ANZFA releases caffeine report

The Australia New Zealand Food Authority today released the report of the Expert Working Group on the safety aspects of dietary caffeine. The report found that very low levels of caffeine could cause subtle behavioural effects.

Acting Managing Director of the Australia New Zealand Food Authority, Ms Claire Pontin, said ANZFA commissioned the report to broaden its knowledge about the impact of caffeine in the diet, and to assist its evaluation of community concerns about its behavioural effects on children.

“The Authority received two applications from manufacturers seeking to add caffeine to drinks, and the findings of this report will be used in developing an overall policy on the regulation of caffeine, and to set caffeine levels in so called ‘energy drinks’, ” Ms Pontin said.

The Expert Group examined:

potential for acute toxicological/pharmacological effects of caffeine at low doses (in particular behavioural effects in children);
potential for an addictive effect of caffeine; and
identification of any other hazards (for example, long-term health effects) of caffeine at low doses.

Commonwealth Medical Adviser and Chair of the Expert Working Group, Dr Alex Proudfoot, said the report concluded there was limited information available on the impact of caffeine on children.

“The report also indicates that the metabolism of caffeine is similar in children and adults (apart from more rapid clearance in children). Therefore, there is no reason to suspect that children are more sensitive to the effects of caffeine than adults.

The report concluded that :

dietary levels of caffeine have measurable effects even at very low levels;
at low doses, for example, ½ cup of tea to three cups of instant coffee, there is increased energy, alertness, motivation and concentration – although the extent to which this is caused by relief from withdrawal symptoms is still subject to debate ;
moderate to high doses of caffeine (equivalent to greater than 3-4 cups of instant coffee) may lead to excitability and anxiety;
there may be some physical dependency and withdrawal effects at doses typically consumed in the diet;
the role of caffeine as a contributor to cardiovascular disease has not been established; and
there is little evidence that caffeine, at doses typically consumed in the diet, contributes to high blood pressure.

The Expert Working Group’s report is accompanied by a commentary from Professor Jack James who was a member of the group but did not participate in finalisation of the report. In his commentary, Professor James says that the habitual use of caffeine could have harmful physical and behavioural effects, which may also affect children.

Background: to the Report of the Expert Working Group on Caffeine

The Australia New Zealand Food Authority (ANZFA) established an Expert Working Group (EWG) to provide an analysis of the scientific literature on the impact of caffeine. This analysis will assist ANZFA in developing appropriate regulatory policy on caffeine in food.

There are several elements to be considered in developing the policy:

regulation of caffeine in different classes of food - ANZFA is currently considering two caffeine related applications. The first seeks to establish a maximum level for caffeine in energy drinks, and the other seeks to change the current permissions for caffeine in soft drinks; and
appropriate regulation of guarana, which is a natural source of caffeine, and other foods which may contain caffeine.

Report of the Expert Working Group on Caffeine (EWG)

The report of the EWG concludes:

The potential for acute toxicological/pharmacological effects at low doses of caffeine

Several variables influence the effects of caffeine, including, age, sex smoking, the source of caffeine (eg coffee may have effects related to other constituents), and the particular population (eg adults versus children) studied.
There are limited data on the effects of caffeine in children and the Expert Group recognised that further studies were needed to establish the likely behavioural and other effects in children.
Caffeine is readily absorbed from the intestine and is extensively broken down (metabolised) in the human body. Available data suggests that metabolism is similar between adults and children, although the period of time for caffeine to be eliminated from the body appears to be shortened in children. Consequently there is no reason to suspect children to be more sensitive to the effects of caffeine when compared to available studies on the effects of caffeine in adults.

Therefore, the Expert Group considered relevant aspects of the effects of caffeine in adults on the basis of the available data and concluded the following:

It is likely that caffeine causes subtle effects at very low amounts (doses), although these effects are increasingly difficult to measure as dosage is reduced. The EWG concluded that a dose level could not be established at which caffeine does not have any effect.
At very low doses (40 mg) of caffeine (eg that contained in 1 cup of tea) there are reports of positive effects of caffeine (eg enhanced performance and improved mood). However, there is still debate as to whether these effects are due to the intrinsic reinforcing properties of caffeine or relief from withdrawal symptoms;
At the equivalent of 1-2 cups of instant coffee there are reports of reductions in the ability to sleep; and
As the amount of caffeine consumed is increased further (up to 3-4 cups instant coffee/day) there are reports of increased anxiety in adults.

The potential for addictive effects

The EWG concluded:

that caffeine at doses typically consumed in the diet may lead to withdrawal effects (notably headaches, fatigue, anxiety and increased work difficulties) and some physical dependence in adults;
the prevalence of such effects has been variable and their intensity is considered minimal in most individuals; and
further research will be required at doses typically consumed in the diet to examine whether similar withdrawal effects and physical dependency occurs in children.

Identification of any other caffeine-related hazards particularly in children

It would appear that a precise link between caffeine contributing to cardiovascular disease has not been established. The published literature provides little evidence that caffeine in typical dosages consumed in the diet contributes to high blood pressure in adults.

Professor Jack James’ views on the report of the EWG

The Report of the EWG was prepared with the assistance of staff from ANZFA. All members of the EWG participated in the working group’s deliberations. However, Professor Jack James did not participate in the finalisation of the report, and should not be regarded as necessarily supporting it. Professor James has provided comments on the final Report which are provided as a supplement at the back of the final report.

Professor James concluded the following:

Habitual use of caffeine leads to physical dependence (as evidenced by the existence of a well characterised abstinence-induced 'withdrawal syndrome').
Habitual use has no demonstrated benefits.
Dietary caffeine has harmful physical and behavioural effects.
The harmful effects of caffeine probably extrapolate to children.

Next Steps

ANZFA is currently in the process of establishing a reference group to assist with the development of appropriate regulatory policy on caffeine in food. ANZFA is currently seeking nominations of people with expertise in the areas of public health/risk management from State and Territory Governments, industry, consumer organisations and/or the health sector to be part of the reference group. ANZFA intends to select from these nominations a group of approximately 5 people to ensure there is an appropriate representation from all sectors of the community.

Caffeine regulation in Australia

Caffeine content of selected foods

Food	Caffeine content
Instant coffee (1 teaspoon/cup)	60-80 mg/250 mL cup
Percolated coffee	60-120 mg/250mL cup
Tea	10-50 mg/250 mL cup
Coca Cola	36 mg/375 mL can
Milk Chocolate	20 mg/100g bar
Energy Drinks (eg Red Bull)	80 mg/250 mL can

The Regulation of Caffeine in Foods (Soft Drinks, Energy Drinks and Sports Foods) in Australia, New Zealand and Internationally

Soft drinks

Australian Food Standards Code

The Australian Food Standards Code restricts the addition of caffeine to kola-type soft drinks, flavoured cordials and flavoured syrups. In these drinks, the total caffeine content must not exceed 145 mg/kg (36mg/250ml serve) in the drink as consumed. The Code does not prescribe limits for naturally occurring caffeine in food - for example, tea, coffee and guarana. The caffeine levels in these foods will not normally exceed 100 mg in a standard serving.

New Zealand Food Regulations

In New Zealand, caffeine may be added to any soft drinks, and a maximum level of 200 mg/kg is prescribed. It is also permitted to be used as a flavouring in any other non-alcoholic beverages where flavourings are permitted, with no maximum level prescribed.

International Regulations

Internationally, caffeine is permitted in soft drinks at levels ranging from 150 to 300 mg/kg. The Codex Alimentarius Commission an international food standards setting body does not prescribe a level for caffeine.

Energy Drinks and Sports foods

Energy drinks are non-alcoholic beverages characterised by the addition of “energy enhancing” ingredients. These may include a number of water-soluble B vitamins, amino acids and caffeine. The caffeine is added as pure caffeine or as guarana, a herbal caffeine source. Most energy drinks do not exceed levels of caffeine of about 80mg/250 mL. This caffeine level in energy drinks is comparable to the caffeine level in a strong cup of coffee.

Guarana is often added to energy drinks either in combination with caffeine or on its own. Guarana is made from the crushed seeds of a native Brazilian plant. The stimulant effect of guarana is related to its caffeine content. A 1 gram dose of guarana will contain about as much caffeine as a medium strength cup of coffee.

Energy drinks are promoted to young people to boost energy and vitality particularly in times of added stress; in New Zealand, they are also promoted as alternatives to alcoholic drinks. Energy drinks are available in over 30 countries, and are well established in Europe and the United States of America.

New Zealand Food Regulations

Energy drinks are regulated in New Zealand under the Dietary Supplements Regulations 1985, made under the Food Act 1981 but are not regulated under New Zealand Food Regulations 1984 . The current New Zealand Food Regulations and the Dietary Supplements Regulations do not require that a food or dietary supplement containing guarana is labelled as a source of caffeine.

Australian Food Standards Code

The Australian Food Standards Code does not have a standard that covers energy drinks. Prior to the introduction of the Trans Tasman Mutual Recognition Arrangement (TTMRA) in 1998, the current formulations of energy drinks could not be legally sold in Australia.

TTMRA permits the importation of energy drinks from or through New Zealand providing they comply with the New Zealand Dietary Supplements Regulations.

Sports Foods

As noted above energy drinks are regulated in New Zealand under the Dietary Supplements Regulations 1985. However, similar products are manufactured in Australia following a re-formulation (and adherence to specified upper limits for ingredients such as vitamins and minerals) of the product under Standard R10-Formulated Supplementary Sports Foods. The caffeine content of such products is from guarana which is legally a food in the Australian regulations and so escapes the restrictions placed on addition of caffeine. Foods can be mixed with other foods without special permission under food laws.