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Publication Date : 18-03-2013
Some countries have begun to regulate caffeine
There is a trend among teenagers and young adults in Singapore of consuming lots of "energy drinks" like Red Bull, Monster and so on.
Such drinks may flood the body with too much caffeine, which can overstimulate the brain and heart, causing seizures and irregular heartbeats. A sudden rush of caffeine could cause some apparently fit, young people with underlying but undetected heart disease to suddenly develop a fatal heart attack during strenuous exercise, cases of which are reported here often enough.
Last November, the US Food and Drug Administration (FDA) began an investigation into whether the beverage called 5-Hour Energy was linked to 13 deaths reported in the United States since 2009.
In the US and here too, caffeine is regulated in some contexts but not others.
Found naturally in coffee, chocolate and tea, this drug acts on the brain to restore alertness or wakefulness. It is marketed on this basis in many products, ranging from soft drinks and alcoholic beverages to bottled water, maple syrup and chewing gum.
While industry claims it is added to enhance flavour, a study in 2000 found that 92 per cent of adults failed to distinguish a cola with caffeine from the same cola that was non-caffeinated. Instead, if there was too much of it, the consumer would detect it as it tasted bitter. Hence, it can hardly be a flavour enhancer.
Instead, another 2000 study concluded that caffeine is added because it is addictive. In 1988, the FDA determined that regular caffeine intake leads to habituation, a mild form of addiction.
Research suggests that caffeinated drinks cause consumers to become physically dependent on the drug so that they experience withdrawal symptoms if they do not get the regular shot about 24 to 48 hours after the last one. These include headaches, fatigue, difficulty in concentration, irritability, nausea and muscle aches.
Having a shot relieves the symptoms and, since caffeine use is socially acceptable, including caffeine in drinks can boost sales.
Because of the smaller body sizes of children, caffeine's impact is amplified in children in whom cyclical caffeine withdrawal symptoms may be magnified. A 2001 study showed that 45mg of caffeine in a drink gave the same jolt for a 35kg child as 90mg for a 70kg adult.
Yet the amount of caffeine in all these drinks that children and adolescents can buy remains unregulated because US politics dictates that caffeine is regulated as a drug or food under one law and, alternatively, as a dietary supplement under another more lax law.
As a drug and as food, caffeine comes under the Food, Drug and Cosmetic Act. As a drug, over-the-counter (OTC) painkillers and stimulants may contain no more than 65mg of caffeine per adult dose.
As food, caffeine may make up no more than 0.02 per cent of the total content - or 71mg of caffeine in a can the size of a regular or diet Coke, which thus contains only 54mg, as does a can of regular or diet Mountain Dew.
But as a dietary supplement, the same drug is regulated much more loosely under the Dietary Supplement Health and Education Act passed in 1994 at the behest of the food sector. This law sets virtually no standards for caffeine.
Because the FDA defers to the food maker as to whether something is a food or a dietary supplement, makers of energy drinks and other caffeinated beverages may classify added caffeine as a dietary supplement, which is thus regulated less strictly.
That is why Starbucks "Tall" coffee, which is the same size as a can of Coke, packs 260mg of caffeine, Starbucks "Grande" coffee, one size larger than "Tall", 330mg, while a can of Monster Energy has 160mg, and Red Bull 80mg.
This regulatory classification befogs the dangers that caffeine found within food and drink may pose to the public. Thus, while the label on OTC drugs must indicate how much caffeine is present - no more than 65mg per dose - and its health risks, energy drinks can pack much more. And they are sold to children and adolescents without age or dose restrictions, though youngsters are affected more adversely than adults may be.
On the issue, the FDA is likely to drag its feet as the food lobby is very powerful, the energy drink industry being a multi-billion-dollar one. But this is no reason for Singapore to follow its lead.
Indeed, some countries have begun to regulate caffeine. Turkey limits it to 150mg per litre, and requires energy drinks to say on the label: "Should not be consumed by mixing with alcohol. This is not a sports drink. Not more than 500ml should be consumed per day. It is not recommended for children under 18, elderly, diabetics, pregnant or breastfeeding women, or people sensitive to caffeine."
Australia, Uruguay, and Canada also regulate caffeine content in and labelling of energy drinks, while Thailand mandates a health warning on all energy drink advertisements.
The Health Sciences Authority here should require comparable products containing caffeine to be treated consistently, limiting it to, say, 0.02 per cent of total content in all foods and beverages. Enhanced caffeinated product labelling is also called for, while directly limiting the sales of highly caffeinated products to children and adolescents might even save some young lives.