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group_2_presentation_2_-_effects_of_caffeine [2018/03/02 12:55]
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group_2_presentation_2_-_effects_of_caffeine [2018/03/02 21:03] (current)
alalawn [Caffeinated Spider]
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 ====== What is Caffeine? ====== ====== What is Caffeine? ======
-<​box ​20% round right| > {{ :​caffeine-chemical-structure.jpg?​150|}} </​box|Figure 1: Chemical structure of Caffeine>​+<​box ​15% round right| > {{ :​caffeine-chemical-structure.jpg?​150|}} </​box|Figure 1: Chemical structure of Caffeine ​(Wikipedia, 2018)>
  
  
-Caffeine is a type drug from the methylxanthines class, meaning that it has a purine base (Nehlig, Daval & Debry, 1992). Purine base consist of a six-membered and a five-membered nitrogen-containing ring, bound together. Caffeine is a legal psychoactive drug and is popularly consumed in coffee, tea and cola drinks. ​+Caffeine is a type drug from the methylxanthines class, meaning that it has a purine base. Purine base consist of a six-membered and a five-membered nitrogen-containing ring, bound together. Caffeine is a legal psychoactive drug and is popularly consumed in coffee, tea and cola drinks. ​(Nehlig, Daval & Debry, 1992)
  
  
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 ====== Mechanisms of Caffeine ====== ====== Mechanisms of Caffeine ======
  
-99% of caffeine is absorbed in humans within 45 minutes of ingestion (Institute of Medicine (US) Committee on Military Nutrition Research). Caffeine is absorbed through the gastrointestinal tract, and due to the fact that it has lipophilic properties, it passes through the phospholipid bilayer of cells such as absorptive cells of the intestines (Fredholm, Bättig, Holmén, Nehlig & Zvartau, 1999). Almost all of the ingested caffeine is metabolized by the CYP1A2 enzyme. ​ Caffeine is metabolized to paraxanthine (81.5%) and to theobromine (10.8%) and theophylline (5.4%) (Perera, Gross & McLachlan, 2010). Caffeine can also travel to the brain and pass the blood-brain barrier (Fredholm, Bättig, Holmén, Nehlig & Zvartau, 1999) and can act as a central nervous system (CNS) stimulant(Nehlig,​ Daval & Debry, 1992). Paraxanthine,​ which is the main metabolite of caffeine, can pass through the placental barrier, and reach the fetus (Jahanfar & Jaafar, 2013). ​+99% of caffeine is absorbed in humans within 45 minutes of ingestion (Institute of Medicine (US) Committee on Military Nutrition Research, 2001). Caffeine is absorbed through the gastrointestinal tract, and due to the fact that it has lipophilic properties, it passes through the phospholipid bilayer of cells such as absorptive cells of the intestines (Fredholm, Bättig, Holmén, Nehlig & Zvartau, 1999). Almost all of the ingested caffeine is metabolized by the CYP1A2 enzyme. ​ Caffeine is metabolized to paraxanthine (81.5%) and to theobromine (10.8%) and theophylline (5.4%) (Perera, Gross & McLachlan, 2010). Caffeine can also travel to the brain and pass the blood-brain barrier (Fredholm, Bättig, Holmén, Nehlig & Zvartau, 1999) and can act as a central nervous system (CNS) stimulant (Nehlig, Daval & Debry, 1992). Paraxanthine,​ which is the main metabolite of caffeine, can pass through the placental barrier, and reach the fetus (Jahanfar & Jaafar, 2013). ​
  
 <box 55% round right| >{{ :​caffeine-02-22_at_1.30.38_pm.png?​500 |}} </​box|Figure 2: Different metabolites of caffeine(Perera,​ Gross & McLachlan, 2010)> <box 55% round right| >{{ :​caffeine-02-22_at_1.30.38_pm.png?​500 |}} </​box|Figure 2: Different metabolites of caffeine(Perera,​ Gross & McLachlan, 2010)>
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 Adenosine receptors are a type of G-protein coupled receptors, which are involved in a signal transduction pathway and their job is to ultimately induce a cell response (Fisone, Borgkvist & Usiello, 2004). There are four subclasses of the adenosine receptors, two of which include: A1 and A2 receptors. One of the differences between these two receptors arises from the affinity they have for adenosine as A1 has a high affinity, whereas A2 has a relatively low affinity (Nehlig, Daval & Debry, 1992). Once adenosine is bound to A1 or A2, it inhibits or stimulates adenylate cyclase respectively and eventually has an effect on the concentration of cyclic AMP (Benowitz, 1990).  ​ Adenosine receptors are a type of G-protein coupled receptors, which are involved in a signal transduction pathway and their job is to ultimately induce a cell response (Fisone, Borgkvist & Usiello, 2004). There are four subclasses of the adenosine receptors, two of which include: A1 and A2 receptors. One of the differences between these two receptors arises from the affinity they have for adenosine as A1 has a high affinity, whereas A2 has a relatively low affinity (Nehlig, Daval & Debry, 1992). Once adenosine is bound to A1 or A2, it inhibits or stimulates adenylate cyclase respectively and eventually has an effect on the concentration of cyclic AMP (Benowitz, 1990).  ​
  
-Since the structures of caffeine and adenosine are similar, caffeine can also bind to adenosine receptor, and inhibit the binding of adenosine to the A1 and A2 receptors. Normally, adenosine binds to adenosine receptors and when there is sufficient amount of binding, it causes the “sleepiness” effect. This effect is due to adenosine’s ability to presynaptically inhibit the release of acetylcholine,​ norepinephrine,​ dopamine, gamma amino butyric acid, and serotonin. Furthermore,​ it is able to reduce the rate of spontaneous firing of different areas of the brain produces sedation, and has anticonvulsant activity. Since adenosine is being inhibited in the presence of caffeine, all it’s effects are being reversed. Caffeine is able to block the A2 receptor in the basal ganglia such as the corpus striatum and globus pallidus, through which it can induce stimulatory effects ​(Cappelletti,​ Daria, Sani, & Aromatario, 2015). These stimulatory effects induced by caffeine includes the release norepinephrine,​ dopamine, and serotonin in the brain.+Since the structures of caffeine and adenosine are similar, caffeine can also bind to adenosine receptor, and inhibit the binding of adenosine to the A1 and A2 receptors. Normally, adenosine binds to adenosine receptors and when there is sufficient amount of binding, it causes the “sleepiness” effect. This effect is due to adenosine’s ability to presynaptically inhibit the release of acetylcholine,​ norepinephrine,​ dopamine, gamma amino butyric acid, and serotonin. Furthermore,​ it is able to reduce the rate of spontaneous firing of different areas of the brain produces sedation, and has anticonvulsant activity. Since adenosine is being inhibited in the presence of caffeine, all it’s effects are being reversed. Caffeine is able to block the A2 receptor in the basal ganglia such as the corpus striatum and globus pallidus, through which it can induce stimulatory effects. These stimulatory effects induced by caffeine includes the release norepinephrine,​ dopamine, and serotonin in the brain. ​(Cappelletti,​ Daria, Sani, & Aromatario, 2015)
  
  
 ====== Frequent Users ====== ====== Frequent Users ======
  
 +<box 35% round right| >{{ :​coffee_consuming_countries_.png?​300 |}} </​box|Figure 4: The top ten coffee consuming countries in the world in litres per captia (Harris, 2016) > 
  
    
-<​box ​35% round right| >​{{:​canadian_coffee_stats.png?​300 |}} </​box|Figure 3: The amount of coffee individuals consumed in litres in Canada in the year 2015 (Harris, 2016)> ​+<​box ​30% round right| >​{{:​canadian_coffee_stats.png?​300 |}} </​box|Figure 3: The amount of coffee individuals consumed in litres in Canada in the year 2015 (Harris, 2016)> ​
    
- 
-In Canada, on average, individual’s drink approximately 152.1 litres of coffee per person annually (Harris, 2016). However, this does not include other beverages that has caffeine in it, such as tea, soda, and energy drinks. This makes Canada the third country in the world to drink the most coffee (Harris, 2016). ​ 
- 
-Other data to support this is that Canadians consume 180 mg of caffeine in coffee per day, significantly higher than all but two other countries (Harris, 2016). When considering caffeinated drinks altogether, 73.6% of Canadians aged 12-24 consume a beverage that has caffeine (including coffee, tea, soda, and energy drinks) and 16% of caffeine consumers report exceeding two or more caffeinated drinks per day (Heath, 2016). <box 35% round right| >{{ :​coffee_consuming_countries_.png?​300 |}} </​box|Figure 4: The top ten coffee consuming countries in the world in litres per captia (Harris, 2016) > Studies have shown that the coffee demand is growing and breaking historical records thanks to millennials of ages 19-34 (Heath, 2016). In the United States, millennials consume 44% of the coffee consumed (Heath, 2016). Those born after 1995 started drinking coffee at about 14.7 years of age, in contrast to those born in the 1980’s that started drinking coffee at 17.1 years of age (Heath, 2016). This could be due to the increase in trend to drink coffee, as it has become a cultural and social activity. ​ 
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 +In Canada, on average, individual’s drink approximately 152.1 litres of coffee per person annually. However, this does not include other beverages that has caffeine in it, such as tea, soda, and energy drinks. This makes Canada the third country in the world to drink the most coffee. (Harris, 2016)
  
 +Other data to support this is that Canadians consume 180 mg of caffeine in coffee per day, significantly higher than all but two other countries. When considering caffeinated drinks altogether, 73.6% of Canadians aged 12-24 consume a beverage that has caffeine (including coffee, tea, soda, and energy drinks) and 16% of caffeine consumers report exceeding two or more caffeinated drinks per day. 
  
  
 +Studies have shown that the coffee demand is growing and breaking historical records thanks to millennials of ages 19-34. In the United States, millennials consume 44% of the coffee consumed. Those born after 1995 started drinking coffee at about 14.7 years of age, in contrast to those born in the 1980’s that started drinking coffee at 17.1 years of age. This could be due to the increase in trend to drink coffee, as it has become a cultural and social activity. (Heath, 2016)
  
-. 
  
  
  
-. 
 ====== General Side Effects ====== ====== General Side Effects ======
  
-The concentration of caffeine in the blood peaks 30-60 minutes after it is consumed, and has a half life from two to ten hours (Weinberg, & Bealer, 2001). This means that in approximately twelve hours most of the caffeine is diminished from the body (Weinberg, & Bealer, 2001). During that time the caffeine has peaked in the body, medical studies have linked caffeine use to a spectrum of symptoms. Some of which include:+The concentration of caffeine in the blood peaks 30-60 minutes after it is consumed, and has a half life from two to ten hours. This means that in approximately twelve hours most of the caffeine is diminished from the body. During that time the caffeine has peaked in the body, medical studies have linked caffeine use to a spectrum of symptoms. Some of which include:
  
   * Aggravation   * Aggravation
   * Improving performance of simple tasks, athletic performance   * Improving performance of simple tasks, athletic performance
-  * Impairing short term memory 
   * Increasing concentration,​ insomnia, restlessness,​ alertness, attentiveness   * Increasing concentration,​ insomnia, restlessness,​ alertness, attentiveness
   * Suppressing appetite   * Suppressing appetite
- 
-(Weinberg, & Bealer, 2001) 
  
 Specifically,​ 1 gram of caffeine (equivalent to about six cups of coffee), can induce: Specifically,​ 1 gram of caffeine (equivalent to about six cups of coffee), can induce:
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-//Caffeine Consumption Post-study//+**Caffeine Consumption Post-study**
  
 <box 35% round right| > {{ :​studies_for_methology_.png?​300|}} </​box|Figure 5: A visual of the study methodology. Participants were asked to recall if a photo presented was one they saw previously, was just a similar photo, or a completely new photo. (Borota et al., 2014)> <box 35% round right| > {{ :​studies_for_methology_.png?​300|}} </​box|Figure 5: A visual of the study methodology. Participants were asked to recall if a photo presented was one they saw previously, was just a similar photo, or a completely new photo. (Borota et al., 2014)>
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-//Caffeine Consumption Pre-study//+**Caffeine Consumption Pre-study**
  
 In a second study, the effects of drinking caffeine before studying was explored. This study examined the effects of caffeine consumption on event-based and time-based prospective memory in 43 regular caffeine drinkers. Half of the participants were given 50 mg via an instant coffee drink, and the other half received decaffeinated coffee (which contains about 1.8 mg of caffeine) prior to the start of their task. Participants were entered into a virtual setting in which they had to complete tasks in order to get ready for a work meeting. This specific setting is to test two different types of memory; event-based and time-based prospective. Event-based prospective memory is the ability to remember to carry out a task when prompted by an event which appeared as you were carrying out another task. Time-based prospective memory is remembering to carry out a task at a specific time. It was found that those who consumed the caffeinated drink were more accurate in both their event-based and time-based prospective memory (87%, 80%) compared to those who consumed a decaffeinated drink (72%, 69%) (Soar, Chapman, Lavan, Jansari, & Turner, 2016). ​ In a second study, the effects of drinking caffeine before studying was explored. This study examined the effects of caffeine consumption on event-based and time-based prospective memory in 43 regular caffeine drinkers. Half of the participants were given 50 mg via an instant coffee drink, and the other half received decaffeinated coffee (which contains about 1.8 mg of caffeine) prior to the start of their task. Participants were entered into a virtual setting in which they had to complete tasks in order to get ready for a work meeting. This specific setting is to test two different types of memory; event-based and time-based prospective. Event-based prospective memory is the ability to remember to carry out a task when prompted by an event which appeared as you were carrying out another task. Time-based prospective memory is remembering to carry out a task at a specific time. It was found that those who consumed the caffeinated drink were more accurate in both their event-based and time-based prospective memory (87%, 80%) compared to those who consumed a decaffeinated drink (72%, 69%) (Soar, Chapman, Lavan, Jansari, & Turner, 2016). ​
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 ====== Negative Effects of Caffeine Consumption ====== ====== Negative Effects of Caffeine Consumption ======
  
-After having read about the effects of caffeine on the body, it has been noted that caffeine, (the only socially acceptable psychoactive drug (Whiteman, 2015), has negative effects on the body if consumed in higher doses (Whiteman, 2015). According to the Mayo Clinic, consuming about 500-600 mg of caffeine a day may lead to: +After having read about the effects of caffeine on the body, it has been noted that caffeine, (the only socially acceptable psychoactive drug), has negative effects on the body if consumed in higher doses (Whiteman, 2015). According to the Mayo Clinic ​(Mayo Clinic, 2017), consuming about 500-600 mg of caffeine a day may lead to: 
   * Insomnia   * Insomnia
   * Nervousness   * Nervousness
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   * Irritability   * Irritability
   * A faster heartbeat   * A faster heartbeat
-  * Muscle tremors ​(Mayo Clinic, 2017) +  * Muscle tremors ​
  
-The three negative effects ​that will be talked about are:+ 
 + 
 +There are three distinct ​negative effects ​(European Society of Cardiology, 2015):
  
   - Frequency of urination   - Frequency of urination
   - Causing changes in mood    - Causing changes in mood 
-  - Increased risk of cardiovascular events ​(European Society of Cardiology, 2015)+  - Increased risk of cardiovascular events ​
  
-//​Lohsiriwat,​ 2011 (Urgency and Frequency of Urination)//​ 
  
-A study looked at effects of caffeine on bladder function in patients with overactive bladder symptoms (Lohsiriwat,​ 2011). Specifically,​ they looked at the effect of caffeine at a dose of 4.5 mg/kg on bladder function in overactive bladder adults (Lohsiriwat,​ 2011). After ingestion of caffeine, at the dose mentioned, there was a decreased threshold of sensation at filling phase, meaning that you feel full earlier and the desire to urinate comes earlier, as well as an increase in flow rate of urine and voided volume (Lohsiriwat,​ 2011). Therefore, caffeine can promote early urgency and frequency of urination as proved in the study as well as nocturia symptoms (Lohsiriwat,​ 2011). Nocturia is defined as a person having the complaint that they need to wake up frequently in the middle of the night for things such as urination (MedicineNet.com,​ 2016). Frequent urination would cause dehydration really quickly and this would lead to increased water loss. 
  
-//Mayo Clinic2017//+<box 35% round left| >​{{:​bladder_function.jpg?​300|}} </box|Figure 6: This image shows the after water and caffeine ingestionsin mililitres, for the 12 subjects, sensation and volumes at the bladder filling phases. (FD=first desire to void, ND=normal desire to void, SD=strong desire to void, MCC=maximal cystometric capacity); * P≤0.05 on comparing the volumes after water and caffeine ingestions (Lohsiriwat,​ 2011).>
  
-It is found that caffeine dulls the nerves that transmit messages between the bladder ​and the brain (Mayo Clinic, 2017). With excess caffeine or a higher dosage, those nerves then are not able to recognize that the bladder has become full and results in an overflowing bladder and involuntary urine leakage (Mayo Clinic, 2017). Therefore, it is important for people to stay hydrated with water or anything that gives the body the electrolytes needed, not just caffeine.  +**Urgency ​and Frequency ​of Urination** - Lohsiriwat2011 
-Taking this at a more relatable level, people who consume caffeine on a higher dose are, evidently, students, the working class, people who are busy and need that quick dose of alertness to start their day or stay up the night to study for an exam. In this hustle, they tend to rely on caffeine, mostly likely coffee as seen in today’s culture, to get them through their day. Higher amounts of caffeine, frequent and urgent of urination, causing increased water loss and electrolytes. It is fortunate howeverthat caffeine does not cause a dehydrating effect even if it is a diuretic (Mayo Clinic 2017). ​+
  
-//Moawad, 2011 (Mood Changes)//+A study looked at effects of caffeine on bladder function in patients with overactive bladder symptoms. Specifically,​ they looked at the effect of caffeine at a dose of 4.5 mg/kg on bladder function in overactive bladder adults. After ingestion of caffeine, at the dose mentioned, there was a decreased threshold of sensation at filling phase, meaning that you feel full earlier and the desire to urinate comes earlier, as well as an increase in flow rate of urine and voided volume. Therefore, caffeine can promote early urgency and frequency of urination as proved in the study as well as nocturia symptoms (Lohsiriwat, 2011). Nocturia is defined as a person having the complaint that they need to wake up frequently in the middle of the night for things such as urination ​(MedicineNet,​ 2016). Frequent urination would cause dehydration really quickly and this would lead to increased water loss.
  
-People who consume caffeine, causes them to become irritable and anxious and in turn may affect their productivity ​(Moawad, 2017). The reason why this happens is due to the enhanced alertness that caffeine induces ​(Moawad, 2017). The enhanced alertness translates to enhanced focus on stimuli that does not need attention and may cause them to become irritated based on their tasks they need to get done and in turn, anxious towards not being able to get their tasks done (Moawad, 2017). This is varied in persons, people who are not regular in-takers of caffeine may feel enhanced of these effects of irritableness and anxiety (Moawad, 2017).+ 
 +**Urgency and Frequency of Urination** - Mayo Clinic, 2017 
 + 
 +It is found that caffeine dulls the nerves that transmit messages between the bladder and the brain. With excess caffeine or a higher dosage, those nerves then are not able to recognize that the bladder has become full and results in an overflowing bladder and involuntary urine leakage. Therefore, it is important for people to stay hydrated with water or anything that gives the body the electrolytes needed, not just caffeine.  
 +Taking this at a more relatable level, people who consume caffeine on a higher dose are, evidently, students, the working class, people who are busy and need that quick dose of alertness to start their day or stay up the night to study for an exam. In this hustle, they tend to rely on caffeine, mostly likely coffee as seen in today’s culture, to get them through their day. Higher amounts of caffeine, frequent and urgent of urination, causing increased water loss and electrolytes. It is fortunate however, that caffeine does not cause a dehydrating effect even if it is a diuretic. (Mayo Clinic, 2017) 
 + 
 +**Mood Changes** - Moawad, 2011  
 + 
 +People who consume caffeine, causes them to become irritable and anxious and in turn may affect their productivity. The reason why this happens is due to the enhanced alertness that caffeine induces. The enhanced alertness translates to enhanced focus on stimuli that does not need attention and may cause them to become irritated based on their tasks they need to get done and in turn, anxious towards not being able to get their tasks done. This is varied in persons, people who are not regular in-takers of caffeine may feel enhanced of these effects of irritableness and anxiety(Moawad, 2017)
  
 In another study, it was found that caffeine reduced fatigue (Loke, 1988), however it also led to increased tension and nervousness (Smith, 2002). Also, Lieberman, 1992, stated that, caffeine seems to increase anxiety when administered in single doses of 300 mg or higher. Of course this is a lot more than a typical caffeine-containing beverage, again increased intake of caffeine, increased effects of mood changes. In another study, it was found that caffeine reduced fatigue (Loke, 1988), however it also led to increased tension and nervousness (Smith, 2002). Also, Lieberman, 1992, stated that, caffeine seems to increase anxiety when administered in single doses of 300 mg or higher. Of course this is a lot more than a typical caffeine-containing beverage, again increased intake of caffeine, increased effects of mood changes.
  
-//Dr. Mos, 2015 (Risk of Cardiovascular Events)//+**Risk of Cardiovascular Events** - European Society of Cardiology, 2015 
  
-__Coffee ​Drinking and Hypertension__+//​Coffee ​Drinking and Hypertension//​
  
  
-In a 12 year study, done by a cardiologist in Italy, Dr. Lucio Mos, evaluated the effects of coffee drinking in more than 1, 200 patients ​(European Society of Cardiology, 2015). He wanted to see if coffee drinking had an effect on the risk of cardiovascular events and if the link was mediated by effects on blood pressure and glucose metabolism ​(European Society of Cardiology, 2015). The summary of the results were that heavy coffee drinkers, meaning they have 4 cups or more of coffee, had a four-fold increased risk of mild hypertension,​ and moderate coffee drinkers, having 1-3 cups of coffee a day, tripled their risk (European Society of Cardiology, 2015)+In a 12 year study, done by a cardiologist in Italy, Dr. Lucio Mos, evaluated the effects of coffee drinking in more than 1, 200 patients. He wanted to see if coffee drinking had an effect on the risk of cardiovascular events and if the link was mediated by effects on blood pressure and glucose metabolism. The summary of the results were that heavy coffee drinkers, meaning they have 4 cups or more of coffee, had a four-fold increased risk of mild hypertension,​ and moderate coffee drinkers, having 1-3 cups of coffee a day, tripled their risk(European Society of Cardiology, 2015)
  
-__How the Research was Conducted__+//How the Research was Conducted//
  
-The participants that were included in the study were from ages 18-45, non-diabetic patients from a prospective study who were untreated of stage 1 hypertension,​ meaning they had systolic pressure of 140-159 mmHg and diastolic pressure of 90 and 99 mmHg (European Society of Cardiology, 2015). The way the patients were categorized was based on coffee consumption,​ by the number of caffeine-containing cups per day: so there were non-drinkers,​ which had no caffeine-containing cups, moderate drinkers who had 1-3 cups of caffeine-containing cups per day, and heavy drinkers who had 4 or more cups of caffeine-containing cups per day (European Society of Cardiology, 2015). So out of the participants then, 26.3% of them were abstainers, never had coffee, thus no caffeine-containing cups, 62.7% were moderate coffee drinkers and 10% were heavy coffee drinkers ​(European Society of Cardiology, 2015). The coffee drinkers, they noted, were older of the 18-45 age group and had a higher body mass index than the ones who did not drink coffee ​(European Society of Cardiology, 2015). From this study, Dr. Mos found that there was a linear relationship between the consumption of coffee, caffeine-containing,​ and risk of hypertension,​ needing treatment ​(European Society of Cardiology, 2015). This relationship actually had statistical significance for the heavy drinkers of coffee of this study (European Society of Cardiology). The study also found a linear relationship between long term coffee drinking and risk of developing prediabetes,​ with a 100% increased risk of prediabetes in the participants who were heavy coffee drinkers ​(European Society of Cardiology, 2015). This however, was true for individuals with slow caffeine metabolizers,​ and this was according to the CYP1A2 genotype, that decides if the individuals can metabolize caffeine faster or slower (European Society of Cardiology)+The participants that were included in the study were from ages 18-45, non-diabetic patients from a prospective study who were untreated of stage 1 hypertension,​ meaning they had systolic pressure of 140-159 mmHg and diastolic pressure of 90 and 99 mmHg. The way the patients were categorized was based on coffee consumption,​ by the number of caffeine-containing cups per day: so there were non-drinkers,​ which had no caffeine-containing cups, moderate drinkers who had 1-3 cups of caffeine-containing cups per day, and heavy drinkers who had 4 or more cups of caffeine-containing cups per day. So out of the participants then, 26.3% of them were abstainers, never had coffee, thus no caffeine-containing cups, 62.7% were moderate coffee drinkers and 10% were heavy coffee drinkers. The coffee drinkers, they noted, were older of the 18-45 age group and had a higher body mass index than the ones who did not drink coffee. From this study, Dr. Mos found that there was a linear relationship between the consumption of coffee, caffeine-containing,​ and risk of hypertension,​ needing treatment. This relationship actually had statistical significance for the heavy drinkers of coffee of this study. The study also found a linear relationship between long term coffee drinking and risk of developing prediabetes,​ with a 100% increased risk of prediabetes in the participants who were heavy coffee drinkers. This however, was true for individuals with slow caffeine metabolizers,​ and this was according to the CYP1A2 genotype, that decides if the individuals can metabolize caffeine faster or slower(European Society of Cardiology)
  
-<box 30% round right| > {{ :​study-_graph_image.jpg?​300|}} </​box|Figure ​6: A This image shows the risk of hypertension development according to level of coffee drinking (Mos, 2015).>+<box 30% round right| > {{ :​study-_graph_image.jpg?​300|}} </​box|Figure ​7: A This image shows the risk of hypertension development according to level of coffee drinking (European Society of Cardiology, 2015).>
  
  
-Dr. Mos concluded from the study that drinking coffee, a caffeine-containing drink, increases the risk of prediabetes in young adults who are slow caffeine metabolizers ​(European Society of Cardiology, 2015)+Dr. Mos concluded from the study that drinking coffee, a caffeine-containing drink, increases the risk of prediabetes in young adults who are slow caffeine metabolizers.
  
-He also said, “Slow caffeine metabolizers have longer exposure to the detrimental effects of caffeine on glucose metabolism and that the risk is even greater if they are overweight or obese and if they are heavy coffee drinkers ​(European Society of Cardiology, 2015). Thus the effect of coffee on prediabetes depends on the amount of daily coffee intake and genetic background ​(European Society of Cardiology, 2015).” +He also said, “Slow caffeine metabolizers have longer exposure to the detrimental effects of caffeine on glucose metabolism and that the risk is even greater if they are overweight or obese and if they are heavy coffee drinkers. Thus the effect of coffee on prediabetes depends on the amount of daily coffee intake and genetic background." ​
  
-Furthermore,​ in this 12 and a half year study, there were 60 cardiovascular events that occured ​(European Society of Cardiology, 2015). About 80% of these events were heart attacks and the remaining events were things such as strokes, peripheral artery disease and kidney failure ​(European Society of Cardiology, 2015)+Furthermore,​ in this 12 and a half year study, there were 60 cardiovascular events that occured. About 80% of these events were heart attacks and the remaining events were things such as strokes, peripheral artery disease and kidney failure. ​
  
-Therefore, the conclusions that were made by Dr. Mos, “Our study shows that coffee use is linearly associated with increased risk of cardiovascular events in young adults with mild hypertension. This relationship seems to be at least partially mediated by the long term effect on blood pressure and glucose metabolism. These patients should be aware that coffee consumption may increase their risk of developing more severe hypertension and diabetes in later life and should keep consumption to a minimum (European Society of Cardiology, 2015).”+Therefore, the conclusions that were made by Dr. Mos, “Our study shows that coffee use is linearly associated with increased risk of cardiovascular events in young adults with mild hypertension. This relationship seems to be at least partially mediated by the long term effect on blood pressure and glucose metabolism. These patients should be aware that coffee consumption may increase their risk of developing more severe hypertension and diabetes in later life and should keep consumption to a minimum." ​(European Society of Cardiology, 2015)
  
  
 ====== Amount of Caffeine Present in Typical Drinks ====== ====== Amount of Caffeine Present in Typical Drinks ======
  
-<​box ​50% round left| > {{:​amount_of_caffeine_per_cup.png?​500 |}} </​box|Figure ​7: This image demonstrates how much caffeine is contained in typical drinks a consumer uses (Gromadzki, 2016).>+The usual drinks that everyone consumes nowadays may or may not have caffeine in them. For instance, Hot chocolate could have up to 19 milligrams of caffeine per cup, Green tea has 20 milligrams of caffeine per cup, a shot of espresso has 27 milligrams of caffeine per container, and a can of cola has up to 40 milligrams of caffeine. Coca-cola and Pepsi beverages, in general, contain a high amount of sugar and caffeine, and most individuals are not aware of that. Since cola beverages have higher doses of caffeine in them, this could lead to heart arrhythmia due to caffeine toxicity, or caffeine overdose. Coffee has the highest amount of caffeine, almost up to 95 milligrams of caffeine per cup and just like cola beverages coffee overdose has severe side effects (Gromadzki, 2016). ​   
 + 
 +<​box ​45% round left| > {{:​amount_of_caffeine_per_cup.png?​500 |}} </​box|Figure ​8: This image demonstrates how much caffeine is contained in typical drinks a consumer uses (Gromadzki, 2016).>
  
  
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 ====== Caffeinated Spider ====== ====== Caffeinated Spider ======
 +The effects of caffeine are universal, meaning every creature who over-consume caffeine will be targeted to specific side effects. In this figure, These are spider webs made by spiders on drugs and toxins. The spider that has no chemical within its body; it is a normal spider, and the normal spider was able to create an intricate web. However, the spider on caffeine was not able to make an intricate design like an ordinary spider, fewer threads are joined, and the web was randomly created. The spider on chloral hydrate, which is used as either a sedative or a hypnotic pharmaceutical drug also has an irregular wed design. Therefore Caffeine could produce side effects if used severely just like any synthesized drug (Gromadzki, 2016). ​
  
-<​box ​40% round middle| > {{:​caffeinatedspider.jpg?​400 |}} </​box|Figure ​8: This image shows how certain drugs and toxins may affect the ability of a spider to build a spiderweb. Particularly,​ on caffeine, the spider is unable to make an intricate design of a web, fewer threads together and randomly done (Gromadzki, 2016).>+<​box ​35% round middle| > {{:​caffeinatedspider.jpg?​400 |}} </​box|Figure ​9: This image shows how certain drugs and toxins may affect the ability of a spider to build a spiderweb. Particularly,​ on caffeine, the spider is unable to make an intricate design of a web, fewer threads together and randomly done (Gromadzki, 2016).>
  
 ====== History of Famous Coffee Chains ====== ====== History of Famous Coffee Chains ======
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 Coffee is considered to be an essential element in our daily lives because coffee has the highest Caffeine concentration of 95 mg per cup as mentioned in the previous information. Coffee is indeed has become a tradition in almost every society in every country on this planet due to its heavy consumption by people. There are twelve famous coffee chains; these chains are distributed in nearly every country. These chains are Gloria Jean's Coffee, Caribou Coffee, Coffee Beanery, Dunkin'​s’ Donuts, Starbucks coffee, McCafe, Costa Coffee, Tully’s Coffee, Peet's Tea and Coffee, Lavazza Coffee, Bewley’s Coffee and Tim Hortons (Top 12 Largest Coffee, 2010). In Canada in Particular, the three most famous chains are:  Coffee is considered to be an essential element in our daily lives because coffee has the highest Caffeine concentration of 95 mg per cup as mentioned in the previous information. Coffee is indeed has become a tradition in almost every society in every country on this planet due to its heavy consumption by people. There are twelve famous coffee chains; these chains are distributed in nearly every country. These chains are Gloria Jean's Coffee, Caribou Coffee, Coffee Beanery, Dunkin'​s’ Donuts, Starbucks coffee, McCafe, Costa Coffee, Tully’s Coffee, Peet's Tea and Coffee, Lavazza Coffee, Bewley’s Coffee and Tim Hortons (Top 12 Largest Coffee, 2010). In Canada in Particular, the three most famous chains are: 
  
-//Tim Hortons//+**Tim Hortons**
  
 It's Known to be Canada’s favorite coffee. It’s a Canadian chain, and it was founded in 1964 by Miles Gilbert “Tim Hortons” which he was a famous hockey player in Canada. It’s the largest quick service restaurant in Canada. There are 4000 stores all around the globe with revenue of 3.225 Billion US Dollar annually with over 100’000 employees (Top 12 Largest Coffee, 2010). There are 3802 stores in Canada alone and its expanding every year. It's Known to be Canada’s favorite coffee. It’s a Canadian chain, and it was founded in 1964 by Miles Gilbert “Tim Hortons” which he was a famous hockey player in Canada. It’s the largest quick service restaurant in Canada. There are 4000 stores all around the globe with revenue of 3.225 Billion US Dollar annually with over 100’000 employees (Top 12 Largest Coffee, 2010). There are 3802 stores in Canada alone and its expanding every year.
  
-//Starbucks//+**Starbucks**
  
 It was founded in 1971 by Three people named: Jerry Baldwin, Zev Siegel, and Gordon Bowker in the United States of America. There are approximately 21,000 shops all over the world with a revenue of over 16 billion US Dollar (Top 12 Largest Coffee, 2010). In Canada alone, there approximately 1200 shops and this number is rising every year. The first shop was opened for the first time in Vancouver in 1987 at Seabus Skytrain Station (Our Canadian story, 2018) It was founded in 1971 by Three people named: Jerry Baldwin, Zev Siegel, and Gordon Bowker in the United States of America. There are approximately 21,000 shops all over the world with a revenue of over 16 billion US Dollar (Top 12 Largest Coffee, 2010). In Canada alone, there approximately 1200 shops and this number is rising every year. The first shop was opened for the first time in Vancouver in 1987 at Seabus Skytrain Station (Our Canadian story, 2018)
  
-//McCafe//+**McCafe**
  
 This Coffee chain is partially part of the McDonald’s chain which is one of the largest fast-food chains in the world. Their coffee chain was founded in 1993 by Dick and Mac McDonald in the United States of America. However, the coffee chain was officially in stores in 2002; there are around 300 stores worldwide with estimated revenue of 1.86 Billion US Dollar mostly is found in USA and Canada (Top 12 Largest Coffee, 2010). The first store in Canada was launched in 2011 (Our History, 2018) This Coffee chain is partially part of the McDonald’s chain which is one of the largest fast-food chains in the world. Their coffee chain was founded in 1993 by Dick and Mac McDonald in the United States of America. However, the coffee chain was officially in stores in 2002; there are around 300 stores worldwide with estimated revenue of 1.86 Billion US Dollar mostly is found in USA and Canada (Top 12 Largest Coffee, 2010). The first store in Canada was launched in 2011 (Our History, 2018)
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   - European Society of Cardiology. (2015). Coffee linked with increased cardiovascular risk in young adults with mild hypertension. ScienceDaily. Retrieved from www.sciencedaily.com/​releases/​2015/​08/​150829123701.htm   - European Society of Cardiology. (2015). Coffee linked with increased cardiovascular risk in young adults with mild hypertension. ScienceDaily. Retrieved from www.sciencedaily.com/​releases/​2015/​08/​150829123701.htm
   - Glade, M.J. (2010). Caffeine-Not just a stimulant. Nutrition, 26(10), 932-938.   - Glade, M.J. (2010). Caffeine-Not just a stimulant. Nutrition, 26(10), 932-938.
 +  - Gromadzki, S. (2016). Caffeine Addiction. Full Health Secrets. Retrieved from http://​www.fullhealthsecrets.com/​diseases/​caffeine-addiction/​.
   - Greden et al. Anxiety and Depression Associated with Caffeinism Among Psychiatric Inpatients. American Journal of Psychiatry, 133:8, Aug 1978.   - Greden et al. Anxiety and Depression Associated with Caffeinism Among Psychiatric Inpatients. American Journal of Psychiatry, 133:8, Aug 1978.
   - Greden, J. F., Fontaine, P., Lubetsky, M., & Chamberlin, K. (1978). Anxiety and depression associated with caffeinism among psychiatric inpatients. The American journal of psychiatry, 135(8):​963-6.   - Greden, J. F., Fontaine, P., Lubetsky, M., & Chamberlin, K. (1978). Anxiety and depression associated with caffeinism among psychiatric inpatients. The American journal of psychiatry, 135(8):​963-6.
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   - Jahanfar, S., & Jaafar, S. H. (2013). Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcome. Cochrane Database Syst Rev, 2.   - Jahanfar, S., & Jaafar, S. H. (2013). Effects of restricted caffeine intake by mother on fetal, neonatal and pregnancy outcome. Cochrane Database Syst Rev, 2.
   - Perera, V., Gross, A. S., & McLachlan, A. J. (2010). Caffeine and paraxanthine HPLC assay for CYP1A2 phenotype assessment using saliva and plasma. Biomedical Chromatography,​ 24(10), 1136-1144.   - Perera, V., Gross, A. S., & McLachlan, A. J. (2010). Caffeine and paraxanthine HPLC assay for CYP1A2 phenotype assessment using saliva and plasma. Biomedical Chromatography,​ 24(10), 1136-1144.
 +  - Wikipedia contributors. (2018, March 2). Caffeine. In Wikipedia, The Free Encyclopedia. Retrieved 00:34, March 3, 2018, from https://​en.wikipedia.org/​w/​index.php?​title=Caffeine&​oldid=828418797
   - Winstead, D. K. (1976). Coffee consumption among psychiatric inpatients. The American Journal of Psychiatry, 133(12), 1447-1450.   - Winstead, D. K. (1976). Coffee consumption among psychiatric inpatients. The American Journal of Psychiatry, 133(12), 1447-1450.
   - Zeratsky K. (2017). The Myth about Caffeine and Dehydration. Mayo Clinic. Retrieved from www.mayoclinic.org/​healthy-lifestyle/​nutrition-and-healthy-eating/​expert-answers/​caffeinated-drinks/​faq-20057965   - Zeratsky K. (2017). The Myth about Caffeine and Dehydration. Mayo Clinic. Retrieved from www.mayoclinic.org/​healthy-lifestyle/​nutrition-and-healthy-eating/​expert-answers/​caffeinated-drinks/​faq-20057965
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