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NEAR EAST UNIVERSITY
FACULTY OF MEDICINE
DEPARTMENT OF PUBLIC HEALTH
CAFFEINE CONSUMPTION
FREQUENCY AND CONSUMPTION
PROPERTIES OF PATIENTS AND
PATIENTS’ RELATIVES WHO
PRESENTED TO THE CLINIC OF
SOME HOSPITALS
REPORTERS:
Intern Dr. Gözdem Durak
Intern Dr. Güldem Durak
Intern Dr. Mustafa Abul
Intern Dr. Nawaf El Assaad
Intern Dr. Cemil Yarsel
Intern Dr. Ayse Aybüke Tahtalı
ACADEMIC ADVISORS:
Prof. Dr. Şanda Çalı
Prof. Dr. Songül Vaizoğlu
Assoc. Dr. Özen Aşut
Dr. Gülpiya Abdülşakir
July - August 2019
NICOSIA
Thanks to our mentors who guide and support us at every stage of the
research; to Dear Prof. Dr. Songül Vaizoğlu, Prof. Dr. Şanda Çalı, Assoc.
Dr. Özen Aşut, and Dr. Gülpiye Abdülşükür. We would also like to thank
the Chief Physician of the Near East University Hospital Prof. Dr. Sevim
Erkmen, who supported us in our research, to our family who brought us to
this day, and to our group that we worked in harmony throughout the study.
CONTENTS
Acknowledgments
Table of Contents Index of
Tables
Summary
1. Introduction and Objectives
1.1 Introduction
1.2 Objectives
1.2.1 Near-term Objectives
1.2.2 Far-term Objectives
2. General Information
2.1 Substances of Caffeine
2.2 Coffee
2.3 Tea
2.4 Energy Drink
2.5 Cola drinks
2.6 Effects of Caffeine on the Body
2.7 Effects on the Cardiovascular system
2.8 Effects on the Central Nervous System
2.9 Caffeine Consumption in the World
2.10 Caffeine Consumption
3. Materials and Methods
3.1 Place and Time of the Study
3.2 Type of the Study
3.3 The Universe and the Study Group
3.4 The Variables of the Study
3.4.1 Independent Variables
3.4.2 Dependent Variables
3.5 Data Collection Purpose and Data Collection Method
3.6 Definition-Terms and Criteria Used in the Research
3.7 Manpower of the Research
3.8 Preliminary Trial
3.9 Analysis of the Data
3.10 Ethical Issues
3.11 Timeline
4. Findings
4.1 Findings Related to sociodemographic features
4.2 Findings Related to Chronic Diseases
4.3 Findings Related to Caffeinated Beverage Consumption
4.4 Causes of Caffeinated Beverage Consumption i Findings Related to
4.5 Relationships Between Some sociodemographic features and Caffeine
Consumption
5. Discussion
6. Conclusion and Suggestions
References
Appendices
1. INTRODUCTION
1.1 Introduction
Caffeine is a chemical in a group called methylxanthines. The chemical name of caffeine is
1,3,7-tri-methylxanthine and is one of the most consumed active pharmacological substances
in the world. Caffeine is found in the leaves and fruit seeds of about 63 plant varieties spread
naturally around the world. The most important sources are coffee beans, tea leaves, cola fruit,
and cocoa seeds. It is mostly consumed in the form of extract drinks from plant sources. The
amount of caffeine in the food product depends on the amount of service, product type, and
preparation method (1).
Caffeine is one of the most common nutritional supplements worldwide. While most of the
caffeine consumption is through coffee, it can enter the body with many other foods,
medicines, and beverages. Caffeine functions as an active ingredient of energy drinks that
have become widespread recently and is also used as a psychoactive agent with its
physiological effects. Although many theories have been proposed about the benefits and
risks of caffeine, it is reported that daily doses of up to 400 mg (about 5.5 mg/kg for a 75 kg
individual) are safe and do not cause any health risks (2).
Information on caffeine consumption dates back to 2700 BC (3). The most common use of
caffeine among people is coffee, tea, and cola drinks. Caffeine is also found in commonly
used drugs such as analgesics, appetite suppressants, and central nervous system stimulants
(1).
Caffeine enters the bloodstream completely by absorption from the gastrointestinal tract. The
caffeine concentration in the bloodstream reaches a maximum level after 1-1.5 hours.
Caffeine, which has been absorbed, is rapidly distributed throughout the body. Caffeine can
pass through the blood-brain-barrier, as well as through the placenta into the fetus and breast
milk. Caffeine has also been detected in semen (4).
In North America, coffee (60-75%) and tea (15-30%) are the most important sources of
caffeine in adult nutrition. In some European countries such as Finland, Sweden, Denmark,
and Switzerland, the main source of caffeine is coffee. Most caffeine is found in cooked
coffee (56—100 mg / 100ml). Then comes instant coffee and tea (20-73 mg / 100ml). In the
third row is the cola (9-19 mg / 100ml) (4).
Coffee is among the most consumed beverages in the world. Although epidemiological
studies in the past have thought that consumption of coffee and therefore caffeine potentially
adversely affect health, recent studies have reported that coffee consumption may be effective
in reducing the risk of some chronic diseases (5). Coffee has important biological effects.
Examples include antioxidant, anticarcinogenic, antimutagenic activities. Many substances
found in coffee have a chemoprotective effect. These substances are mainly polyphenols,
chlorogenic acids, and digestive products. Coffee can have a protective effect or a negative
effect in many systems (skeletal system, reproductive system, cis system) (6).
In recent years, the consumption of energy drinks has been increasing among young people all
over the world. It is very important to raise awareness about the potential negative effects of
high caffeine and other stimulants contained in energy drinks (7).
Tea also naturally contains caffeine. The caffeine content of tea; brewing time, whether the
tea is mixed during brewing. It depends on many variables such as tea-water ratio and cup
size served (10). There is no previous study on caffeine consumption in Cyprus. Since
caffeine consumption is very common in Cyprus, this study is planned to determine whether
caffeine is related to its frequency of consumption and some health problems.
1.2 Objectives
1.2.1 Near-term Objectives:
Patients and their relatives who presented to Near East University Hospital, Kyrenia
University Dr. Suat Günsel Hospital, and the Primary Health Care Clinic;
1-Determining some sociodemographic characteristics
2-Determining the frequency of caffeine consumption
3-Determining the relationship between some sociodemographic characteristics of these
people and caffeine consumption
4-Determining the possible relationships of caffeine consumption with some diseases
1.2.2 Distant Term Objectives:
1-Determining the possible relations of caffeine consumption with some diseases take
necessary precautions afterward,
2-Improve awareness of healthy caffeinated beverage consumption.
2. GENERAL INFORMATION
Caffeine, a herbal alkaloid, is a stimulant frequently consumed by human beings from past to
present. Caffeine, which has been used in the production of carbonated beverages such as cola,
has been used in medicine production to stimulate the central nervous system, to create pain
relief effects, to correct respiratory difficulties, and to facilitate drug absorption. is used (8).
Caffeine production is produced synthetically by methylation of "Teobromin" material
obtained from cola plant in the laboratory environment, but it can be obtained naturally from
caffeine-free tea and decaffeinated coffee production or residues in tea production (8).
Caffeine-containing beverages that are frequently consumed in society are coffee, tea varieties,
and soft drinks such as cola, but energy drink consumption has increased in recent years (9).
Unlike caffeinated soft drinks such as cola, the caffeine content of energy drinks are not
regulated by the American Food and Drug Administration, and the caffeine content of cola
drinks is set at 18mg / 100ml by the American Food and Drug Administration, and it is
recommended that daily caffeine intake should not exceed 100mg (9). Caffeine, the main
effect of which is stimulating, has been discovered that if the daily dose is exceeded, it can
disrupt the body's fluid balance, disrupt coordination, easy anger, insomnia, arrhythmias and
hypertension (10,13), as well as the functioning of calcium channels due to its diuretic effect.
It has been discovered that it can degrade and reduce the absorption of vitamins and
electrolytes (11,12). One of the most important reasons why caffeine consumption is harmful
in children and adolescents is the relationship between growth rate and calcium use during
these periods, and high doses of caffeine during these periods may affect growth and
development (11,12). High doses of caffeine can prevent the central nervous system from
working regularly (14). Oral caffeine is absorbed well due to its molecular structure and is
rapidly distributed to all organs including the brain via the bloodstream, and when individuals
regularly consume high amounts of caffeine, it may cause various symptoms such as fatigue,
concentration disorder, and headaches when the caffeine intake is stopped or reduced rapidly
( 16,17). Also, the acceleration of metabolism, which is one of the positive effects of caffeine
use, was reported in a study in which caffeine helps fight obesity (15).
2.1 Substances containing
caffeine Chronic use of caffeine in high doses may cause "caffeinism" in individuals with
symptoms such as insomnia, arrhythmia, palpitation, anxiety disorder, easy anger, muscle
spasms. If the dose of 400 mg daily limit is exceeded, high dose It can be accepted that
considering the caffeine amounts of the drinks consumed, it can be seen that it is not difficult
to exceed this dose (18,19). It is known that there is 30-180 mg in coffee varieties, 15-30 mg
in caffeinated soft drinks such as cola, and 20-110 mg in tea varieties (20). The table below
shows the symptoms and signs of caffeine in different doses (Table.1).
Chart. 1 - Effects of using different doses of caffeine (21).
15-30 mg /
kg
●Myocardial arrhythmias
●Myocardial irritability,
●muscle contractions
●Nausea and vomiting
50 mg
In susceptible individuals
●Insomnia
●Gastrointestinal disorders
●Anxiety disorders
●Nausea and vomiting
85-250 mg
●concentration increases
●alertness sensation Increased
●tired feeling reduction of
250-500 mg
●Arrhythmias
●Insomnia
●Anxiety Disorder
●Easy Anger
●Hyperactivity
2.2 Coffee
With the increase of different types of coffee, second and third-wave coffee shops, coffee
consumption has started to become a different culture compared to the past, thanks to
technology and transportation facilities. While evoking coffee sharing and sociality in the past,
and coffee was sold only in coffee shops, the meaning it evokes today is due to the increase in
brand coffee shops and the provision of other kinds of cold and hot beverages and foods in
these shops as well (22). Social and emotional new meanings are loaded against coffee
consumption and shops (23).
2.3 Tea
Although there are many tea varieties, there are three different types of tea that contain
caffeine and are most frequently consumed in the world. These teas are Oolong tea, Black tea,
and Green tea, respectively, according to the amount of caffeine they contain (24,26,27).
Oolong tea is widely consumed in China and it is the tea with the highest amount of caffeine
but the least (2%) of production. Black tea is the most varied (76%) tea variety worldwide
(27,25).
2.4 Energy Drink Energy
drinks, which are frequently consumed by young adults today, are not considered safe by the
American Food and Drug Administration (FDA), although they are considered socially safe to
consume. Republic of Turkey, Energy drinks, according to the Ministry of Agriculture and
Rural Affairs; Refers to beverages with available carbohydrate content, providing energy for
the human body and containing substances whose limits are determined in the product
properties, including vitamins and minerals. The Ministry of Agriculture and Rural Affairs
published this definition in its official newspaper on January 27, 2006 (29). When the
“energetic state” created by the substances in energy drinks ends, it causes intense fatigue in
the person, because the content of energy drinks ensures the rapid release of substances such
as epinephrine in our body (30).
2.5 Cola Beverages
Unlike the canned and bottled cola bought in the markets, some businesses may mix more or
less of the cola extracts they use when preparing the blends of caffeinated beverages, and this
intensity can cause the amount of caffeine in the prepared drink to change. The changing
amount of caffeine may be important for children, pregnant women, and people sensitive to
caffeine (31).
2.6 Effects on the Body
While the Caffeine's possible mechanism of action of caffeine is explained in different ways,
the most accepted mechanism is anti-adenosine. This antagonist effect (adenosine
antagonism), which enhances the sensation of pain and prevents the release of regulators that
regulate the nervous system, prevents its functioning from doing its work, is shown to be the
most important mechanism supported by the physiological effects of caffeine, with the
increases in physical work capacity, perceived difficulty, and power output. (2nd).
Physiological effects related to caffeine; central nervous system stimulation is an increase in
metabolic rate, diuresis, and an acute increase in blood pressure. Although case-control
studies show that coffee has the potential to increase cardiovascular risk, cohort studies have
reported no association between coffee intake and cardiovascular risks in individuals who
consume large amounts of coffee. In another study, blood pressure, CRP, heart rate,
cholesterol, and fibrinogen were evaluated in 52 normotensive healthy adults, and increased
systolic blood pressure and cortisol values in response to stress in men and women receiving
caffeine (32). Caffeine from coffee or other beverages is absorbed by the small intestine
within 45 minutes of digestion and is distributed throughout the body tissues. Caffeine
reaches the highest blood concentration within 1-2 hours, it is metabolized in the liver into
three main substances, especially with the CYP1A2 isoenzyme: paraxanthin (84%),
theobromine (12%) and theophylline (4%) (33). In healthy adults, the half-life of caffeine is
between 3 and 7 hours (33,34). The half-life of caffeine is 20 to 30% shorter in women than in
men. Caffeine spreads throughout the body and passes the blood-brain barrier and is found in
amniotic fluid, especially in breast milk, fetus, placenta (33). The therapeutic dose of
theophylline, one of the metabolites of caffeine, used in treatment is much higher than the
theophylline levels obtained from caffeine metabolism. Each of the mentioned metabolites is
excreted in the urine after secondary metabolism. Caffeine accumulates in individuals with
severe liver disease and prolongs its half-life (33,34,35).
2.7 Effects on the cardiovascular system
Studies on the relationship between coffee consumption and coronary heart disease have been
inconclusive. Coffee is a complex mixture of compounds that have both beneficial and highly
harmful effects on the cardiovascular system. Randomized controlled studies confirm the
cholesterol-raising effects of diterpenes in boiled coffee, and these effects may contribute to
the risk of coronary heart disease, which is associated with unfiltered coffee consumption. A
recent study addressing the relationship between coffee and the risk of myocardial infarction
has identified a genetic polymorphism that leads to a slower caffeine metabolism rate, and this
finding is an important data showing that caffeine also increases the risk of coronary heart
disease (36). In many studies, moderate coffee consumption has been shown to have a
protective effect, suggesting that coffee contains other compounds that are beneficial for heart
health. Diterpenes and caffeine found in unfiltered coffee are thought to affect to increase
coronary heart disease. The fact that there is a much lower risk of coronary heart disease
among people consuming moderate coffee may be due to the effect of antioxidants found in
coffee (36).
2.8 Effects on Central Nervous System
Coffee is a widely consumed beverage worldwide and its consumption has various effects on
health. Coffee's Alzheimer's, Parkinson, etc. It is associated with rich phytochemicals such as
caffeine, chlorogenic acid, and caffeic acid in the composition of reducing the risk of diseases.
Caffeine suppresses amyloid-beta production and can play an important role in
neurodegenerative diseases as an antioxidant, anti-inflammatory agent. Caffeine can reduce
tau protein phosphorylation. At the same time, caffeine, an adenosine receptor antagonist,
may have a neuroprotective effect. Adenosine receptor antagonists can protect neurons from
excitotoxicity. Also, caffeine is a stimulant for glucose use and mitochondrial activator.
Caffeic acid can reduce oxidative stress and trigonelline is important for dendrites and axon
regeneration. Coffee diterpenes can prevent neuron damage as it is an antioxidant and brown
coffee. Besides reducing oxidative stress, chlorogenic acid can benefit glucose homeostasis.
Chlorogenic acid can exert this effect by reducing hepatic glucose output or competing with
glucose absorption. One of its advantages is that chlorogenic acid has anti-inflammatory
properties. Chlorogenic acid lactones have a protective effect against neuron cell death.
Niacin, another component of coffee, is an enzyme cofactor in dopamine synthesis. Coffee
can increase insulin sensitivity due to its magnesium content. Thus, amyloid-beta degradation
may increase. For these reasons, it is thought that daily consumption of two or three cups of
coffee can be effective against Parkinson's and Alzheimer's disease. However, when making
suggestions about the amount of coffee consumption, individual characteristics should be
taken into consideration (37).
2.9 Caffeine Consumption in the World
According to recent calculations, 85% of American citizens have regularly observed an
average of 180 mg/day of caffeine. This amount corresponds to approximately two cups of
coffee (38,39). Although there is an increase in the amount of new caffeine-containing
products, there is a decrease in caffeine consumption among adults and children. According to
the NHANES report, 75% of children aged 6-19 in America consume caffeine (40).
According to another study, children between the ages of 2-11 consumed an average of 25 mg
of caffeine daily, and children aged 12-17 ate 50 mg of caffeine daily (41). Caffeine
consumption is diverse in the world and annual caffeine consumption per capita is highest in
Norway and Finland. The average annual consumption of 9.6 and 7.2 kg per person is
consumed (42). According to the research conducted in Canada, it is seen that most coffee is
consumed after the amount of water perfection (43). Finally, according to the study conducted
by England's National Diet and Nutrition Survey, daily caffeine consumption in adults was
130 mg and 35 mg in children (44).
2.10 Caffeine Consumption
Caffeine is one of the most commonly used psychoactive stimulant drugs. It is generally used
to improve behavioral and cognitive performance deficits secondary to sleep deprivation
(45,46). When consumed in moderation, it appears that there are no serious adverse health
effects associated with use by adults. However, it has been reported that those who are very
sensitive should not consume more than 400 mg/day to avoid problems such as headache,
drowsiness, anxiety, and nausea (47). In recent years, the risk of caffeine poisoning has
increased due to the prevalence of analgesics, Central Nervous System (SSS) stimulant drugs
and health supplements, and dietary supplements in e-markets. However, fatal cases resulting
from caffeine poisoning are extremely rare (48). Caffeine toxicity is defined by specific
symptoms that occur as a direct result of caffeine consumption. Among the common features
of caffeine poisoning; irritability, anxiety, restlessness, insomnia, digestive system discomfort,
tremor, tachycardia, psychomotor agitation are found (49). Consumption of coffee and other
caffeinated beverages has been associated with insufficient sleep time or short sleep time, in
addition to the occurrence or exacerbation of sleep continuity problems. Short sleep time is
defined as a total sleep time of fewer than 6 hours per night and has been associated with a
wide range of medical and psychiatric comorbidities (50). Caffeine is a powerful antagonist of
the central and peripheral nervous system adenosine receptors, therefore, it stimulates the
release of stimulating neurotransmitters (51). In blocked adenosine receptor blockade, it may
lead to an increase in sympathetic nervous system activity, bronchospasm, increased
contraction of smooth muscles, and an increase in my heart rate (52). Other neurovascular
changes may occur at higher serum concentrations (over 25 mcg / mL) (53). Caffeine can
block the monoamine oxidase enzyme, which leads to increased levels of epinephrine,
dopamine, and glutamate in the body. These neurotransmitters stimulate direct and indirect
neuroendocrine changes, including vasoconstriction, increased heart rate, hypokalemia,
increased sodium, and water excretion (53,54). Caffeine binds at high levels to ryanodine
receptors, which increase serum calcium levels (52). Both increased calcium availability and
low serum potassium levels can cause cardiac arrhythmias in those who consume caffeine at a
toxic level (52.53). Moderate toxicity can cause restlessness, tremors, anxiety, mood changes,
and gastrointestinal discomfort (such as vomiting) (55). Caffeine (more than 6 mg/kg) taken
at very high doses can decrease both physical and cognitive performance and trigger serious
gastrointestinal discomfort (56). Causing caffeine, hypokalemia, ventricular dysrhythmias,
hypotension, rhabdomyolysis, and death at extremely high blood levels (up to 150 mg/kg).
Blood caffeine concentrations of about 150 mg/kg body weight can be fatal. This equates to
about 50 caffeine pills or 1 tablespoon of powder caffeine (55).
3. MATERIAL AND METHOD
3.1 Place and Time of the
Study This study was carried out between 2-9 August for 6 days, at Near East University
Hospital, Kyrenia University Dr. Suat Günsel Hospital, and the Primary Health Care Clinic.
3.2 Type of the Study
551 people were interviewed to investigate the caffeine consumption frequency of the patients
and their relatives who presented to Near East University Hospital, Kyrenia University Dr.
Suat Günsel Hospital, and the Primary Health Care Clinic, 386 of them (70.1%) agreed to
participate in the study. The research is descriptive since the participants in the research were
less than 85% of all applicants.
3.3 The Universe of the Study and the Study Group
In the study titled the frequency of caffeine consumption of patients and their relatives who
came to Near East University Hospital, Kyrenia University Dr. Suat Günsel Hospital, and the
Primary Health Care Clinic, 381 people participated in the study and the study group of the
study.
3.4 Variables Research
3.4.1 Independent Variables
variables related to sociodemographic features
-Age
-Gender
-Civil case
-Country
- Education Situation
-Economic conditions
3.4.2 Dependent Variables
-Caffeine consumption
-Caffeine possible effects on health
3.5 Data Collection Tool and Method of Data Collection
A survey research form was used (APPENDIX 1). The first 8 questions are about the
sociodemographic characteristics of the individuals and the other 4 are about the caffeine
consumption characteristics. The questionnaires were conducted face to face with the
participants in the form of questions and answers.
3.6 Definition-Term and Criteria Used in the Research
Age Groups: The ages of the people participating in the research are divided into 4 main
groups. There 4 groups as: <24, 25-44, 45-64, > 65 (57).
Occupational Groups: Those who reported their professions were divided into 10 groups
according to the International Standard Classification of Occupations - ISCO 08 (58).
Chronic Diseases: Chronic diseases of the participants of the study were divided into 15
groups according to the systems. These groups are; Cardiovascular System Diseases,
Respiratory System Diseases, Gastrointestinal System Diseases, Musculoskeletal and
Rheumatological Diseases, Neurological Diseases, Endocrine, and Metabolic Diseases,
Psychiatric Diseases, Allergic-Immunological Diseases, Hematological Diseases,
Genitourinary Diseases, Nephrological Diseases, Ear Nose Throat Eye Diseases,
Dermatological Diseases, and Oncological Diseases.
Disturbances Feeling: The symptoms that the participants of the research complained about
when they did not drink caffeinated beverages were classified into 4 main groups. These
disturbing feelings are; It was identified as the main group as withdrawal, low energy, pain
and palpitations, and mood complaints.
3.7 The Manpower study
Data was collected under the supervision of 6 intern doctors, under the supervision of 4 public
health faculty members in NEU Faculty of Medicine, Department of Public Health.
3.8 Preliminary Trial
The preliminary trial of the questionnaire was conducted on 20 students studying at NEU
Faculty of Medicine. No question was not understood. It was understood that the questions
were understandable and that the questionnaire lasted about 5 minutes.
3.9 Analysis of Data
The data obtained were analyzed using SPSS 18.0.0 (Statistical Package for the Social
Sciences). Descriptive statistics (frequency, mean, median, standard deviation, maximum and
minimum values) were calculated for the analysis data and marginal and cross tables were
made. The value of accepting p-value as important is determined as p <0.05.
3.10 Ethical Issues
Participants were not asked their names and were not asked to write in the questionnaire. The
participants were informed about the study and their verbal consent was obtained before
starting the survey. The research will not be used for scientific purposes. Near East University
Hospital for Research and Dr. Permission was obtained from Suat Günsel Kyrenia Hospital
(APPENDIX 2). The ethics committee report is attached (APPENDIX 3).
3.11 Time Schedule
JULY 2019
AUGUST 2019
1
Week
2
Week
3
Week
Week
4
Week
5
Week
6
Week
7
Week
8
Week
Week
9
Determination of the
research topic
Literature review
Data collection survey
Pretrial
Research proposal
presentation
Data collection
Evaluation of the data
Preparation of the
research report
Presentation of the
research report
4. RESULTS
551 people were interviewed to investigate the caffeine consumption frequency of patients
and their relatives who presented to Near East University Hospital, Kyrenia University Dr.
Suat Günsel Hospital, and the Primary Health Care Clinic.) agreed to participate in the
research. Findings obtained;
1. Findings related to sociodemographic characteristics, Findings related to, Findings between
2. 2.caffeinated beverage consumption3.caffeinated beverage consumption and possible
health effects of the participants are given in 3 headings.
4.1 Findings Related to sociodemographic features
Table 2 presents the gender, age, and country distributions of the participants.
Table 2. Gender, age group and country distribution of the participants (TRNC July-
August 2019) (N = 386)
sociodemographic
characteristics
n
%
Gender
Male
189
49.0
Female
197
51.0
Age group
<24
55
14.2
25-44
177
45.9
45-64
114
29.5
65+
40
10.4
Average ± SS = 41.74 ± 16.24, Median = 38,, Smallest-Largest = 19-86
Country (n = 386)
TRNC
185
47.9
Turkey
155
40.2
England
32
8.3
Romania
3
0.8
Other *
11
2.9
* Other countries include Vietnam, Nigeria, India, Turkmenistan, the Netherlands, Syria, Canada, America.
As can be seen in Table 2, 197 (51.0%) of the participants were female and 189 (49.0%) were
male. 177 (45.9%) of the survey participants are between the ages of 25-44. The average age
of the participants is 41.74 (SD = ± 16.24), the median is 38, the youngest of the participants
is 19 and the oldest is 86 years old. 185 (47.9%) of the participants are TRNC citizens, 155
(40.2%) are Turkish citizens, 32 (8.3%) are British citizens, 3 (0.8%) are Romanian citizens
( Table 2). Table 3 gives information about the educational status, marital status, and
economic status of the participants.
Table 3. Educational status, marital status and economic status of the participants of the
research (TRNC July-August 2019) (N = 386)
sociodemographic features
N
%
Educational status
Illiterate
6
1.6
Literate
10
2.6
Primary school /
primary school
36
9.3
Middle School
32
8.3
High School
103
26.7
University and Above
199
51.6
Marital Status
Single
114
29.5
Married
223
57.8
Divorced
26
6.7
Widows
17
4.4
Live separately
6
1.6
Economic Status
Good
113
29, 3
Middle
240
62,2
Low
33
8,5
In Table 3, the education level of the university, and the above is 199 (51.6%). The married
person is 223 (57.8%). It is 114 (29.5) people who are single. It is 240 (62.2%) with a
moderate economic status and 113 (29.3%) with a good average.
In Table 4, the participants of the study were classified under 10 main headings according to
the International Standard Classification of Occupations-ISCO 08
Table 4. The occupational distribution of the participants. (TRNC July-August 2019) (N
= 223)
Occupation Group
n
%
Occupations Related to
Armed Forces
12
5.4
Managers
2
0.9
Professional Occupational
Groups
97
43.5
Technicians, Technicians,
and Assistant Professional
Occupational Groups
11
4.9 In
Office Services Employees
23
10.3
Service and Sales Staff
26
11.7
Qualified Agricultural,
Forestry, and Qualified
Aquaculture Employees
6
2.7
Artisans and Related
Workers
23
10.3
Plant and Machine Operators
and Installers
4
1.8
Employees in Non-Jobs
19
8.5 In
Table 4, 97 (43.5%) of the participants are working in the professional profession group. 26
(11.7%) people work as service and sales personnel. The craftsmen and those working in
related jobs are 23 (10.3%). 23 (10.3%) stated that they are in the group working in-office
services.
4.2 Findings Related to Chronic Diseases
The presence of chronic disease of the participants in the study and the chronic diseases stated
by the participants with chronic disease are grouped according to the systems and the
distribution of these diseases is given in Table 5.
Table 5. Whether the participants had a chronic disease or not and their distribution
according to the system (TRNC July-August 2019) (N = 386)
Chronic Diseases
n
%
Yes
154
39.9
No
232
60.1
Chronic Disease Groups (n
= 153 )
n
% *
Cardiovascular System
Diseases
69
45.1
Endocrine and Metabolic
Diseases
50
32.7
Musculoskeletal and
Rheumatological Diseases
20
13.1
Neurological Diseases
15
9.8
Respiratory System Diseases
10
6.5
Psychiatric Diseases
11
7.2
Allergic - Immunological
Diseases
8
5.2
Gastrointestinal System
Diseases
7
4.6
Hematological Diseases
5
3.3
Genitourinary System
Diseases
4
2.6
Nephrological Diseases
2
1,3
Ear Nose Throat Diseases
2
1,3
Eye Diseases
2
1,3
Oncological Diseases
2
1,3
Dermatological Diseases
1
0.7
* Percentage of each line is given on 153 patients.
Table 5 is 154 (39.9%) people with a chronic disease of the participants. It is 232 (60.1%)
people without chronic disease. Those with diseases of the cardiovascular system are 69
(45.1%), those with endocrine and metabolic diseases are 50 (32.7%), and those with
musculoskeletal and rheumatological diseases are 20 (13.1%). Those with a disease related to
neurological diseases are 15 (9.8%) and those with psychiatric diseases are 11 (7.2%).
4.3 Findings Related to Caffeinated Beverage Consumption
Table 6 gives the Turkish coffee consumption status of the participants, how long they have
consumed, the frequency of consumption, and the amount of consumption.
Chart 6. Status of participants consume Turkish coffee (TRNC July-August 2019) using
an (N = 386)
Consumption Status
the
consumes
294
76.2%
does not consume
92
23.8
Duration (years) (n = 294)
<5
57
19.4
5- 9
26
8.8
10-14
62
21.1
15-19
33
11.2
20-24
36
12.2
25-29
14
4.8
30-34
24
8.2
35-39
7
2.4
≥40
35
11.9
Average ± SD = 4.18 ± 2.58 Median = 4.0 Minimum-Maximum = 1.9
Frequency of consumption (n = 294)
Every day
221
75.2
Twice per week
33
11.2
Once per week
22
7.5
Less than once per week
18
6.1
Consumed quantity (n = 294)
1
108
36.7
2
71
24.1
3
46
15.6
4
32
10.9
≥5
37
12.6
Average ± SD = 2 , 66 ± 2.30 Median = 2.0 Smallest-Largest = 1-20 In
Table 6, 294 (76.2%) of the participants in the study consume Turkish coffee. 62 (21.1%) of
the participants have consumed Turkish coffee for 10-14 years. 221 (75.2%) of the
participants consume Turkish coffee every day. 108 (36.7%) of the participants consume 1
cup of Turkish coffee, 37 (12.6%) stated that they consume Turkish coffee over 5 cups.
Table 7 shows the consumption of instant coffee or filter coffee, the duration of consumption,
the frequency of consumption, and the amount of consumption of the participants.
Table 7. Participants of instant coffee or filter coffee consuming state (TRNC July-
August 2019) using an (N = 386)
Consumption Status
n
consumes
234
60.6
does not consume
152
39.4
Duration (years) (n = 234)
<5
42
17, 9
5-9
23
9.8
10-14
57
24.4
15-19
36
15.4
20-24
22
9.4
≥25
54
23.1
Average ± SD = 16.46 ± 12.65 Median = 12, 0 Minimum-Maximum = 1.0-55.0
Frequency of consumption (n = 234)
Every day
145
62.0
Twice per week
56
23.9
Once per week
17
7.3
Less than once per
week
1616
6.8
Consumed quantity (n = 234)
1
143
61.1
2
46
19.7
3
22
9.4
≥4
23
9.8
Average ± SD = 1.76 ± 1.24 Median = 1.0 Minimum-Maximum = 1- 8 In
Table 7, 234 (60.6%) of the survey participants consume instant coffee or filter coffee. 57
(24.4%) of the participants have consumed instant coffee or filter coffee for 10-14 years. 145
(62.0%) of the participants consume instant coffee or filter coffee every day. 143 (61.1%) of
the participants consume 1 cup of instant coffee or filter coffee a day.
Table 8 shows the cola beverage consumption status, consumption time, frequency of
consumption, and consumption amount of the participants.
Table 8. Status of participants consume cola drinks (TRNC July-August 2019) using an
(N = 386)
Consumption Status
the
consumes
239
61.9%
does not consume
147
38.1
Duration (years) (n = 239)
<5
18
7.5
5 -9
10
4.2
10-14
39
16.3
15-19
60
25.1
20-24
40
16.7
≥25
72
30.1
Average ± SD = 4.29 ± 1.51 Median = 4.0 Width small-largest = 1.0-6.0
Frequency of consumption (n = 239)
Every day
121
50.6
Twice per week
58
24.3
Once per week
37
15.5
Less than once per week
23
9.6
Amount consumed (n = 239)
1
122
51.0
2
74
31.0
3
18
7.5
≥4
25
10.5
Average ± SD = 1.85 ± 1.23 Median = 1.0 Minimum-Maximum = 1-8
Table In 8, 239 (61.9%) of the participants of the research consume cola drinks. 72 (30.1%) of
the participants have consumed cola drinks for 25 years and more. 121 (50.6%) of the
participants consume cola drinks every day. 122 (51.0%) of the participants consume 1 glass
of cola drinks a day.
In Table 9, the energy drink consumption status, consumption period, consumption frequency,
and consumption amount of the individuals participating in the research are given.
Table 9. Participants consume energy drinks states (Cyprus July-August 2019) using an
(N = 386)
Consumption Status
N
consumes
59%
15.3
does not consume
327
84.7
Duration (years) (n = 59)
<5
30
50.8
5-9
11
18.6
≥10
18
30.5
Average ± SD = 1.79 ± 0.88 Median = 1.0 Minimum-Maximum =
1.0-3.0 Frequency of consumption (n = 59)
Every day
16
27.1
Twice per week
10
16.9
Once per week
10
16.9
Less than once per week
23
39.0
Quantity consumed (n = 59)
1
48
81.4
2
9
15.3
≥3
2
3.4
Average ± SS = 1.25 ± 0.63 Median = 1.0 Minimum-Largest = 1-4 In
Table 9, 327 (84.7%) of the participants in the research consume energy drinks. 30 (50.8%) of
the participants have been consuming energy drinks for 5 years and more. 23 (39.0%) of the
participants consume less than one energy drink per week. 48 (81.4%) of the participants
consume one can of energy drink per day.
Table 10 shows the tea consumption status of the participants, how long they have consumed,
the frequency of consumption, and the amount of consumption.
Table 10. Tea consumption status of participants (TRNC July - August 2019) (N = 386)
Consumption Status
consumes
301%
78.0
does not consume
85
22.0
Duration (years) (n = 301)
<5
13
4.3
5-9
5
1.7
10-14
33
11.0
15-19
39
13.0
20-24
50
16.6
25-29
26
8.6
30-34
46
15.3
35-39
12
4.0
≥40
77
25.6
Average ± SD = 5.96 ± 2.37 Median = 6.0 Minimum-Maximum = 1.9
Frequency of consumption
(n = 301)
Every day
239
79.4
Twice per week
40
13.3
Once per week
9
3.0
Less than once per week
13
4.3
Amount consumed (n = 301)
1
96
31.9
2
68
22.6
3
46
15.3
≥4
91
30.2
Average ± SD = 3.38 ± 3.61 Median = 2.0 Minimum-Maximum = 1-20
Table In 10, 301 (78.0%) of the respondents consume tea. 77 (25.6%) of the participants have
been consuming tea for 40 years or more. 239 (79.4) of the participants consume tea every
day. 96 (31.9%) of the participants stated that they drink 1 cup of tea a day, 91 (30.2%) of the
drink 4 cups, and more.
4.4 Findings related to caffeinated beverage consumption reasons
Table 11 groups of individuals participating in the study are grouped as the main reasons
answered.
Table 11.caffeinated beverage consumption of the participants of the study (TRNC July-
August 2019) (N = 386)
Reasons for consumption
n
% No
special purpose
216
56,0
To feel fit
71
18.4
To stay awake until late
16
4, 1
To be more productive
26
6.7
To relieve headaches
29
7.5
To increase concentration
24
6.2
Drinking with smoking
4
1.0
216 (56.0%) of the individuals participating in the study stated that they did not drink
caffeinated beverages for a specific purpose. The number of individuals consuming
caffeinated beverages to feel more fit is 71 '(18.4%). The number of people consuming it to
relieve headaches is 29 (7.5%). The number of drinkers to be more productive is 26 '(6.7%).
The number of people consuming caffeinated beverages to increase concentration is 24
(6.2%). The number of people drinking to stay awake until late hours is 16 (4.1%). The
number of people who say that I consume caffeinated beverages with cigarettes is 4 (1.0%).
In Table 12, the negative symptoms expressed by the participants in the study whether they
feel any negativity in their body after drinking a caffeinated beverage and those who feel any
negative in their body after drinking caffeinated beverages are given in the table below.
Table 12. Whether the participants of the study feel any positivity in their body after
drinking a caffeinated beverage and the distribution of the negativities felt (TRNC July-
August 2019) (N = 386)
Do you feel any negativity
in your body after
consuming caffeinated
beverages?
n
%
Yes
86
22.3
No
300
77.7
Negative symptoms seen (n
= 86)
n
%
Palpitations
40
46.5
Burning sensation in the
stomach
24
28.0
Inability to sleep at night
15
17.4
Other *
7
8.1
* Other negative symptoms hand tremor, toilet need, thirst, sweating, change in mouth taste, swelling in the body.
The number of people who feel any negativity in their body after consuming caffeinated
beverages is 86 (22.3%). The number of people who do not feel any negative in their body
after consuming caffeinated beverages is 300 (77.7%). In Table 14, the negativities stated by
people who feel any negativity in their bodies after drinking caffeinated beverages are
grouped. Among 86 people, there are 40 (46.5%) who say the sign of palpitations, 24 (28.0%)
who say the burning sensation in the stomach, and 15 (17.4%) who complained of not
sleeping at night. The number of people who report complaints not included in this grouping
is 7 (8.1%).
In Table 13, whether the participants in the study feel any discomfort when they do not drink
caffeinated beverages as a yes-no question, and the disturbances felt are divided into main
groups and indicated in the table.
Table 13. Whether the participants of the study felt any discomfort when they did not
drink caffeinated beverages and the distribution of the symptoms they complained
(TRNC July-August 2019) (N = 386)
Do you feel any discomfort
when the caffeinated
beverage is not consumed?
n
%
Yes
134
34.7
No
252
65.3
Disturbed Feels (n = 132)
N
% *
Deprivation
45
34.1
Low Energy
43
32.6
Pain and Palpitations
Complaints
56
42.4
Mood Complaints
8
6.1
* Each one line percentage was calculated on 132 patients.
252 (65.3%) of the respondents said that they did not feel any discomfort when they did not
drink caffeinated beverages. 134 (34.7%) people stated that they feel any discomfort when
they do not drink caffeinated beverages. The number of people who report pain and
palpitation complaints is 56 (42.4%), the number of people who report withdrawal complaints
is 45 (34.1%), the number of people who report energy loss complaints is 43 (32.6%) and the
number of people with mood complaints is 8 ' (6.1%).
4.5 Relationships between some sociodemographic characteristics and caffeine
consumption
Table 14 Relationship Between Age Groups and Caffeine Consumption (TRNC July-
August 2019) (N = 386)
Caffeinated
Drinks
<40 years
≥40 years
Total
n
%
N
%
n
%
Turkish coffee
consumes
168
81.2
126
70.4
294
76.2
does not
consume
39
18.8
53
29.6
92
23.8
X2= 6.132p = 0.013
Instant coffee or filter coffee
consumes
138
66.7
96
53.6
234
60.6
does not
consume
69
33.3
83
46.4
152
39.4
X2= 6.833 p = 0.009
Cola drinks
consumes
154
74.4
85
47.5
239
61.9
does not
consume
53
25.6
94
52.5
147
38.1
X2= 29.480 p <0.001
Energy drinks
consumes
54
26.1
5
2.8
59
15.3
does not
consume
153
73.9
174
97.2
327
84.7
X2= 40.224p <0.001
Tea
consumes
156
75.4
145
81.0
301
78.0
does not
consume
51
24.6
34
19.0
85
22,0
X2= 1,780 p = 0,182
As seen in Table 1, Turkish coffee consumption (81.2%) of participants under 40 years of age
is higher than participants aged 40 and over (70.4%) and this difference is statistically
significant. (p = 0.013). Considering the use of instant coffee or filter coffee, the consumption
rate of participants under the age of 40 (66.7%) is higher compared to the group of 40 and
over (53.6%) and this difference is statistically significant. In cola drinks, the consumption
rate of the group under the age of 40 (74.4%) is higher than the group of age 40 and over
(47.5%) and this difference is statistically significant. Considering the frequency of
consumption of energy drinks, the group under 40 consumes 26.1%, while group 40 and over
consumes only 2.8%, and this difference is statistically significant. There is no statistically
significant difference in terms of tea consumption by age groups.
Table 15. Relationship Between Gender and Availability consume caffeine (TRNC July-
August 2019) using an (N = 386)
Male
Female
Total
n%
n%
n%
Turkish coffee
consumes
140
74.1
154
78.2
294
76.2
does not
consume
49
25, 9
43
21.8
92
23.8
X2= 0.893 p = 0.345
Instant coffee
or filter coffee
consumes
113
59.8
121
61.4
234
60.6
does not
consume
76
40.2
76
38.6
152
39.4
X2= 0.108p = 0.743
Cola drinks
consumes
129
68.3
110
55.8
239
61.9
does not
consume
60
31.7
87
44.2
147
38.1
X2= 6.307 p = 0.012
Energy drinks
consumes
41
21.7
18
9.1
59
15.3 Not
does not
consume
148
78.3
179
90.9
327
84.7
X2= 11.744 p = 0.001
Tea
consumes
149
78.8
152
77.2
301
78.0 Not
does not
consume
40
21.2
45
22.8
85
22.0
X2= 0,158 p = 0,691
As seen in Table 2, the number of people who consume Turkish coffee in women is 154
(78.2%), while this number is 140 (74.1%) in men. There is no statistically significant
difference between genders in terms of Turkish coffee consumption (X2= 0.893, p = 0.345).
The number of women who consume instant coffee or filter coffee is 121 (61.4%) and the
number of men who consume said drinks is 113 (59.8%). There is no statistically significant
difference between genders in terms of instant coffee or filter coffee consumption (X2= 0.108,
p = 0.743).
When we look at the number of people who consume cola drinks, 129 of the men (68.3%)
consumed the mentioned drinks, while 110 (55.8%) of the women mentioned that they
consume. There is a statistically significant difference between genders in terms of cola
beverage consumption (X2= 6.307, p = 0.012).
Considering the consumption of energy drinks, the number of people consuming male
participants is 41 (21.7%), and the number of women consuming 18% (9.1%) of the said
drinks. There is a statistically significant difference between the sexes in terms of energy
drinks consumption (X2= 11,744, p = 0.001).
In terms of tea consumption, 152 (77.2%) of the female participants say that they consume tea,
while this number is 149 (78.8%) for men. There is no statistically significant difference
between genders in terms of tea consumption (X2= 0.158, p = 0.669).
Table 16. Distribution of participants according to their feeling of negative health effects
after drinking and drinking caffeinated beverages (TRNC July-August 2019) (N = 386)
Negative feelings after consuming
feels
does not feel
Total
n
%
n
%
n
%
Turkish coffee
Consuming
71
24 1
223
75.9
294
76.2 Not
Consuming
15
16.3
77
83.7
92
23.8
X2= 2.491 p = 0.115
Amount of Turkish coffee Consumed (cup/day)
1
22
20.4
86
79.6
108
36, 7
2
21
29.6
50
70.4
71
24.2
3 or more
28
24.3
87
75.7
115
39.1
X2= 1.987 p = 0.370Instant
Coffee or Filter Coffee
consumes
54
23.1
180
76.9
234
60.6
does not consume
32
21.1
120
78.9
152
39.4
X2= 0.218 p = 0.641
Amount consumed Nescafe or filter coffee (medium cup/day)
1
31
21.7
112
78.3
143
61.1
2
11
23,9
35
76,1
46
19,7
3 or more
12
26,7
33
73,3
45
19,2
X2= 0,502 p = 0,778Cola
Drinks
consumes
51
21,3
188
78,7
239
61,9
does not consume
35
23,8
112
76,2
147
38,1
X2= 0,321 p = 0,571Cola
Amount of drink Consumed (cups/day)
1
25
20,5
97
79,5
122
51,0
2
16
21,6
58
78 4
74
31.0
3 or more
10
23.3
33
76.7
43
18.0
X2= 0.150 p = 0.928
Energy drinks
consumes
16
27.1
43
72.9
59
15.3
does not consume
70
21.4
257
78, 6
327
84,7
X2= 0,942 p = 0,332Energy
Consumed Drinks Amount (cans/ day)
1
12
25.0
36
75.0
48
81.4
2
3
33.3
6
66.7
9
15.2
3 or more
1
50.0
1
50.0
2
3.4
X2= 0.815p = 0.665
Tea
consumes
68
22.6
233
77.4
301
78.0
does not consume
18
21.2
67
78.8
85
22.0
X2= 0.077 p = 0,782
Amount of Tea Consumed (tea glass/day)
1
19
19.8
77
80.2
96
31.9
2
19
27.9
49
72.1
68
22.6
3 or more
30
21.9
107
78.1
137
45.5
X2= 1.581 p = 0.445
As seen in Table 16, the number of people who feel negative health effects after consuming
Turkish coffee is 71 (24.1%). The number of people who do not consume Turkish coffee and
feel a negative health effect is 15 (16.3%). There is no statistically significant difference
between the consumption status of Turkish coffee and the feeling of negative health effects
when the drink does not drink (X2= 2.491, p = 0.115).
The number of people who consume 1 cup of Turkish coffee per day and feel a negative
health effect is 22 (20.4%). The number of people who consume 2 cups of Turkish coffee per
day and feel a negative health effect is 21 (29.6%). The number of people who feel negative
health effects after consuming 3 or more cups of Turkish coffee per day is 28 (24.3%). There
is no statistically significant difference between the amount of Turkish coffee consumed and
the negative health effect when the said drink is not drunk (X2= 1,987, p = 0,370).
The number of people who feel negative health effects after consuming instant coffee or filter
coffee is 54 (23.1%). The number of people who do not consume instant coffee or filter coffee
and feel a negative health effect is 32 (21.1%). There is no statistically significant difference
between the consumption of instant coffee or filter coffee and the negative health effect when
the drink is not mentioned (X2= 0.218, p = 0.641).
The number of people who consume 1 medium glass of instant coffee or filter coffee per day
and feel a negative health effect is 31 (21.7%). The number of people who consume 2
medium-sized glasses of instant coffee or filter coffee per day and feel a negative health effect
is 11 (23.9%). The number of people who consume 3 or more medium-sized glasses of instant
coffee or filter coffee per day is 12 (26.7%). There is no statistically significant difference
between the amount of instant coffee or filter coffee consumed and the negative health effect
when not drinking the drink (X2= 0,502, p = 0,778).
The number of people who feel negative health effects after consuming cola drinks is 51
(21.3%). The number of people who do not consume cola drinks and feel negative health
effects is 35 (23.8%). There is no statistically significant difference between the consumption
of cola drinks and the feeling of negative health effects when not drinking the mentioned
drink (X2= 0.321, p = 0.571).
The number of people who consume 1 glass of cola drink per day and feel a negative health
effect is 25 (20.5%). The number of people who consume 2 cups of cola drinks per day and
feel a negative health effect is 16 (21.6%). The number of people who consume 3 or more
cups of cola drinks per day and feel negative health effects is 10 (23.3%). There is no
statistically significant difference between the amount of cola drink consumed and the state of
feeling negative health effects when not drinking the mentioned drink (X2= 0.150, p = 0.928).
The number of people who feel negative health effects after consuming energy drinks is 16
(27.1%). The number of people who do not consume energy drinks and feel negative health
effects is 70 (21.4%). There is no statistically significant difference between the state of
consuming energy drinks and feeling negative health effects when not drinking the mentioned
drink (X2= 0.942, p = 0.332).
The number of people who consume 1 can of energy drink per day and feel a negative health
effect is 12 (25.0%). The number of people who consume 2 cans of energy drink per day and
feel a negative health effect is 3 (33.3%). The number of people who consume 3 or more cans
of energy drinks per day and feel a negative health effect is 1 (50.0%). There is no statistically
significant difference between the amount of energy drink consumed and the feeling of
negative health effects when the said drink is not drunk (X2= 0.815, p = 0.665).
The number of people who feel negative health effects after consuming tea is 68 (22.6%). The
number of people who do not consume tea and feel negative health effects is 18 (21.2%).
There is no statistically significant difference between the state of consuming tea and feeling
negative health effects when not drinking the drink mentioned (X2= 0.077, p = 0.782).
The number of people who consume 1 tea glass per day and feel a negative health effect is 19
(19.8%). The number of people who consume 2 teacups a day and feel a negative health effect
is 19 (27.9%). The number of people who consume 3 or more tea glasses a day and feel
negative health effects is 30 (21.9%). There is no statistically significant difference between
the amount of tea consumed and the negative health effect when not drinking the drink (X2=
1,581, p = 0,454).
Table 17.Distribution of participants according to caffeinated beverage consumption
and their feeling of negative health effects when they do not consume (TRNC July-
August 2019) (N = 386)
Feeling negative health effect when they do not
feel Feels not
feeling
Total
n
%
n
%
n
%
Turkish coffee
Consuming
114
38,8
180
61,2
294
76,2
Doesn't Consume
20
21,7
72
78,3
92
23,8
X2= 8,974 p = 0,003
Turkish coffee Consumed (cup/day)
1
28
25,9
80
74,1
108
36,7
2
31
43,7
40
56,3
71
24,2
3 or more
55
47,8
60
52,2
115
39,1
X2= 12,193 p = 0,002
Instant Coffee or Filter Coffee
consumes
87
37,2
147
62,8
234
60, 6
does not consume
47
30.9
105
69.1
152
39.4
X2= 1.592 p = 0.207
Amount of Instant Coffee or Filter Coffee (medium glass/day)
1
51
35.7
92
64.3
143
61.1
2
12
26 1
34
73.9
46
19.7
3 or more
24
53.3
21
46.7
45
19.2
X2= 7.591 p = 0.022 Cola
Drinks
consumes
90
37.7
149
62.3
239
61.9 Not
does not consume
44
29, 9
103
70,1
147
38,1
X2= 2,397 p = 0,122
Amount of Cola Drink Consumed (cups/day)
1
45
36.9
77
63.1
122
51.0
2
31
41.9
43
5 8.1
74
31.0
3 or more
14
32.6
29
67.4
43
18.0
X2= 1.072 p = 0.585
Energy drinks
consumes
27
45.8
32
54.2
59
15.3
does not consume
107
32.7
220
67.3
327
84.7
X2= 3.751 p = 0.053Energy
Consumed Drinks Amount (cans/day)
1
20
25.0
28
58.3
48
81.4
2
5
33.3
4
44.4
9
15.2
3 or more
2
50,0
0
0,0
2
3,4
X2= 3,043 p =
Tea
consumes
101
33,6
200
66,4
301
0,21878,0
Not
does not consume
33
38,8
52
61,2
85
22,0
X2= 0,812 p = 0,368
Amount of Tea Consumed (tea glasses/day)
1
35
36.5
61
63.5
96
31.9
2
21
30.9
47
69.1
68
22.6
3 or more
45
32.8
92
67.2
137
45,5
X2= 0,612 p = 0,737
As seen in Table 17, 114 (38.8%) of those who consumed Turkish coffee reported that they
felt negative health effects when they did not consume Turkish coffee. 20 (21.7%) people
who did not consume Turkish coffee reported that they felt negative health effects when they
did not consume Turkish coffee. There is a statistically significant difference between Turkish
coffee consumption and the feeling of negative health effects when the said drink is not
consumed (X2= 8,974, p = 0,003).
28 (25.9%) of those who consumed 1 cup of Turkish coffee per day reported that they felt
negative health effects when they did not consume Turkish coffee. 31 '(43.7) of those who
consumed 2 cups of Turkish coffee per day reported that they felt negative health effects
when they did not consume Turkish coffee. 55 (47.8%) of those who consume 3 or more cups
of Turkish coffee per day stated that they feel negative health effects when they do not
consume Turkish coffee. There is a statistically significant difference between the amount of
Turkish coffee consumption and the negative health effect they feel when they do not
consume Turkish coffee (X2= 12,193, p = 0,002).
87 (37.2%) people who consumed instant coffee or filter coffee stated that they felt negative
health effects when they did not drink instant coffee or filter coffee. 47 (30.9%) people who
did not consume instant coffee or filter coffee reported that they felt negative health effects
when they did not consume instant coffee or filter coffee. There is no statistically significant
difference between the consumption of instant coffee or filter coffee and the negative health
effect when the said drink is not consumed (X2= 1,592, p = 0,207).
51 (35.7%) people who consume 1 medium-sized instant or filtered coffee per day feel
negative health effects when they do not consume instant coffee or filter coffee. 12 (26.1%)
people who drink 2 medium-sized instant coffee or filter coffee per day feel negative health
effects when they do not consume instant coffee or filter coffee. 24 (53.3%) people who
consume 3 or more medium-sized instant coffee or filter coffee per day feel negative health
effects when they do not drink any of these drinks. There is a statistically significant
difference between the amount of instant coffee or filter coffee consumption and the negative
health effect when the said drink is not consumed (X2= 7.591, p = 0.022).
90 (37.7%) people consuming cola drinks reported that they feel negative health effects when
they do not drink cola drinks. 44 (29.9%) people who did not consume cola drinks reported
that they felt the negative health effect when they did not drink this drink. There is no
statistically significant difference between the consumption of cola drinks and the negative
health effect when the said beverage is not consumed (X2= 2,397, p = 0,122).
45 (36.9%) people who consumed 1 glass of cola drink per day reported that they felt negative
health effects when they did not drink cola drinks. 31 (41.9%) people who consumed 2 cups
of cola drinks per day stated that they felt negative health effects when they did not drink cola
drinks. 14 (32.6%) people who consumed 3 glasses of cola drinks per day stated that they feel
negative health effects when they do not drink cola drinks. There is no statistically significant
difference between the amount of cola beverage consumption and the negative health effect
felt when the said beverage is not consumed (X2= 1,072, p = 0,585).
27 (45.8%) people who consume energy drinks said that they feel negative health effects
when they do not consume energy drinks. 107 (32.7%) people who did not consume energy
drinks reported negative health effects when they did not consume energy drinks. There is a
statistically significant difference between energy drink consumption and the state of feeling
negative health effects when the said drink is not consumed (X2= 3.751, p = 0.053).
20 (25.0%) people consuming 1 can of energy drink per day reported that they felt negative
health effects when they did not consume energy drinks. 5 (33.3%) people who consumed 2
cans of energy drink per day reported that they felt negative health effects when they did not
consume energy drink. 2 (50.0%) people consuming 3 or more cans of energy drinks per day
stated that they feel negative health effects when they do not consume energy drinks. There is
no statistically significant difference between the amount of energy drink consumption and
the negative health effect felt when the said drink is not consumed (X2= 3,043, p = 0,218).
101 (33.6%) people who consumed tea reported that they felt negative health effects when
they did not consume tea. 33 (38.8%) people who did not consume tea reported that they felt
negative health effects when they did not consume tea. There is no statistically significant
difference between the consumption of tea and the feeling of negative health effects when the
said beverage is not consumed (X2= 0.812, p = 0.368).
35 (36.5%) people who consumed 1 cup of tea a day reported their negative health effects
when they did not consume tea. 21 (30.9%) people who consumed 2 cups of tea a day
reported their negative health effects when they did not drink tea. 45 (32.8%) people who ate
3 or more tea glasses a day reported that they felt negative health effects when they did not
consume tea. There is no statistically significant difference between the amount of tea
consumption and the negative health effect felt when the drink is not consumed (X2= 0.612, p
= 0.737).
5. Discussion
This study was conducted to evaluate the caffeine consumption frequency and consumption
characteristics of patients and relatives who presented to polyclinics of some hospitals in
TRNC. A total of 551 people were interviewed, 386 of them agreed to participate in the study.
The study was planned to represent the applicants between 2-9 August 2019, but since the
number of admissions was low, the study was planned cross-sectional but completed
descriptively. Turkish coffee, instant coffee-filter coffee, cola drinks, energy drinks, and tea
consumption of caffeinated beverages were evaluated. The age group that consumes the most
tea, energy drink, instant coffee or filter coffee, cola drinks and Turkish coffee is under 40
years old. Traditionally, coffee consumption is widely known in the TRNC society. In our
study, less than half of the participants were TRNC citizens, so the accuracy of this
information could not be reached.
Some participants' daily tea consumption amounts to 20 glasses. The health effects seen in
those who consume too many caffeinated beverages could not be evaluated in detail. It has
been observed that women consume more tea than men. People who consumed 3 cups of tea a
day or more stated that they felt more negative health effects after consuming tea than those
who consumed 1 and 2 a day.
Most of those who consume Turkish coffee are under 40 years old. Turkish coffee
consumption in women is the majority compared to men. People who consume Turkish coffee,
who do not feel negative health effects after consuming this drink, are more than those who
feel negative health effects after consuming this drink. People who consumed 3 or more
Turkish coffees per day stated that after consuming this drink, they felt the negative health
effect more than those who consumed 1 and 2 coffees a day. People who do not feel negative
health effects when they consume Turkish coffee are more than those who feel negative
health effects when they do not consume this drink.
Those who consume cola drinks are mostly under the age of 40. Cola beverage consumption
in men is higher than in women. People who do not feel negative health effects after
consuming cola drinks are more than people who feel negative health effects after consuming
this drink. People who consumed 3 or more cola drinks per day stated that they felt less
negative health effects after consuming this drink than people who consumed 1 and 2 cola
drinks a day. People who do not feel negative health effects when they do not drink cola
drinks are more than those who feel negative health effects when they do not drink this drink.
Most of the instant coffee filter coffee consumers are under 40 years old. The consumption of
instant coffee filter coffee is higher in women than in men. People who do not feel negative
health effects after consuming instant coffee-filter coffee are more than people who feel
negative health effects after consuming these drinks. Those who consume 3 or more instant
coffee/filters per day are less likely to have negative health effects after consuming this drink
than those who have a negative health effect after consuming 1 instant-filter coffee per day,
but to those who have a negative health effect after consuming 2 instant-filtered coffee a day.
is it more than? People who do not feel negative health effects when they do not consume
instant coffee-filter coffee are more than those who feel negative health effects when they do
not consume this drink.
The majority of those who consume energy drinks are under 40 years old. Energy drink
consumption is higher in males than in females. People who do not feel negative health
effects after consuming energy drinks are more than people who feel negative health effects
after consuming this drink. People who consume 3 or more energy drinks per day and feel
negative health effects after consuming this drink are less than those who feel negative health
effects after consuming 1 and 2 energy drinks per day. People who do not feel negative health
effects when they do not consume energy drinks are more likely than those who feel negative
health effects when they do not consume this drink.
In a study, male students 'caffeine consumption is higher than female students' caffeine
consumption. Male students consume tea more than female students (9). Since the age
distribution is wide in our study, our younger individual study group is not sufficient to
compare this study.
In a study on the relationship between tea and coffee with nutrition and health, caffeine has
been found to have a stimulating effect on the central nervous system and heart. It was found
that when taken in small quantities, tea and coffee increased the efficiency of the brain, it was
found to cause heart palpitations, insomnia, and headache. (59) According to the results of our
study, since the number of participants is low, definitive results could not be reached in terms
of the relationship between the cardiovascular system and caffeine consumption.
According to another study, the occurrence of symptoms such as headache, fatigue, easy
anger, which occurred 24 hours after stopping caffeine consumption was evaluated as caffeine
withdrawal (60). In those who participated in our study, 3 or more instant coffee-filter coffee
and those who consumed energy drinks were found to be more likely to feel negative health
effects when they did not consume these drinks.
6. Conclusion and Suggestions In the
the study, it was observed that the consumption of caffeinated beverages was quite high.
It is the most preferred tea among caffeinated beverages.
Caffeine consumption varies between age groups and caffeine consumption is predominantly
between the ages of 25-44. While instant coffee and energy drinks are not preferred in groups
aged 65 and over, consumption of cola and energy drinks was high in young people.
When we consider the relationship between long-term caffeine consumption and chronic
diseases, cardiovascular diseases were found to be quite high. In future studies, health
problems should be asked with more detailed questions. Those who drink more than 5
caffeinated beverages per day will be useful in terms of cardiological examination.
In case of excessive consumption of caffeine, disturbances such as palpitations, insomnia, and
stomach discomfort have been observed. If we consider that caffeine is a pharmacological
substance, controlling caffeine consumption will help us avoid possible health effects that
may result from caffeine. It is necessary to bring the knowledge that caffeine is not only in
coffee but in many foods and beverages. Thus, society will be more conscious about caffeine
consumption.
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APPENDIX
APPENDIX 1
NEAR EAST UNIVERSITY
ASSESSMENT OF SCIENTIFIC RESEARCH ETHICS COMMITTEE
Caffeine of Some Health Organization Patient and Patient Relatives of the applicant
Consumption Frequency
SURVEY FORM
Demographic Features Related Questions
1. What is your gender? 1. Male 2. Female
2. Please indicate how old you are. ........................
3. Indicate your citizenship.
1. Cyprus 2.Turkey 3. Other (specify ........................)
4. Please indicate your job. ..............................................
Dear participant,
This study is planned to examine your caffeine consumption. The data of the research will
never be used except for the purpose mentioned above. Participating in the study,
answering the questions carefully, and sincerely will ensure correct results and it is
important for the place of caffeine in our society. Thank you for your participation.
I want to participate in the research
Tel:6751000/3026
Danışman Öğretim Üyeleri: Araştırma Ekibi:
Prof. Dr. Şanda Çalı Int. Dr. Gözdem Durak
Prof. Dr. Songül A.Vaizoğlu Int. Dr. Güldem Durak
Doç. Dr.Özen Aşut
Yrd. Doç Gülpiya Abdülşakir Int. Dr. Cemil Yarsel
Int. Dr.Mustafa Abul
Int. Dr. Nawaf El Assaad
Int. Dr.Ayşe Aybüke Tahtalı
5. What is your education level?
1. Illiterate 2.Literate (not finished primary school)
3. Primary School / Primary School 4. Middle School 5. High School 6. University and
Above
6. What is your marital status?
1. Single 2. Married 3. Divorced 4. Widow (spouse is dead)
5. Separate lives 6. Other (indicate what happened ......................)
7. How do you evaluate your economic situation?
1.Good 2.Medium 3. Poor
8. Do you have a long-term (chronic) disease? Indicate what it is, if any (hypertension, diabetes,
headache, psychological problem, etc.) ............................... ................................................
II. Questions about caffeinated beverage consumption question about caffeinated beverage
consumption and
9. Read each writes the answer in the relevant box.
The beverages
listed below
Do you
drink?
1. Yes
2. No
How many
years have
you been
drinking?
How often do you
drink?
1.Every day
2. Twice per
week
3. Once per week
4. Less than once
per week
What amount do you
consume?
....cup/glass/tea
glass/small cup/water
cup/day
Turkish coffee
(cups/day)
Instant coffee or
filter coffee
(medium-sized
cups/day)
Cola drinks
(cups/day)
Energy drinks
(small)
Tea (cups/day)
Other (Please
state)
10. What is the reason do you mostly consume caffeinated beverages?
1. I have no special purpose
2. To feel fit
3. To stay awake until late hours
4. To be more productive
5.relieve headaches
6. To increase my concentration
7. Other (Indicate .............. ..........................................)
11. After consuming caffeinated beverages in our body Do you feel any negativity? (only one option
will be marked.)
1. No
2. Flutter
3. Burning in my stomach
4. I can't sleep at night
5. Other (Indicate …………………… ............)
12. Do you feel uncomfortable when you do not drink caffeinated beverages (coffee, tea, cola, energy
drink, etc.)? If yes, please state how you
feel. ............................................... ... ........... ............................................................... .................. ..........
................. ...
APPENDIX 2
APPENDIX 3
