Caffeine is a naturally occurring substance that has been enjoyed by people for thousands of years. It is generally regarded as the most widely consumed, food/drug in the world. Caffeine enhances certain aspects of both physical and mental performance, as well as alertness.

People who use caffeine regularly and responsibly to make the most of their day, often face conflicting and confusing statements regarding the effects of caffeine on a person's health. Caffeine is one of the most comprehensively studied substances with centuries of safe consumption when taken in moderate doses. As a result, there is a vast amount of scientific data that can provide answers to the many questions that exist surrounding the use of caffeine.

Myth: Caffeine is not safe.

Fact: Because caffeine is so widely used, the US Food and Drug Administration (FDA) carefully reviewed and deemed it as safe and effective. In 1958, caffeine was placed on the Food and Drug Administration's list as generally recognized as safe (GRAS). A comprehensive review of caffeine safety was recently published and concluded that moderate daily caffeine intake at doses up to 400 mg per/day was not associated with adverse effects such as general toxicity, cardiovascular effects, effects on bone status and calcium balance (with consumption of adequate calcium), changes in adult behavior, increased incidence of cancer and effects on male fertility. Another article that reviewed the effects of caffeine on human behavior also concluded that caffeine is unlikely to cause adverse events when taken in moderation.

Experts agree that moderation and common sense are the keys to safe consumption of caffeine. What is considered a "normal" amount of caffeine depends on an individual's sensitivity, and can be affected by frequency and amount of intake, body weight, age and a person's overall health. People with health problems may want to consult their physician regarding their use of caffeine.

Myth: Caffeine is an addictive drug.

Fact: Caffeine is a pharmacologically active substance; it can work as a mild stimulant, and therefore is considered a drug. Few caffeine users report loss of control of caffeine intake or significant difficulty in reducing or stopping caffeine if desired. Thus, caffeine is not addictive and is not listed in the category of addicting stimulants.

Caffeine, on the other hand, is classified by the FDA as an over-the-counter (OTC) substance and thereby regulated by more stringent safety standards. As mentioned earlier, the FDA has approved caffeine as a safe and effective substance and placed caffeine on the generally recognized as safe (GRAS) listing.

Myth: Caffeine causes heart disease.

Fact: A comprehensive review of caffeine safety was recently done and published which concluded that moderate daily caffeine intake at a dose level up to 400 mg per/day was not associated with cardiovascular effects.

Furthermore, the Framingham Heart Study examined potential links between caffeine intake and cardiovascular disease. This study showed that there is no significant relationship between caffeine consumption and development of stroke or cardiovascular disease. Thus, it was concluded that moderate caffeine consumption is not a factor in the development of atherosclerotic cardiovascular disease. A Harvard University study confirmed this report, concluding that caffeine intake does not "appreciably increase the risk of coronary heart disease or stroke."

Myth: Caffeine causes cancer.

Fact: Many studies have looked at the relationship between caffeine intake and increased risk of certain cancers, but no associations have been discovered or supported by this research. A recent paper by Nawrot called "The Effects of Ceffeine on Human Health" concluded that moderate daily caffeine intake at doses up to 400 mg per/ day is not associated with an increased incidence of cancer. Subsequent studies have also confirmed these findings, further indicating no evidence for increased risk of the following cancers: lower urinary tract cancer pancreatic cancer, breast cancer, ovarian cancer, or large bowel cancer.

Myth: Caffeine causes osteoporosis.

Fact: It has been suggested in the past that caffeine intake may affect bone health. However, there is no evidence that caffeine has any harmful effect on the bones or on the amount of calcium in the body in individuals who ingest the currently recommended daily allowances of calcium. In addition, any negative effects of caffeine on calcium absorption are small enough to be fully offset by as little as one to two tablespoons of milk. The Framingham Osteoporosis Study evaluated risk factors for bone loss in 800 elderly women and men for 4 years. The change in bone mineral density (BMD) in the hip, radius, and spine in elders was measured. This study concluded that bone loss was not affected by caffeine intake. The Nottingham EPIC Study Group compared the effects of caffeine consumption on bone mineral density in 580 postmenopausal women. This study concluded that caffeine consumption did not affect bone mineral density. Another study evaluated the effect of dietary intake of caffeine on bone loss in 138 postmenopausal women and this also concluded that caffeine intake of up to 1400 mg per/ day was not associated with bone loss.

Myth: Caffeine can affect fertility.

Fact: The data available on the effects of caffeine on fertility are conflicting, but most studies found that moderate caffeine intake does not affect fertility or increase the chance of having a miscarriage or birth defects. The Organization of Teratology Information Services (OTIS) also stated that there is no evidence that moderate caffeine intake causes birth defects in humans. In fact, pre-pregnant or pregnant women who do not smoke or drink alcohol and who consume moderate amounts of caffeine (< 5-6 mg/kg/day) have no increase in reproductive risks. However pregnant women should limit their caffeine intake to 250mg-300mg per/day.

Myth: Caffeine has no health benefits.

Fact: Caffeine increases alertness and reduces fatigue thus enhancing the ability to work and concentrate. Caffeine also improves performance tasks that require one to be alert and enhances reaction time.

Ongoing research is being conducted on caffeine and its potential role in the prevention of some diseases. Caffeine may have a role in the prevention of gallstones, Alzheimer's Disease, and possibly Parkinson's disease. However, additional studies are needed to confirm these findings. Therefore, caffeine may have some health benefits but it is too early to make recommendations at this time.

Myth: Caffeine pills are more dangerous than drinking coffee.

Fact: Experts agree that consistency is the key to using caffeine safely, and caffeine pills provide certain benefits in terms of dose regulation as compared to other sources of caffeine. According to Barbara Levine, R.D., Ph.D., Director of the Nutrition Information Center at Weill Medical College of Cornell University- New York Presbyterian Hospital, caffeine pills offer users a more regulated dose of caffeine (200 mg/tablet), as compared to coffee, which may fluctuate depending on serving size and preparation (e.g., regular coffee vs. espresso).

In addition, according to a government appointed panel of experts, caffeine pills have been found to be less irritating to your stomach than coffee. Recent consumer focus groups discussing the advantages of caffeine pills over traditional caffeinated beverages suggest that the average American consumer found caffeine pills easy to carry, readily available, inexpensively priced and because no preparation is required, they can be consumed virtually anywhere.

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