"Pregnant women should not drink coffee" declared the newspaper article. Coffee consumption was always considered undesirable for children and pregnant women. Now this old wives' tale has been vindicated and proven, based on scientific facts.
The problem with coffee is that it contains caffeine, a xanthine alkaloid that acts as a stimulant in humans. It is not just coffee that contains caffeine. It is also found in tea, carbonated beverages and chocolate. Consumption is legal, universal and unregulated. 90% of the adults use caffeine in some form, making it the world's most widely consumed psychoactive substance.
Coffee contains 40 to 120 mgms of caffeine /120ml , tea 15-30 mgms/120ml, chocolate 3 mgs/30gms and cola drinks 20 to 50 mgms/240ml. An acute overdose of caffeine can occur if more than 3–4 cups of brewed coffee, tea or cola drinks (providing 400 milligrams) is taken in a short time. It causes caffeine intoxication, with restlessness, nervousness, agitation, excitement, insomnia, flushing, urination, muscle twitching, rambling thought processes and speech, irritability and palpitations.
Caffeine ingestion can be fatal if more than 150 to 200 mgm per kilogram (80 to 100 cups of coffee for an average adult ) is taken within a limited time frame. Overdose fatalities can occur in addicted people who snort pure caffeine powder.
Caffeine stimulates the central nervous system. It makes the person alert, with faster and clearer thought processes, improved focus, coordination, endurance and peak performance especially in sports. It delays but does not eliminate the need for sleep. It takes an hour for caffeine to work and three to four hours for the effects to wear off. If large amounts are consumed over a prolonged period, caffeinism, addiction or dependency can occur. The person exhibits nervousness, irritability, anxiety, tremulousness, muscle twitching, insomnia, headaches, palpitations, peptic ulcers, and gastroesophageal reflux disease (GERD).Tolerance develops quickly, especially among heavy coffee and cola drink consumers. Withdrawal is associated with symptoms like headache, irritability, and an inability to concentrate, which may last for day.
10% of heavy coffee or tea drinkers develop symptoms that mimic organic mental disorders with anxiety agitation and panic attacks. They may be misdiagnosed and unnecessarily medicated. Withholding caffeine would have actually cured them in a few days.
Children should not be given tea and coffee. Most parents are aware of this. Contrary to popular belief, caffeine does not stunt growth in children. It does however stimulate their nervous system. They cannot tolerate more than 45 milligrams of caffeine a day. Children who consume more than this become nervous , jittery, hyperactive, have difficulty concentrating and sleeping and have a rapid heart rate.
Parents sometimes do give their children "cola drinks." Some of the orange or lime and lemony flavoured drinks also contain caffeine. The ingredients should be carefully checked on the beverage label before it is given to the child. Unfortunately regulations in India are not as strict as they are in other countries; the listing may be absent, inaccurate or incomplete.
During the hot summer months drinking caffeine containing beverages to overcome thirst is counterproductive. Caffeine acts a mild diuretic, urine production is increased, thirst is not assuaged and dehydration may be aggravated.
Coffee and tea drinking is not all bad. Caffeine consumption has its plus points. It increases mental alertness and reduces drowsiness, two qualities essential for those on night shift work or driving a vehicle for prolonged periods. It potentiates the action of many painkillers. The onset of action is faster as absorption is rapid and eventual relief is 40% better. Many over-the-counter (OTC) headache, cold, and flu drugs contain caffeine. Coffee and tea drinking is also associated with a reduced risk of developing type 2 diabetes, gallstone disease, rheumatoid arthritis, alcoholic cirrhosis, and Parkinson's disease.
Adults can safely consume two to three cups of coffee daily as it causes no detrimental long-term health consequences in them and may even confer some health benefits.
Menopausal women are more sensitive to caffeine than their menstruating counterparts. It may produce jitteriness and interfere with sleep at lower levels. The traditional tea time consumption may need to be curtailed to ensure a good night's rest.
Women have to careful about their caffeine intake from all sources (not just tea and coffee) if they are pregnant or are planning to have a baby. The best time to stop is around a month before the pregnancy is planned. This abstinence should ideally be continued throughout the pregnancy. The caffeine is harmful because it stimulates the baby's immature metabolism and stresses it. Is also suspected to decrease blood flow to the placenta. This in turn increases the risk of miscarriages and may eventually result in a small underweight baby.
If you enjoy your tea or coffee,
- Start after you are an adult
- Restrict yourself to 3-4 cups a day
- Avoid additional caffeine in carbonated beverages
- Have your last cup at least 6 hours before your bedtime
- Avoid both during pregnancy.
Dr. Gita Mathai
The writer is a paediatrician with a family practice at Vellore.
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