BRUCE ROSEMAN, M.D.
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BRUCE ROSEMAN, M.D.
NICOLE LIVESCU, R.N.


ENERGY DRINKS ARE BAD AS KIDS ARE TARGETED
Experts warn beverages can hook kids on unhealthy jolt-and-crash cycle
CHICAGO - More than 500 new energy drinks launched worldwide this year, and coffee fans are probably too old to understand why.
Energy drinks aren’t merely popular with young people. They attract fan mail on their own MySpace pages. They spawn urban legends. They get reviewed by bloggers. And they taste like carbonated cough syrup.
Vying for the dollars of teenagers with promises of weight loss, increased endurance and legal highs, the new products join top-sellers Red Bull, Monster and Rockstar to make up a $3.4 billion-a-year industry that grew by 80 percent last year.
Thirty-one percent of U.S. teenagers say they drink energy drinks, according to Simmons Research. That represents 7.6 million teens, a jump of almost 3 million in three years.
Nutritionists warn that the drinks, laden with caffeine and sugar, can hook kids on an unhealthy jolt-and-crash cycle. The caffeine comes from multiple sources, making it hard to tell how much the drinks contain. Some have B vitamins, which when taken in megadoses can cause rapid heartbeat, and numbness and tingling in the hands and feet.
Health risks add to appeal
But the biggest worry is how some teens use the drinks. Some report downing several cans in a row to get a buzz, and a new study found a surprising number of poison-center calls from young people getting sick from too much caffeine.
Danger only adds to the appeal, said Bryan Greenberg, a marketing consultant and an assistant professor of marketing at Elizabethtown College.
“Young people need to break away from the bonds of adults and what society thinks is right,” he said. They’ve grown up watching their parents drink Starbucks coffee, and want their own version. Heart palpitations aren’t likely to scare them off.
Most brands target male teens and 20-somethings. Industry leader Red Bull, the first energy drink on the market, is now the “big arena band” of the bunch “teetering on the edge of becoming too big and too corporate,” Greenberg said.
“Monster is more of a hard rocker, maybe with a little punk thrown in, much more hardcore,” he said. “Rockstar is the more mainstream, glam rock band that’s more about partying then playing.”
(Monster is produced by Corona, Calif.-based Hansen Natural Corp., and Rockstar, distributed by Coca-Cola Co., is made by Las Vegas-based Rockstar Inc.)
Fierce competition
Greenberg said the fierce competition among hundreds of new drinks, with Austria-based Red Bull guarding the biggest market share, leads to a “ratcheting up” of taboo names as companies try to break out from the crowd.
Cocaine Energy Drink, which launched in September and now sells in convenience stores and nightclubs in six states, is the latest example, following a twisted logic set by drinks named Pimpjuice and Bawls.
Hannah Kirby of the Las Vegas company behind Cocaine Energy Drink said Greenberg has it right. Kirby and her husband, Redux Beverage founder James Kirby, wanted to call their drink by the ho-hum name Reboot. That name was taken, so they decided to get provocative.
“We knew we would get noticed against a thousand other energy drinks,” she said. “We knew kids would find it cool, but we also wanted to stress the idea that it’s an energy drink, you don’t need drugs.” Their slogan is “The Legal Alternative.”
The Kirbys are parents of an 18-year-old son, Kirby said. The boy grew up hearing he shouldn’t drink energy drinks on a school night.
Rumors swirl around Red Bull
Red Bull founder Dietrich Mateschitz based his product on tonics sold in Asia. He started selling Red Bull in 1987 in Austria, his native country, and today 2.5 billion cans are sold a year in more than 130 nations. The industry leader grabbed more than 37 percent of the U.S. market last year, according to Beverage Digest.
Rumors have swirled around Red Bull for years. Contrary to hearsay, the ingredient taurine (an amino acid important in making bile to aid digestion) is not made from bull urine, and Mateschitz did not learn about Red Bull from rickshaw drivers in Thailand. The urban legends-debunking Web site www.snopes.com has a page devoted to exposing the false claim that Red Bull contains a banned substance linked to brain tumors.
No evidence was ever found that sudden deaths in Ireland and Sweden were caused by people drinking Red Bull. But it’s true that the Swedish government studied energy drinks and recommended they not be used to quench thirst or replenish liquid when exercising. And they should not be mixed with alcohol.
'Energy beers' stir controversy
Too late. Anheuser-Busch and Miller Brewing now produce several “energy beers” — beer containing caffeine. And Red Bull and vodka — mixed up by bartenders who call it a Friday Flattener or a Dirty Pompadour — has been popular for a decade. On Red Bull’s MySpace page, the product’s 11,000 “friends” include alcohol products, which also have their own MySpace pages.
A Brazilian study found college students didn’t feel as drunk as they actually were after drinking vodka and Red Bull. Their perception of their coordination and reaction time didn’t match objective tests.
The potential for accidents and alcohol poisoning worries Dr. Sandra Braganza, a pediatrician and nutrition expert at the Children’s Hospital at Montefiore in New York. As she prepared to write an article about energy drinks for a pediatrics journal, she was surprised how little published research she could find on them.
“The truth is, we don’t know what kind of effects these ingredients can have,” Braganza said of taurine, glucuronolactone and guarana. “We have to start doing more studies on this.”
Caffeine overdoses
Earlier this month, a new study found a surprising number of caffeine overdose reports to a Chicago poison control center. These involved young people taking alertness pills such as NoDoz or energy drinks, sometimes mixed with alcohol or other drugs. During three years of reports to the center, the researchers found 265 cases of caffeine abuse. Twelve percent of those required a trip to the hospital. The average age of the caffeine user was 21.
“Young people are taking caffeine to stay awake, or perhaps to get high, and many of them are ending up in the emergency department,” said Dr. Danielle McCarthy of Northwestern University, who conducted the study. “Caffeine is a drug and should be treated with caution, as any drug is.”
How much caffeine do energy drinks contain? A University of Florida study found that some products, although served in cans two-thirds the size of a standard can of Coke, contain two to four times the amount of caffeine as that Coke. Energy drinks are unregulated in the United States, but the authors of the University of Florida paper suggest warning labels for them.
And now energy drinks are moving toward bigger cans with some products raising the caffeine content to gain a competitive edge, said John Sicher of Beverage Digest. The biggest, so far, is 24 ounces.
Moderation is key
Parents should think twice before sending their children out the door with an energy drink, said Molly Morgan, a dietitian in upstate New York who consults with schools and talks to students, parents and coaches about energy drinks.
“My message to parents is moderation,” Morgan said. “That means one can a day or less, and view it as a treat, not part of a daily routine.”
Full of sugar and caffeine, energy drinks share the same health problems as soft drinks, she said. But some parents and coaches have bought the message that the drinks can enhance kids’ performance in sports and increase concentration in school.
The evidence is weak, involving tiny studies. British research by a scientist who has since received funding from Red Bull found that among 36 volunteers, those who drank the product improved aerobic endurance and recalled numbers better. A British study of 42 people found Red Bull had no effect on memory, but did improve attention and verbal reasoning.
A University of Wisconsin study of 14 students found that two energy drink ingredients, caffeine and taurine, didn’t improve short-term memory but led to slower heart rates and higher blood pressure. Since some energy drink ingredients generally speed up heart rates, the researchers could only speculate on the cause.
Carol Ann Rinzler, author of “Nutrition for Dummies,” examined the labels of the top three energy drinks.
“The labels simply don’t deliver all the facts,” she said. “For example, while all list caffeine as an ingredient, and most tell you exactly how much caffeine is in the drink, they also list guarana, a caffeine source, as a separate ingredient but don’t tell how much caffeine one gets from the guarana.”
Drinks also deliver sugar high
Rinzler said energy drinks also deliver a huge hit of sugar.
“Drink more than one and you get lots of sugar — 14 teaspoons in two cans, 21 teaspoons in three,” she said. Add in megadoses of some vitamins; unnecessary nutrients (taurine) and more caffeine than plain sodas and you get “a fast up-and-down sugar high and a really rough caffeine buzz,” she said. “And drinking two or three cans a day for a period of weeks or months might trigger some side effects from the vitamin megadoses.”
New brands are appearing at the rate of almost one per day, making it difficult for Denver blogger Dan Mayer to keep up. As a hobby, Mayer reviews each new energy drink he can find. His is not the only energy drink review site, but it’s one of the most popular.
“I’ve reviewed a little over 200 now. For most of these, the companies contact me. I’ll find something new at 7-Eleven once in a while, but that’s kind of rare,” he said.
When Mayer meets an energy drink he doesn’t like, his words can sting: “This is the kind of drink that was created by a bunch of rich fat people that have never had an energy drink in their life and really don’t understand why this fad is around, they just know they want to be a part of the profit from it.”
A Los Angeles company has asked him to design a new drink, but Mayer hasn’t quit his day job yet. Pressed to explain the appeal of energy drinks, the 24-year-old spokesman for the buzzed generation said: “It’s Starbucks for kids. With the tons of caffeine they put into these things, it gives you a little legal form of speed essentially


Caffeine decreases heart's blood flow during exercise
Drinking two cups of caffeinated coffee decreases blood flow to the heart during exercise, researchers report, and the reduction may be most pronounced at high altitudes. While healthy people may tolerate the reduced blood flow fairly easily, it may be harmful to people with coronary artery disease.

Dr. Philipp A. Kaufmann and colleagues from University Hospital Zurich, examined the immediate effects of caffeine on blood flow to the heart at rest and after exercise in healthy young adult volunteers exercising at normal oxygen levels or simulated low-oxygen levels that occurs at high altitudes.

The team measured cardiac blood flow at baseline and 50 minutes after ingestion of 200 mg caffeine, equivalent to about two cups of coffee.

They report that caffeine did not alter resting myocardial blood flow at normal oxygen levels. At low-oxygen levels, resting myocardial blood flow was significantly increased by caffeine.

During exercise, a significant decrease in blood flow to the heart was observed at normal oxygen levels and at low-oxygen levels.

Caffeine led to a 22 percent drop off in so-called "myocardial flow reserve" at normal oxygen levels and a 39 percent decrease at low-oxygen levels.

These findings, the authors conclude, support that exercise-induced blood flow response may at least in part be antagonized by caffeine.

SOURCE: Journal of the American College of Cardiology, January 17, 2006.

Too Much Caffeine Ups Risk of Kidney Stones
. SOURCE: The Journal of Urology, August 2004
Fri Sep 3, 9:15 AM ET By Alison McCook

NEW YORK (Reuters Health) - People who are prone to kidney stones should limit their caffeine intake, new research suggests.

When investigators gave people with a history of kidney stones a dose of caffeine equivalent to that found in two cups of coffee, they began to excrete more calcium in their urine, putting them at increased risk of forming kidney stones.

Study author Dr. Linda K. Massey told Reuters Health that stone suffers should limit themselves to less than two cups of coffee per day or a comparable amount of caffeine from other sources. And that limit of two cups means, literally, 16 ounces-not two enormous mugs of coffee, which can contain much more caffeine, she said.

Massey, who is based at Washington State University in Spokane, explained that a spike in urinary calcium increases the risk of stones because calcium is an important ingredient in kidney stones -- so the more there is, the more likely there will be stones.

Previous research has shown that people who do not tend to form kidney stones also excrete more calcium in their urine after consuming caffeine.

To investigate whether the same thing happens in people prone to stones, Massey and Dr. Roger A. L. Sutton at the University of British Columbia in Vancouver, asked 39 people with kidney stones and nine who never had stones to drink caffeine added to water after 14 hours of fasting. The researchers tested their urine 2 hours before and after they consumed caffeine.

As the investigators report in the Journal of Urology, after caffeine, the stone-formers showed an increase in calcium, sodium, magnesium and citrate in their urine. The same pattern also occurred in the people with no history of kidney stones.

In an interview, Massey explained that more calcium and sodium in urine likely increases the risk of kidney stones, while increases in magnesium and citrate appear to protect people from kidney stones.

However, after plugging these changes into a formula that predicts kidney stone risk, Massey said, "The increase in magnesium and citrate did not offset the increase in calcium."

Study: Caffeine Interferes with Diabetes Control
WASHINGTON (Reuters) - Caffeine could interfere with the body's ability to handle blood sugar, thus worsening type 2 diabetes, U.S. researchers said on Monday.

The team at Duke University Medical Center in North Carolina found a strong correlation between caffeine intake at mealtime and increased glucose and insulin levels among people with type 2 diabetes.

The American Diabetes Association says that at least 90 percent of the 17 million Americans diagnosed with diabetes have type 2, in which the body either does not produce enough insulin or cells ignore the insulin, which the body needs to convert food into energy.

The findings are significant enough that the researchers recommend people with diabetes consider reducing or eliminating caffeine from their diets.

"In a healthy person, glucose is metabolized within an hour or so after eating. Diabetics, however, do not metabolize glucose as efficiently," said James Lane, a psychiatry professor who led the study.

"It appears that diabetics who consume caffeine are likely having a harder time regulating their insulin and glucose levels than those who don't take caffeine."

Writing in the journal Diabetes Care, Lane and colleagues said they studied 14 habitual coffee drinkers with type 2 diabetes.

The researchers put the volunteers on a controlled diet.

They took their medications, had their blood tested and then were given caffeine capsules. More blood was taken then and after giving the volunteers a liquid meal supplement.

Caffeine had little effect on glucose and insulin levels when the volunteers fasted, the researchers found.

But after the liquid meal, those who were given caffeine had a 21 percent increase in their glucose level and insulin rose 48 percent.

"The goal of clinical treatment for diabetes is to keep the person's blood glucose down," Lane said in a statement.

"It seems that caffeine, by further impairing the metabolism of meals, is something diabetics ought to consider avoiding. Some people already watch their diet and exercise regularly. Avoiding caffeine might be another way to better manage their disease. In fact, it's possible that staying away from caffeine could provide bigger benefits altogether."


consumer reports on Coffee:
If you're among the roughly 160 million Americans who drink coffee, you've probably followed news reports that implied the brew could damage your health--particularly since it contains caffeine, a potent, potentially habit-forming stimulant. Over the past few decades, coffee has been linked to an array of possible health risks, ranging from stroke and miscarriage to high cholesterol and even cancer.

But now the jury is pretty much in, and for most people, the news is good: Consuming two or three cups of coffee a day does no harm; it boosts mood, alertness, and physical performance; and it may even help prevent certain diseases. However, the news isn't bracing for everyone: Heavy coffee drinkers, pregnant women, and possibly people with heartburn, breast lumps, or anxiety disorders may benefit from cutting back on the brew. Here's a look at the latest findings on what coffee does to the body and mind.

Safe for the average heart
The idea that coffee is bad for your heart pops up periodically--and seems to have a certain logic. Over a decade ago, several epidemiologic studies found that heavy coffee drinkers had higher blood-cholesterol levels than nondrinkers. Then lab tests, mainly from Europe, found that regularly drinking very strong coffee could sharply increase volunteers' cholesterol levels. Researchers even isolated a fatlike chemical in coffee, cafestol, that was clearly responsible for the rise. (Cafestol shows up in coffee whether or not it's decaffeinated.)
However, the brewing methods used in the lab studies involved boiling ground coffee in water, a method that produces extremely high concentrations of cafestol. By contrast, the filter and percolation brewing methods used by more than nine of ten Americans remove all but a trace of cafestol. (So-called French-press brewing results in a cafestol content close to that of the boiling method.)
Moreover, the laboratory studies involved large amounts of coffee--six cups a day of boiled brew. The average American coffee drinker downs about three cups a day.
In addition, research has clearly shown that regular moderate coffee drinking doesn't substantially raise blood pressure. Studies have also failed to substantiate fears that coffee might trigger or worsen abnormal heart rhythms (arrhythmias).
The only remaining doubt about coffee and heart disease lies in its effect on homocysteine, another likely cardiac risk factor. A recent Dutch clinical trial found that drinking the equivalent of six cups a day of very strong filtered coffee raised the blood homocysteine level an average of 20 percent, even though the coffee contained practically no cafestol.
Meir Stampfer, M.D., a Harvard epidemiologist who has studied many aspects of coffee and health, says the impact of that finding, if any, "seems modest."
More important, large, lengthy epidemiologic studies of coffee and heart disease itself have overwhelmingly shown little or no risk from drinking the brew. Within the last two years alone, researchers announced the results of two more long-term studies. A follow-up of more than 11,000 Scots found that the more coffee they drank, the less likely they were to develop heart disease. The other study, involving some 20,000 Finns (who drink the boiled brew), found that coffee drinking had no effect on the risk of heart disease or death.
"For heart disease, I think the issue is closed," says Stampfer. "Coffee drinking at reasonable levels is unrelated to heart risk."


Parkinson's protection and more?
Within the last year, evidence has emerged suggesting that coffee may help fend off Parkinson's disease. A 30-year study of 8,000 Japanese-American men living in Hawaii found that the more coffee they drank, the lower the incidence of the disease. The most avid coffee drinkers, who consumed three to four to five cups a day, had one-fifth the risk of those who didn't drink the brew.
At Minnesota's Mayo Clinic, researchers compared people who had Parkinson's disease with a matched group of people who didn't have it. Coffee drinkers had less than half the risk of developing Parkinson's, compared with nondrinkers.
Demetrius Maraganore, M.D., who directed the study, believes there's a plausible alternative explanation for those findings: People who are developing Parkinson's may form an aversion to coffee long before they notice the disease's physical symptoms.
However, scientists at Massachusetts General Hospital recently found evidence that caffeine really may combat Parkinson's. They found that caffeine (not coffee) seemed to protect animals' brain cells from depletion of the nerve chemical dopamine--he problem underlying human Parkinson's disease. However, these are preliminary findings. Human studies have not consistently supported caffeine's protective role.
When it comes to gallstones, a recent Harvard study of some 46,000 men found that those who drank two to three cups of coffee a day had a 40 percent lower risk of developing gallstones than non-coffee drinkers; those who drank more coffee had even lower risk.


Miscarriage concerns
A recent Canadian reanalysis of ten studies on coffee and miscarriage concluded that pregnant women who drank the caffeine equivalent of about two cups of coffee a day had 36 percent more miscarriages than women who drank less than that.
But again, "You're never sure whether drinking coffee increases the risk of a miscarriage or whether many women who have a normal, healthy pregnancy just lose their taste for coffee," says Mark Klebanoff, M.D., director of the division of epidemiology at the National Institute of Child Health and Human Development. Indeed, studies show that pregnant women who experience nausea, or "morning sickness"--a sign of a healthy pregnancy--do tend to cut back on their coffee drinking.
Klebanoff oversaw a recent study that measured a metabolic product of caffeine in the women's blood--a more accurate gauge of coffee consumption than the ones used in the Canadian analysis. In this study, only those who drank the equivalent of more than five to six cups of coffee a day had an increased likelihood of miscarriage. (No one knows which component of coffee might be responsible for that apparent risk--if it is real, and not just the result of losing taste for the brew.)

Cancer: Reassuring news
Studies of coffee and cancer have focused on three organs:
Pancreas. You may remember a brief coffee scare back in the early 1980s, when a single study linked coffee with pancreatic cancer. False alarm--many studies since then have shown that the association is either extremely weak or nonexistent.
Bladder. The many studies done so far have produced little in the way of coherent results. Researchers have had difficulty distinguishing the effects of caffeine from those of tobacco, which does increase the risk of bladder cancer and often goes along with heavy coffee drinking. Overall, a connection between coffee and bladder cancer, if it exists at all, likely applies only to true coffee junkies. A recent reanalysis of ten European studies found an increased risk only among people who drank ten or more cups a day.
Colon. Studies show that drinking coffee seems to have no influence on the risk of colon cancer.

Energy levels
"Caffeine may be the most commonly consumed pharmacologically active substance in the world," Klebanoff says. It's such a powerful stimulant that the International Olympic Committee and the National Collegiate Athletic Association set limits on how much caffeine can remain in the blood during competition. In addition to boosting physical endurance, caffeine increases alertness and improves mood.
The buzz sometimes comes at a price, though. People who drink more than they're used to may become restless, jittery, and unable to sleep. Moreover, it's possible to become physically addicted to caffeine within a matter of days. After that, some people find that unless they keep up their usual daily consumption, they develop a splitting headache. But coffee's addictive potential may be less universal than previously believed. In a recent study of 57 habitual coffee drinkers who were forced to quit cold turkey, only about one-third reported withdrawal symptoms.

Other concerns
Ulcers and heartburn. Coffee does not seem to increase the risk of developing ulcers but can stimulate heartburn in some people.
Breast lumps. The idea that the caffeine in coffee encourages the development of fibrous (benign) breast lumps dates back to a study done in the 1980s. More-recent studies have had contradictory results: A few show that abstaining from coffee causes the sometimes-painful lumps to regress, while other studies show no effect. There is no evidence that coffee increases the risk of breast cancer.
Anxiety. Some evidence suggests that people with anxiety problems tend to feel better when they avoid caffeine.

Recommendations
Women who are pregnant, likely to become pregnant, or breast-feeding should drink no more than two cups of coffee a day, to avoid the possible risk of miscarriage or--since caffeine gets into breast milk--a jittery breast-fed baby. In addition, people with heartburn, breast lumps, or anxiety problems may want to see whether cutting back on coffee improves the condition.
For most people, however, there's virtually no risk in consuming up to three normal-sized (6- to 9-ounce) cups of coffee per day. (Heavy coffee drinkers can reduce any risks caffeine might pose by switching to decaf.)
Understand, though, that if you drink coffee on a daily basis--even as little as a cup or two--you'll likely become habituated to its effects. Harvard's Stampfer says he tries to keep his coffee drinking irregular enough to avoid habituation. "That way, I can get a buzz when I feel like it."

Coffee's Jolt Tied to Genes
MONDAY, Dec. 9 (HealthScoutNews) -- American and German researchers say they've found the genetic basis for the jitters that come with your java.

People with two linked genetic variations are far more likely to suffer caffeine-induced anxiety than other people, says the study, which was presented yesterday at the American College of Neuropsychopharmacology's annual meeting in San Juan, Puerto Rico.

It's the first study to identify why people have different behavioral reactions to the same drug. Not only does it provide new insight into why caffeine affects people in different ways, the study also validates a testing method that may help identify individual differences in how people respond to a number of major drugs, the researchers say.

The study was done by researchers from the University of Chicago and two German universities. They studied 94 healthy, infrequent caffeine users. The subjects were given either oral doses of caffeine or a placebo, and the researchers recorded the subjects' physiological reactions and their mood states.

Blood samples were also collected from the study participants and checked for the genes that code for two proteins, called adenosine receptors, that are known to interact with caffeine.

The researchers found four genetic variations of the adenosine receptors in the study group. After analyzing their results, they found that people with two specific variants in the A2a receptor gene had much higher levels of anxiety after consuming caffeine than other people in the study.

Previous studies found that people who suffer from panic disorder are likely to have one of the same variants. Caffeine is a common trigger of panic attacks in people with panic disorder.

The researchers plan to use the same testing method to study how people react differently to amphetamines.


Caffeine Vs. Skin Cancer
Caffeine may protect you from skin cancer -- if you're a mouse,
anyway. A recent study found that mice who were smeared with
lotions containing caffeine or EGCG (a compound contained in
green tea) after ultraviolet light exposure developed fewer skin
tumors than mice who didn't get the lotions. Researchers exposed
90 mice to high levels of ultraviolet radiation twice daily for
20 days. The mice were then divided into three groups: One group
was treated with caffeine lotion, one was treated with EGCG
lotion, and one was treated with lotion containing neither
chemical. After 18 weeks, the researchers found that the mice in
the caffeine group had 72 percent fewer and mice in the EGCG
group had 66 percent fewer malignant skin cancer compared to mice
in the no-chemical group. The mice treated with caffeine or EGCG
also had fewer non-malignant tumors, The Associated Press
reports. The researchers say caffeine appears to protect against
sun-induced cancer by causing abnormal cells to kill themselves,
rather than growing into cancers. The AP quotes other experts
who caution that findings in animals don't always translate to
humans. The study was published online on the Proceedings of the
National Academy of Sciences site.


Scientists See Possible Cancer Risk in Coffee
Tue Aug 27, 5:53 PM ET
BERLIN (Reuters) - German researchers said on Tuesday they had found traces in coffee of a substance that some experts fear could cause cancer.
   
Researchers for German ecology magazine Oeko-Test discovered acrylamide, which can cause cancer in animals, in all 24 brands of ground coffee and seven brands of espresso they tested.
"It was known that there is acrylamide in coffee beans," Oeko-Test editor Hella Hansen told Reuters. "We wanted to know how much of it gets into a cup of coffee."
The test found the substance was present in brewed coffee, although in much lower quantities than in ground coffee beans.
Preliminary scientific studies have found that acrylamide--a substance found in french fries, potato chips, water and carbohydrate-rich foods such as bread that are fried or baked--can cause cancer in animals.
The World Health Organization ( news - web sites) (WHO) said in June that acrylamide was a cause of concern but more research was needed about the possible effect on humans.
It repeated its long-standing nutrition advice--eat a balanced and varied diet and limit consumption of fried and fatty foods.
The US Food and Drug Administration ( news - web sites) has also said the information currently available about acrylamide is not sufficient to assess the substance's impact on public health.
Coffee has been the subject of a wide range of studies, looking at its link to cancer, heart disease and infertility.
According to the American Cancer Society ( news - web sites), "the vast majority of studies agree that coffee has not been shown conclusively to have a link to bladder, breast, lung, pancreatic, prostate or any other cancers."
Earlier studies found that some compounds in coffee seemed to be anti-mutagenic, meaning they prevent DNA damage. Experts point out coffee is a highly complex food and no studies of a single compound are likely to show for certain what its health effects might be.
The head of the German coffee federation, Winfried Tigges, said acrylamide was not present in raw coffee beans, but was formed when they were roasted.
He said coffee producers were researching ways of producing coffee without the substance building up.
"It is an issue for us. It is not clear at the moment whether acrylamide is dangerous for people, but if it is we want to get it out of coffee," he told Reuters.
"Thank goodness, it is found in very low quantities in coffee, but all coffee producers are carrying out research into how acrylamide is formed," Tigges said.
Swedish scientists earlier this year prompted a worldwide food scare when they reported finding high levels of acrylamide when carbohydrate-rich foods such as rice, potatoes and cereals were fried or baked.

Good News, Bad News on Cancer for Caffeine Lovers
Mon Aug 26, 5:29 PM ET
By Alison McCook
NEW YORK (Reuters Health) - Caffeine in the form of a lotion may help to prevent skin cancer, according to the results of a new study. But a separate study found that caffeine may actually promote cancer.
   
In the "good news" study, skin cancer was prevented in mice at risk of developing the disease if a lotion containing caffeine was applied to their skin. In the "bad news" study, when a dish of hamster cells was exposed to tumor-inducing radiation, adding caffeine appeared to inhibit the cells' ability to repair themselves, increasing their likelihood of becoming cancerous.
Both studies appear in the online Early Edition of the Proceedings of the National Academy of Sciences ( news - web sites).
These studies add to a growing body of contradictory results about the links between caffeine and cancer. For example, one study showed that caffeine may help fight off cancer by blocking an enzyme that is crucial for cell growth, thereby potentially inhibiting the uncontrolled growth that characterizes cancer. In contrast, another report showed that drinking coffee did not reduce women's risk of developing colorectal cancer.
In the first of the two recent studies, Dr. Allan H. Conney of Rutgers, The State University of New Jersey, and his colleagues exposed mice to ultraviolet light twice a week for 20 weeks. As a result of this exposure, the mice--initially tumor-free--had an increased risk of developing skin cancers over the next several months.
Five days a week for the next 18 weeks, the researchers rubbed an inactive lotion onto the backs of some of the mice, one that contained caffeine onto the backs of others, and a lotion with the compound epigallocatechin gallate (EGCG), an ingredient of green tea, onto the rest. The investigators then measured how many tumors the mice developed.
Conney's team found that mice treated with a caffeinated lotion developed 44% fewer non-cancerous tumors and 72% fewer cancerous tumors than those given the inactive treatment. Mice that received the EGCG-filled substance had a reduction in their non-cancerous and cancerous tumors of 55% and 65%, respectively.
In the second study, Dr. Theodore Puck and his colleagues exposed hamster cells to low doses of radiation--levels similar to those found in the basements of some buildings and in mines. This type of radiation, known as alpha radiation, has been linked to the development of lung cancer.
Exposure to radiation caused a certain number of mutations--alterations to the cells' genetic material that can increase the risk of developing cancer--the authors note. Cells contain natural mechanisms to repair many of these mutations; however, when Puck and his team added caffeine to the samples, the cells were much less able to repair these mutations than when they were caffeine-free.
Speaking with Reuters Health, Puck said that researchers still do not know why caffeine might inhibit cellular repair. He added that his experiment also shows how radiation exposure can induce mutations, and recommended that investigators continue working to pinpoint the sources of this radiation, and try to eliminate them.
"We can detect sources of mutations in the environment with extremely good sensitivity," he said. "And that makes it possible to remove them from the environment."
SOURCE: Proceedings of the National Academy of Sciences 2002;10.1073/pnas.152433699, 182429899.


OTC Drugs
NoDoz, maximum strength; Vivarin 1 tablet 200
Excedrin  2 tablets 130
NoDoz, regular strength  1 tablet 100
Anacin  2 tablets 64

Coffees
Coffee, brewed 8 ounces 135
General Foods International Coffee, Orange Cappuccino 8 ounces 102
Coffee, instant 8 ounces 95
General Foods International Coffee, Cafe Vienna 8 ounces 90
Maxwell House Cappuccino, Mocha 8 ounces 60-65
General Foods International Coffee, Swiss Mocha 8 ounces 55
Maxwell House Cappuccino, French Vanilla or Irish Cream 8 ounces 45-50
Maxwell House Cappuccino, Amaretto 8 ounces 25-30
General Foods International Coffee, Viennese Chocolate Cafe 8 ounces 26
Maxwell House Cappuccino, decaffeinated 8 ounces 3-6
Coffee, decaffeinated 8 ounces 5

Teas
Celestial Seasonings Iced Lemon Ginseng Tea 16-ounce bottle 100
Bigelow Raspberry Royale Tea 8 ounces 83
Tea, leaf or bag 8 ounces 50
Snapple Iced Tea, all varieties 16-ounce bottle 42
Lipton Natural Brew Iced Tea Mix, unsweetened 8 ounces 25-45
Lipton Tea 8 ounces 35-40
Lipton Iced Tea, assorted varieties 16-ounce bottle 18-40
Lipton Natural Brew Iced Tea Mix, sweetened 8 ounces 15-35
Nestea Pure Sweetened Iced Tea 16-ounce bottle 34
Tea, green 8 ounces 30
Arizona Iced Tea, assorted varieties 16-ounce bottle 15-30
Lipton Soothing Moments Blackberry Tea 8 ounces 25
Nestea Pure Lemon Sweetened Iced Tea 16-ounce bottle 22
Tea, instant 8 ounces 15
Lipton Natural Brew Iced Tea Mix, diet 8 ounces 10-15
Lipton Natural Brew Iced Tea Mix, decaffeinated 8 ounces < 5
Celestial Seasonings Herbal Tea, all varieties 8 ounces 0
Celestial Seasonings Herbal Iced Tea, bottled 16-ounce bottle 0
Lipton Soothing Moments Peppermint Tea 8 ounces 0



Caffeine withdrawal
Caffeine-Induced Organic Mental Disorder 305.90 Caffeine Intoxication
Recent consumption of caffeine, usually in excess of 250 mg.
At least five of the following signs:
Not due to any physical or other mental disorder, such as an Anxiety Disorder.
Basically, overdosing on caffeine will probably be very very unpleasant but not kill or deliver permanent damage. However, People do die from it.

Caffeine and Osteoporosis (Calcium loss)
From the Journal of AMA: (JAMA, 26 Jan. 1994, p. 280-3.)
"There was a significant association between (drinking more) caffeinated coffee and decreasing bone mineral density at both the hip and the spine, independent of age, obesity, years since menopause, and the use of tobacco, estrogen, alcohol, thiazides, and calcium supplements [in women]."
















   

   
Fibrocystic Breast Syndrome

Although October is Breast Cancer Awareness Month, women need to be aware of their breast self-exams every month. No one, not even your doctor, knows your body like you do. Many women, as many as fifty percent, suffer from fibrocystic breast syndrome. These are benign (non-cancerous) lumps filled with fluid that change during your menstrual cycle. They can make your breasts swell and become tender, sometimes painful, just before and during your period. They are hormonally related. For this reason, the best time to examine your breasts is one week after your period. Everyone should do a breast self-examination once a month. Pamphlets and instruction is available in your doctor's office or by request from the American Cancer Society, Avon Products, or pharmaceutical companies, such as Wyeth-Ayerst. This condition DOES NOT MAKE YOU MORE SUSCEPTIBLE TO BREAST CANCER.
   
What you put in your body can also make a difference in the amount of swelling and pain you have on a monthly basis. Caffeine intake can greatly influence the tenderness you may have. Limiting caffeine will help alleviate the symptoms of fibrocystic breast syndrome. Some people think of caffeine in the form of coffee only However, non-herbal teas, sodas, diet sodas, and chocolate al contain caffeine

Caffeine,  Even in Small Doses, May Hurt Arteries
NEW YORK (Reuters Health) - Small doses of caffeine--even as little as that in one cup of coffee--can cause temporary stiffening of the blood vessel walls, according to two small studies released here this week at the American Society of Hypertension's annual meetingResearchers led by Dr. Charalambos Vlachopoulos of Athens Medical School in Greece looked at the effect of caffeine in people with mild hypertension, or high blood pressure, and in individuals with normal blood pressure.The researchers found that people with mild hypertension who took a pill that contained 250 milligrams (mg) of caffeine, equivalent to the amount contained in 2 to 3 cups of coffee, experienced a temporary increase in blood pressure and in the stiffness of the aorta, the main artery leaving the heart.In the other study, a small group of people with normal blood pressure who were given a pill containing as much caffeine as one cup of coffee also experienced a temporary increase in the stiffening of arterial walls.Vlachopoulos and his team measured arterial stiffness by looking at pulse velocity in the aorta.

Arteries need to be supple enough to expand when muscles--including the heart--demand more oxygen, and a loss of elasticity spells trouble for the body. Arterial stiffening places an extra load on the heart, and is a primary cause of hypertension.In the general population, hypertension is a major risk factor for serious conditions such as heart disease, stroke and kidney disease. Blood pressure is considered high when systolic pressure--the first number in a blood pressure reading--is above 140 mm Hg, and diastolic pressure--the second number in the reading--goes over 90 mm Hg.In the first study, Vlachopoulos and his team gave 10 mildly hypertensive people a high-dose caffeine pill and placebo. Caffeine increased systolic pressure by 11.4 mm Hg relative to placebo.In the other study, the caffeine equivalent of one cup of coffee also increased arterial stiffness in 10 non-hypertensive patients, and raised their systolic blood pressure by 3 mm Hg and their diastolic reading by 6.5 mm Hg.Pulse velocity eventually returned to its normal levels, Vlachopoulos noted, but remained higher than average even three hours after patients took the caffeine pills.Vlachopoulos explained that the increased arterial stiffness that comes with caffeine might worsen hypertension in people who already have high blood pressure, and may also increase the risk that these individuals have of suffering a serious cardiovascular event such as heart attack or stroke. The increased stiffness also reduces the amount of oxygen that is supplied to the heart, he noted.Both studies used only a small number of patients, the Greek researcher noted, and further research is needed before doctors can make specific recommendations about who should avoid caffeine and who should simply reduce the amount they consume.In the meantime, however, Vlachopoulos said that certain patients, such as those whose arteries are already stiff, may wish to start reducing caffeine consumption now.





 

 http://www.brucerosemanmd.com/1x1.gifAMOUNT OF CAFFEINE

Cup of coffee   

90-150mg

Instant coffee  

60-80mg

Tea              

30-70mg

Mate

25-150mg

Cola             

30-45mg

Chocolate bar      

30mg

Stay-awake pill  

100mg

Vivarin          

200mg  

Cold relief tablet

30mg

http://www.brucerosemanmd.com/1x1.gif

 

 http://www.brucerosemanmd.com/1x1.gifcaffeine content in mgs per 12 oz can of soda:

According to the National Soft Drink Association, the following is the

 

   Jolt                    

71.2

   Sugar-Free Mr. Pibb    

 58.8

   Mountain Dew            

55.0  (no caffeine in Canada)

   Diet Mountain Dew       

55.0

   Kick citrus             

54

   Mello Yellow        

52.8

   Surge                   

51.0

   Tab                      

46.8

   Coca-Cola              

 45.6

   Diet Cola               

45.6

   Shasta Cola             

44.4

   Shasta Cherry Cola      

44.4

   Shasta Diet Cola        

44.4

   Mr. Pibb                

40.8

   OK Soda                

40.5

   Dr. Pepper              

39.6

   Pepsi Cola            

37.2

   Aspen                   

36.0

   Diet Pepsi              

35.4

   RC Cola                

 36.0

   Diet RC                 

36.0

   Diet Rite               

36.0

   Canada Dry Cola         

30.0

   Canada Dry Diet Cola    

1.2

   7 Up                   

0

http://www.brucerosemanmd.com/1x1.gif

 

 http://www.brucerosemanmd.com/1x1.gifCAFFEINE CONTENT COFFEE AND TEA

Drip                   

 115-175

   Espresso        

 100mg of caffeine   

   1 serving (1.5-2oz)

http://www.brucerosemanmd.com/1x1.gif

   Brewed                  

80-135

   Instant                 

65-100

   Decaf, brewed           

3-4

   Decaf, instant         

 2-3

   Tea, iced (12 ozs.)     

70

   Tea, brewed, imported  

 60

   Tea, brewed, U.S.     

  40

   Tea, instant            

30

   Mate                   

 25-150mg

http://www.brucerosemanmd.com/1x1.gif

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Caffeine,  Even in Small Doses, May Hurt Arteries
By Alison McCook

NEW YORK (Reuters Health) - Small doses of caffeine--even as little as that in one cup of coffee--can cause temporary stiffening of the blood vessel walls, according to two small studies released here this week at the American Society of Hypertension's annual meeting.

Researchers led by Dr. Charalambos Vlachopoulos of Athens Medical School in Greece looked at the effect of caffeine in people with mild hypertension, or high blood pressure, and in individuals with normal blood pressure.

The researchers found that people with mild hypertension who took a pill that contained 250 milligrams (mg) of caffeine, equivalent to the amount contained in 2 to 3 cups of coffee, experienced a temporary increase in blood pressure and in the stiffness of the aorta, the main artery leaving the heart.

In the other study, a small group of people with normal blood pressure who were given a pill containing as much caffeine as one cup of coffee also experienced a temporary increase in the stiffening of arterial walls.

Vlachopoulos and his team measured arterial stiffness by looking at pulse velocity in the aorta.

Arteries need to be supple enough to expand when muscles--including the heart--demand more oxygen, and a loss of elasticity spells trouble for the body. Arterial stiffening places an extra load on the heart, and is a primary cause of hypertension.

In the general population, hypertension is a major risk factor for serious conditions such as heart disease, stroke and kidney disease. Blood pressure is considered high when systolic pressure--the first number in a blood pressure reading--is above 140 mm Hg, and diastolic pressure--the second number in the reading--goes over 90 mm Hg.

In the first study, Vlachopoulos and his team gave 10 mildly hypertensive people a high-dose caffeine pill and placebo. Caffeine increased systolic pressure by 11.4 mm Hg relative to placebo.

In the other study, the caffeine equivalent of one cup of coffee also increased arterial stiffness in 10 non-hypertensive patients, and raised their systolic blood pressure by 3 mm Hg and their diastolic reading by 6.5 mm Hg.

Pulse velocity eventually returned to its normal levels, Vlachopoulos noted, but remained higher than average even three hours after patients took the caffeine pills.

Vlachopoulos explained that the increased arterial stiffness that comes with caffeine might worsen hypertension in people who already have high blood pressure, and may also increase the risk that these individuals have of suffering a serious cardiovascular event such as heart attack or stroke. The increased stiffness also reduces the amount of oxygen that is supplied to the heart, he noted.

Both studies used only a small number of patients, the Greek researcher noted, and further research is needed before doctors can make specific recommendations about who should avoid caffeine and who should simply reduce the amount they consume.

In the meantime, however, Vlachopoulos said that certain patients, such as those whose arteries are already stiff, may wish to start reducing caffeine consumption now.

Caffeine Ingestion Is Associated With Reductions in Glucose Uptake Independent of Obesity and Type 2 Diabetes Before and After Exercise Training
SoJung Lee, PHD1, Robert Hudson, MD, PHD2, Katherine Kilpatrick, MD3, Terry E. Graham, PHD4 and Robert Ross, PHD1,2

1 School of Physical and Health Education, Queen’s University, Kingston, Ontario, Canada
2 Department of Medicine, Division of Endocrinology and Metabolism, Queen’s University, Kingston, Ontario, Canada
3 Department of Medicine, Division of Geriatrics, Queen’s University, Kingston, Ontario, Canada
4 Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada

Address correspondence and reprint requests to Robert Ross, PhD, School of Physical and Health Education, Queen’s University, Kingston, Ontario, Canada, K7L 3N6. E-mail: rossr@post.queensu.ca

OBJECTIVE—We investigated the effect of caffeine ingestion on insulin sensitivity in sedentary lean men (n = 8) and obese men with (n = 7) and without (n = 8) type 2 diabetes. We also examined whether chronic exercise influences the relationship between caffeine and insulin sensitivity in these individuals.

RESEARCH DESIGN AND METHODS—Subjects underwent two hyperinsulinemic-euglycemic clamp procedures, caffeine (5 mg/kg body wt) and placebo, in a double-blind, randomized manner before and after a 3-month aerobic exercise program. Body composition was measured by magnetic resonance imaging.

RESULTS—At baseline, caffeine ingestion was associated with a significant reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (33%), obese (33%), and type 2 diabetic (37%) groups in comparison with placebo. After exercise training, caffeine ingestion was still associated with a reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (23%), obese (26%), and type 2 diabetic (36%) groups in comparison with placebo. Exercise was not associated with a significant increase in insulin sensitivity in either the caffeine or placebo trials, independent of group (P > 0.10).