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Counting Your Caffeine Intake: How much is too much?

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If you’re among the 64 percent of American adults who drinks at least one cup of coffee every morning, you may know exactly how much to drink and what time to stop drinking to avoid any unpleasant caffeine side effects such as jitters and insomnia. What you may not know is that an increasingly wide variety of foods and beverages contain significant amounts of caffeine, making it nearly impossible to accurately gauge yours and your children’s daily intake.

The tragic story of 16-year-old Davis Allen Cripe underscores why counting caffeine milligrams is important. The South Carolina teen, who was found to have no undiagnosed heart condition, died from a rapid, irregular heartbeat called arrhythmia caused by an overdose of caffeine. Cripe’s friends told the coroner that within two hours of his death, he drank a large diet Mountain Dew®, a McDonald’s café latte and an energy drink.

Dale Yoo, MD, a cardiac electrophysiologist at Medical City McKinney, an affiliate of HCA Healthcare, confirmed that caffeinated drinks can absolutely affect your heart rhythm.

“Anything that’s a stimulant or increases the stress on your heart will increase your adrenaline and your heart rate,” Dr. Yoo said. “Things like coffee, tea and herbal supplements will increase your adrenaline and heart rate. Drinks like 5-hour ENERGY®, Red Bull® and Monster Energy® have a lot of taurine and caffeine that can also increase the stimulant effect on your heart and increase the risk of arrhythmia.”

In addition to soft drinks and energy drinks, caffeine is being added to a growing list of products, including marshmallows, oatmeal, jelly beans, waffles, gum, mints, sunflower seeds, syrup and even water. It can be found in chocolate, ice cream (those with chocolate or coffee flavors), weight loss pills and over-the-counter pain relievers.  This prompted the U.S. Food and Drug Administration (FDA) last year to announce an investigation into the safety of caffeine in food products, with special attention paid to its effects on children and adolescents.

Because caffeine is not a nutrient, but a naturally occurring chemical found in items such as tea leaves, coffee beans and cacao (used to make chocolate), the FDA does not require the amount in a food or beverage to be listed on nutrition labels unless it is added. Many of these products also contain hidden caffeine or other stimulants. Here’s what to look for:

  • Sugar
  • Guarana
  • Taurine
  • Kola nut
  • Yerba mate
  • Cocoa or cacao

How much caffeine is too much?

According to the FDA, a safe amount of caffeine for healthy adults is up to 400mg a day. That’s anywhere from three to five eight-ounce cups of regular coffee, depending on the bean source and brewing method. For children and adolescents, the American Academy of Pediatrics’ recommendation is to avoid energy drinks entirely — which the CDC says sent 1,499 adolescents to the ER in 2011 — and limit caffeine for ages 12 to 18 to 100mg daily.

We’ll never know for sure exactly how much caffeine Davis Cripe ingested, but we can estimate it based on his friends’ report and use this as an opportunity to educate everyone on the effects of caffeine on the body.

Large diet Mountain Dew: “Large” is a relative term, but even if he had a “small large” at 20 ounces, that’s 91mg of caffeine — nearly the AAP-recommended limit of 100mg. A Long John Silver’s large is 40 ounces with a whopping 180mg of caffeine and 7-11 has soda cups much bigger than that.

McDonald’s café latteThese espresso-based drinks come in small, medium and large. Espresso has about 64mg of caffeine per ounce.

Small cafe latte (12 ounces)

Medium café latte (16 ounces)

  • 142mg caffeine, 13g sugar

Large cafe latte (20 ounces)

  • 178mg caffeine, 16g sugar

Red Bull energy drink (12 ounces): The type and size of energy drink Cripe had is unknown, so we’ll use this popular one.

  • 111mg caffeine, 37g sugar

In our example, Cripe would have ingested a minimum of 273mg and a maximum of 468mg of caffeine in a short period. And this may be a very low estimate, as the American Academy of Pediatrics says some energy drinks can contain more than 500mg of caffeine.

Research debunks myth that coffee improves alertness and mood.

We all know the negative effects of caffeine. The FDA says that it can make you:

  • Jittery and shaky
  • Unable to fall asleep, stay asleep or get a good night’s sleep

Experience:

  • rapid, uneven heart rate (arrhythmia)
  • raised blood pressure
  • headaches, nervousness, anxiety and dizziness
  • dehydration
  • heartburn
  • dependency and the need to drink increasingly more

But other than that, coffee is good for you, right? While coffee in moderation has been shown to reduce the risk of several diseases, including certain cancers and stroke, it’s most likely the health benefits of coffee’s antioxidants that are responsible, not the caffeine. Look for other ways to get antioxidants, including eating lots of healthy fruits and vegetables.

As to coffee’s magical brain-enhancing powers, study results from Johns Hopkins Medical School (featured on Forbes.com) show that caffeine-related performance improvement (a boost in mood and alertness) is nonexistent without caffeine withdrawal. In other words, that kick that you get from your morning cup of Joe is really just caffeine taking you back to “normal” for a short time.

We hope that this information is a wake-up call for you and your loved ones about the effects of caffeine on the body and how to gauge your daily intake.

About HCA Healthcare

HCA Healthcare, one of the nation's leading providers of healthcare services, is comprised of 183 hospitals and more than 2,300 sites of care, in 20 states and the United Kingdom. Our more than 283,000 colleagues are connected by a single purpose — to give patients healthier tomorrows.

As an enterprise, we recognize the significant responsibility we have as a leading healthcare provider within each of the communities we serve, as well as the opportunity we have to improve the lives of the patients for whom we are entrusted to care. Through the compassion, knowledge and skill of our caregivers, and our ability to leverage our scale and innovative capabilities, HCA Healthcare is in a unique position to play a leading role in the transformation of care.

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