The world’s favorite addictive stimulant — caffeine — isn’t always a harmless, perky pick-me-up.
Sarah Katz was a 21-year-old student at the University of Pennsylvania when she drank a 30-ounce “Charged Lemonade” at a Panera Bread restaurant in Philadelphia.
A few hours later, she was pronounced dead at an area hospital after suffering two heart attacks, allegedly caused by the high caffeine content in the Panera beverage.
Katz had a heart condition called long QT type 1 syndrome, which affects the electrical impulses that control a person’s heartbeat, and she typically avoided caffeinated drinks.
Her family is now suing the restaurant chain in a wrongful death suit filed on Monday in Philadelphia, alleging Panera Bread didn’t warn “of any potentially dangerous effects…on blood pressure, heart rate, and/or brain function” due to consuming the beverage.
Panera Bread labeled their “Charged Lemonade” beverage as “Plant-based and Clean with as much caffeine as our Dark Roast coffee.”
But that’s 390 milligrams of caffeine — more than triple the 111 milligrams of caffeine found in a standard 12-ounce can of Red Bull. The Post has reached out to Panera Bread for comment.
And caffeine is unexpectedly added to hundreds of foods and beverages — and in shockingly high amounts — so for many people, the stimulant can be dangerous, even deadly.
What is caffeine?
Caffeine is a bitter chemical compound found in many plants, including tea leaves, coffee beans, kola nuts, cacao beans, guarana berries and yerba mate leaves.
Plants use caffeine as a pesticide to defend against insects, which typically sicken and die from consuming the caffeinated leaves or beans of the plant.
In people, however, caffeine has a stimulant effect — but that effect can vary wildly from one person to the next, and from one drink to another.
The amount of caffeine in brewed coffee “can vary greatly depending on the type of bean, the amount of grind, the size of the particles, the brew time and other factors pertaining to the source,” Dr. Shannon Kilgore, a neurologist at the Stanford University School of Medicine, said in an American Medical Association report.
“And then, of course, tea and soft drinks tend to have less caffeine. Most people have safely under 400 milligrams a day, which is what the Food and Drug Administration considers safe,” she said.
That’s roughly the amount in two 8-ounce cups of coffee — a cup size that most American coffee lovers would consider laughably small.
And caffeine is often a hidden ingredient in foods like gum, waffles, syrup, ice cream, breakfasts cereals, energy bars, bottled water, candy and more, making it easy for consumers to exceed the recommended 400 mg per day.
Caffeine and anxiety
Medical experts warn that caffeine can often make people feel jittery and anxious — a far cry from the calm, relaxing portrayal of coffee drinkers seen in television ads.
“There are concerns about increasing anxiety for some people,” Dr. Nicole Clark, a neurologist at St. Peter’s Health Medical Group in Helena, Montana, said in the AMA report. This is “because caffeine is a stimulant and it stimulates some of the chemicals in your brain, speeding everything up.”
“Even in moderate amounts it can cause jitteriness and anxiety,” said Kilgore, noting that caffeine “can also increase respiratory rate, heart rate and blood pressure, which is most often fine in normal people, but if they have a … health condition it should be under consideration.”
Caffeine interactions
Doctors also warn that people taking certain medications or supplements should carefully watch their caffeine intake.
Ephedrine is used in many over-the-counter decongestants, but mixing caffeine with ephedrine — which is also a stimulant — can increase the risk of high blood pressure, heart attack, stroke or seizure, according to the Mayo Clinic.
The herbal supplement echinacea, sometimes taken to prevent colds or other infections, may increase the concentration of caffeine in your blood and may increase caffeine’s negative effects.
Theophylline is a drug used to open up bronchial airways, but it also has some caffeine-like effects. Taking theophylline-containing medication with caffeine could increase the adverse effects of caffeine, such as nausea and heart palpitations.
Caffeine in energy drinks
In addition to containing a mind-boggling array of sugars, vitamins, herbs and supplements, energy drinks are also popular sources of caffeine.
In a 2018 medical report, researchers noted that excessive caffeine intake by teenagers has been linked to nervousness, irritability, nausea, cardiovascular symptoms, sleep impairment, osteoporosis and gastric ulcers — and the “principal sources of caffeine intake among adolescents are sweetened coffee and energy drinks.”
“The more serious risks of caffeine are mostly related to heavy consumption from use in energy drinks and in supplement form,” Dr. Stephen Devries, a preventive cardiologist, said in the AMA report.
“Anxiety and unsafe behaviors — especially in adolescents—are associated with energy drink use. High blood pressure, palpitations and arrhythmias are other possible risks with high intake of supplemental caffeine,” he added.
Caffeine and pregnancy
Women who are pregnant are often advised to strictly limit their caffeine consumption. This is because “the caffeine does go to the baby and can speed up the baby’s heart rate,” said Clark.
Additionally, “the baby can become dependent on caffeine and have withdrawals when the baby is born,” she said. That’s why “you should dramatically limit your caffeine intake when pregnant.”
The American College of Obstetrics and Gynecology recommends that those who are pregnant limit caffeine intake to less than 200 milligrams per day, which is about one small cup of coffee.
Caffeine withdrawal
When people stop taking any addictive stimulant, withdrawal symptoms can set in — and caffeine is no exception.
If you need to reduce the amount of caffeine you are consuming, “slowly decrease your intake,” said Clark. This means you can “do half caffeinated or you can mix in some decaffeinated beverages in sodas and coffee.”
“Don’t cut out caffeine completely all of a sudden because them you may experience some bad withdrawal syndromes,” she said. “If you need help with how to decrease your intake or you’re getting headaches when you’re trying to go off caffeine, talk to your doctor.”
Who should avoid caffeine?
According to the National Institutes of Health, the following people should strictly limit or avoid caffeine:
- Pregnant women, since caffeine passes through the placenta to your baby
- Breastfeeding women, since caffeine is passed to the baby via breast milk
- Anyone with sleep disorders, including insomnia
- People with migraines or other chronic headaches
- People with anxiety
- Anyone with gastroesophageal reflux disease (GERD) or ulcers
- People with arrhythmia (a problem with the rate or rhythm of your heartbeat)
- People with high blood pressure
- Children and adolescents, who should not consume as much caffeine as adults (children can be especially sensitive to the effects of caffeine)
- Anyone whose health care provider has warned them against the effects of caffeine
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