A 17-Year-Old, Caffeine, and a Proprietary Focus Blend
A 17-year-old player on an academy roster asks you, the team's contracted performance coach, for advice. He wants to lose 3 kg before the next split because he believes it will improve his reaction time. He skips breakfast, drinks three 250 mL energy drinks daily, and has started taking beta-alanine and a proprietary 'focus' blend bought online. The label lists caffeine 200 mg per serving but not the full blend. He also takes a prescribed SSRI, though he cannot name the medication. His parent has asked to be included in any health decisions. The team has a dietitian available one day per week and a physician by phone. He says, 'Don't make a big deal, everyone on the team does this.'
1. What are the immediate risks and scope-of-practice issues?
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- Caffeine load: Three 250 mL energy drinks at about 80 mg/250 mL is roughly 240 mg, plus 200 mg from the blend, for about 440 mg/day. That is high for a 17-year-old and higher if the blend contains hidden caffeine.
- Proprietary blend: The full content is unknown, so risk cannot be assessed. This is a contamination and dosing problem, not just a preference.
- Medication: A prescribed SSRI means any stimulant or supplement interaction needs physician review. I would not advise on the SSRI or on weight loss outside my scope.
- Weight loss: A growing adolescent restricting intake without dietitian assessment risks low energy availability and impaired recovery.
- Scope: Refer to the dietitian and physician, involve the parent, and seek same-day medical review if palpitations, chest pain, severe anxiety, or suicidal thoughts occur.
2. How do you handle the conversation with the player and parent ethically?
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- Explain limits early: Performance coaching notes may be shared with staff on a need-to-know basis; health information is not. Because he is 17, parent or guardian involvement follows policy and law.
- Avoid shame: Do not dismiss him with 'everyone does it' or lecture. Acknowledge that he wants a performance edge, then explain that unknown blends and high caffeine are poor bets.
- Parent: Invite the parent into the referral with the player's assent. Share the functional concern: medical review needed, supplement use, and weight-loss intent.
- Coach: Do not disclose the SSRI. With consent, share only what affects training, such as 'needs a medical review and a meal break in the schedule.'
- Documentation: Record the advice, referral, and consent. Ethical practice here means protecting a minor while preserving trust.
3. What interprofessional plan would you recommend?
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- Dietitian: Assess growth, iron status, and energy availability. Build a fueling plan with breakfast and lunch before scrims. No weight loss during growth without medical and dietitian supervision; if pursued, no more than 0.25–0.5 kg/week.
- Physician: Review the SSRI and total caffeine, screen for anxiety, sleep problems, and cardiac symptoms.
- Coach: Adjust the schedule to allow meals and avoid a weigh-in culture.
- Supplements: Stop the proprietary blend until reviewed. Beta-alanine is not a proven esports ergogenic in the way it is for repeated sprint exercise; use only if clinician and dietitian approve. Check event anti-doping rules and batch testing.
- Review: Reassess in 2–4 weeks. This is a shared plan, not a solo coaching decision.