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Caffeine consumption common in kids

Even young children appear to be consuming more caffeine, so much so that caffeine could be contributing to sleep problems in primary school children, researchers found. Three-quarters of children ages 5 to 12 consumed caffeine on an average day in a survey of parents at routine clinic visits by William J. Warzak, PhD, of the University of Nebraska Medical Center in Omaha, and colleagues. The more caffeine children consumed, the fewer hours they slept on average (P=0.02), the researchers reported online in the Journal of Pediatrics, although not drawing a causal link. The average intake was two or three times higher than the 22- to 23-mg daily average reported nearly a decade ago, they noted.

Eight- to 12-year-olds in Warzak's study averaged 109 mg of caffeine — the equivalent of nearly three 12-oz cans of soda each day. But even the 52 mg of caffeine consumed by 5- to 7-year-olds on an typical day was well above the level known to have a physiologic effect on adults, the researchers noted. “There's really no role for caffeine in kids,” Marcie Schneider, MD, of the Albert Einstein College of Medicine in New York City, emphasized in commenting on the study. “We know that caffeine raises your blood pressure, raises your heart rate, and can be addictive.” Unlike older teens who are likely drinking coffee to wake up in the mornings for school, the assumption is that younger kids are getting most of their caffeine from soda, noted Schneider, who serves as a member of the American Academy of Pediatrics Committee on Nutrition.

She urged pediatricians to raise parents' awareness of the issue, perhaps as part of the yearly checkup. “We routinely ask kids what they're eating and drinking,” “It may be something that is worth pediatricians pointing out to parents that this kid does not need caffeine in their life partially because it does some things that are negative.”

Warzak's group surveyed parents of 228 children seen at an urban outpatient pediatric clinic during routine visits about the children's average daily consumption of drinks and snacks with an emphasis on caffeine-containing items. None of the children had a known sleep disorder or medical condition that might cause bedwetting. Illustrated depictions were provided to help parents accurately estimate serving sizes.

Nearly all of the caffeine intake was consumed through beverages. Few children got a meaningful amount of caffeine from food. “Caffeine's diuretic properties have encouraged behavioral health practitioners to eliminate caffeine from the diet of children with enuresis,” the researchers noted. However, they found that intake didn't correlate with the number of nights a child wet the bed (P=0.49). Overall, enuresis was actually less likely in children who consumed caffeine.

The researchers cautioned that interpretation of these results may be complicated by cultural differences in reporting children's behavioral health concerns and that their study could not draw any causal conclusions. Schneider also noted the use of parental reports and the relatively small sample as limitations. Although the findings offered no support for removing caffeine from children's diets on the basis of bedwetting, Warzak's group concluded in the paper that “given the potential effects of caffeine on childhood behavior, a screen of caffeine consumption might be beneficial when evaluating childhood behavioral health concerns.”

Source: Warzak WJ, et al “Caffeine consumption in young children” J Pediatr 2011; DOI: 10.1016/j.jpeds.2010.11.022.

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Vitamin E May Reduce Dementia Risk

The prospective Rotterdam Study involved 5,395 people over age 55 with no dementia at baseline. All of the participants, who lived in one section of the Rotterdam area, provided dietary information when the study began in 1990.

The researchers previously reported a similar association of vitamin E intake with a lower risk of dementia and Alzheimer's disease over six years of follow-up among the cohort.

The current study found that after 9.6 years of follow-up, 465 of the participants had developed dementia; 365 of these cases were classified as Alzheimer's disease.

Higher baseline vitamin E consumption correlated with lower long-term risk of dementia in models minimally adjusted for age only and those adjusted for age, education, apolipoprotein genotype, total caloric intake, alcohol and smoking habits, body mass index, and use of supplements (both P=0.02 for trend).

Dietary surveys indicated that margarine was by far the biggest contributor to vitamin E intake at 43.4%, followed by sunflower oil at 18.5%, butter at 3.8%, and cooking fats at 3.4%.

Participants with vitamin E intakes in the top third, averaging 18.5 mg per day, were 25% less likely to develop dementia of any kind over almost 10 years of follow-up than those in the bottom third, who averaged only 9.0 mg per day. Higher baseline vitamin E consumption correlated with lower long-term risk of dementia (both P=0.02 for trend).

While the top versus bottom tertile comparison was significant, the middle group with vitamin E intake averaging 13.5 mg per day was no less likely to develop dementia than the lowest intake group.

For Alzheimer's disease alone, the multivariate-adjusted risk was 26% lower among those with the highest intake compared with the lowest (95% confidence interval 3% to 44%, P=0.03 for trend). But intermediate intake again appeared to have no impact.

Other antioxidants — vitamin C, beta-carotene, and flavonoids — held no significant associations with dementia or Alzheimer's disease risk (multivariate adjusted P=0.50 to >0.99 for trend).

Sensitivity analyses excluding participants who reported taking supplements at baseline showed similar results.

The researchers noted that the vitamin intakes seen in the study were consistent with a typical Western diet but cautioned about the possibility of residual confounding in the observational results.

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