting: University medical center. Participants: One hundred fifty-two normal-elderly community volunteers. Measurements: Two tests each of information-processing speed and of working memory were administered, and blood samples were drawn before and after cognitive testing to determine serum levels of anticholinergic activity and of paraxanthine-a caffeine metabolite. Results: Elevated SAA was associated with a significant but modest slowing in information-processing time but only in those individuals who had low levels of serum paraxanthine. SAA did not correlate with performance on tests of working memory. Conclusions: These results suggest that anticholinergic medications are a relatively minor contributor to the decrements in basic processing resources commonly found in studies of normal aging.

Nicoletti A; Mostile G; Cappellani R; Contrafatto D; Arabia G; Lamberti P et al. Wine drinking and essential tremor: A possible protective role. Movement Disorders 26(7): 1310-1315, 2011. (34 refs.)

The purpose of this study was to evaluate the possible association of cigarette smoking, coffee drinking, and wine consumption with essential tremor using a matched case-control design. Cases and controls were enrolled from 6 Movement Disorder centers in central-southern Italy. Essential tremor was diagnosed according to Bain's criteria. Three unrelated healthy controls (not affected by neurological disorders) per each enrolled case, matched by sex and age (+/- 5 years), were selected. A standardized questionnaire was administered to record demographic, epidemiological, and clinical data. All cases and controls underwent a standard neurological examination. Adjusted odds ratios and 95% confidence intervals were estimated using conditional logistic regression for the matched cases and controls. Eighty-three patients with essential tremor (38 men and 45 women; mean age, 68.2 +/- 8.6 years) and 245 matched control subjects (113 men and 132 women; mean age, 68.4 +/- 9.7 years) were enrolled in the study. Multivariate analysis showed a significant negative association between essential tremor and wine consumption preceding the onset of disease (adjusted odds ratio, 0.23; 95% confidence interval, 0.08-0.64; P = .0005) with a significant dose effect (1-2 glass of wine per day: odds ratio, 0.32; 95% confidence interval, 0.10-0.95; P = .04; more than 3 glass of wine per day: odds ratio, 0.14; 95% confidence interval, 0.03-0.62; P = .01). In our sample no association between essential tremor and cigarette smoking or coffee drinking was found. Our data suggest a negative association between wine drinking and essential tremor, which could be explained by the long-term neuroprotective effect of its antioxidant components.

Olcina G; Maynar M; Munoz D; Timon R; Caballero MJ; Maynar J. Plasma total fatty acid responses to exercise following caffeine ingestion. European Journal of Sport Science 11(2): 111-118, 2011. (32 refs.)

Aerobic exercise is associated with changes in the blood profile of fatty acids. Caffeine is known to be a potential lipolytic agent. Hence, caffeine ingestion in addition to exercise might have an influence on fatty acids, with positive effects on health and performance. The aim of the present study, therefore, was to assess the effect of caffeine (5 mg center dot kg body mass-1) ingested before aerobic exercise on the total plasma fatty acid profile. In a crossover, double-blind, randomized study involving 20 untrained males ([image omitted] 43.57 +/- 6.48 ml center dot kg-1 center dot min-1), blood lactate concentration, plasma caffeine values, and plasma fatty acid profile were examined using chromatographic techniques before and after 30 min of steady-state cycle exercise at 75% [image omitted] under placebo and caffeine conditions. Ventilatory responses and substrate oxidation rates were determined during exercise and recovery. Ventilatory responses, lactate concentrations, and fat and carbohydrate oxidation rates were not affected by caffeine ingestion. Carbohydrate was the main substrate oxidized during steady-state trials under both conditions, although exercise increased blood saturated fatty acids (placebo: 28.30 +/- 5.90% vs. 31.09 +/- 4.59, P0.05; caffeine: 28.88 +/- 4.12% vs. 29.60 +/- 4.56%). Unsaturated blood concentrations of oleic fatty acid trans (C18:1t) increased due to caffeine (placebo: 2.22 +/- 2.81% vs. 2.61 +/- 3.86%; caffeine 1.53 +/- 0.19% vs. 1.70 +/- 0.49%, P0.05). In conclusion, the ingestion of caffeine prior to moderate-to-high aerobic exercise may not have a clear metabolic advantage under the conditions of the present study in untrained individuals, although it might influence some individual unsaturated fatty acids (C18:1t) despite low fat oxidation rates.

Perera V; Gross AS; Xu HM; McLachlan AJ. Pharmacokinetics of caffeine in plasma and saliva, and the influence of caffeine abstinence on CYP1A2 metrics. Journal of Pharmacy and Pharmacology 63(9): 1161-1168, 2011. (50 refs.)

Objectives: To investigate the utility of metrics of CYP1A2 activity using caffeine as a probe, and saliva and plasma sampling with or without a 24-h caffeine abstinence. Methods This was a cross-over pharmacokinetic study in 30 healthy male subjects who received a single oral 100 mg caffeine dose after 24-h caffeine abstinence or after maintaining their regular caffeine intake (no caffeine abstinence). Serial blood and saliva samples were collected simultaneously over 24 h. Caffeine and paraxanthine concentrations were measured using a validated HPLC assay. Key findings There was a strong correlation between the paraxanthine/caffeine AUC(0-24) ratio (reference metric) and the paraxanthine/caffeine concentration (C(t)) ratio at 4 h (C(4)) in both saliva and plasma (r >= 0.75). The paraxanthine/caffeine AUC(0-24) ratio in plasma and saliva did not differ between the 24-h caffeine abstinence and the no abstinence period (P > 0.05). The optimal paraxanthine/caffeine C(t) that correlated with the plasma paraxanthine/caffeine AUC(0-24) ratio in the 24-h abstinence period was 2 and 4 h (r = 0.88) in plasma, and 4 and 6 h in saliva (r = 0.70), while it was the saliva 4 h time-point in the no abstinence period (r = 0.78). Conclusions: The saliva paraxanthine/caffeine concentration ratio at 4 h was a suitable metric to assess CYP1A2 activity after oral administration of caffeine without the need for 24-h caffeine abstinence.

Prat G; Adan A. Influence of circadian typology on drug consumption, hazardous alcohol use, and hangover symptoms. Chronobiology International 28(3): 248-257, 2011. (59 refs.)

Few studies have focused on the influence of circadian typology on drug use, and none has considered the use of illegal drugs and hazardous alcohol consumption. This study analyzes the influence of circadian typology on several types of drug consumption (habitual or sporadic), hangover symptoms (past 12 mos), and, more specifically, hazardous alcohol consumption of young adults. Five hundred seventeen university students (173 males), between 17 and 30 yrs of age, answered the Composite Scale of Morningness (CSM), the Alcohol Use Disorders Identification Test (AUDIT), and a self-referred questionnaire on drug consumption during the previous month and on the prevalence of different hangover symptoms during the previous year. Our results confirm a higher prevalence of consumption of addictive substances, both legal (nicotine and cola drinks) and illegal (cannabis and ecstasy), in evening-compared to morning-and neither-type subjects (p < .001 in all cases). Evening-type subjects also obtained a higher total score on the AUDIT (p < .001) and showed a greater prevalence in the subscales of potential alcohol problems (p < .02), as well as more frequent different hangover symptoms (learning difficulties, thirst, tiredness, headaches, sensorial hypersensitivity, anxiety, and irritability; p < .04 in all cases) compared with morning-and neither-type subjects, except for sensorial hypersensitivity and anxiety, for which the evening-type did not differ from the neither-type. Our results provide substantial evidence that the evening circadian typology is a risk factor for the development of drug consumption and that it should be taken into account both in preventive and treatment approaches. Moreover, the data regarding hazardous alcohol use and hangover symptoms emphasize the need to include circadian typology in future studies on the pattern of heavy episodic drinking.

Reich MS; Dietrich MS; Martin PR. Temporal sequence of incident cigarette, coffee, and alcohol use among AA participants. (review). American Journal of Drug and Alcohol Abuse 37(1): 27-36, 2011. (48 refs.)

Background: Cigarettes and coffee are widely used psychoactive substances among alcoholics. Due to the devastating public health impact of alcohol use disorders, it is important to determine if using cigarettes or coffee may influence alcoholism. Previous studies indicate that cigarette smoking is associated with progression of alcohol dependence, but the effects of coffee drinking have yet to be investigated. Objectives: To retrospectively determine the temporal sequence of incident cigarette, coffee, and alcohol use and attributed subjective effects in AA participants. Methods: Volunteers at all Nashville open-AA meetings (n = 289 [126 women], completion rate = 94.1%) were administered a Lifetime Drinking History modified to also include lifetime cigarette and coffee consumption, as well as coffee consumption and effects questions, the Fagerstrom Test for Nicotine Dependence, and the Smoking Effects Questionnaire. Results: Average ages (years) at first regular use of alcohol, cigarettes, and coffee were 15.4 (IQR: 13.0-18.0), 16.7 (IQR: 13.0-18.5), and 18.5 (IQR: 14.0-23.5), respectively. In a subset who used all three substances (n = 236; 102 women) alcohol consumption preceded cigarette smoking (p < .001) and coffee drinking (p < .001), and cigarette smoking preceded coffee drinking (p < .001); these relationships did not differ by gender. Conclusions: Recovering alcoholics started regular alcohol consumption prior to cigarette smoking and coffee drinking. Scientific Significance: In AA participants, coffee does not precede initiation of regular smoking or alcohol drinking as might be anticipated for a gateway drug.

Santini A; Ferracane R; Mikusova P; Eged S; Srobarova A; Meca G et al. Influence of different coffee drink preparations on ochratoxin A content and evaluation of the antioxidant activity and caffeine variations. Food Control 22(8): 1240- 1245, 2011. (34 refs.)

Coffee is one of the most frequently consumed beverages in North America and Europe. It is well known that coffee contains caffeine and that coffee beans can be contaminated by Ochratoxin A (OTA). The operating conditions however affect OTA and caffeine extraction from the roasted coffee. OTA content found in the beverages can be greater than that found in the roasted coffee used to prepare it, representing a potential OTA related risk factor for the human health. Moreover the coffee beans and coffee based beverages have an anti oxidant activity. This study investigates the OTA content, the amount of caffeine, and the antioxidant activity in five different preparations: American coffee, Moka, Italian Espresso, Neapolitan and Turkish coffee. Artificially OTA spiked samples were prepared using artificially contaminated roasted coffee beans. High Pressure Liquid Chromatography with fluorimetric detector was used (LC-FLD). The OTA amount, in all preparations, was 85% lower then the spiking level. Quantitative analysis of the caffeine content in the five coffee preparations was determined by spectrophotometry, and the antioxidant lipophilic and hydrophilic activities of the different coffee preparations were investigated and compared. The caffeine content was directly related to its antioxidant activity; no relation was found between OTA, antioxidant activity and caffeine.

Schneider MB; Benjamin HJ; Bhatia JJS; Abrams SA; De Ferranti SD; Schneider MB et al. Clinical report. Sports drinks and energy drinks for children and adolescents: Are they appropriate? Pediatrics 127(6): 1182-1189, 2011. (45 refs.)

Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The primary objectives of this clinical report are to define the ingredients of sports and energy drinks, categorize the similarities and differences between the products, and discuss misuses and abuses. Secondary objectives are to encourage screening during annual physical examinations for sports and energy drink use, to understand the reasons why youth consumption is widespread, and to improve education aimed at decreasing or eliminating the inappropriate use of these beverages by children and adolescents. Rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents. Furthermore, frequent or excessive intake of caloric sports drinks can substantially increase the risk for overweight or obesity in children and adolescents. Discussion regarding the appropriate use of sports drinks in the youth athlete who participates regularly in endurance or high-intensity sports and vigorous physical activity is beyond the scope of this report.

Schoffl I; Kothmann JF; Schoffl V; Rupprecht HD; Rupprecht T. "Vodka Energy": Too much for the adolescent nephron? Pediatrics 128(1): E227-E231, 2011. (20 refs.)

We report here the case of a 17-year-old boy who suffered acute renal failure after consuming 3 L of energy drink (ED) in combination with 1 L of vodka amounting to 4600 mg of taurine and 780 mg of caffeine mixed with 380 g of alcohol. The consumption of this mixture is extremely popular in adolescents, because the joint effects of caffeine and taurine reduce the effect of alcohol. Although there have been case reports of deaths linked to the consumption of EDs with and without alcohol, awareness of the possible dangers is still low. The fact that athletes and major sports events are sponsored by ED manufacturers implies that they may even be healthy and performance-enhancing.

Seifert SM; Schaechter JL; Hershorin ER; Lipshultz SE. Health effects of energy drinks on children, adolescents, and young adults. Pediatrics 127(3): 511-528, 2011. (116 refs.)

OBJECTIVE: To review the effects, adverse consequences, and extent of energy drink consumption among children, adolescents, and young adults. METHODS: We searched PubMed and Google using "energy drink," "sports drink," "guarana," "caffeine," "taurine," "ADHD," "diabetes," " children," " adolescents," "insulin," "eating disorders," and "poison control center" to identify articles related to energy drinks. Manufacturer Web sites were reviewed for product information. RESULTS: According to self-report surveys, energy drinks are consumed by 30% to 50% of adolescents and young adults. Frequently containing high and unregulated amounts of caffeine, these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioral disorders or those who take certain medications. Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising. CONCLUSIONS: Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy drink use. In the short-term, pediatricians need to be aware of the possible effects of energy drinks in vulnerable populations and screen for consumption to educate families. Long-term research should aim to understand the effects in at-risk populations. Toxicity surveillance should be improved, and regulations of energy drink sales and consumption should be based on appropriate research.

Shechter M; Shalmon G; Scheinowitz M; Koren-Morag N; Feinberg MS; Harats D et al. Impact of acute caffeine ingestion on endothelial function in subjects with and without coronary artery disease. American Journal of Cardiology 107(9): 1255- 1261, 2011. (30 refs.)

Although coffee is a widely used, pharmacologically active beverage, its impact on the cardiovascular system is controversial. To explore the effect of acute caffeine ingestion on brachial artery flow-mediated dilation (FMD) in subjects without coronary artery disease (CAD; controls) and patients with CAD, we prospectively assessed brachial artery FMD in 40 controls and 40 age- and gender-matched patients with documented stable CAD on 2 separate mornings 1 week to 2 weeks apart. After overnight fasting, discontinuation of all medications for >= 12 hours, and absence of caffeine for > 48 hours, participants received capsules with caffeine 200 mg or placebo. One hour after drug ingestion, participants underwent brachial artery FMD and nitroglycerin-mediated dilation (NTG) using high-resolution ultrasound. As expected, patients with CAD were more oftein diabetic, hypertensive, obese, dyslipidemic, and smoked more than controls (p < 0.01 for all comparisons). Aspirin, Clopidogrel, angiotensin-converting enzyme inhibitors, beta blockers, and statins were significantly more common in patients with CAD than in controls (p < 0.01 for all comparisons). At baseline, FMD, but not NTG, was significantly lower in patients with CAD compared to controls. Acute caffeine ingestion significantly increased FMD (patients with CAD 5.6 +/- 5.0% vs 14.6 +/- 5.0%, controls 8.4 +/- 2.9% vs 18.6 +/- 6.8%, p < 0.001 for all comparisons) but not NTG (patients with CAD 13.0 +/- 5.2% vs 13.8 +/- 6.1%, controls 12.9 +/- 3.9% vs 13.9 +/- 5.8%, p = NS for all comparisons) and significantly decreased high-sensitivity C-reactive protein (patients with CAD 2.6 +/- 1.4 vs 1.4 +/- 1.2 mg/L, controls 3.4 +/- 3.0 vs 1.2 +/- 1.0 mg/L, p < 0.001 for all comparisons) in the 2 groups compared to placebo. In conclusion, acute caffeine ingestion significantly improved endothelial function assessed by brachial artery FMD in subjects with and without CAD and was associated with lower plasma markers of inflammation.

Sim WJ; Lee JW; Lee ES; Shin SK; Hwang SR; Oh JE. Occurrence and distribution of pharmaceuticals in wastewater from households, livestock farms, hospitals and pharmaceutical manufactures. Chemosphere 82(2): 179-186, 2011. (35 refs.)

Twenty-four pharmaceuticals were measured in wastewater from 12 municipal wastewater treatment plants (M-WWTPs), four livestock WWTPs (L-WWTPs), four hospital WWTPs (H-WWTPs) and four pharmaceutical manufacture WWTPs (P-WWTPs). The total concentration of pharmaceuticals in the influent samples was highest in the L-WWTPs followed by the P-WWTPs, H-WWTPs and M-WWTPs. The effluents had different patterns of pharmaceuticals than their corresponding influents because of the different fate of each compound in the WWTPs. Non-steroidal anti-inflammatory drugs (NSAIDs) were the most dominant in the influents from the M-WWTPs and P-WWTPs, while antibiotics were dominantly detected in the L-WWTP. In the H-WWTP influents, NSAIDs, caffeine and carbamazepine were dominant. In the P-WWTPs, the distribution of pharmaceuticals in the effluents varied with sampling sites and periods. The M-WWTP influents had the highest daily loads, while the effluents showed somewhat similar levels in all source types.

Tettamanti G; Altman D; Pedersen NL; Bellocco R; Milsom I; Iliadou AN. Effects of coffee and tea consumption on urinary incontinence in female twins. International Journal of Obstetrics and Gynaecology 118(7): 806- 813, 2011. (25 refs.)

Objectives: To assess the effect of coffee and tea consumption on symptoms of urinary incontinence. Design: Population-based study. Setting: The Swedish Twin Register. Population: In 2005, all twins born between 1959 and 1985 in Sweden (n = 42 852) were invited to participate in a web-based survey to screen for common complex diseases and common exposures. The present study was limited to female twins with information about at least one urinary symptoms and coffee and tea consumption (n = 14 031). Main outcome measure: The association between coffee and tea consumption and urinary incontinence, as well as nocturia, was estimated as odds ratios (ORs) with 95% confidence intervals. Results: Women with a high coffee intake were at lower risk of any urinary incontinence (OR 0.78, 95% CI 0.64-0.98) compared with women not drinking coffee. Coffee intake and incontinence subtypes showed no significant associations whereas high tea consumption was specifically associated with a risk for overactive bladder (OR 1.34, 95% CI 11.07-1.67) and nocturia (OR 1.18, 95% CI 1.01-1.38). Results from co-twin control analysis suggested that the associations observed in logistic regression were mainly the result of familial effects. Conclusions: This study suggests that coffee and tea consumption has a limited effect on urinary incontinence symptoms. Familial and genetic effects may have confounded the associations observed in previous studies.

Trabulo D; Marques S; Pedroso E. Caffeinated energy drink intoxication. Emergency Medicine Journal 28(8): 712-714, 2011. (18 refs.)

In recent years an increasing number of different energy drinks have been introduced to provide an energy boost. They contain high levels of caffeine and other additives that act as stimulants. Several recent studies present that energy drinks could increase the risk of seizures, acid-base disorders and cardiovascular events. The authors report a 28-year-old man who was brought to the emergency room after sudden onset of tonic-clonic seizures and metabolic acidosis after drinking several cans of a caffeinated energy drink. The authors believe that this clinical picture was caused by caffeine intoxication from an energetic drink causing a syndrome of catecholamine excess. The patient was discharged within a week with no complaints and no neurological signs. Finally, recognising the features of caffeine intoxication and its potential health consequences may be especially relevant when treating younger persons who may be more likely to consume energy drinks.

Turati F; Galeone C; Talamini R; Franceschi S; Manzari M; Gallino G et al. Coffee, decaffeinated coffee, tea, and pancreatic cancer risk: A pooled-analysis of two Italian case-control studies. European Journal of Cancer Prevention 20(4): 287- 292, 2011. (66 refs.)

To evaluate the association between coffee, decaffeinated coffee, and tea consumption and pancreatic cancer risk in a pooled analysis of two Italian case-control studies, between 1983 and 2008, we conducted two case-control studies in Northern Italy, including a total of 688 pancreatic cancer cases and 2204 hospital controls with acute, non-neoplastic diseases. We computed multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for coffee drinking (mostly espresso and mocha), adjusting for age, sex, center, year of interview, education, body mass index, tobacco smoking, alcohol drinking, and diabetes. Compared with coffee nondrinkers, the multivariate OR for coffee drinkers was 1.34 (95% CI: 1.01-1.77). However, there was no trend in risk with respect to dose and duration. The OR for an increment of one cup per day was 1.05 (95% CI: 0.98-1.11). There was no heterogeneity in strata of age, sex, and other covariates, including tobacco smoking. No association emerged for decaffeinated coffee (for drinkers the OR was 0.87, 95% CI: 0.60-1.26, compared with decaffeinated coffee nondrinkers) or tea (for tea drinkers the OR was 0.92, 95% CI: 0.75-1.14). The lack of relationship with dose and duration weighs against a causal association between coffee and pancreatic cancer, which is in agreement with most evidence on the issue.

Tverdal A; Hjellvik V; Selmer R. Coffee intake and oral-oesophageal cancer: Follow-up of 389,624 Norwegian men and women 40-45 years. British Journal of Cancer 105(1): 157-161, 2011. (16 refs.)

BACKGROUND: The evidence on the relationship between coffee intake and cancer of the oral cavity and oesophagus is conflicting and few follow-up studies have been done. Methods: A total of 389 624 men and women 40-45 years who participated in a national survey programme were followed with respect to cancer for an average of 14.4 years by linkage to the Cancer Registry of Norway. Coffee consumption at baseline was reported as a categorical variable (0 or <1 cup, 1-4, 5-8, 9+ cups per day). RESULTS: Altogether 450 squamous oral or oesophageal cancers were registered during follow-up. The adjusted hazard ratios with 1-4 cups per day as reference were 1.01 (95% confidence interval: 0.70, 1.47), 1.16 (0.93, 1.45) and 0.96 (0.71, 1.14) for 0 or <1 cup, 5-8 and 9+ cups per day, respectively. Stratification by sex, type of coffee, smoking status and dividing the end point into oral and oesophageal cancers gave heterogeneous and non-significant estimates. CONCLUSION: This study does not support an inverse relationship between coffee intake and incidence of cancer in the mouth or oesophagus, but cannot exclude a weak inverse relationship.

Waiser MJ; Humphries D; Tumber V; Holm J. Effluent-dominated streams. Part 2: Presence and possible effects of pharmaceuticals and personal care products in Wascana Creek, Saskatchewan, Canada. Environmental Toxicology and Chemistry 30(2): 508-519, 2011. (58 refs.)

Recent worldwide surveys have not only established incomplete removal of pharmaceuticals and personal care products (PPCPs) by sewage treatment plants, but also their presence in surface waters receiving treated sewage effluent. Those aquatic systems where sewage effluent dominates flow are thought to be at the highest risk for ecosystem level changes. The city of Regina, Saskatchewan, Canada (population 190,400) treats its sewage at a modern tertiary sewage treatment facility located on Wascana Creek. The Wascana Creek hydrograph is dominated by one major event: spring snow melt. Thereafter, creek flow declines considerably and in winter treated sewage effluent makes up almost 100% of stream flow. Four water surveys conducted on the creek from winter 2005 to spring 2007 indicated that PPCPs were always present, in nanogram and sometimes microgram per liter concentrations downstream of the sewage treatment plant. This mixture included antibiotics, analgesics, antiinflammatories, a lipid regulator, metabolites of caffeine, cocaine and nicotine, and an insect repellent. Not surprisingly, concentrations of some PPCPs were highest in winter. According to hazard quotient calculations and homologue presence, ibuprofen, naproxen, gemfibrozil, triclosan, erythromycin, trimethoprim, and sulfamethoxazole were present in Wascana Creek at concentrations that may present a risk to aquatic organisms. The continual exposure to a mixture of pharmaceuticals as well as concentrations of un-ionized ammonia that far exceed Canadian and American water quality guidelines suggests that Wascana Creek should be considered an ecosystem at risk. Although the Wascana Creek study is regional in nature, the results highlight the considerable risks posed to aquatic organisms in such effluent-dominated ecosystems.

Wang YJ; Tuomilehto J; Jousilahti P; Antikainen R; Mahonen M; Mannisto S et al. Coffee consumption and the risk of heart failure in Finnish men and women. Heart 97(1): 44-48, 2011. (30 refs.)

Objectives: To evaluate the association of coffee consumption with the risk of heart failure (HF) in the Finnish population. Design Prospective population-based cohort study. Setting This study, which is a part of FINRISK study, was carried out in Finland. Subjects: Study cohorts included 59 490 Finnish participants aged 25-74 years who were free of HF at baseline. Main outcome measures HF (2020 men and 1807 women) during a mean follow-up of 19.2 years. Results: Multivariable-adjusted (age, study year, body mass index, smoking, education, alcohol consumption, tea consumption, physical activity, systolic blood pressure, history of myocardial infarction, history of valvular heart disease, history of diabetes and total cholesterol) HRs (with 95% CI) of HF associated with the amount of coffee consumption daily (0, 1-2, 3-4, 5-6, 7-9 and >= 10 cups) were 1.00, 0.91 (0.71 to 1.16), 0.88 (0.70 to 1.10), 0.91 (0.73 to 1.13), 0.96 (0.76 to 1.22) and 1.02 (0.80 to 1.30) (p(trend)=0.485) for men and 1.00, 0.73 (0.56 to 0.97), 0.77 (0.60 to 0.98), 0.68 (0.53 to 0.88), 0.80 (0.61 to 1.04) and 0.88 (0.65 to 1.19) (p(trend)=0.007) for women, respectively. Stratification by age, smoking status, alcohol consumption, history of type 2 diabetes mellitus and body mass index gave similar results. Conclusion: Coffee consumption does not increase the risk of HF in Finnish men and women. In women, an inverse association was observed between low to moderate coffee consumption and the risk of HF.

Warzak WJ; Evans S; Floress MT; Gross AC; Stoolman S. Caffeine consumption in young children. Journal of Pediatrics 158(3): 508-509, 2011. (10 refs.)

Two hundred twenty-eight surveyed parents reported that their 5 to 7 year old children drank approximately 52 mg of caffeine daily and their 8 to 12 year old children drank 109 mg daily. Caffeine consumption and hours slept were significantly negatively correlated, but caffeine consumption and enuresis were not significantly correlated. Spanish-speaking parents reported fewer bedwetting events than their English-speaking peers.

Yu XF; Bao ZJ; Zou JA; Dong J. Coffee consumption and risk of cancers: A meta-analysis of cohort studies. (review). BMC Cancer 11: article 96, 2011. (89 refs.)

Background: Coffee consumption has been shown to be associated with cancer of various sites in epidemiological studies. However, there is no comprehensive overview of the substantial body of epidemiologic evidence. Methods: We searched MEDLINE, EMBASE, Science Citation Index Expanded and bibliographies of retrieved articles. Prospective cohort studies were included if they reported relative risks (RRs) and corresponding 95% confidence intervals (CIs) of various cancers with respect to frequency of coffee intake. We did random-effects meta-analyses and meta-regressions of study-specific incremental estimates to determine the risk of cancer associated with 1 cup/day increment of coffee consumption. Results: 59 studies, consisting of 40 independent cohorts, met the inclusion criteria. Compared with individuals who did not or seldom drink coffee per day, the pooled RR of cancer was 0.87 (95% CI, 0.82-0.92) for regular coffee drinkers, 0.89 (0.84-0.93) for low to moderate coffee drinkers, and 0.82 (0.74-0.89) for high drinkers. Overall, an increase in consumption of 1 cup of coffee per day was associated with a 3% reduced risk of cancers (RR, 0.97; 95% CI, 0.96-0.98). In subgroup analyses, we noted that, coffee drinking was associated with a reduced risk of bladder, breast, buccal and pharyngeal, colorectal, endometrial, esophageal, hepatocellular, leukemic, pancreatic, and prostate cancers. Conclusions: Findings from this meta-analysis suggest that coffee consumption may reduce the total cancer incidence and it also has an inverse association with some type of cancers.

Zhang Y; Lee ET; Cowan LD; Fabsitz RR; Howard BV. Coffee consumption and the incidence of type 2 diabetes in men and women with normal glucose tolerance: The Strong Heart Study. Nutrition, Metabolism and Cardiovascular Diseases 21(6): 418-423, 2011. (39 refs.)

Background and aims: It was reported that high coffee consumption was related to decreased diabetes risk. The aim of this study is to examine the association between coffee consumption and the incidence of type 2 diabetes in persons with normal glucose tolerance in a population with a high incidence and prevalence of diabetes. Methods. and results: In a prospective cohort study, information about daily coffee consumption was collected at the baseline examination (1989-1992) in a population-based sample of American Indian men and women 45-74 years of age. Participants with normal glucose tolerance (N = 1141) at the baseline examination were followed for an average of 7.6 years. The incidence of diabetes was compared across the categories of daily coffee consumption. The hazard ratios of diabetes related to coffee consumption were calculated using Cox proportional hazards models, adjusted for potential confounders. Levels of coffee consumption were positively related to levels of current smoking and inversely related to body mass index, waist circumference, female gender, and hypertension. Compared to those who did not drink coffee, participants who drank 12 or more cups of coffee daily had 67% less risk of developing diabetes during the follow-up (hazard ratio: 0.33, 95% confidence interval: 0.13, 0.81). Conclusion: In this population, a high level of coffee consumption was associated with a reduced risk of deterioration of glucose metabolism over an average 7.6 years of follow-up. More work is needed to understand whether there is a plausible biological mechanism for this observation.

Zhang ZZ; Hu G; Caballero B; Appel L; Chen LW. Habitual coffee consumption and risk of hypertension: A systematic review and meta-analysis of prospective observational studies. American Journal of Clinical Nutrition 93(6): 1212- 1219, 2011. (36 refs.)

Background: In 2 meta-analyses of randomized controlled trials, increased coffee intake was associated with slightly higher blood pressure. However, these trials were short in duration (<85 d). Objective: We conducted a systematic review and meta-analyses of long-term prospective studies that examined the association of habitual coffee consumption with risk of hypertension. Design:: We searched electronic databases (MEDLINE, EMBASE, Agricola, and Cochrane Library) through August 2009 with the use of a standardized protocol. Eligible studies were prospective cohort trials that examined the association of coffee consumption with incident hypertension or blood pressure. Results: From 6 prospective cohort studies, a total of 172,567 participants and 37,135 incident hypertension cases were included. Mean follow-up ranged from 6.4 to 33.0 y. Compared with the lowest consumption [<1 cup (approximate to 237 mL)/d], the pooled relative risks (RRs) for hypertension were 1.09 (95% CI: 1.01, 1.18) for the next higher category (1-3 cups/d), 1.07 (95% CI: 0.96, 1.20) for the second highest category (3-5 cups/d), and 1.08 (95% CI: 0.96, 1.21) for the highest category (>5 cups/d). A dose-response meta-analysis showed an inverse "J-shaped" curve (P for quadratic term < 0.001) with hypertension risk increasing up to 3 cups/d (RR for comparison of 3 with 0 cups/d: 1.07; 95% CI: 0.97, 1.20) and decreasing with higher intakes (RR for comparison of 6 with 0 cups/d: 0.99; 95% CI: 0.89, 1.10). Conclusion: The results suggest that habitual coffee consumption of >3 cups/d was not associated with an increased risk of hypertension compared with <1 cup/d; however, a slightly elevated risk appeared to be associated with light-to-moderate consumption of 1 to 3 cups/d.