Caffeine self-administration in humans: 2. A within-subjects comparison of coffee and cola vehicles.

The reinforcing effects of caffeine ingested in coffee versus cola were studied. Eleven participants who drank both coffee and cola (3–10 cups of coffee and 1–6 cans of cola daily; M?=?632 mg caffeine/day) were tested in 4 conditions: cola at 33 mg/serving (the usual dose), coffee at 33 mg/serving, cola at 100 mg/serving, and coffee at 100 mg/serving (the usual dose). Each condition consisted of 6 double-blind weekly trials. In each trial, participants sampled caffeinated and noncaffeinated beverages and then had concurrent access to the 2 beverages. Relative use of these beverages was used to assess caffeine reinforcement. Across the 4 conditions (24 weeks), reliable caffeine reinforcement occurred in 5 participants (45%). Caffeine reinforcement did not differ as a function of vehicle or serving dose, and no vehicle-dose interactions were found. With both cola and coffee at the commonly used doses, self-reported motivation to work was greater and drowsiness and laziness smaller with caffeinated than noncaffeinated beverages. Results indicate that, among users of both coffee and cola, caffeine self-administration and subjective effects occur with both vehicles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of caffeine consumption on delayed conception

The authors examined the effects of caffeine consumption on waiting time to conception in the Reproductive Health Study, a retrospective study of 1,430 non-contracepting, parous women interviewed between July 1989 and June 1990 at Fishkill, New York, and Burlington, Vermont. Information was obtained on 2,501 pregnancies since 1980. Women's reported consumption of caffeinated beverages during the first month of pregnancy was used to estimate daily caffeine intake, which was categorized as none, 1-150, 151-300, and > or = 301 mg. Information on delayed conception was analyzed as a dichotomous variable (< or = 12 months delay vs. > 12 months delay), and the per cycle probability of conception (fecundability) was estimated using waiting time to conception as a continuous variable. Odds ratios of delayed conception and fecundability ratios adjusted for age, parity, smoking, last contraceptive used, infertility history, and race, were estimated by logistic regression and Cox proportional hazard models, respectively. Women who did not smoke and who consumed no caffeine were used as a reference group. The adjusted odds ratio of delayed conception for more than one year was not increased among women who consumed < or = 300 mg of caffeine daily. However, the odds ratio (OR) was 2.65 (95% confidence interval (CI) 1.38-5.07) among nonsmokers who consumed > or = 301 mg of caffeine daily. Although smoking per se was associated with a significant increased risk of delayed conception (OR = 1.77, 95% CI 1.33-2.37), no effect of high caffeine consumption was observed among women who smoked. Fecundability was reduced among nonsmokers who consumed more than 300 mg caffeine daily (fecundability ratio = 0.74, 95% CI 0.59-0.92). Smoking reduced the fecundability ratio, but the authors observed no effect of caffeine consumption on fecundability among women who smoked. Other studies provide biologic plausibility for these findings. The authors conclude that high levels of caffeine consumption may result in delayed conception among women who do not smoke cigarettes.     

Caffeinated beverages, decaffeinated coffee, and spontaneous abortion

We examined the relations between spontaneous abortion and the consumption of caffeine, individual caffeine-containing beverages (coffee, tea, and soda), and decaffeinated coffee in a prospective study of 5,144 pregnant women. We collected information about potential risk factors for spontaneous abortion, including consumption of caffeinated beverages and decaffeinated coffee before and during pregnancy, by interview in the first trimester. Neither total estimated caffeine nor individual caffeinated beverage consumption during the first trimester was associated with an appreciable increase in risk for spontaneous abortion. The adjusted odds ratio for consumption of greater than 300 mg per day of caffeine was 1.3 [95% confidence interval (CI) = 0.8-2.1] after adjustment for maternal age, pregnancy history, cigarette and alcohol consumption, employment, race, gestational age at interview, and marital and socioeconomic status. The adjusted odds ratio for spontaneous abortion related to consumption of three or more cups of decaffeinated coffee during the first trimester was 2.4 (95% CI = 1.3-4.7) in the same model. Although we could not demonstrate this with available data, we suspect that this association was due to bias resulting from the relations among fetal viability, symptoms of pregnancy such as nausea, and consumption patterns during pregnancy.     

The ability of low doses of caffeine to serve as reinforcers in humans: A replication.

Eleven coffee drinkers were given concurrent access to placebo coffee versus coffee to which 25 or 50 mg of caffeine had been added. The 25-mg dose reliably served as a reinforcer in 2 participants and the 50-mg dose served as a reinforcer in 5 participants. When only placebo coffee was available, participants reported more headaches and drowsiness and less stimulation, alertness, and relaxation. The occurrence of headache and drowsiness with placebo coffees predicted subsequent caffeine reinforcement. These results replicate our prior findings that low doses of caffeine can reliably serve as a reinforcer in a subsample of caffeine users and that caffeine withdrawal predicts caffeine reinforcement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dietary caffeine intake and bone status of postmenopausal women

Dietary caffeine intake has been suggested as a risk factor for bone loss in postmenopausal women. We measured the bone density of both hips and the total body in 138 healthy, postmenopausal women aged 55-70 y who had either never used hormone replacement therapy (HRT) or had used HRT for < 1 y. In this cross-sectional study, participants were stratified according to their reported current and long-time caffeinated beverage use into one of three groups: low [0-2 cups (180 mL, or 6 oz per cup) caffeinated coffee per day], moderate (3-4 cups caffeinated coffee per day), or high (> or = 5 cups caffeinated coffee per day). Caffeine intake was measured from diet records and by gas chromatography of each subject's brewed, caffeinated beverages. No association between caffeine intake and any bone measurement was observed. The anthropometric and nutrient intakes of the three groups were similar. Compared with caffeine intake based on chemical analysis of brewed beverages, 3-d prospective food records and computer-assisted analysis overestimated caffeine intake by nearly two-thirds. In conclusion, the habitual dietary caffeine intake of this cohort of 138 postmenopausal women ranged from 0-1400 mg/d and was not associated with total body or hip bone mineral density measurements. This study does not support the notion that caffeine is a risk factor for bone loss in healthy postmenopausal women.     

A systematic survey of caffeine intake in Vermont.

Detailed data were collected on lifetime caffeine intake from 202 Vermont residents using a random-digit dial telephone survey. The sample appeared representative and test–retest reliability of caffeine intake was high (r?=?.95). Almost all participants (96%) had ever used and most (83%) presently used one or more caffeinated beverages weekly. The average caffeine intake was 186 mg/day. Many caffeine users (61%) used caffeinated beverages other than coffee. Current caffeine intake was a poor measure of lifetime intake. For example, among ever-users of caffeine, 41% had stopped at least 1 type of caffeinated beverage and 14% had stopped caffeine altogether. Cessation was mostly due to health concerns and unpleasant side effects. It was concluded that simply asking about "usual" coffee use is a poor and biased estimate of lifetime caffeine use. Thus, prior findings that caffeine is not associated with medical or behavioral disorders may represent false-negative results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clubgoers and their trendy cocktails: Implications of mixing caffeine into alcohol on information processing and subjective reports of intoxication.

Alcoholic drink preferences in college students have made an interesting shift recently, with trends in consumption leaning toward caffeinated alcohol in various forms (e.g., Red Bull and vodka or caffeinated beers such as Anheuser-Busch's B-to-the-E). Despite the dramatic rise in popularity of these beverages, little research has examined the combined effects of alcohol and caffeine, which is problematic for adequately informing the public about the risk or lack thereof of these drinks. The purpose of this study was to directly investigate the acute effects of alcohol and caffeine, alone and in combination, on well-validated measures of cognitive performance and subjective intoxication in social drinkers. Participants (N = 12) performed a psychological refractory period task that measured dual-task interference as the prolonged reaction time to complete the 2nd of 2 tasks performed in close temporal sequence. Performance was tested under 2 active doses and 1 placebo dose of caffeine (0.0 mg/kg, 2.0 mg/kg, and 4.0 mg/kg) in combination with 1 active dose and 1 placebo dose of alcohol (0.0 g/kg and 0.65 g/kg). As expected, alcohol impaired task performance by increasing dual-task interference and increasing errors. The coadministration of caffeine counteracted the effects of alcohol on interference but had no effect on the degree to which alcohol increased errors. Subjective measures of intoxication showed that coadministration of caffeine with alcohol reduced participants' perceptions of alcohol intoxication compared with administration of alcohol alone. The results highlight the complexity of drug interactions between alcohol and caffeine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular reactivity, mood, and task performance in deprived and nondeprived coffee drinkers.

40 habitual, heavy coffee drinkers (aged 18–48 yrs; mean consumption of 5.7 cups/day) were deprived of their morning coffee for 1 experimental session and not deprived of the other. During each session, Ss consumed 12 oz of caffeinated coffee, decaffeinated coffee, or caffeine-free herbal tea. Measurements of heart rate, blood pressure, mood, and catecholamine response to deprivation and consumption of the beverage, alone and in combination with challenging tasks, were made. Caffeine continues to cause blood pressure increases with chronic, heavy consumption and these effects do not appear to habituate with regular use. Ss reacted to behavioral challenge with fewer negative mood effects if they had consumed caffeine or coffee. Mild caffeine deprivation was associated with symptoms of stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High-resolution microscopic determination of hepatic NADH fluorescence for in vivo monitoring of tissue oxygenation during hemorrhagic shock and resuscitation

Psychopharmacological studies using caffeinated beverages or caffeine have rarely considered temporal effects on psychological and physiological function or the specific contribution of caffeine, hot water, or beverage type to the observed effects. The effect of 400 ml hot tea, coffee, and water consumption on systolic and diastolic blood pressure (SBP and DBP), heart rate, skin conductance (a measure of sympathetic nervous system activation), skin temperature, salivary cortisol, and mood were monitored in 16 healthy caffeine-withdrawn (14 h) subjects in a complete crossover design. Beverages were ingested with/without 100 mg caffeine and milk (tea/coffee only). Hot beverage ingestion rapidly increased skin conductance and temperature (+1.7 degrees C) with peak effects observed only 10-30 min post-consumption. Caffeine in the beverage rapidly augmented skin conductance responses but, in contrast to the effect of hot water, reduced the skin temperature response and increased SBP (+2.8 mmHg) and DBP (+2.1 mmHg) 30-60 min post-consumption. Both caffeine and milk addition to beverages independently improved mood and reduced anxiety 30 and 60 min post-consumption. Milk addition had no other effects apart from attenuating the transient increase in physiological responses associated with the drinking phase. There were no effects of beverage consumption on salivary cortisol or of beverage vehicle on salivary caffeine levels, the latter indicating that caffeine pharmacokinetics was similar in both tea and coffee, and not different from caffeinated water. In keeping with this, the responses to tea and coffee ingestion were similar and largely accounted for by the effects of hot water and caffeine. However, tea potentiated the increase in skin temperature compared to coffee and water indicative of a greater vasodilatory response plausibly related to the presence of flavonoids in tea. We conclude that ingestion of hot caffeinated beverages stimulates physiological processes faster than hitherto described, primarily via the effects of hot water and caffeine, but with beverage type and milk playing important modulatory roles.     

Caffeine self-administration in humans: 1. Efficacy of cola vehicle

Eight exclusive cola drinkers in Experiment 1 (mean caffeine intake = 157 +/- 74 mg/day) and 16 drinkers of both cola and coffee in Experiment 2 (mean caffeine intake = 579 +/- 201 mg/day) underwent 6 independent, double-blind weekly trials. Each trial began with a randomized cross-over sampling period of 1 day of access to noncaffeinated cola and 1 day of access to caffeinated (33 mg/8 oz) cola. During the subsequent 1- or 2-day test period, participants had unlimited concurrent access to the 2 colas. Reliable caffeine self-administration occurred in 2 of 8 participants in Experiment 1 and in 4 of 16 participants in Experiment 2. Self-reported drowsiness, fatigue, and headache were higher when participants received only placebo colas in Experiment 2, but not Experiment 1. Caffeine self-administration via cola occurs both among people whose primary source of caffeine is cola and among those whose primary source of caffeine is coffee.     

Laparoscopic management of adnexal masses in premenopausal and postmenopausal women

OBJECTIVE: Caffeine is by far the most commonly consumed psychoactive substance. The use and abuse of most other licit and illicit psychoactive drugs have been shown to be substantially heritable. However, the impact of genetic factors on caffeine consumption, heavy use, intoxication, tolerance, and withdrawal is largely unknown. METHOD: Caffeine consumption, in the form of brewed coffee, instant coffee, tea, and caffeinated soft drinks, as well as caffeine intoxication, tolerance, and withdrawal, were assessed by personal interviews of 1,934 individual twins from female-female pairs ascertained from the population-based Virginia Twin Registry. The sample included both members of 486 monozygotic and 335 dizygotic pairs. Twin resemblance was assessed by probandwise concordance, odds ratios, and tetrachoric correlations. Biometrical model fitting was also performed. RESULTS: The resemblance in twin pairs for total caffeine consumption, heavy caffeine use, caffeine intoxication, caffeine tolerance, and caffeine withdrawal was substantially greater in monozygotic than in dizygotic twin pairs. Model fitting suggested that twin resemblance for these measures could be ascribed solely to genetic factors, with estimated broad heritabilities of between 35% and 77%. CONCLUSIONS: Caffeine is an addictive psychoactive substance. Similar to previous findings with other licit and illicit psychoactive drugs, individual differences in caffeine use, intoxication, tolerance, and withdrawal are substantially influenced by genetic factors.     

Caffeine self-administration and subjective effects in adolescents.

Eighteen adolescents (ages 11–15) underwent 6 independent, randomized, double-blind, placebo-controlled trials. In each trial, participants sampled a noncaffeinated and a caffeinated soda (33 mg per 8 oz) in a 2 day crossover, followed by concurrent access to the same 2 sodas the following 2 days. Four of the 18 (22%) participants met a repeatability criterion, and 1 also met a statistical criterion for reliable caffeine self-administration. Across-subjects ratings of depression, drowsiness, and fatigue were increased on noncaffeinated compared with caffeinated soda sampling days. These results are similar to, but less robust than, previous research in adults showing that 31–36% of coffee drinkers reliably self-administer caffeine and experience adverse effects from caffeine abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Optimal CT scanning plan for long-bone 3-D reconstruction

OBJECTIVES: This study examined whether pregnancy intention was associated with cigarette smoking, alcohol drinking, use of vitamins, and consumption of caffeinated drinks prior to pregnancy and in early pregnancy. METHODS: Data from a telephone survey of 7174 pregnant women were analyzed. RESULTS: In comparison with women whose pregnancies were intended, women with unintended pregnancies were more likely to report cigarette smoking and less likely to report daily vitamin use. Women with unintended pregnancies were also less likely to decrease consumption of caffeinated beverages or increase daily vitamin use. CONCLUSIONS: Pregnancy intention was associated with health behaviors, prior to pregnancy and in early pregnancy, that may influence pregnancy course and birth outcomes.     

Lack of significant effect of coffee and caffeine on fluoride metabolism in rats

It has been reported that rat plasma fluoride (F) concentrations are higher by up to 100% when F is administered ig in coffee or a caffeine solution compared with when it is administered in water. It was hypothesized that the consumption of caffeinated beverages has contributed to the prevalence of dental fluorosis. The present studies were done to determine the physiological mechanisms for these effects. For approximately 2 h after F was administered in coffee, plasma F concentrations were higher than when administered in water, decaffeinated coffee, or a caffeine solution (3 mg/kg), but the intergroup differences were small and generally not statistically significant. The 4-hour plasma AUC values did not differ with statistical significance. There were no differences among the groups in the renal or extrarenal (skeletal) clearances of F, which suggested that the higher plasma F concentrations in the coffee groups may have been due to a slight and transient increase in absorption rate. The possibility that caffeine per se might elevate endogenous plasma F and calcium concentrations was excluded after caffeine (25 mg/kg) ig without F was given. In addition, the renal excretion, clearance, and fractional renal clearance of calcium did not differ among the groups. The results indicated that decaffeinated coffee and caffeine had no effect on F metabolism, whereas caffeinated coffee appeared to increase the initial absorption rate but not the 4-hour bio-availability.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of caffeine on metabolism, exercise endurance, and catecholamine responses after withdrawal

In this study the effects of acute caffeine ingestion on exercise performance, hormonal (epinephrine, norepinephrine, insulin), and metabolic (free fatty acids, glycerol, glucose, lactate, expired gases) parameters during short-term withdrawal from dietary caffeine were investigated. Recreational athletes who were habitual caffeine users (n = 6) (maximum oxygen uptake 54.5 +/- 3.3 ml x kg-1 x min-1 and daily caffeine intake 761.3 +/- 11.8 mg/day) were tested under conditions of no withdrawal and 2-day and 4-day withdrawal from dietary caffeine. There were seven trials in total with a minimum of 10 days between trials. On the day of the exercise trial, subjects ingested either dextrose placebo or 6 mg/kg caffeine in capsule form 1 h before cycle ergometry to exhaustion at 80-85% of maximum oxygen uptake. Test substances were assigned in a random, double-blind manner. A final placebo control trial completed the experiment. There was no significant difference in any measured parameters among days of withdrawal after ingestion of placebo. At exhaustion in the 2- and 4-day withdrawal trials, there were significant increases in plasma norepinephrine in response to caffeine ingestion. Caffeine-induced increases in serum free fatty acids occurred after 4 days and only at rest. Subjects responded to caffeine with increases in plasma epinephrine (P < 0.05) at exhaustion and prolonged exercise time in all caffeine trials compared with placebo, regardless of withdrawal from caffeine. It is concluded that increased endurance is unrelated to hormonal or metabolic changes and that it is not related to prior caffeine habituation in recreational athletes.     

Effect of caffeine on the recognition of and responses to hypoglycemia in humans

OBJECTIVE: To determine whether two effects of acute caffeine ingestion--decrease in cerebral blood flow and increase in brain glucose use--alter the recognition of and physiologic responses to hypoglycemia. DESIGN: On two occasions, a hyperinsulinemic glucose clamp technique (2 mU/kg body weight per minute) was used to maintain plasma glucose at 5 mmol/L for 90 minutes, followed by 60 minutes at 3.8 mmol/L, and then 2.8 mmol/L. After 30 minutes at 5 mmol/L, participants consumed, using a randomized, double-blind design, caffeine-free cola with or without caffeine (400 mg) added. SETTING: Yale Clinical Research Center. PARTICIPANTS: Eight healthy, nonobese volunteers (5 men; age range, 20 to 33 years). MEASUREMENTS: Middle cerebral artery velocity (V MCA), counter-regulatory hormone levels, hypoglycemic symptoms, and cognitive function (P300 evoked potentials). RESULTS: Caffeine caused an immediate and sustained 23% decrease in VMCA from 64 to 49 cm/s (point estimate of difference, +15 cm/s [95% CI, 10 to 21 cm/s], P < 0.001). At a glucose level of 3.8 mmol/L, only the participants given caffeine had warning symptoms and "felt hypoglycemic." Moreover, the level of epinephrine was 118% ([CI of point difference, 76% to 158%] [CI, P < 0.001]) higher after caffeine consumption compared with placebo. Similarly, levels of norepinephrine (41% [CI, 26% to 60%], P < 0.002), cortisol (65% [CI, 26% to 78%], P < 0.008), and growth hormone (60% [CI, 16% to 143%], P < 0.05) were higher after caffeine consumption compared with placebo. At 2.8 mmol/L, epinephrine (40% [point estimate of the percentage difference], P < 0.05), norepinephrine (27%, P < 0.05), and cortisol (24%, P < 0.05) levels were higher, participants were more aware (P < 0.02) of hypoglycemia, and P300 latency was prolonged in the group that consumed caffeine (7.2%, P < 0.05). CONCLUSIONS: Acute ingestion of caffeine is associated with sympathoadrenal activation and awareness of hypoglycemia at a glucose level not usually considered hypoglycemic. Our data suggest that individuals who ingest moderate amounts of caffeine may develop hypoglycemic symptoms if plasma glucose levels fall into the "low-normal" range, as might occur in the late postprandial period after ingestion of a large carbohydrate load.     

Gallstone prevalence in relation to smoking, alcohol, coffee consumption, and nutrition. The Ulm Gallstone Study

BACKGROUND: Besides considering well-known risk factors for the development of gallbladder stones, such as age, sex, fecundity, and hereditary predisposition, efforts at prevention have focused increasingly on other factors, such as nicotine, alcohol, and caffeine consumption, as well as general nutrition, which may be modified. METHODS: A total of 1116 blood donors were examined between April 1994 and February 1995 in the central blood bank of the German Red Cross in Ulm, Germany. Each subject received a questionnaire and underwent to an upper abdominal ultrasound examination. RESULTS: Gallbladder stone disease (current cholecystolithiasis and history of cholecystectomy) was detailed in 5.8% of the men and 6.3% of the women. Neither regularity nor number of daily meals correlated with the frequency of gallstone disease. Vegetarians (n = 48), as a group, were not found to have gallstones. In relation to the consumption of alcohol, tobacco, or caffeine higher prevalence of cholecystolithiasis was found only in heavy drinkers of coffee (P = 0.051; odds ratio (OR), 1.083; 95% confidence interval (CI), 0.999, 1.174). CONCLUSION: Results of the present study do not show a definite relationship between nutritional factors and the consumption of alcohol, tobacco, or caffeine and an increased prevalence of gallbladder stone disease.     

Stress and alcohol use: A daily process examination of the stressor–vulnerability model.

The authors used a daily diary methodology to examine over 60 days how the within-person associations among event stress, alcohol consumption, and desire to drink varied as a function of gender, positive and negative alcohol-outcome expectancies,' and avoidant coping in a sample of 88 regular drinkers. Multilevel regression analyses indicated that men who more strongly anticipated positive outcomes or a sense of carelessness from drinking drank relatively more on stressful days compared with low-stress days. Similar results were found predicting desire to drink. Men who anticipated greater impairment from drinking drank relatively less on stressful days. In general, these effects did not hold for women. Little evidence was found for the predicted effects for avoidant coping style, and some results showed that avoidant coping style buffered the exacerbating effects of careless unconcern expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical features of daily chronic headache

INTRODUCTION: Although the International Headache Society considers chronic tension headache to be a chronic headache, patients with daily chronic headache may have pain which is not only due to tension but also has migrainous features. OBJECTIVE: To evaluate the clinical differences and abuse of drugs in a group of patients with chronic daily headache who were consecutively evaluated in the Neurology Clinic. MATERIAL AND METHODS: We consider the patients to have daily chronic headache when they have had pain at least 6 days a week for the past 6 months. Using this criterion, we studied 112 patients, of whom 90 (80.4%) were women and 22 (19.6%) men. Results. Sixty nine (61.6%) had transformed migraine and 43 (38.4%) tension headache. There were no differences in their current ages but the age of onset of the headaches varied (p = 0.000,t). Unilateral pain, trigger factors and a family history were more frequent in the cases of transformed migraine. Eighty four patients (75%) abused analgesics. Although we found different pain intensities (p = 0.000, chi 2) there was no difference in the weekly consumption of analgesics (p = 0.64, t) in the mg/week of ergotamine (p = 0.96, t) nor in absence from work between the two types of headache. CONCLUSIONS: In spite of clinical differences between transformed migraine and tension headache, which may help diagnosis, in our series abuse of analgesics (including ergotamine) was a common characteristic.