disease. Over 45,000 people were evaluated and the data indicated a slightly increased risk of death from heart disease in individuals who had an average daily consumption of more than 5 cups of *decaffeinated* coffee.
As a trial lawyer who must present evidence with sufficient reliability to pass muster in court, the question becomes, “How can we know for sure if the combination of intense swimming, changing suddenly from a vertical position to a horizontal one, sudden increase in stress and anxiety, coupled with significant caffeine intake will lead to a cardio-pulmonary event or syncope ?” While testing on a swimming ergometer (VASA or similar equipment) with a sufficiently large number of subjects and placebos such as would yield statistically significant results, the fact that actual competition can occur in very cold or hot water and the athletes do not always get “air” every time they breath. The added stress of ingesting water during intense aquatic competition could be another piece of the puzzle. Certainly further study is warranted, and all athletes should have regular physical exams.