By Carole Sugarman
Washington Post Staff Writer
Tuesday, March 23, 1999; Page Z14

It's "appalling" how many students at the Sidwell Friends School have Coke for breakfast, says Lydia Adelfio. All too often, Adelfio, a mother and vice president of the PTA at the Northwest Washington private school, has seen kids buying their morning meal from a campus soda machine.

Gulping down a sugary, nonnutritious drink to introduce the day is bad enough, but what about that kick from the caffeine. Should parents worry about that, too? Or should they take a more laid-back approach? Is caffeine the real issue, or are colas--not to mention cappuccinos of the new coffee bar craze--simply replacing better, healthier beverages and foods?

These days, soda pop and coffee drinks are virtually a rite of passage for many kids, as ubiquitous as Beanie Babies and baggy jeans. And they're also beverages with a buzz, for a generation bred on high-tech stimuli. A 12-ounce can of Coke or Pepsi has about 45 milligrams of caffeine; those frothy milky drinks with a shot of espresso have about 90 milligrams.

While there has been a lot of research on caffeine and fertility, pregnancy, osteoporosis, cancer and heart disease, there have been far fewer studies on caffeine and children. Essentially unknown are the answers to two central questions: How much caffeine does it take to wire a kid, and how much is too much?

Most researchers agree that caffeine has the same effect on children as it does on adults. That means it can increase alertness and improve performance, as well as cause anxiety, nervousness and sleeplessness. In adults, as in children, caffeine sensitivity differs widely, although some scientists believe that because they are generally smaller than adults, children get a bigger bang from products containing caffeine. It has no toxic effects, but after repeated use, caffeine can cause withdrawal symptoms. In fact, in adults repeated use of as little as 100 milligrams of caffeine--the amount in a 6-ounce cup of coffee--can produce dependence, says Roland Griffiths, professor in the departments of psychiatry and neuroscience at the Johns Hopkins University School of Medicine in Baltimore.

It is that withdrawal that concerns Gail Bernstein, director of the division of child and adolescent psychiatry at the University of Minnesota. In a recent study, she gave 30 children, ages 8 to 12, the equivalent of the amount of caffeine in about three soft drinks every day for 13 days. Twenty-four hours after discontinuing the caffeine, she found deterioration in the children's performance on a computerized test.

Bernstein said her findings suggest that kids who drink large quantities of caffeine-containing beverages, or who have erratic spells of heavy soda guzzling--while they're on vacation, for example--may experience a dip in performance when they abruptly stop.

Griffiths has similar concerns, particularly since children, unlike adults, may have less control over a consistent supply of caffeinated beverages. Griffiths said he worries that older kids, whose bodies are going through hormonal gymnastics as it is, may be going in and out of caffeine withdrawal without even realizing it.

"With all the turmoil in adolescence . . . do they need this?" Griffiths asked.

Marlys Bernal of Herndon, mother of 12-year-old Tony, knows what it's like to have a kid unaware of caffeine sensitivity. Bernal had to ask her son to stop drinking caffeinated sodas because she believes they made him much more aggressive and impatient.

Still, Tony Bernal, who tries to stick with ginger ale, said he didn't notice any difference in how he behaved when he drank caffeinated beverages.

"Well, I noticed," replied his mother.

Behavioral observations aside, a larger concern among health experts is that sugary caffeine-containing beverages are replacing other drinks.

Like water. Or 100 percent fruit juices. Or, "God forbid, milk," says Edith Hogan, a Washington dietitian who advocates flavored milks and yogurt drinks as an easier way for kids to get fluid calcium.

For those who complain that soft drinks are replacing milk, Richard Adamson of the National Soft Drink Association pointed out that "there are other sources of calcium," including yogurt and cheese, that kids are more likely to want to consume. Adamson, the association's vice president for scientific and technical affairs, said soda is not "marketed as something that adds nutrition. It's a refreshment." And for those who are concerned about the caffeine, he said, there are plenty of noncaffeinated varieties among the 450 soft drinks on the market.

What's more, some kids may be consuming more milk, thanks to the coffee bar craze. Most teens aren't ordering straight java at coffee bars, but the milky, sweetened coffee drinks, according to Gary Goldstein, spokesman for the National Coffee Association. A standard tall latte at Starbucks, for example, contains almost 1 1/2 cups of milk.

At the same time, the smallest version of most of those foamy drinks contains a shot of espresso, which has double the amount of caffeine in a can of soda. Grandes and ventes contain two shots of espresso, and caffeine equal to the amount in four Cokes. Yet few teenagers are aware of the amount of caffeine they're consuming.

For the most part, "kids drink Cokes and other caffeine-containing beverages without even thinking about the caffeine," says Ann Litt, a Bethesda dietitian who counsels adolescents and teenagers. Anecdotedly, teenagers will tell you that it's not the caffeine that lures them to sodas and coffee drinks, but the social aspect of them, she says. And the taste. No Doz and coffee-crazed all-nighters don't usually come until college.

Because of the advertising and availability, getting precollege kids to ignore soda is like getting them to neglect Nintendo. And school systems, which make a lot of money from vending machines sales, don't help.

Lynn Downing of Chevy Chase, mother of 14-year-old Mandy, said she didn't allow her daughter to drink soft drinks when she was little. "She had a limited amount of space in her tummy, and I didn't want it filled up with soda," she said. "Then the school system kind of took it out of my hands."

Now Mandy, like other students at Eastern Middle School in Silver Spring, can buy soda whenever she wants. Downing still serves her daughter milk for dinner, but discussions about the importance of calcium often fall on deaf ears. Kids "think nothing will ever happen to them," says Lynn Downing.

Lynne Myers, a pediatrician in Falls Church, tries to take a wellness approach with her patients, explaining that caffeine-containing beverages are "nonessential parts of their life," and that they should not be "using artificial states of well-being."

Still, Myers realizes that everywhere kids go--movie theaters, parties, restaurants--they will encounter soft drinks. Parents shouldn't make things forbidden, because that will just increase children's desire for them, she says. "If you go to McDonald's, don't say, 'you can't have XYZ.' You go and let it be a fun occasion, or you don't go." But she advises that concerned parents not stock soda in the house. If you buy it for a party and have some left over, "let them have it. The rest of the time there's only milk or juice or water available," she added.

Dietitian Hogan says another way to handle it is to keep some soft drinks in the house, but put limits on the amount your kids can drink. Tell them they can have four soft drinks a week, for example, but they get to choose when. At the same time, says Hogan, emphasize that although soda isn't a "bad food, it's an extra thing that won't give any benefits." This approach, says Hogan, "teaches them responsibility. There will be all kinds of choices in life."

Learning to make decisions is what Jen Cort, school counselor at the Sidwell Friends Middle School, focuses on in the school's advisory curriculum. Cort said she teaches students about "moderation versus abuse" and that "everything you do with your body should be a decision, not a reaction."