Food Standards Agency publishes new caffeine advice for pregnant women
Monday 3 November 2008
The Food Standards Agency (FSA) has today issued new advice to pregnant women on daily caffeine consumption. This follows research carried out on behalf of the Agency by the Universities of Leeds and Leicester.
Pregnant women are being advised to limit their daily caffeine intake, ideally keeping this below 200mg a day. This is roughly two mugs of coffee a day, although caffeine is also present in tea, chocolate, some soft drinks, and certain medicines.
Too much caffeine might result in a baby having a lower birth weight than it should, which can increase the risk of some health conditions for the baby in later life, or could possibly result in spontaneous miscarriage.
The Agency had previously set a maximum daily intake of 300mg. However, the new research suggests, that although the risk is low, a limit of 200mg per day will help to minimise the risk further. The research showed that the average daily caffeine intake during pregnancy was already below 200mg, so for many pregnant women this change in advice will not affect them.
Andrew Wadge, FSA Chief Scientist, said: 'This new advice doesn’t mean that pregnant women have to cut out caffeine completely, simply that they should be careful and make sure they don't have too much. We would emphasise that the risks are likely to be very small and believe our new advice, which is based on new research and has been considered by leading independent scientists, is sensible and proportionate.'
The Agency says that for pregnant women who have been following the previous advice and limiting consumption to below 300mg a day should not be concerned, as the risk is likely to be very low. They are advised not to worry and to simply reduce their caffeine consumption to less than 200mg a day for the remainder of their pregnancy. If there are still concerns they should seek further advice from their midwife or GP.
The new research carried out by the Universities of Leeds and Leicester suggested that caffeine intake during pregnancy is associated with an increased risk of foetal growth restriction. These findings and the results of other studies were considered by independent experts of the FSA’s Committee on Toxicity who advised a change in the FSA's advice on daily caffeine intake for pregnant women.
Professor Justin Konje, Chair of the Project Steering Group from the University of Leicester, said: 'This was a large study involving about 2,500 pregnant women, designed to overcome the limitations of previous research in this area. Tea was the major source of caffeine for most of the women in the study, and it is important for expectant mothers to understand that caffeine is not just in coffee and cola. I am pleased that this work has helped the FSA to refine their advice.'
Professor Janet Cade, from the University of Leeds, said: 'Everyone wants the best for their baby. Limiting daily caffeine intake is one way which you can ensure your baby has the best start in life.'
Full FSA advice:
You should limit the amount of caffeine you have each day, but you don't need to cut it out completely. Caffeine occurs naturally in a range of foods, such as coffee, tea and chocolate, and it's also added to some soft drinks and 'energy' drinks.
It's important not to have too much caffeine. This is because high levels of caffeine might result in babies having a lower birth weight than they should, which increases the risk of some health conditions in the baby and in later life. High levels of caffeine may also possibly cause miscarriage. It would be best to try to keep your caffeine intake below 200mg per day.
The amount of caffeine in food and drink will vary, but as a guide each of these contains roughly 200mg or less of caffeine:
- 2 mugs of instant coffee (100mg each)
- 1 mug of filter coffee (140mg each)
- 2 mugs of tea (75mg each)
- 5 cans of cola (up to 40mg each)
- 2 cans of 'energy' drink (up to 80mg each)
- 4 (50g) bars of plain chocolate (up to 50 mg each). Caffeine in milk chocolate is about half that of plain chocolate
So if you eat a bar of plain chocolate and drink one mug of filter coffee, or if you drink two mugs of tea and a can of cola you'll have almost reached 200mg. But don’t worry too much if you occasionally have a little more because the risks are likely to be very small.
If you are pregnant and were already following the previous advice and limiting consumption to below 300mg a day, the risk is likely to be very small. Try to reduce your caffeine consumption to less than 200mg a day for the remainder of your pregnancy. Remember that caffeine is also found in certain cold and flu remedies, so always check with your GP or another health professional before taking any of these.
We consider that the FSA-funded research contributes usefully to the body of evidence on the relation between quantified caffeine intake and fetal growth restriction (FGR).
From this work and from the other studies that have been published, we conclude that caffeine intake during pregnancy is associated with an increased risk of FGR. It is still not possible to be confident that the association is causal rather than a consequence of residual confounding, but it would be prudent to assume causation.
The evidence that is now available does not make it possible to identify a threshold level of caffeine intake below which there is no elevation of risk, and it seems likely that risk is increased in association with intakes in the order of 200 mg per day and perhaps even lower. However, if the relation is indeed causal, then the absolute increase in incidence of FGR from intakes less than 200mg per day is likely to be less than 2% of infants.
The literature suggests a positive association of caffeine intake with spontaneous miscarriage, however there are uncertainties relating to recall bias and confounding.
Data on maternal caffeine consumption during pregnancy and associations with adverse effects other than FGR or spontaneous miscarriage, such as pre-term birth and adverse effects on the fetus, are inconclusive.
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