Caffeine intake from foods and beverages and trends among Chinese children and adolescents: 2004-2018

Background: The popularity of caffeinated foods and beverages poses risks of high caffeine exposure among Chinese children and adolescents. Nevertheless, there is a lack of national assessments on their caffeine consumption. Objective: To estimate daily caffeine intake and analyze time trends among Chinese children and adolescents. Methods: The study subjects were participants of the China Health and Nutrition Survey in 2004, 2006, 2009 and 2011, and the National Food and Beverage Consumption Survey in 2014 and 2018. Caffeine content was determined using chromatographic instrument. The Monte Carlo simulation was utilized to estimate daily caffeine intake and the Kruskal-Wallis test was used to analyze differences between population characteristics. To examine yearly trends in caffeine intake from 2004 to 2018, the partial Mann-Kendall test was applied. Results: The median daily caffeine intake of Chinese children and adolescents was 0.17 (95%CI: 0.15-0.20) mg/ kg BW/day. Main contributors were tea (55.52%), sodas (19.52%) and tea beverages (10.37%). Approximately 4.68% of individuals consumed caffeine exceeding 2.5 mg/kg BW/day. Higher caffeine intake was observed in adolescents aged 12-17 years, males, and consumers residing in northeastern China. While no significant overall yearly trends in caffeine intake were detected from 2004 to 2018, there was an increase in intake driven by beverage consumption between 2006 and 2014. Conclusion: This study provided a national assessment of caffeine consumption among Chinese children and adolescents. Caffeinated beverages like tea, soda, and tea beverages emerged as major contributors to caffeine intake. These findings could contribute to the regulation of caffeine consumption and the promotion of healthy habits among children and adolescents.