Caffeine intake in children in the United States and 10-ytre.docx

Caffeine intake in children in the United States and 10-y
trends: 2001–20101–4
Namanjeet Ahluwalia, Kirsten Herrick, Alanna Moshfegh, and
Michael Rybak
ABSTRACT
Background: Because of the increasing concern of the potential
adverse effects of caffeine intake in children, recent estimates
of
caffeine consumption in a representative sample of children are
needed.
Objectives: We provide estimates of caffeine intake in children
in
absolute amounts (mg) and in relation to body weight (mg/kg)
to
examine the association of caffeine consumption with
sociodemo-
graphic factors and describe trends in caffeine intake in children
in
the United States.
Design: We analyzed caffeine intake in 3280 children aged 2–19
y
who participated in a 24-h dietary recall as part of the
NHANES,
which is a nationally representative survey of the US population
with a cross-sectional design, in 2009–2010. Trends over time
be-
tween 2001 and 2010 were examined in 2–19-y-old children (n
=
18,530). Analyses were conducted for all children and repeated
for

caffeine consumers.
Results: In 2009–2010, 71% of US children consumed caffeine
on
a given day. Median caffeine intakes for 2–5-, 6–11-, and 12–
19-y
olds were 1.3, 4.5, and 13.6 mg, respectively, and 4.7, 9.1, and
40.6
mg, respectively, in caffeine consumers. Non-Hispanic black
chil-
dren had lower caffeine intake than that of non-Hispanic white
counterparts. Caffeine intake correlated positively with age; this
association was independent of body weight. On a given day,
10% of 12–19-y-olds exceeded the suggested maximum caffeine
intake of 2.5 mg/kg by Health Canada. A significant linear trend
of decline in caffeine intake (in mg or mg/kg) was noted overall
for
children aged 2–19 y during 2001–2010. Specifically, caffeine
in-
take declined by 3.0 and 4.6 mg in 2–5- and 6–11-y-old caffeine
consumers, respectively; no change was noted in 12–19-y-olds.
Conclusion: A majority of US children including preschoolers
con-
sumed caffeine. Caffeine intake was highest in 12–19-y-olds
and
remained stable over the 10-y study period in this age group.
Am J
Clin Nutr 2014;100:1124–32.
INTRODUCTION
Caffeine is a commonly consumed stimulant present naturally
in or added to foods and beverages. Caffeine consumption in
children has received considerable interest because of the con-
cern of adverse health effects. Caffeine intake of 100–400 mg
has
been associated with nervousness, jitteriness, and fidgetiness

(1, 2). Because of the continued brain development involving
myelination and pruning processes, children may be particularly
sensitive to caffeine (3, 4). There has been some evidence that
has linked caffeine intake in children to sleep dysfunction, el-
evated blood pressure, impairments in mineral absorption and
bone health, and increased alcohol use or dependence (1, 5–7).
In addition, the routine use of caffeinated sugar-sweetened
beverages may contribute to weight gain and dental cavities (8).
Caffeine toxicity in children has also been described involving
tachycardia, central nervous system agitation, gastrointestinal
disturbance, and diuresis (6, 9, 10). Health Canada has put forth
maximal daily caffeine intake guidelines for children and ado-
lescents (6, 11). Although no such recommendations have been
set in the United States, the American Academy of Pediatrics
has underscored that “caffeine and other stimulant substances
contained in energy drinks have no place in the diet of children”
(12).
Caffeine consumption has also been associated with certain
health benefits such as increased endurance, attention, and vig-
ilance and a reduced reaction time in some studies (9, 13, 14).
Perceived positive effects on mood and cognition as well as
physical performance may encourage preteens and adolescents
to
consume caffeinated products (2, 15, 16).
The literature on caffeine consumption in a representative
sample of US children has been primarily based on older data,
namely the US Department of Agriculture Continuing Survey of
Food Intakes by Individuals (CSFII)5 1994–1996 and 1998 (16,
17). In addition, caffeine intake from beverages from the 1999
US Share of Intake Panel (SIP) survey in caffeine consumers
has
also been published (18). A 2010 US Food and Drug Admin-
istration report also presented findings from the analysis of

older
data from NHANES 2005–2006 (19). Because of the current
1
From the Division of Health and Nutrition Examination
Surveys, Na-
tional Center for Health Statistics, CDC, Hyattsville, MD (NA
and KH);
the National Center for Environmental Health, CDC, Atlanta,
GA (MR);
and the Food Surveys Research Group, Beltsville Human
Nutrition Research
Center–Agricultural Research Service, USDA, Beltsville, MD
(AM).
2 Findings and conclusions in this report are those of the
authors and do
not necessarily represent the official position of the National
Center for
Health Statistics, CDC.
3 This work was not supported by any external grant.
4 Address correspondence to N Ahluwalia, Division of Health
and Nutri-
tion Examination Surveys, National Center for Health Statistics,
CDC, 3311
Toledo Road, Room 4110, Hyattsville, MD 20782. E-mail:
[email protected]
cdc.gov.
5 Abbreviations used: CSFII, Continuing Survey of Food

Intakes by In-
dividuals; MEC, mobile examination center; PIR, poverty
income ratio; SIP,
Share of Intake Panel.
ReceivedDecember 19, 2013. Accepted for publication July 3,
2014.
First published online August 27, 2014; doi:
10.3945/ajcn.113.082172.
1124 Am J Clin Nutr 2014;100:1124–32. Printed in USA. �
2014 American Society for Nutrition
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debate on the safety of caffeine intake by children (1, 12, 18)
and deliberations to evaluate maximal intake recommendations,
it is important to describe caffeine intake from more recent data
available on a nationally representative sample such as the
NHANES.
Trends in beverage consumption have changed over time (16,

20), and several caffeinated beverages and energy drinks have
been
introduced in the past decade, some marketed especially to
youth
(12, 15, 16). Few reports have described trends in caffeine
intake
both in milligrams and milligrams per kilogram of body weight
by
age in the United States (16, 21). Thus, our objective was to
provide estimates of the distribution of caffeine intake in
absolute
amounts and in milligrams per kilogram in a representative
sample
of American children (2–19 y old) by using the most recent di-
etary data available from the NHANES (ie, 2009–2010) in re-
lation to demographic characteristics and examine the trends in
caffeine consumption between 2001 and 2010 in children.
SUBJECTS AND METHODS
Study design
The NHANES is a series of large, complex, stratified,
multistage
probability surveys of the US civilian, noninstitutionalized pop-
ulation conducted by the National Center for Health Statistics,
CDC (22). Briefly, NHANES is conducted yearly in w5000
individuals, and data are publicly released every 2 y on w10,000
individuals. Participants in the NHANES are administered a se-
ries of questionnaires in a detailed in-home interview followed
by a scheduled visit at the mobile examination center (MEC).
At the MEC visit, participants receive a physical examination
as well as a dietary interview, which is commonly referred to as
the What We Eat in America component of the NHANES. The
NHANES protocol was approved by the National Center for
Health Statistics’s Research Ethics Review board. Informed

consent was obtained from persons aged $18 y. For participants
,18 y of age, written parental consent was obtained, and child
assent was obtained for individuals from 7 to 17 y of age. The
most recent available data on caffeine intake from the NHANES
(from the 2009–2010 survey) were used for the current analysis
to describe caffeine consumption by demographic characteris-
tics; data from this single survey cycle were sufficient to
provide
stable national estimates. We used NHANES data from 2001
to 2010 (2001–2002, 2003–2004, 2005–2006, 2007–2008, and
2009–2010 survey cycles) to conduct the trends analysis; be-
cause of changes in the dietary data collection methodology on
merging of the CSFII with NHANES in 1999–2000, data from
1999 to 2000 were not included in the trends analysis. The un-
weighted total examination response rate for the 5 survey cycles
examined for participants 2–19 y of age ranged from 81% to
88%
(23).
Dietary interview
The type and quantity of all foods and beverages consumed in
a single 24-h period, specifically the 24-h period before the
dietary interview (from midnight to midnight) at the MEC, were
collected by trained interviewers with the use of a computer-
assisted dietary interview system with standardized probes (ie,
the USDA’s Automated Multiple-Pass Method). Specifically for
beverages for which caffeine may be removed such as soda,
coffee,
tea, and energy drinks, probes were used to ascertain if the bev-
erage reported was caffeine free. The Automated Multiple-Pass
Method is designed to enhance a complete and accurate data
collection while reducing the respondent burden (24, 25). For
children aged #5 y, interviews were obtained through proxies,
generally a parent. Proxies also assisted with dietary interviews

of children aged 6–11 y. Dietary intakes were self-reported for
participants aged $12 y. Since 2003–2004, a second, telephone-
administered 24-h recall has been collected (3–10 d after the
first
24-h recall at the MEC), but only one 24-h dietary recall was
included in this analysis to maximize the comparability between
surveys. Furthermore, one 24-h recall is sufficient to estimate
population means because the effects of random errors associ-
ated with dietary recall, including the day-to-day variability, are
generally assumed to cancel out if days of the week are evenly
represented (26).
Caffeine intake for all foods and beverages (including energy
drinks) consumed during the 24-h period was calculated by
using
the USDA Food and Nutrient Database for Dietary Studies (27).
The basis of nutrient values for foods and beverages, such as
energy drinks, is the USDA National Nutrient Database for
Standard Reference. Sources of nutrient data include scientific
literature, data provided by food companies and trade associa-
tions, and USDA analytical contracts. Caffeine intake was es-
timated by summing the caffeine consumed for each food and
beverage during the 24-h recall.
Demographic variables
Sex, age, race-Hispanic origin, and poverty income ratio (PIR)
were used. Age was categorized as 2–5, 6–11, and 12–19 y
TABLE 1
Percentage of US children aged 2–19 y old who consumed
caffeine on
a given day by demographic characteristics: NHANES 2009–
2010

1
Characteristic n (% 6 SE) P
All children 3280 (71.0 6 1.0) —
Age ,0.01
2–5 y 861 (58.3 6 2.4)
6–11 y 1154 (74.9 6 1.7)
12–19 y 1265 (74.5 6 2.2)
Sex NS
M 1712 (70.6 6 1.9)
F 1568 (71.5 6 1.3)
Poverty income ratio2 NS
#130% 1422 (70.0 6 1.8)
131–349% 1023 (74.2 6 1.9)
$350% 555 (69.6 6 2.7)
Race-Hispanic origin3 ,0.001
Non-Hispanic white 1101 (74.9 6 1.8)a
Non-Hispanic black 654 (56.3 6 2.2)b
Mexican American 914 (71.7 6 2.0)a
1 NS at P $ 0.05. A test of linear trend was used for ordinal
variables
(age and poverty income ratio) and Wald’s F test was used for
sex and race-
Hispanic origin; significance was set at P , 0.05. Different
superscript

letters represent a significant difference between categories
compared by
using the t test adjusted with the Bonferroni method for
multiple compari-
sons.
2
Index calculated by dividing family income by a federal poverty
threshold specific to family size defined by the US Census
Bureau.
3 “Other” race category not shown.
CAFFEINE INTAKE IN US CHILDREN 1125
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consistent with NHANES sample-selection methods (28). Self-
reported race-Hispanic origin was categorized as non-Hispanic
white, non-Hispanic black, Mexican American, and other. Par-
ticipants with a race-Hispanic origin categorized as other were
included in overall estimates, but findings from this group are
not reported (because of the small sample size and unstable
variance estimates for a very heterogeneous group). Socioeco-

nomic status was defined by using the PIR, which is an index
calculated by dividing family income by a federal poverty
threshold specific to family size defined by the US Census Bu-
reau (29). The PIR was categorized as #130%, 131–349%, and
$350%; for reference, a family income that corresponds to
a 130% PIR qualifies for the Supplemental Nutrition Assistance
Program (formerly the Food Stamp Program) and free school
meals (30).
Analytic population
All children and adolescents aged 2–19 y who participated in
the examination component of the NHANES were eligible for
the dietary interview. In each survey cycle, a small proportion
(4–6%) of participants were excluded because their 24-h recalls
did not meet the standards of reliability that ensure the com-
pleteness of recalls (31). In addition, 5 children who were re-
portedly breastfed during the 24-h recall were excluded from
the
analysis because their caffeine intakes from breast milk could
not be ascertained. The final analytic sample, after exclusions,
comprised 4288, 3824, 4029, 3159, and 3280 participants aged
2–19 y in 2001–2002, 2003–2004, 2005–2006, 2007–2008, and
2009–2010, respectively.
Data analysis
Statistical analyses were conducted with SAS software (version
9.3; SAS Institute Inc) and SUDAAN software (version 11.0;
RTI
International). Caffeine intake on a given day was examined in
absolute amounts (mg) and in relation to body weight (mg/kg)
in
all analyses. Caffeine intake displayed a skewed distribution;
w30% of the analytic population did not report any caffeine in-
take during the 24-h recall period. Thus, logarithmically (base

10)
transformed data on caffeine intake were used to test statistical
hypotheses because they were identified (by using the Box-Cox
procedure in SAS) to be more consistent with a normal distri-
bution (32, 33). To accommodate respondents who reported no
caffeine consumption on the day of recall, caffeine intakes of
zero
were set to 0.0001 to allow the log base 10 transformation. Ex-
treme values were examined to determine whether they exerted
undue influence. Plots of dietary sample weight compared with
caffeine intake showed that extreme values were not associated
with influential weights. Preliminary analyses indicated that the
exclusion of these extreme values did not change the results;
thus,
no exclusions or corrections were made.
Dietary sample weights were used to account for a differential
probability of selection and adjust for nonresponse,
noncoverage,
and sample design. These publically available sample weights
also include a poststratification step to balance recalls across
days
of the week (31).
Weighted, untransformed estimates of the 50th (median), 75th,
90th, and 95th percentiles and percentages (6SEs) were com-
puted for children and adolescents (aged 2–19 y) by demo-
graphic characteristics. Statistical hypotheses regarding the
TABLE 2
Caffeine intake on a given day by demographic characteristics
for US children 2–19 y old: NHANES 2009–2010
1
Characteristics

Caffeine
Pn Median2 75th percentile 90th percentile 95th percentile
mg/d
All children 3280 4.6 30.8 94.6 147.6 —
Age ,0.0001
2–5 y 861 1.3 5.9 13.4 23.8
6–11 y 1154 4.5 19.2 49.7 72.3
12–19 y 1265 13.6 70.9 147.9 260.5
Sex NS
M 1712 4.7 30.0 102.1 169.5
F 1568 4.5 31.3 85.1 132.5
Poverty income ratio
3
NS
#130% 1422 4.5 30.2 77.4 131.7
131–349% 1023 5.5 36.4 106.5 141.9
$350% 555 3.6 26.5 88.9 153.0
Race-Hispanic origin
4 ,0.0001

Non-Hispanic white 1101 6.4
a
43.2 112.0 177.9
Non-Hispanic black 654 1.3b 9.7 55.2 93.1
Mexican American 914 4.2a 22.7 70.3 112.8
1
Medians and percentiles were calculated from untransformed
weighted data; 5th and 25th percentiles are not
presented and were essentially equal to zero because of a high
proportion of children who did not consume any caffeine.
A test of linear trend was used for ordinal variables age and
poverty income ratio. Wald’s F test was used for sex and race-
Hispanic origin. Significance was set at P , 0.05. Different
superscript letters represent a significant difference between
categories compared by using the t test adjusted with the
Bonferroni method for multiple comparisons.
2 All statistical tests were performed on log-transformed means.
3 Index calculated by dividing family income by a federal
poverty threshold specific to family size defined by the US
Census Bureau.
4
“Other” race category not shown.
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proportion of children who consumed caffeine in relation to
sociodemographic variables were tested on weighted, untrans-
formed percentages. Hypotheses concerning caffeine intake (mg
and mg/kg) in relation to sociodemographic variables were
tested
by using weighted means of the log-transformed variable. SEs
were estimated by using Taylor’s series linearization. Statistical
hypotheses were tested by using Wald’s F tests with a = 0.05. If
the hypothesis that the mean or percentage of all subgroups
being
equal was rejected, pairwise t tests were performed. An
adjustment
for multiple comparisons was made by using the Bonferroni
method (34). Linear trends in log-transformed caffeine intake
by age and PIR were determined by using orthogonal contrast
matrices (35). We also tested for linear trends in log-
transformed
caffeine intake across the survey periods between 2001 and
2010
by using orthogonal contrast matrices (35); tests were
conducted
for all children and within age groups over time. Analyses were
carried out for all children in the analytic population and re-
peated for children who consumed caffeine (consumers only).
For the purpose of the current analyses, caffeine consumers

were
defined as children who reported the consumption of caffeine on
the 24-h dietary recall.
RESULTS
A majority (71%) of 2–19-y-olds consumed caffeine on
a given day (Table 1). A linear trend was noted in the
proportion
of 2–19-y-olds who consumed caffeine with age but not PIR. No
differences were seen between males and females in terms of
the
proportion of children who consumed caffeine. However, dif-
ferences were noted in caffeine consumption by race-Hispanic
origin as follows: non-Hispanic black children (56%) were less
likely to consume caffeine than were non-Hispanic white (75%)
or Mexican American (72%) children (Table 1); however, no
differences between non-Hispanic white or Mexican American
children were noted.
The distribution of caffeine intake (mg) on a given day by
selected demographic characteristics (Table 2) showed that
the median caffeine intake by US children 2–19 y of age was
4.6 mg. An increasing linear trend in caffeine intake was noted
by age. No significant associations were shown between the
PIR and caffeine intake. Non-Hispanic black children consumed
significantly less caffeine than did non-Hispanic white or
Mexican
American children (Table 2). No differences in caffeine intake
between non-Hispanic white and Mexican American children
were noted.
When these analyses were restricted to children who con-
sumed caffeine (ie, consumers only) (Table 3), the median
caffeine intake on a given day was 12.4 mg. The significant

linear trend for caffeine intake and age remained, with the
oldest
age group (12–19-y-olds) having the highest caffeine intake
(40.6 mg). Non-Hispanic black children consumed significantly
less caffeine (8.0 mg) than did non-Hispanic white children
(14.4 mg) (Table 3). No other racial-ethnic group differences
were noted.
When caffeine intake (mg) was expressed in relation to body
weight (kg), the median caffeine consumption for US children
2–19 y of age was 0.15 mg/kg (Table 4). Associations of
caffeine
intake (mg/kg) with age and race-Hispanic origin were similar
TABLE 3
Caffeine intake in consumers of caffeine on a given day by
demographic characteristics for US children 2–19 y old:
NHANES 2009–2010
1
Characteristics
Caffeine
Pn Median2 75th percentile 90th percentile 95th percentile
mg
All children 2230 12.4 52.2 116.6 184.0 —
Age ,0.0001
2–5 y 485 4.7 10.3 20.9 36.1
6–11 y 826 9.1 31.4 58.5 85.3

12–19 y 919 40.6 96.6 186.3 284.4
Sex NS
M 1154 12.1 56.2 124.0 223.6
F 1076 12.6 49.0 105.3 148.0
#130% 952 14.3 51.6 98.9 155.3
131–349% 717 11.6 55.4 119.4 184.2
$350% 382 9.5 48.7 113.3 204.4
Race-Hispanic origin
4 ,0.01
a
60.1 137.3 220.2
Non-Hispanic black 367 8.0b 41.3 89.4 109.6
Mexican American 633 11.6a,b 42.5 91.5 131.5
1
Medians and percentiles were calculated from untransformed
weighted data. A test of linear trend was used for
ordinal variables age and poverty income ratio. Wald’s F test
was used for sex and race-Hispanic origin. Significance was

set at P , 0.05. Different superscript letters represent a
significant difference between categories compared by using the
t
test adjusted with the Bonferroni method for multiple
comparisons.
2
All statistical tests were performed on log transformed means.
Census Bureau.
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as noted for caffeine intake in absolute amounts (mg). Non-
Hispanic black children had significantly lower caffeine intake
(0.04 mg/kg) than did other race-ethnicities examined (Table 4).
When analyses of caffeine intake (mg/kg) were restricted to

children who consumed caffeine, (ie, consumers only) (Table
5), the
median caffeine intake was 0.40 mg/kg on a given day. A linear
trend in caffeine intake (mg/kg) with age was again observed.
As
for the results concerning the absolute amount (mg) of caffeine
ingested in consumers only, the finding that non-Hispanic black
children consumed significantly lower caffeine (0.24 mg/kg)
than
did non-Hispanic white children (0.47 mg/kg) remained
unaltered
(Table 5). No other race-ethnic differences were noted.
Caffeine intake did not differ by sex or poverty level whether
expressed as total intake (mg) or in relation to body weight
(mg/kg) for all children 2–19 y of age or in caffeine consumers
2–19 y of age (Tables 2–5).
We estimated 90th and 95th percentiles of caffeine intake by
various sociodemographic factors to provide national estimates
that may be useful for policy makers in future evaluations of the
upper end of the distribution. As expected, the 90th percentile
of
caffeine intake (mg) was lower in all children than caffeine
consumers (Tables 2 and 3, respectively). Health Canada has
put
forth maximal caffeine intake (mg) guidelines for children that
vary by age; specifically, 45, 62.5, and 85 mg caffeine/d have
been suggested as maximum caffeine intakes for 4–6-, 7–9-, and
10–12-y-olds, respectively (11). Our analyses show that most
(90–95%) children ,12 y old had caffeine intakes below these
guidelines (Tables 2 and 3). For older children, caffeine con-
sumption guidance has been based on milligrams per kilogram
of body weight; Health Canada has suggested that daily caffeine
intake for children .12 y of age should be ,2.5 mg/kg (6, 11).

Our findings indicated that 90% of children 12–19 y of age and
$75% and ,90% of 12–19-y-old caffeine consumers on a given
day met these guidelines and had caffeine intakes ,2.5 mg $
kg21 $ d21 (Tables 4 and 5, respectively).
We also examined trends in caffeine intake from 2001 to 2010.
The caffeine intake in 2–19-y-old children decreased overall in
the 10-y study period for all children (Figure 1A; n = 18,530
and P , 0.05) and caffeine consumers only (Figure 1B; n =
12,776 and P , 0.001). No major trends were noted for specific
age groups in all children (caffeine consumers and non-
consumers) (Figure 1A). However, when trends analyses were
restricted to caffeine consumers only, 2–5- and 6–11-y-olds
showed a significant decrease in caffeine intakes from 2001–
2002 to 2009–2010 (Figure 1B; P-trend , 0.001 for both age
groups); the magnitude of these changes, however, was small,
by
3.0 and 4.6 mg in children 2–5 and 6–11 y of age, respectively.
Identical findings were noted with caffeine intake expressed as
milligrams per kilogram of body weight (data not shown) for all
children (consumers and nonconsumers of caffeine) as well as
for children who consumed caffeine.
DISCUSSION
Caffeine intake in children has received much attention be-
cause of potential adverse health effects (1, 2, 10, 36). Most
TABLE 4
Caffeine intake in relation to body weight on a given day by
demographic characteristics for US children 2–19 y old:
NHANES 2009–20101
Caffeine

Characteristic n Median2 75th percentile 90th percentile 95th
percentile P
mg/kg
All children 3280 0.15 0.75 1.78 2.70 —
Age ,0.01
2–5 y 861 0.11 0.36 0.86 1.43
6–11 y 1154 0.15 0.62 1.68 2.49
12–19 y 1265 0.22 1.13 2.45 3.27
Sex NS
M 1712 0.15 0.72 1.83 2.98
F 1568 0.15 0.80 1.69 2.58
#130% 1422 0.15 0.77 1.71 2.76
131–349% 1023 0.17 0.86 1.87 2.70
$350% 555 0.13 0.63 1.47 2.44
a
0.90 2.09 3.02
Non-Hispanic black 654 0.04

b
0.28 1.07 1.55
Mexican American 914 0.14a 0.65 1.47 2.21
1 Medians and percentiles were calculated from untransformed
weighted data. Fifth and 25th percentiles are not
presented and were essentially equal to zero because of a high
proportion of children who did not consume any caffeine.
A test of linear trend was used for ordinal variables age and
poverty income ratio. Wald’s F test was used for sex and race-
Hispanic origin. Significance was set at P , 0.05. Different
superscript letters represent a significant difference between
categories compared by using the t test adjusted with the
Bonferroni method for multiple comparisons.
2
Census Bureau.
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healthy persons tolerate caffeine well; however, there is a large
variation in individuals in their responses to caffeine (37, 38).
Estimates of caffeine consumption in a nationally representative
sample of young children that were based on recent data may be
informative for updating recommendations. To our knowledge,
this is the first report of caffeine intake in US children aged 2–
19 y,
which was examined both in absolute amount (mg) and milli-
grams per kilogram of body weight, and its associations with
sociodemographic factors from the most-recent available na-
tional data from NHANES 2009–2010. In addition, trends in
caffeine consumption (both in mg and mg/kg) over a decade
(2001–2010) are reported for the first time to our knowledge.
In the current study, 71% of US children aged 2–19 y con-
sumed caffeine on a given day. Our finding that 58% of 2–5-y-
olds and 75% of 6–11-y-olds consumed caffeine on a given day
was lower than estimates reported by Frary et al (16) on the
basis of older national data from the CSFII in these age groups.
In that study, 76% of 2–5-y-olds and 86% of 6–11-y-olds con-
sumed caffeine. For older children, Frary et al (16) reported that
91 and 88% of 12–17-y-old boys and girls, respectively, con-
sumed caffeine on a given day. Because of differences in ages
reported, no direct comparison could be made for older
children.
We showed that over one-half of US children aged 2–5 y and 3

in 4 children aged $6 y consumed caffeine on a given day. This
finding is important because food habits are formed early and
continue into later years and in light of the American Academy
of Pediatrics recommendation that “caffeine and other stimulant
substances contained in energy drinks have no place in the diet
of children” (12).
We noted a positive linear trend between age and caffeine
consumption (expressed as mg or mg/kg) as has been reported in
other studies (16, 18, 19, 39). This association may be driven by
biological changes such as disrupted sleep rhythm in puberty
(40)
as well as psychosocial factors including a greater autonomy in
beverage purchase and consumption, peer pressure, and desire
for
enhanced academic or physical performance (1, 15, 41, 42).
Limited comparative estimates of caffeine intake are available
from large representative studies (16, 18, 19, 43). Besides dif-
ferences in study designs, methodologies, time periods, and the
use of different age and sex groups, an additional complexity
arises because most studies have reported mean intakes (despite
a skewed distribution for caffeine). For comparison purposes,
we computed mean caffeine intakes (6SEs) for 2–5-, 6–11-,
and 12–19-y-olds. These intakes were 5.8 6 0.45, 17.2 6 1.1,
and 58.3 6 6.4 mg, respectively, in all children and 10.0 6 1.0,
23.0 6 1.4, and 78.3 6 7.4 mg, respectively, in caffeine con-
sumers. These estimates are similar to those reported for the
NHANES 2005–06 (19) but lower than those reported for
caffeine
consumers in the SIP survey (1-5-y olds: 13.5 mg/d) (18) and
the
CSFII in middle to late 1990s (2–5-y-olds: 16 mg) (16).
Caffeine is generally regarded as a safe substance; however,
the US Food and Drug Administration has suggested the use of
the .90th percentile to indicate a “heavy consumption” of

caffeine (18, 19). Our results showed that, in adolescents ages
12–19 y, caffeine intake at the 90th percentile was 2.45 mg/kg.
This intake is identical to the maximal consumption limit sug-
gested for children by Health Canada (6, 11) that was based on
reported behavioral effects (44). On the basis of the NHANES
TABLE 5
Caffeine intake in relation to body weight on a given day in
caffeine consumers by demographic characteristics for US
children 2–19 y old: NHANES 2009–20101
Characteristic n
Caffeine
PMedian2 75th percentile 90th percentile 95th percentile
mg/kg
All children 2230 0.40 1.13 2.27 3.18 —
Age ,0.01
2–5 y 485 0.29 0.62 1.34 1.34
6–11 y 826 0.30 0.90 1.80 2.77
12–19 y 919 0.64 1.47 2.66 3.65
Sex NS
M 1154 0.39 1.18 2.49 3.26
F 1076 0.40 1.09 2.11 2.77

#130% 952 0.44 1.10 2.19 3.47
131–349% 717 0.43 1.24 2.46 3.04
$350% 382 0.31 0.86 1.79 3.10
a
1.32 2.58 3.28
Non-Hispanic black 367 0.24
b
0.74 1.46 1.86
Mexican American 633 0.35a,b 0.93 1.81 2.56
1 Medians and percentiles were calculated from untransformed
weighted data. A test of linear trend was used for
ordinal variables age and poverty income ratio. Wald’s F test
was used for sex and race-Hispanic origin. Significance was
set at P , 0.05. Different superscript letters represent a
significant difference between categories compared by using the
t
test adjusted with the Bonferroni method for multiple
comparisons.
2

3
Index calculated by dividing family income by a federal poverty
threshold specific to family size defined by the US
Census Bureau.
4 “Other” race category not shown.
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2009–2010, we showed that 10% of children 12–19 y of age
consumed .2.5 mg caffeine/kg on a given day and ,25% of
12–19-y-old caffeine consumers had intakes greater than this
guideline.
Children may metabolize caffeine differently than adults do
(18) and show a large variation in body weight across
childhood,
and recommendations to limit caffeine intake have been based
on
body weight for children by Health Canada (6, 11). Few reports
have examined caffeine intake in children expressed as milli-
grams per kilogram, and they presented findings in caffeine
consumers only (16, 18, 21, 43). Thus, there has been no

comparative literature on caffeine consumption in all children
(caffeine consumers and nonconsumers) as has been provided in
this study.
Our estimates of caffeine intake (mg/kg) in caffeine consumers
were generally lower than those previously reported (16, 18,
21).
Frary et al (16), on the basis of older CSFII data, reported 0.4,
0.4,
0.5, and 0.6 mg/kg for 2–5-, 6–11-, and12–17-y-old boys and
12–
17-y-old girls, respectively, compared with our estimates of 0.3
mg/kg for 2–5- and 6–11-y-olds. Barone and Roberts (21) re-
viewed studies up to the early 1990s and showed that caffeine
intake (mg/kg) declined between 1975 and 1989. Our finding of
a significant linear decreasing trend from 2001 to 2010 sug-
gested that this trend has likely continued since that report (21)
and could explain our lower estimates.
We also examined sociodemographic patterns in caffeine
consumption related to race-Hispanic origin and income. Our
finding that non-Hispanic black children consumed significantly
less caffeine than that of non-Hispanic white children was
consistent with findings from the Bogalusa study (39) and
CSFII
(17). However, to our knowledge, this is the first report to show
higher caffeine intake by Mexican American compared with
non-
Hispanic black 2–19-y-olds. In the current study, we did not
find
any difference in caffeine intake in relation to socioeconomic
status that was contrary to findings from a small study that in-
volved 24–32-mo-old children (45). Other authors have reported
lower caffeine intakes by female than male children (46); this
difference was more pronounced particularly at older ages (16,

19). However, we did not find a significant association with
sex,
which was consistent with findings from the SIP survey (18).
FIGURE 1. Trends over time in caffeine intake on a given day
(mg) in US children aged 2–19 y: 2001–2010. Trends are shown
for all children aged 2–19 y
(A) (n = 18,530) and caffeine consumers aged 2–19 y (B) (n =
12,776). P-linear trend , 0.05 by using the t statistic for all
children 2–19 y of age (A); NS for
specific age groups (A). P-linear trend , 0.001 by using the t
statistic for caffeine consumers 2–19 y of age, and P-linear
trend , 0.001 for both 2–5- and 6–
11-y-old groups (B). Error bars represent 6 1 SE; bars capped
by diamonds, circles, dashes, and triangles represent variations
for all (solid line), 2–5-y-old
(dashed and dotted line), 6–11-y-old (dotted line), and 12–19-y-
old (dashed line) children, respectively.
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Overall, findings for the association of caffeine intake with
sociodemographic factors were consistent whether caffeine in-

take was expressed as an absolute amount or in milligrams per
kilogram. Moreover, results were similar when analyses were
conducted with all children or consumers only. The only ex-
ception was that differences in caffeine intake by race-Hispanic
origin were less prominent in consumers only. Specifically,
caffeine intake of non-Hispanic black and Mexican American
children was no longer different in consumers.
Last, our results from the trend analysis showed a significant,
albeit small, decline over the 10-y study period (2001–2010) in
caffeine intake in all children and caffeine consumers only re-
gardless of how caffeine intake was expressed (ie, mg or
mg/kg).
The decrease in caffeine intake (mg) observed over this period
was significant only in younger caffeine consumers (ages ,12
y), which suggested that caffeine intake by adolescents (aged
12–19 y) who consumed the highest amounts of caffeine in all
age groups examined remained stable over the 10-y study pe-
riod. In view of an increasing choice of products that contain
caffeine such as energy drinks targeted to youth, another pos-

sibility is that children may be replacing some of their caffeine
intakes from sodas by other caffeinated products such as energy
drinks. This hypothesis fits well with the findings from the
NHANES that showed a decrease in soda along with a signifi-
cant increase in energy or sport-drink consumption in 2–19-y-
olds (20).
The NHANES design allows the estimation of caffeine con-
sumption on a representative sample and examination of the
association of caffeine consumption with sociodemographic
factors including race-Hispanic origin. The continuous nature of
the NHANES since 1999 offers the possibility of evaluating
trends over time from different survey cycles that used the same
data-collection methodology and are linked to nutrient data
banks
that are updated periodically to capture new products introduced
during the survey years. The current analyses were based on
a single 24-h recall that was sufficient to estimate population-
level estimates because random errors associated with a dietary
recall, including the day-to-day variability, can be generally

assumed to cancel out if days of the week are evenly
represented
(26). The database used in this study did not include caffeine
intake from herbals, supplements including energy shots, or
medications.
In conclusion, this study provides updated national estimates
of caffeine intakes in children that may be useful in the context
of
the mounting evidence of adverse health effects associated with
high caffeine intake while balancing benefits of caffeine. Future
research should identify the contribution of specific foods and
beverages to caffeine intake as well as the chief sources of
caffeine in children and adolescents.
We are grateful to Margaret Carroll for her expert guidance
with the sta-
tistical analysis.
The authors’ responsibilities were as follows—NA: was
responsible for
the concept development, supervision of the statistical analysis,
and writing
of the manuscript; KH: conducted the statistical analysis and
assisted with

preparing the tables and figure; NA and KH: were responsible
for the final
content of the manuscript; and all authors: provided input on the
writing of
the manuscript and reviewed and provided critical feedback on
the manu-
script. None of the authors had a conflict of interest.
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You will be responsible for answering this question with the
required number of examples and historical periods.
Please respond to the following question in 400-500 words.
Your short essays should be well-organized, thoughtful analyses
that engage the course material. Your responses must discuss

specific works of art/architecture and provide ample visual
evidence from the textbook to support your argument. Use the
lecture notes and textbook for support, but you do not need to
consult outside sources. Your response will run through
TurnItIn software, so be sure to cite the textbook, when
necessary.
Question:
Over the course of the five hundred years we have studied this
semester, the representation of subjectivity in portraiture has
changed drastically.
Please choose four examples and discuss the changing approach
to subjectivity by considering not only aspects such as realism
and style but also qualities such as the implied
movement/activity of the sitter, the gaze, attributes, etc. At
least one of your examples (but no more than two) must be from
before the first half of the semester (prior to the midterm). You
may analyze how the different concepts of subjectivity relate to
the culture/society in question. Your four examples must come
from four different stylistic periods. Each of the four examples
must be identified by artist, title, date, medium, and
cultural/historical period.
4 Examples:
Jan van Eyck, Giovanni Arnolfini and His Wife, 1434. Oil on
wood, 29 90 × 19 10 120. National Gallery, London.
John Henry Fuseli, The Nightmare, 1781. Oil on canvas, 39
3340 × 49 1120. Detroit Institute of the Arts (Founders Society
purchase with funds from Mr. and Mrs. Bert L. Smokler and Mr.
and Mrs. Lawrence A. Fleishman).
Henri Matisse, Woman with the Hat, 1905. Oil on canvas, 29 7
30 × 19 1110. San Francisco Museum of Modern Art, San
Francisco

Kehinde Wiley, Napoleon Leading the Army over the Alps,
2005. Oil on canvas, 99 × 99. Brooklyn Museum, Brooklyn
(Collection of Suzi and Andrew B. Cohen).
SAMPLE ESSAY
Question: Compare Michelangelo and Titian’s approach to color
and nature.
“Michelangelo and Titian are both outstanding artists who have
made huge impacts on the subject of art, though their
approaches to their work can be hugely different. Influenced
hugely by High Renaissance artists Leonardo Da Vinci and
Raphael, Titian encourages imaginations and participations
from viewer. Michelangelo, on the other hand, references more
to human anatomy and the central belief of Humanism: beauty
of body. The way they expresses such difference is mainly
through colors and contour: Michelangelo cast more emphasis
on the harsh contour as well as the contrast between colors;
while Titian neglects contour and focuses more on natural color.
Firstly, the color styles of the two are significantly different.
Take Last Judgement (1541) as an example. In this masterpiece,
the artist depicts a scene where one line of people is elevating
to the heaven while the other line falling into the hell. In an
attempt to express the seriousness of the religions and holiness,
as well as the perfection of human bodies, Michelangelo mixes
his colors with black and white, as a mean to raise the contrast
level between each objects that make up the space, so that the
skins can look perfectly pale and the holiness can be
highlighted. Clearly contradicting the color style of
Michelangelo, Titian tend to use more soft, natural colors, of
which the brightness and intensity are often not very high.
His Meeting of Bacchus and Ariadne (1523) marks his signature
natural way of using colors. In this work, he used variety of
earth toned red and yellow to detail the figures, clothings, and
animals. Even the color selections for negative space, sky and

ground, does not like abrupt at all, due to his avoidance of high
contrast between elements.
Secondly, the two artists have a different view on the use of
contour lines as well. Michelangelo advocates harsh contours as
he believes it singularizes the beauty of human and makes
movements vivid. In Michelangelo’s Creation of Adam (1512),
he made huge emphasis on the contour of every object within
the painting. From god, Adam, to the smaller details like the
fabrics behind them. If you look closely, the contour around the
body of Adam is so harsh that it looks as if Adam is floating.
On the other hand, preferring imagination over reality and
stressing the nature over perfection, Titian avoids all forms of
clear lines and harsh contours. In Titian’s pastoral symphony
(1510), there is barely contour lines since he gives positive
space a very natural colors that mesh well with the negative
space. As a result, the contour is barely seen and the painting as
a whole, looks more like natural world where no contour lines
exist.
To sum up, both Michelangelo and Titian are outstanding
masters with respect to their eras. And their ways of using color
and contour, though vastly different from each other, reflect
their own background, style, and school. Most importantly, both
styles are intriguing to the futurity.”
1006! CHAPTER 32 Contemporary Art Worldwide
Kehinde Wiley. !e paintings and photographs
of Basquiat, Marshall, and Simpson, which all fea-
ture African Americans as subjects, stand in vivid
contrast to the near-total absence of blacks in
Western painting and sculpture until the past half
century. One major contemporary artist who has
set out to correct that discriminatory imbalance

is Los Angeles native K"#$%&" W$'"( (b. 1977).
Wiley earned his BFA at the San Francisco Art
Institute and his MFA at Yale University and is
currently based in New York City, where he was
artist-in-residence at the Studio Museum in Har-
lem in 2001–2002. Wiley has achieved renown for
his large-scale portraits of young urban African
American men. His trademark paintings, however,
are reworkings of historically important portraits
in which he substitutes )gures of young black men
in contemporary dress in order to situate them in
what he calls “the )eld of power.”
A characteristic example is Napoleon Lead-
ing the Army over the Alps (*$+. 32-4) based on
Jacques-Louis David’s painting (*$+. 27-2A) of
the same subject. To evoke the era of the original,
Wiley presented his portrait of an African Ameri-
can Napoleon on horseback in a gilt wood frame.
Although in many details an accurate reproduc-
tion of David’s canvas, Wiley’s version is by no
means a mechanical copy. His heroic narrative
unfolds against a vibrantly colored ornate wallpa-
per-like background instead of a dramatic sky—a
distinctly modernist reminder to the viewer that
this is a painting and not
a window onto an Alpine
landscape.
Faith Ringgold. Like Bas-
quiat and Wiley, M"',$%
E&-./&0 (b. 1937) has
examined the lives—or,
more precisely, the death by
lynching (*$+. 32-4A)—of

African American men in
his art. Similarly, Simpson
32-5 F!"#$ R"%&&'(), Who’s Afraid of Aunt
Jemima? 1983. Acrylic on canvas with fabric borders,
quilted, 79 60 * 69 80. Private collection.
In this quilt, a medium associated with women, Ringgold
presented a tribute to her mother that also addresses
African American culture and the struggles of women to
overcome oppression.
32-4A EDWARDS,
Tambo, 1993.
32-4 K+$"%)+ W"(+,, Napoleon Leading the
Army over the Alps, 2005. Oil on canvas, 99 * 99.
Brooklyn Museum, Brooklyn (Collection of Suzi
and Andrew B. Cohen).
Wiley’s trademark paintings are reworkings of famous
portraits (FIG. 27-2A) in which he substitutes young
African American men in contemporary dress in order
to situate them in “the field of power.”
1 ft.
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Copyright 2020 Cengage Learning. All Rights Reserved. May
not be copied, scanned, or duplicated, in whole or in part.
WCN 02-200-203
of the status quo gave rise to the notion of an artistic avant-
garde.

!e term, which means “front guard,” derives from 19th-century
French military usage. !e avant-garde were the troops sent
ahead
of the army’s main body to scout the enemy’s position and
strength.
Politicians who deemed themselves visionary and forward
thinking
subsequently adopted the term. It then migrated to the art world
in the 1880s, when artists and critics used it to refer to the
Realists,
Impressionists, and Post-Impressionists—artists who were ahead
of
their time and who transgressed the limits of established art
forms.
Today, art historians generally use the term to describe more
nar-
rowly the modernist art movements of the opening decades of
the
20th century.
FAUVISM
In 1905, at the third Salon d’Automne (Autumn Salon) in Paris,
a
group of young painters exhibited canvases so simpli"ed in
design
and so shockingly bright in color that a startled critic, Louis
Vaux-
celles (1870–1943), described the artists as Fauves (“wild
beasts”).
!e Fauves were totally independent of the French Academy and
the “o#cial” Salon (see “Academic Salons and Independent Art
Exhibitions,” page 853). !eir aim was to develop an art having
the
directness of Impressionism but employing intense color
juxtaposi-
tions for expressive ends. Building on the legacy of artists such

as
Vincent van Gogh and Paul Gauguin, the Fauves went even
further
in liberating color from its descriptive function and exploring
the
e$ects that di$erent colors have on emotions. !e Fauves
produced
portraits, landscapes, still lifes, and nudes of spontaneity and
verve,
with rich surface textures, lively linear patterns, and, above all,
bold
colors. In an e$ort to release internal feelings, they employed
star-
tling contrasts of vermilion and emerald green and of cerulean
blue
and vivid orange held together by sweeping brushstrokes and
bold
patterns.
!e Fauve painters never o#cially organized, and within "ve
years, most of the artists had departed from a strict adherence to
Fauve principles and developed their own more personal styles.
During its brief existence, however, Fauvism made a signi"cant
contribution to the direction of art by demonstrating color’s
struc-
tural, expressive, and aesthetic capabilities.
Henri Matisse
!e dominant Fauve artist was Henri Matisse (1869–1954), who
believed that color could play a primary role in conveying
meaning,
and consequently focused his e$orts on developing this notion.
In
an early painting, Woman with the Hat (fig. 29-2), Matisse
depicted
his wife, Amélie, in a rather conventional manner

compositionally,
but the seemingly arbitrary colors immediately startle the
viewer,
as does the sketchiness of the forms. !e entire image—the wom-
an’s face, clothes, hat, and background—consists of patches and
splotches of color juxtaposed
in ways that sometimes pro-
duce jarring contrasts. Matisse
explained his approach in this
painting and his contemporary
Le Bonheur de Vivre (fig. 29-2A):
“What characterized Fauvism
was that we rejected imitative
colors, and that with pure colors
we obtained stronger reactions.”1
For Matisse and the Fauves, therefore, color became the formal
element most responsible for pictorial coherence and the
primary
conveyor of meaning (see “Henri Matisse on Color,” page 890).
Harmony in Red. !ese color discoveries reached maturity in
Matisse’s Red Room (Harmony in Red; fig. 29-3). !e subject is
the
interior of a comfortable, prosperous household with a maid
plac-
ing fruit and wine on the table, but Matisse’s canvas is radically
dif-
ferent from traditional paintings of domestic interiors (for
example,
figs. 25-19 and 25-19A). !e Fauve painter depicted objects in
simpli"ed and schematized fashion and .attened out the forms.
For
example, Matisse eliminated the front edge of the table,
rendering
the table, with its identical patterning, as .at as the wall behind

it.
!e window at the upper le/ could also be a painting on the wall,
further .attening the space. Everywhere, the colors contrast
richly
and intensely. Matisse’s process of overpainting reveals the
impor-
tance of color for striking the right chord in the viewer.
Initially, this
work was predominantly green. !en Matisse repainted it blue,
but
blue also did not seem appropriate to him. Not until he
repainted
the canvas red did Matisse feel that he had found the right color
for
the “harmony” he wished to compose.
29-2A MATISSE, Le Bonheur
de Vivre, 1905–1906.
29-2 Henri Matisse, Woman with the Hat, 1905. Oil on canvas,
29 7 340 × 19 11120. San Francisco Museum of Modern Art,
San Francisco
(bequest of Elise S. Haas).
Matisse’s portrayal of his wife, Amélie, features patches and
splotches of
seemingly arbitrary colors. He and the other Fauve painters
used color not
to imitate nature but to produce a reaction in the viewer.
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WCN 02-200-203

808! CHAPTER 27 Romanticism, Realism, Photography: Europe
and America, 1800 to 1870
ROMANTICISM
Whereas Neoclassicism’s rationality reinforced Enlightenment
thought, particularly Voltaire’s views (see “Voltaire,” page
779),
Romanticism owed much to the ideas of Jean-Jacques Rousseau
(see “Rousseau,” page 781). Rousseau’s exclamation “Man is
born
free, but is everywhere in chains!”—the opening line of his
Social
Contract (1762)—summarizes a fundamental Romantic premise.
Romanticism emerged from a desire for freedom—not only
politi-
cal freedom but also freedom of thought, feeling, action,
worship,
speech, and taste. Romantics asserted that freedom was the right
and property of all. !ey believed that the path to freedom was
through imagination and feeling rather than reason.
!e allure of the Romantic spirit grew dramatically during the
late 18th century, when the term originated among German liter-
ary critics. !eir aim was to distinguish peculiarly “modern”
traits
from the Neoclassical traits that already had displaced Baroque
and Rococo design elements. Consequently, some scholars refer
to
Romanticism as a phenomenon that began around 1750 and
ended
about 1850, but most use the term more narrowly to denote an
art
movement that "ourished from about 1800 to 1840, between
Neo-

classicism and Realism.
Roots of Romanticism
!e transition from Neoclassicism to Romanticism in art was
more than a stylistic shi#. It represented a philosophical change
in
emphasis from calculation to intuition, from reason to emotion.
Among the leading manifestations of Romanticism was height-
ened interest in the medieval period and in the sublime. For
people
living in the 18th century, the Middle Ages were
the “dark ages,” a time of barbarism, superstition,
mystery, and miracle. !e Romantic imagina-
tion stretched its perception of the Middle Ages
into all the worlds of fantasy open to it, includ-
ing the ghoulish, infernal, terrible, nightmarish,
grotesque, and sadistic—the imagery that comes
from the chamber of horrors when reason sleeps.
Related to the imaginative sensibility was the
period’s notion of the sublime. Among the indi-
viduals most involved in studying the sublime was
the British politician and philosopher Edmund
Burke (1729–1797). In A Philosophical Enquiry
into the Origins of Our Ideas of the Sublime and
Beautiful (1757), Burke articulated his de$nition
of the sublime: feelings of awe mixed with terror.
Burke observed that pain or fear evoked the most
intense human emotions and that these emotions
could also be thrilling. !us raging rivers and
great storms at sea could be sublime to their view-
ers. Accompanying this taste for the sublime was
the taste for the fantastic, occult, and macabre.
John Henry Fuseli. !e Swiss painter Johann
Heinrich Füssli, better known by his English

name—J%&' H(')* F+,(-. (1741–1825)—lived
in Rome from 1770 to 1778, settled in England
in 1799, and eventually became a member of the
Royal Academy of Art and one of its instruc-
tors. Largely self-taught, he contrived a distinc-
tive manner to express the fantasies of his vivid
27-8 J!"# H$#%& F'($)*, !e Nightmare, 1781. Oil on canvas, 39
3 340 + 49 1
1
20. Detroit
Institute of the Arts (Founders Society purchase with funds
from Mr. and Mrs. Bert L.
Smokler and Mr. and Mrs. Lawrence A. Fleishman).
The transition from Neoclassicism to Romanticism marked a
shift in emphasis from reason
to feeling. Fuseli was among the first painters to depict the dark
terrain of the human
subconscious.
imagination. Fuseli specialized in night moods of horror and in
dark fantasies—in the demonic, the macabre, and o#en the
sadistic.
In !e Nightmare (/.0. 27-8), a beautiful young woman lies
asleep, draped across the bed with her limp arm dangling over
the
side. An incubus, a demon believed in medieval times to prey,
o#en
sexually, on sleeping women, squats ominously on her body. In
the background, a ghostly horse with "aming eyes bursts into
the
scene from beyond the curtain. Despite the temptation to see the
painting’s title as a pun because of this horse, the word

nightmare
in fact derives from “night” and “Mara.” Mara was an evil spirit
in
Scandinavian mythology who tormented and su1ocated sleepers.
Fuseli was among the $rst to attempt to depict the dark terrain
of
the human subconscious that became fertile ground for later
artists.
William Blake. In their images of the sublime and the terrible,
Romantic artists o#en combined something of Baroque dyna-
mism with naturalistic details in their quest for grippingly
moving
visions. !ese elements became the mainstay of Romantic art and
contrasted with the more intellectual, rational Neoclassical
themes
and compositions. !e two were not mutually exclusive, however.
Gros, Girodet-Trioson, and Ingres e1ectively integrated
elements of
Neoclassicism with Romanticism. So, too, did the visionary
English
poet, painter, and engraver W.--.23 B-24( (1757–1827).
Blake greatly admired ancient Greek art because it exempli-
$ed for him the mathematical and thus the eternal, and his work
o#en incorporated classical references. Yet Blake did not align
himself with prominent Enlightenment $gures. Like many other
Romantic artists, he also found the art of the Middle Ages
appeal-
ing. Blake derived the inspiration for many of his paintings and
poems from his dreams. !e importance he attached to these
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WCN 02-200-203

Flanders 577
crown at his feet and resplendent in a deep-
scarlet mantle—presides in majesty. To God’s
right is the Virgin, represented, as in the Gothic
age and in a small Jan van Eyck diptych (two-
paneled painting; !"#. 20-10A), as the queen of
Heaven, with a crown of 12 stars on her head.
John the Baptist sits to God’s le$. To either side
is a choir of angels, with an angel playing an
organ on the right. Adam and Eve appear in
the far panels. %e inscriptions in the arches
above Mary and Saint John extol the Virgin’s
virtue and purity and Saint John’s greatness as
the forerunner of Christ (see “Early Christian
Saints,” pages 246–247). %e inscription above
the Lord’s head translates as “%is is God,
all-powerful in his divine majesty; of all the best, by the gentle-
ness of his goodness; the most liberal giver, because of his
in&nite
generosity.” %e step behind the crown at the Lord’s feet bears
the
inscription “On his head, life without death. On his brow, youth
without age. On his right, joy without sadness. On his le$,
security
without fear.” %e entire altarpiece ampli&es the central theme
of
salvation. Even though humans, personi&ed by Adam and Eve,
are
sinful, they will be saved because God, in his in&nite love, will
sac-

ri&ce his own son for their sake.
%e panels of the lower register extend the symbolism of the
upper. In the center panel, saints arrive from the four corners of
the earth through an opulent, 'ower-spangled landscape. %ey
pro-
ceed toward the altar of the Lamb and the octagonal fountain of
life
(compare !"#. 20-2). %e book of Revelation passage that
recounts
the adoration of the Lamb is the main reading on All Saints’
Day
(November 1). %e Lamb symbolizes the sacri&ced son of God,
whose heart bleeds into a chalice, while into the fountain spills
the “pure river of water of life, clear as crystal, proceeding out
of
the throne of God and of the Lamb” (Rev. 22:1). On the right,
the
20-10A VAN
EYCK, Madonna
in a Church,
ca. 1430–1440.
A SECOND OPINION
Giovanni Arnolfini and His Wife
In 1434, Jan van Eyck depicted Giovanni Arnolfini, a Lucca
financier
who had established himself in Bruges as an agent of the Medici
family,
and his second wife in their home (FIG. 20-11). Arnolfini holds
the hand
of his spouse, whose name is not known. That much is certain,
but the
purpose and meaning of the double portrait remain the subject

of con-
siderable debate, with a few new interpretations having been
advanced
just during the last several years. According to the traditional
interpreta-
tion of the painting, Jan recorded the couple taking their
marriage vows.
As in the Mérode Triptych (FIG. 20-8), almost every object
portrayed car-
ries meaning. For example, the little dog symbolizes fidelity
(the com-
mon canine name Fido originated from the Latin fidere, “to
trust”). The
finial (crowning ornament) of the marriage bed at the right is a
tiny statue
of Saint Margaret, patron saint of childbirth. (The bride is not
yet preg-
nant, although the fashionable costume she wears makes her
appear
so.) From the finial hangs a whiskbroom, symbolic of domestic
care.
Indeed, even the placement of the two figures in the room is
meaningful.
The woman stands near the bed and well into the room, whereas
the
man stands near the open window, symbolic of the outside
world.
Many art historians, however, dispute this interpretation
because,
among other things, the room in which Arnolfini and his wife
stand is a
public reception area, not a bedchamber. One scholar has
suggested
that Arnolfini is conferring legal privileges on his wife to
conduct busi-

ness in his absence. Another thinks that this may be a memorial
portrait
of a wife who died in childbirth.
In any case, an important aspect of the painting is that the artist
functions as a witness to whatever event is taking place. In the
back-
ground, framed by the arms and joined hands of the two figures,
is a
convex mirror (complete with its spatial distortion, brilliantly
recorded;
compare FIG. 22-40), in which Jan depicted not only the
principals,
Arnolfini and his wife, but also two persons who look into the
room
through the door. (Arnolfini’s raised right hand may be a
gesture of
greeting to the two men.) One of these must be the artist
himself, as
the elegant inscription above the mirror, Johannes de Eyck fuit
hic (“Jan
van Eyck was here”), announces that he was present. The self-
portrait
also underscores the painter’s self-consciousness as a
professional art-
ist whose role deserves to be recorded and remembered.
20-11 J!" #!" E$%&, Giovanni Arnol!ni and His Wife, 1434.
Oil on wood, 29 90 ' 19 10 120. National Gallery, London.
Jan van Eyck played a major role in establishing portraiture as
an important
Flemish art form. In this portrait of an Italian financier and his
wife, he also
portrayed himself in the convex mirror on the rear wall.

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