- Consuming caffeine-laden drinks is a common habit among Singapore youth
- Adverse effects of caffeine include hyperactivity, poor sleep, headaches and depression
- For children under the age of 12, there are no proven safe doses, a doctor and dietitian said
- Parents also do not always know how much caffeine their children can safely consume
- A dietitian provided tips on helping children and teenagers cut back on caffeinated drinks
SINGAPORE, July 13 — Teenager Titus Yan used to start his day by drinking a bottle of green tea (or two) in the morning, followed by bubble tea or an energy drink to power through the afternoon, and then some fizzy soft drink, preferably cola, to wash down his dinner.
“It got to a point where I was drinking all these daily. I thought they made me more focused and energised,” the 15-year-old said.
For the Secondary 3 student, his caffeine habit was nothing out of the ordinary. When asked by TODAY, he could not think of anyone in his circle of friends who did not consume caffeinated drinks.
“During recess, my friends usually buy two bottles of (flavoured) tea,” he added.
A caffeinated drink is also a regular indulgence for Ms Disa Tan’s seven-year-old son, who drinks Coca Cola — his favourite — two to three times a week. He also drinks green tea in addition to plain water.
“We tried to curb his cola (habit) to once a week but he keeps asking for it every other day. He whines a bit when we don’t give him,” Tan said.
The 40-year-old finance manager, an avid tea drinker herself, drinks several cups of tea a day “for survival”.
Singaporeans are a highly caffeinated people, and it is not just adults fuelling the multi-million market here.
Students hang out at cafes after school or imbibe copious amounts of caffeinated drinks thinking these can keep them sharp as they catch up on schoolwork. On top of that, advertisements lure the young with celebrity endorsements and fancy-looking or trendy drinks that they are bound to share on social media.
Dietitian Anthea Zee, from the nutrition and dietetics department at KK Women’s and Children’s Hospital (KKH), observed that children and teenagers are consuming more caffeine due to several reasons.
Ready-to-drink caffeinated drinks have become increasingly available, while single-serve home coffee machines make it convenient to get hold of these beverages.
Trend-driven adolescents want to have what their peers are having and it is not hard to find a place to get the drinks — with cafes, bubble-tea chains and coffee chains everywhere across the island from MRT stations to neighbourhood shops, all encouraging consumption.
Additionally, for energy drinks, caffeine content has increased in recent years.
Zee also noticed that parents are now more lenient about how much caffeine their children consume.
“This can be attributed to a possible lack of awareness of the potential risks associated with caffeine consumption,” she said.
“Parents may also be unaware that there are other drinks, besides coffee and tea, which could contain caffeine.
“For example, some energy drinks may not have explicit caffeine content labelling.
“One may not realise that it contains caffeine, unless they read the ingredients listed carefully.”
What is caffeine and where is it found?
Caffeine is a naturally occurring substance in coffee beans, tea leaves and other plants.
Apart from coffee and tea, it is also found in cola-flavoured soft drinks, vitamin and energy drinks as well as in foods such as chocolate and hot cocoa.
When consumed, it stimulates the nervous system, making the person feel more alert.
Physically, though, it can temporarily raise your blood pressure and breathing rate.
On the flip side, it can affect your mood, making you feel more nervous, irritable or anxious.
How much caffeine is too much?
Just how much caffeine is safe for children and adolescents who are still developing?
For teenagers aged 12 years and above, the caffeine intake should be limited to no more than 100mg daily — which equates to one serving of coffee or two cans of cola.
“Any amount above these recommendations is considered excessive,” Zee the dietitian said.
Children under the age of 12 should not consume caffeinated food and drinks, she added, quoting The American Academy of Pediatrics.
Comparatively, for adults, the United States’ Food and Drug Administration states that the recommended daily intake is not more than 400mg.
However, this does not apply to children and teenagers.
Dr Seo Woon Li, consultant at the paediatric arm of the National University Hospital (NUH), said that there are no proven safe doses of caffeine for children.
“Be aware that children should not even be consuming caffeine, but this is generally okay from the teenage years,” she added.
Dr Seo is head of children’s emergency from the department of paediatrics at the Khoo Teck Puat – National University Children’s Medical Institute.
How much caffeine is in your favourite drinks?
Latte (470ml): 150mg caffeine
Brewed coffee (470ml): 320mg caffeine
Generic coffee, brewed: 60mg to 180mg caffeine a cup
Instant coffee: 30mg to 90mg caffeine a teaspoon
Brewed green/black tea: 28mg to 38mg caffeine in each tea bag
Cola drinks (regular or diet): 54mg caffeine in a can
Energy drinks (240ml to 500ml can): 50mg to more than 200mg caffeine in each can
Vitamin water: 50mg caffeine for each 590ml bottle
Bubble tea (black, green or milk tea): 100mg to 160mg for a standard cup (depending on type of tea and size)
Chocolate bar: Range of 9mg to 30mg caffeine for every 45g chocolate (one standard-sized snack bar or six to eight squares of chocolate pieces)
Source: Anthea Zee, dietitian with the nutrition and dietetics department at KK Women’s and Children’s Hospital
How caffeine affects the young
The effect of caffeine varies with each person.
Besides age, factors such as body weight and overall health can determine a person’s tolerance to caffeine, Zee pointed out.
“The smaller body size of children makes them much more sensitive to the effects of caffeine, as compared to adults. This means that they are more likely to feel the effects of caffeine much faster and stronger even in smaller amounts.”
Even in minimal amounts, caffeine can still potentially affect the child’s sleep and behaviour, the experts warned.
Dr Seo explained that caffeine is a stimulant that affects primarily the central nervous system and cardiovascular system.
Caffeine can be detected in the blood five to 15 minutes after consumption, with the peak of its effect measured at between 40 minutes and 80 minutes.
In children, the short-term effects of excessive caffeine intake may include headaches, hyperactivity, poor sleep and heart racing, Dr Seo said.
Long-term exposure may lead to a vicious circle of poor sleep, somnolence (excessive sleepiness) and taking more caffeine to combat tiredness, she added.
It could also be a perpetuating factor for chronic headaches, whereby both caffeine ingestion and withdrawal can cause headaches.
Zee said: “Regular consumption may also result in physical and psychological dependence on caffeine to function effectively.
“This can result in withdrawal symptoms such as fatigue, crankiness, persistent headaches and migraines.”
Caffeinated drinks, which are often used to improve concentration and stay awake, could backfire and lead to adverse effects.
Dr Seo said: “Concentration and hyperactivity are ends of the same spectrum.
“One individual may feel quite alert with a cup of coffee, but if more cups are consumed, one may feel jittery, hyper-alert, ‘off the walls’, and quite possibly, experience palpitations, chest pain and anxiety.
“And remember the concept of tolerance: The parent you spoke to may feel that one cup of coffee improves her concentration. But we may all know of someone who needs two, three cups of coffee to feel alert.
“A child is expected to be naive to the exposure and thus more sensitive to small amounts of caffeine.”
Researchers have found that many young people consume energy drinks and other caffeinated products despite common “unpleasant” side effects such as weakness, shaking, fast heart rate, insomnia, tremors or depression.
They concluded that the “consumption of energy drinks is correlated with depression, negative behavioural changes, and they are addictive”.
This was in a review on the effects of caffeine and caffeinated beverages in children, adolescents and young adults, which analysed more than 156 scientific papers. It was published in 2021 in the International Journal of Environmental Research and Public Health.
The review’s authors wrote that further research is needed to find safe dosages for adults and to protect developing children and adolescents from addiction and negative neurological or behavioural changes.
They also suggested stricter regulations for distribution and retailer possibilities.
In his interview with TODAY, Titus said he noticed that as his reliance on caffeine grew, he had trouble sleeping and started experiencing heart palpitations.
He also put on 7kg due to the high sugar and calorie content in the drinks and felt extremely unfit.
Once, while hanging out with friends, he consumed more caffeinated drinks than usual — around five cups — and was unable to fall asleep all night.
“I was tossing and turning all night until around 5am. I only had two hours of sleep that day before waking up for school. It was dreadful,” he recalled.
When asked why he consumed so much caffeine that day, he simply said: “I was craving it.”
Zee from KKH pointed out that most caffeine-laden drinks are also high in sugar and calories, which can result in weight gain, obesity and dental caries.
For example, a regular can of energy drink can contain up to 17 teaspoons of sugar.
“One main concern is that these caffeinated beverages tend to end up replacing nutritious beverages such calcium-rich milk or soy milk, which could affect the nutritional quality of a teenager’s diet,” Zee said, referring to a recent study, which showed that calcium intake among Singapore adolescents are below the daily recommendations of two dairy servings.
Furthermore, caffeine can also interfere with the nutrient absorption of essential minerals and vitamins such as calcium, iron, magnesium and B-vitamins.
“All these can adversely affect the growth potential and immune function of a child,” she added.
How to reduce reliance on caffeine
It takes time for a person to develop a dependency on caffeine, and this varies with each individual.
Some typical withdrawal signs are sleepiness, lethargy, headaches, trouble focusing, and signs of depression, Zee said.
Dr Seo said that parents ought to be attuned to the fact that young people may not be able to report or recognise the effects of caffeine.
For example, they may mistake palpitations for anxiety, or hyperactivity as a desirable increase in energy levels.
To help children and teenagers cut back on caffeine, if they are already hooked, Zee advised:
- Cutting down slowly and setting limits. For example, drinking caffeinated beverages only for lunch and not anytime of the day, or only during weekends
- Avoiding using cola as a reward or emotional dependence to calm an upset child
- Reducing the serving size each time
- Finding suitable alternatives. For example, sparkling water, caffeine-free floral tea or fruit teas, milk, freshly squeezed fruit juice
In a bid to lose weight, Titus decided to “quit caffeine” early this year because most of the drinks he was consuming were high in sugar and calories.
He lost 10kg in half a year, and now limits his caffeine intake to one cup of tea a week.
As for Tan, she is on a mission to gradually reduce the amount of her seven-year-oldson’s caffeine and sugar intake. Her son’s cola habit began after he was found to be allergic to milk.
“We all know about the adverse effects like diabetes and hyperactivity in kids, so I try to limit his cola consumption,” she said.
She noticed that consuming too much of his favourite drink affected her son’s focus, causing him to become distracted when doing his homework.
To start, Tan is cutting down the number of times he drinks cola in a week.
When asked if there are plans to eliminate caffeinated drinks from his diet entirely, she said: “Not at the moment. It’s hard to restrict what he drinks when we eat out. Does it sound like a poor excuse? But I can’t even stop myself.” — TODAY
