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The impact of caffeine on mood, cognitive function, performance and hydration: a review of beneﬁts and risks
C. H. S. Ruxton
Nutrition Communications, Cupar, UK
The reputed beneﬁts of moderate caffeine consumption include improvements in physical endurance, cognitive function, particularly alertness and vigilance, mood and perception of fatigue. In contrast, there are concerns that excessive intakes increase the risks of dehydration, anxiety, headache and sleep disturbances. This paper is a review of double-blind, placebo-controlled trials published over the past 15 years to establish what range of caffeine consumption would maximise beneﬁts and minimise risks for cognitive function, mood, physical performance and hydration. Of the 41 human studies meeting the inclusion criteria, the majority reported beneﬁts associated with low to moderate caffeine intakes (37.5 to 450 mg per day). The available studies on hydration found that caffeine intakes up to 400 mg per day did not produce dehydration, even in subjects undergoing exercise testing. It was concluded that the range of caffeine intake that appeared to maximise beneﬁt and minimise risk is 38 to 400 mg per day, equating to 1 to 8 cups of tea per day, or 0.3 to 4 cups of brewed coffee per day. The limitations of the current evidence base are discussed.
Keywords: caffeine, cognitive function, mood, performance, risk
Caffeine (1,3,7-trimethylxanthine) is the most consumed psychoactive substance in the world. Although caffeine is naturally present in many plant-based foods, the main sources in the Western diet are coffee, tea, cocoa products and cola products. Table 1 provides typical caffeine levels found in standard portions of these. The wide variation in the caffeine content of tea and coffee can be explained by differences in the blend
Correspondence: Dr Carrie H. S. Ruxton, Freelance Dietitian, 6 Front Lebanon, Cupar KY15 4EA, UK. E-mail: firstname.lastname@example.org
and brewing times (FSA 2004). Caffeine is used as a stimulant in traditional South American and African communities via consumption of caffeine-rich plant products, such as cola nut and maté. It is also used in supplements and drinks designed for weight management, sports performance or energy boosting, and in some medicines (e.g. cold and ﬂu remedies). Most of the average UK caffeine intake of 4 mg per kg bodyweight originates from tea (Thomas 2003). Caffeine is rapidly absorbed from the gastrointestinal tract, with plasma levels peaking at 60–90 minutes postingestion. Urine is a poor method of assessing caffeine exposure, as less than 6% of a caffeine dose is excreted (Thomas 2003). Instead, caffeine is metabolised, mostly
© 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin, 33, 15–25
ranging from 37. 15–25 . ‘cognitive function’. even at moderate levels. producing a range of metabolites. it is claimed that regular caffeine consumption. physical performance and hydration. peerreviewed studies published between 1992 and 2007. Smith 2002). short-term recall and reaction time.H. including dimethylxanthine. acetylcholine. The maximum caffeine dose for the longer studies. assuming a typical 70 kg person. blind. Average values from FSA website. such as memory. increases the risk of dehydration. anxiety and sleep disorders. Search terms included ‘caffeine’ in combination with ‘mood’. Reference lists of acceptable papers were hand searched in an attempt to locate all relevant studies. Ruxton Table 1 Caffeine content (mg/serving) of commonly consumed beverages Beverage (serving size) Tea (190 ml) Instant coffee (190 ml) Ground coffee (190 ml) Hot chocolate (150 ml) Dark chocolate (bar) Cola (330 ml) Energy drink (250 ml) Range 1–90 21–120 15–254 1–6 – 11–70 27–87 Average 50 75 100 – 50* 40 80 Source: compiled from FSA (2004) and product information. A typical study would involve volunteers being given a placebo. While the duration of most of the studies may Methods Medline was searched for English-language. rested subjects and. There are no ofﬁcial recommendations to limit caffeine consumption in non-pregnant consumers. of these. Speciﬁcally. These considered a range of cognitive measures. Mood and cognitive performance Caffeine is believed to impact on mood and performance by inhibiting the binding of both adenosine and benzodiazepine receptor ligands to brain membranes. This review aims to examine and collate double-blind. The average half-life of caffeine is 2. ‘diuresis’. including noradrenaline. placebo could be extracted. and may provide a source of polyphenols (Gardner et al. dopamine. However. Mood and cognitive tests (often using computer software) would be undertaken at baseline and shortly after consumption of the placebo/caffeine. serotonin. The focus on placebo-controlled experiments was important as regular caffeine consumers may be conditioned to anticipate cognitive effects from caffeinated products (Smit et al. 2006).5 to 450 mg. herbs and drugs) were excluded unless the results for caffeine vs. was in the region of 450 mg. As these neurotransmitters are known to slow down brain activity. taken up to four times daily.5 to 4. ‘Before’ and ‘after’ test results could then be compared to look for differences that may relate to caffeine consumption. placebo-controlled trials in order to investigate the risks and beneﬁts of regular caffeine consumption on mood.16 C. a blockade of their receptors lessens this effect. vigilance and speed. including improved alertness. or one or more doses of caffeine in drinks/ capsules. monomethylxanthine and uric acid.g. 33.5 hours but can vary from 1 to 10 hours in certain individuals (ANZFA 2000). there is also a considerable body of literature suggesting that natural caffeine-containing foods and beverages offer cognitive and performance-related beneﬁts. Studies using combinations of caffeine and other substances (e. The Food Standards Agency (FSA 2001) advises pregnant women to limit their caffeine intake to a maximum of 300 mg per day owing to concerns that excessive caffeine may cause miscarriage or low birthweight. 1999). ‘performance’ and ‘exercise’.g. in the liver by the P45 enzyme system.S. While the published literature contains examples of high-dose caffeine studies where negative effects have been found (e. The caffeine dose varied depending upon the study. Sixteen of the studies in Table 2 were on healthy. *Milk chocolate contains about half as much caffeine. ‘hydration’. Twenty-three studies were found and are summarised in Table 2. There were also consistent ﬁndings for positive mood and lower perceived fatigue. it is acknowledged that decaffeinated tea and coffee are not actually caffeine-free and can contain up to 8 mg caffeine per cup (FSA 2004). with most using a single bolus of caffeine. cognitive function. glucose. The use of caffeinecontaining beverages as test products was allowed if similar non-caffeinated products were used as controls. as well as self-reported mood and perceived fatigue. A few studies considered caffeine intake over several days using doses of 1 to 6 mg per kg bodyweight. 14 reported beneﬁts relating to caffeine consumption. Inclusion criteria were that studies had to be on healthy adults and that a double- © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin. although this has not prevented the assumption by media commentators and others that caffeine can be harmful. 2007). placebo-controlled methodology was used. accuracy. Meta-analyses were included but were used only to support the discussion. glutamate and gamma-aminobutyric acid (Fredholm et al. Caffeine intake also causes changes to a variety of other neurotransmitters.
to mimic tea/ coffee intake Cognitive performance. mood Christopher et al. 75. Within-person study 100-mg bolus as tea. 200-mg bolus Hindmarch et al. psychomotor skills. mood. 50-. mood Both regimes improved performance and increased reported anxiety Brice & Smith (2002) 65 mg q. (2002) Improvements in reaction time.d.1 or 2 mg/kg bodyweight caffeine 102 light caffeine users. 100-. Dose–response. 15–25 Childs & de Wit (2006) 1. 25-. placebo* Reference Subjects Not sleep-restricted Haskell et al. (2006) 25 habitual caffeine users following 24-hour abstinence vs. mood Cognitive performance. vs. Tea and coffee had similar effects Caffeine increased blood pressure and elevated mood. mood 12. thirst. mood Cognitive performance. Regular caffeine users beneﬁted more than low users Caffeine improved cognitive function after one exposure. 75-. 450-mg bolus Smith et al. (2005) Memory. (2005) 2 mg/kg BW bolus Cognitive performance. Within-person study 32 habitual caffeine users. alertness Quinlan et al. reaction time.or 8-hour abstinence 1. Within-person study 64 habitual caffeine users following 24-hour abstinence 1. 25 non-users 2 mg/kg BW bolus Cognitive performance.2 mg/kg BW bolus Cognitive performance. 100-mg bolus Smit & Rogers (2000) Robelin & Rogers (1998) 23 habitual caffeine users following 24-hour abstinence. mood Both regimes improved performance but higher doses of caffeine disrupted sleep Alertness maintained with caffeine. (2000) 30 habitual caffeine users preloaded with 0. Intra-individual differences Performance and mood improvements Cognitive performance.i. 1 mg/kg BW bolus Psychomotor skills and mood tested after drink to assess cumulative effect Cognitive performance. 150-mg bolus Cognitive performance. (2005) 24 habitual caffeine users following 24-hour abstinence vs. coffee or caffeinated water 25-.d. 50-.i. memory. 100 mg q. No dose–response Performance and mood improvements regardless of caffeine withdrawal 17 . Habitual users outperformed non-users Caffeine had short-term stimulant effects after 8-hour abstinence.2 mg/kg BW given t. in novel fruit drink 0 vs. 33. 150-.Table 2 Caffeine and mood/cognitive function Caffeine test Outcome variables Results for caffeine vs. sleep quality Hindmarch et al. 6. vigilance.5. (2005) 75-. mood Yeomans et al.5-. Normal consumption maintained before trial 68 habitual caffeine users. 200-mg bolus Caffeine: a review of beneﬁts and risks Smith et al. (2000) 19 habitual caffeine users. Within-person study 60 habitual caffeine users. mood Heatherley et al. alertness. mood Performance enhanced and mood improved in short-term Performance and mood improvements. Normal consumption maintained before trial 24 habitual caffeine users. Not all were positive Caffeine improved cognitive function at all doses.d. No cumulative effect Performance improved after 1st dose of caffeine but not after 2nd © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin.5 mg/kg BW bolus 50-. vigilance. 24 non-users 49 habitual caffeine users following 4-. Within-person study involving decaffeinated coffee + added caffeine 30 habitual caffeine users 37. (1998) Cognitive performance Blood pressure.i.
1. (2005) 400-mg bolus 1.d. Both groups sleep-restricted 96 habitual caffeine users alternating between 4-week caffeine use and 4-week placebo. four times a day. mood No effects over and above withdrawal alleviation James & Gregg (2004) 1.i.2 mg/kg BW bolus Cognitive performance Cognitive performance. 300-mg bolus Vigilance.. sleep-restricted 48 habitual caffeine users alternating between 4-week caffeine use and 4-week placebo. Caffeine restored some measures but not marksmanship © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin. (2005) 600 mg 10 sleep-restricted subjects 17 habitual caffeine users following 3-week abstinence vs.i. BW. 200-.d. .75 mg/kg BW t. Effects greatest one hour post consumption No effects No effects over and above withdrawal alleviation James et al.d. Mood Some subjects experienced poorer mood scores after caffeine van Duinen et al. psychomotor skills. Caffeine users beneﬁted more than infrequent users No effects James (1998) 60 subjects after 3 day of caffeine equilibration (3 mg/kg bodyweight/ day) 36 habitual caffeine users 1.75 mg/kg BW t.vs. psychomotor skills. Rested vs. three times a day. sleep-deprived Caffeine partly prevented fatigue-related cognitive decline All measures of performance declined with sleep deprivation. No effect on cognitive performance Sleep-restricted Lieberman et al. 56 infrequent users Judelson et al. 17 habitual caffeine users following 24-hour abstinence. psychomotor skills Improvements in all except marksmanship.S. (2005) 1. q. (2004) 20 military personnel. Rested vs. alertness 68 sleep-deprived US Navy trainees Deslandes et al. Control vs. bodyweight. Ruxton Hewlett & Smith (2006) 120 habitual caffeine users following 24-hour abstinence vs. not sustained over 6 days. alertness Performance and mood improvements regardless of caffeine withdrawal. 6-day exposure. (2006) Rogers et al. sleep-restricted 23 fatigued subjects 3 mg/kg BW bolus Cognitive performance Cognitive performance around shooting skills Tikuisis et al. 15–25 *Only statistically signiﬁcant ﬁndings reported. (2002) 100-. placebo* Reference Subjects C.H. t.i. (2005) 3 or 6 mg/kg BW/day for 5 days Cognitive performance.i. Acute improvements in alertness.18 Table 2 Continued Caffeine test 1 mg/kg BW bolus Cognitive performance Outcome variables Results for caffeine vs.75 mg/kg BW bolus Cognitive performance. mood Cognitive performance. marksmanship. 33.. reaction time.d.
g. opinion was evenly split. tea and coffee produced similar cognitive and mood effects. It has been argued that regular exposure to caffeine could increase tolerance to cognitive and mood effects (Childs & de Wit 2006). caffeine ingestion has been found to increase plasma free fatty acids and promote insulin resistance (Norager et al. However. This could suggest that cognitive function is not inﬂuenced by increasing caffeine dose. some authors have noted that the cognitive/mood effects of tea and coffee are not fully explained by the caffeine content (Hindmarch et al. coffee (moderate/high caffeine) adversely affected sleep onset and duration. which is surprising as tolerance would be expected to blunt any effects.5 mg. only two reported a dose–response for cognitive performance (Lieberman et al. A review of the World Anti-doping Code in 2003 reversed the ban (World Anti-doping Agency 2003). Schwenk & Costley 2002). 33. 2005). which may have inﬂuenced the results. regardless of exposure to withdrawal.e. This ﬁnding is backed up by other reviews (ANZFA 2000). Thus. Smith et al. which could have raised expectations among regular consumers of these beverages. In the latter study. 1998. 2002.g. If it is assumed that caffeine does have a real impact on cognitive function. Sleep deprivation is known to affect cognitive function and mood. In the study by Smit and Rogers (2000). Certainly. while a further two found a dose–response for blood pressure. 15–25 . blood pressure). although caffeine is still considered to be ergogenic even at levels below the former IOC threshold (Graham 2001. Childs & de Wit 2006) cite experimental examples where subjects. 2000). The level of caffeine intake at which cognitive effects were generated was fairly low in terms of normal daily consumption patterns. Yeomans et al. Seven studies examined the impact of caffeine on sleep-restricted subjects. In most of these. (2005) simulated normal consumption of caffeinated beverages. but differed in terms of other outcomes (e. while tea (low/ moderate caffeine) did not. any cognitive effects would be expected to occur in the short-term. this proposed mecha- © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin. The dose of caffeine used in these studies ranged from 84 to 600 mg per day. Indeed. sleep quality. Supporters of this theory (e. 2002. performance-enhancing) compound. usually taken as a single bolus. Quinlan et al. the International Olympic Committee (IOC) restricted caffeine use during competition as it was believed to be an ergogenic (i. while other physiological systems are. Smit and Rogers (2000) found that habitual caffeine users demonstrated tolerance to the thirst-inducing effects of caffeine but not to the performance-enhancing and mood effects. 2005. The issues of tolerance and dose– response are addressed later in this review. 2000). with only three ﬁnding that caffeine restored at least some measures of cognitive function. which equates to one third of a cup of tea. ﬂavonoids. Smith et al. Physical performance Until 2004. although it is worth noting that most of the studies supporting the withdrawal alleviation theory were carried out on sleep-deprived subjects. Of the 15 studies that compared different levels of caffeine intake. the lowest dose was 12. It may also reﬂect differences in the presence of other biologically active components in tea and coffee (e. This point was addressed by a number of studies involving comparisons between habitual users of caffeine and low/non-users. 1998. it is logical to consider whether a dose–response exists. 2005). A commonly cited mechanism links caffeine consumption to increased free fatty acid oxidation. It was clear that the majority of studies did not support a dose–response argument and that the ﬁrst exposure to caffeine appeared to induce the cognitive and mood effects. which would have the effect of sparing glycogen and prolonging the duration of exercise (Nehlig & Debry 1994.g. experience cognitive and mood enhancements with caffeine consumption. heart rate. theophylline or theobromine). heart rate or skin temperature (Hindmarch et al. Heatherley et al. habitual users appeared to experience greater cognitive or mood effects compared with low/non-users. The maximum permitted level was 12 mg caffeine per litre of urine (equivalent to around 5 cups of coffee). Paluska 2003). rather than tea or coffee. In studies of caffeinated beverages. A single study by James and Gregg (2004) reported a negative impact of caffeine in sleeprestricted subjects.g.Caffeine: a review of beneﬁts and risks 19 appear short. James & Gregg 2004) suggest that caffeine withdrawal in habitual users worsens cognitive function while re-introduction of caffeine simply restores cognitive function to baseline levels. Among the studies collated for this review. thus offering no additional beneﬁt (see Rogers 2007). This was even the case when the caffeine was supplied as capsules. ﬁnding that the ‘second cup’ did not induce further cognitive or mood beneﬁts until at least 8 hours had elapsed. There is controversy about whether or not the cognitive effects associated with caffeine consumption are related to withdrawal alleviation. Caffeine is thought to impact on physical and sporting performance via one or more modes of action. it is worth bearing in mind that plasma caffeine levels peak at 60–90 minutes post-ingestion. Those in opposition to this theory (e.
caffeine could have an adverse effect on hydration as it increases blood ﬂow to the kidneys and inhibits the re-absorption of sodium. perception of fatigue and cycling power. Excretion of both sodium and potassium increased. 15–25 . So these drinks can lead to an increased need for water or other ﬂuids that don’t have a diuretic effect’. The second meta-analysis (Doherty & Smith 2005) examined the impact of caffeine ingestion on perceived exertion using data from 21 studies. Hydration It is a common perception that caffeine-containing drinks cause a net loss in ﬂuid and may lead to dehydration. coffee and cola) can act as diuretics.5 to 6 mg per kg bodyweight. consume 85% of daily nonfood ﬂuid from tea (Taylor Nelson Sofres 2003). and increased tolerance to fatigue via production of plasma catecholamines and inhibition of adenosine receptors (Nehlig & Debry 1994). calcium and magnesium. and there was evidence of dehydration from bodyweight and body water estimates.4 to 6 mg per kg bodyweight (98 to 420 mg per day for an average 70 kg person) did not have an adverse effect on hydration. Despite the view that caffeine may act as a diuretic. but not on days 2 or 3. The effect was more pronounced for endurance exercise than for graded or short-term exercise. calcium and potassium concentrations (Magkos & Kavouras 2005). and these are summarised in Table 3. These studies taken together suggest that higher levels of caffeine can cause dehydration. particularly when subjects have abstained from the © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin. ﬁnding that urine output increased by 400 ml compared with the placebo condition when subjects (n = 8) were at rest. 2006). (1997) used a dose of 8. 2000). Heatherley et al. although this was not conﬁrmed by a randomised controlled trial in women with detrusor overactivity (Swithinbank et al. 33. Doherty and Smith (2004) examined the evidence from 40 double-blind studies on exercise performance. 2006).75 mg per kg bodyweight. and the authors proposed that this may have been due to elevated catecholamine levels.S. rather than cycling to exhaustion. enhanced physical performance. the theory may not translate into practice because much of the research used high caffeine intakes in the form of capsules. who. which means they can make your body lose greater volumes of water than usual. It would appear. The authors proposed that the impact of caffeine on ratings of perceived exhaustion could partly explain its ergogenic effects. running/cycling performance. This suggests tolerance to the renal effects of caffeine after 48 hours.6 mg caffeine per kg bodyweight. no signiﬁcant differences in hydration were seen when subjects performed a three hour cycle test. Neuhauser-Berthold et al. that caffeine has ergogenic properties and. If this were the case. thus expelling more water (Birkner et al. In ﬁve of these.1 and 1. In theory. urine output increased in the caffeine group by 753 ml. rather than caffeinated beverages. large numbers of UK adults would be at risk from dehydration because 70–97% are regular consumers of caffeinated beverages (Henderson et al.1 cups per day. 2006). FSA advice (2007) states: ‘Drinks that contain caffeine (such as tea. as this type of protocol would not have picked up any impact of caffeine consumption on endurance. Any risk of dehydration would be higher in elderly people. while one was on active elderly people. at intakes of 2.20 C. there were surprisingly few studies in humans. Outcome measures included time to exhaustion. Other mechanisms include enhancing muscle contractions via changes to sodium. However. There is also epidemiological evidence that caffeine consumption provokes the need to urinate by stimulating the bladder’s detrusor muscles (Arya et al. Over the four hour trial. and mechanistic studies were performed in rats. 2002. The latter authors wondered whether the lack of effect was due to the cyclists performing over a ﬁxed distance. this is the view taken by two meta-analyses by the same authors. According to the National Drinks Survey (Taylor Nelson Sofres 2007). 2005) reported increased urine output (360 ml) on day one. Five used trained subjects. (1997) compared six cups of coffee (providing 642 mg caffeine) with a water placebo in 12 non-exercising subjects who had been deprived of caffeine for ﬁve days. from the available evidence. one gave 34 students 201 mg per day of caffeine for 8 weeks (Malek et al. a daily caffeine intake of 1. The majority of studies found that caffeine consumption. 2002). Eleven studies were found that met our criteria. of a trial of 5. indeed. Interestingly. Habitual intake of caffeine does not appear to diminish any ergogenic properties (Paluska 2003). respectively.H. Ruxton nism is disputed by some researchers (Graham 2001). It was reported that the lower ratings of perceived exhaustion relating to caffeine ingestion accounted for 30% of the improvement in exercise performance. Wemple et al. average intakes of tea and coffee in UK adults are 2. A further study (Bird et al. ﬁnding that caffeine improved exercise test performance by 12%. while the other gave 8 trained cyclists 6 mg per kg bodyweight per day (Hunter et al. on average. Table 4 gives details on the eight studies found. In the two studies where a null effect was found. Caffeine intakes were substantially higher in two studies that did ﬁnd evidence of dehydration. 2005).
3 or 6 hours prior to exercise 8. Within-person study.Table 3 Caffeine and physical performance Caffeine test 201 mg/day for 8 weeks 5 mg/kg BW bolus 201 mg bolus 6 mg/kg BW bolus 3 mg/kg BW bolus 6 mg/kg BW bolus 600 mg taken over 7. (2006) Wiles et al.5 hours 2. blood lactate © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin. power and passing accuracy improved. 15–25 Stuart et al. running time to exhaustion Cycling endurance 100-km cycling time trial Hunter et al. 48-hour abstention from caffeine 8 male distance runners. (2002) 8 trained cyclists Performance greater. (2005) Speed and power improved Weight lifted in the one repetition bench press increased by 2 kg Endurance improved Bridge & Jones (2006) 30 healthy elderly subjects. Time to exhaustion increased Time to exhaustion increased after both doses of caffeine No effect Bell & McLellan (2002) 13 habitual caffeine users vs. (1997) 6 trained cyclists. BW. Effects greater in non-users No impact Caffeine: a review of beneﬁts and risks *Only statistically signiﬁcant ﬁndings reported. anaerobic capability VO2 peak. Cross-over design Simulation of rugby performance Cycling and upper body endurance. (2006) 34 students undergoing 8-week aerobic training 8 trained cyclists 37 resistance-trained men Norager et al. 5 mg/kg BW bolus Cycling speed and power Muscular endurance. placebo* Reference Subjects Malek et al.75 mg/kg BW taken over 4-hour period Cycling endurance Wemple et al. bodyweight. Blood lactate levels higher 3 minutes after exercise Speed. Cross-over design McLellan et al.5. 21 . 8 non-users 6 mg/kg BW preload followed by 0. (2004) Bell & McLellan (2003) 16 subjects after 28 hours of sleep deprivation in military-style setting 9 male caffeine users Marching endurance.33 mg/kg BW every 15 minutes during trial 5 mg/kg BW bolus taken 1. (2005) 9 male rugby players. Cross-over design in resting condition and after 3-hour cycling Maximal performance at 85% VO2 max Time to exhaustion increased when caffeine taken 1 or 3 hours prior to exercise. running time to exhaustion No effect Outcome variables Results for caffeine vs. Perceived fatigue lower Perceived exertion lower during march. (2006) Beck et al. walking speed 8-km run performance. 33.
BW reduced in all ﬂuid conditions 24-hour urine output increased by 753 ml. Cross-over design Urine output 360 ml greater on day 1.1 mg/kg BW) 1-day test of 6 cups of coffee (642 mg caffeine/day) No impact.75 mg/kg BW taken over 4-hour period Fluid-electrolyte balance Caffeine test Outcome variables Results for caffeine vs. body mass Fluid balance Thermoregulation. ﬂuid balance post exercise Falk et al. Cross-over design of 4 commercially-available test drinks 12 healthy volunteers after 5-day abstention from methylxanthines 5 mg/kg BW preload followed by 2. bioelectrical impedance analysis. thermoregulation post exercise Fluid-electrolyte balance. (2006) No impact Grandjean et al.7 kg. . (1997) Fiala et al. Ruxton Table 4 Caffeine and hydration Subjects 8. 33. urine colour. (1990) 59 healthy men following 6-day equilibrium on 3 mg/kg BW 80 habitual caffeine users following 24-hour abstinence 7 trained male athletes. TBW. TBW reduced by 2. (2004) 6 trained cyclists. (2005) Hydration following 2 x 2 hour exercise sessions Fluid-electrolyte balance. BIA. No differences on days 2 and 3 No impact Roti et al.7%. BW. total body water. Cross-over design in resting condition and following 3-hour cycling 10 partially heat-acclimated athletes Caffeinated (mean 244 mg/day) vs. caffeine-free cola 5-day test period of 3 or 6 mg/kg BW 3-day regime of 5.4–3. BW. BW reduced by 0. (2005) No impact on hydration apart from urine colour (darker after caffeine) No impact on hydration Bird et al. Na and K urinary excretion increased © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin.S.5 mg/kg BW 2 and 0.5 hours prior to exercise 5-day test period of 3 or 6 mg/kg BW with exercise test 1-day test periods of 111–254 mg/day (1. TBW (estimated by BIA) Neuhauser-Berthold et al.6 mg/kg BW/day Armstrong et al.22 C. bodyweight. body mass Fluid-electrolyte balance. 15–25 *Only statistically signiﬁcant ﬁndings reported. No differences during exercise Reference Wemple et al. (2000) Fluid-electrolyte balance.H. (1997) 59 active male students following 6-day equilibrium on 3 mg/kg BW 18 healthy adult men. placebo* Urine output 400 ml greater at rest.
the use of differing cognitive and mood tests made some comparisons challenging. as data are currently unavailable. or 0. Acknowledgements This review was made possible by a grant from the Tea Council (UK). International Journal of Sports Nutrition and Exercise Metabolism 15: 252–65. In the USA. Thus. there are difﬁculties in translating any caffeine ranges from experimental evidence to real life owing to differences in how tea and coffee. for sports people. Finally. the range of caffeine intake that would appear to maximise beneﬁt while minimising risk. cognitive function. The UK Department for Transport (2007) recommends that drivers consume two cups of coffee or another high-caffeine drink to help combat tiredness. although some disturbances to sleep were seen at around 400 mg per day. is likely to be minimal. a beneﬁcial range of caffeine consumption would equate to a tea intake of 1 to 8 cups per day. Obstetrics and Gynecology 96: 85–9. for example from dehydration. References Armstrong LE. It is not known how many UK consumers exceed 400 mg per day. Average tea and coffee consumption in the UK is within this range. This would be in the low to medium range according to an Australian/New Zealand expert group (ANZFA 2000). Roti MW et al. a condition of which was that Tea Council representatives and associates played no role in writing the review. This group identiﬁed intakes of caffeine greater than 500 mg per day (>7 mg per kg bodyweight) as high. Thus. average caffeine intakes according to an ongoing study of 5870 adult consumers are 241 mg per day. with 97% of people identiﬁed as caffeine consumers (Heatherley et al. a brewed coffee intake of 0. 2006). Myers DL & Jackson ND (2000) Dietary caffeine intake and the risk for detrusor instability: a case-control study. military personnel are advised that 100 to 600 mg of caffeine can maintain cognitive performance during periods of sleep deprivation (Institute of Medicine 2001). within-person comparisons are most appropriate. assuming a typical 70 kg person. (2005) Fluid. as yet. equating to 1 to 8 cups of tea. © 2008 The Author Journal compilation © 2008 British Nutrition Foundation Nutrition Bulletin. because most people are now exposed to some dietary caffeine (Heatherley et al. the available studies on hydration found no ill effects of caffeine at intakes up to 400 mg per day. are prepared by individual consumers. However. Given the average caffeine content of beverages (Table 1). performance and hydration is 38 to 400 mg per day. intakes of 2. Current levels of caffeine intake in the UK fall well within this range. 15–25 . Conclusions From a review of double-blind. was in the region of 450 mg. However. Pumerantz AC. There is no evidence at present that low to moderate intakes of caffeine.3 to 4 cups of brewed coffee per day. ANZFA (Australian New Zealand Food Authority) (2000) Report of the Expert Working Group on the Safety Aspects of Dietary Caffeine. even when consumed around extreme exercise.1 cups per day for tea. although it is acknowledged that these studies were relatively few in number. although the body of evidence was considerable for mood and cognitive function. the main sources of caffeine in the UK diet. suggesting that risk. Limitations of the review Many of the available studies had small sample sizes. at 2. studies need to be of sufﬁcient duration to judge the long-term effects of caffeine.3 to 4 cups per day or an energy drink intake of 5 cans. it would appear that the range of caffeine intake that could maximise beneﬁt and minimise risk in relation to mood.1 cups per day for coffee (Taylor Nelson Sofres 2007). and renal indices of hydration during 11 days of controlled caffeine consumption. There are no recommendations. seems to be 38 to 400 mg per day. placebo-controlled studies published over the past 15 years. Recommendations have been made by a few organisations to help groups of people gain beneﬁts from caffeine consumption. Finally. in relation to the topics covered by this review. power and tolerance of fatigue. affect hydration in a negative way. The maximum daily caffeine dose in the cognitive studies. electrolyte. yet include caffeine consumers who have experienced sufﬁcient abstinence to get beyond any impact of withdrawal alleviation. different levels of caffeine had different effects.Caffeine: a review of beneﬁts and risks 23 substance for a number of days. 33. Arya LA.5 to 6 mg per kg bodyweight (equivalent to 175 to 420 mg per day for an average person) improved measures of endurance. As mood and cognitive function are subjective variables.5 to 450 mg. 2006). ANZFA: Canberra/Wellington. and 1. The issue of whether caffeine merely reverses withdrawal symptoms or confers a real cognitive beneﬁt remains controversial and is hard to resolve. Safe limits and applications In the studies reviewed here. Turning to the physical performance data. Enhancements in mood and cognitive function were seen following daily caffeine intakes of 37.
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