الفهرس 
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Abstract
Throughout the centuries humans have searched for stimulants in their food and beverages, they discovered caffeine and now it’s the most commonly used mood-altering drug in the world. Therefore the consumption of caffeine has increased in many countries worldwideand in Egypt in the past years. In 1978, Food and Drug Administration (FDA) has described caffeine as Generally Recognized As Safe (GRAS). In 2015 The European Food Safety authority (EFSA) published their scientific opinion on caffeine safety, suggesting that caffeine intake of 3 mg/kg body weight per day (200 mg) is safe for adults.
Caffeine induces positive effects in both cognitive and affective domains, when its consumed in moderation, it enhances alertness, reduces fatigue, improves performance in simple tasks requiring vigilance and sustained response, elevates mood, reduces depressive symptoms, among other effects. It also stimulates thermogenesis and fat oxidation. Caffeine also has adverse physical effects such as sleep deprivation, increased heart rate and blood pressure, central nervous systems disorders, vasodilation, trembling, seizures, and headaches. Therefore it was important to conduct this study.
Caffeine consumers can experience symptoms of withdrawal when daily consumption of caffeine is terminated. Common caffeine withdrawal symptoms include headache, fatigue, irritability, sleepiness/drowsiness, increased work difficulty, lack of concentration/decreased alertness, decreased energy and activeness, decreased feelings of well-being/contentment, decreased sociability/friendliness/talkativeness, flu-like symptoms, and blurred vision. Caffeine intoxication include recent consumption of caffeine, usually in excess of 250 mg (e.g. more than 2-3 cups of coffee) and “five (or more) of the following signs, developing during, or shortly after, caffeine use: restlessness, nervousness, excitement, insomnia, flushed face, diuresis, gastrointestinal disturbance, muscle twitching, rambling flow of thought and speech, tachycardia or cardiac arrhythmia, periods of inexhaustibility, and psychomotor agitation
This study was conducted on 400 female and male students in different faculties of Alexandria University to estimate the proportion of consumption of caffeine among them. Data was collected using a pre-designed questionnaire to assess the: socio-demographic characteristics, medical history and dietary habits and lifestyle.The purpose of the study was to assess their daily caffeine intake, to detect the presence of withdrawal symptoms and intoxication symptoms and to investigate the relationship between their intake and different anthropometric measures, blood pressure, and withdrawal and intoxication symptoms. Anthropometric assessment were carried out for each subject to measure the height and weight, body mass index was calculated, waist and hip circumferences. Blood pressure was measured too.
The results of the study can be summarized as follows:
• The consumption of caffeine containing drinks among Alexandria University students was very high among males and females.
• The most commonly consumed caffeine containing drinks were carbonated beverages, followed by coffee drinks, and red tea.
• The majority of the students consumed caffeine daily in amounts that exceeded the safe level set by the FDA.
• Caffeine withdrawal was reported by nearly quarter of the students, while any symptom in general was experienced by nearly half of the sample. The most commonly encountered symptom was headache followed by sleepiness followed by depressed mood.
• The presence of caffeine intoxication was very rare. The most commonly encountered symptom was insomnia, followed by nervousness followed by frequent urination.
• No significant relationship between the caffeine intake and the anthropometric measures in general:
• Safe level consumers were more in the normal weight range and overweight than unsafe level consumers. Whereas they were less in the underweight and obese categories, hence no relationship was established between the consumption level and the body weight (represented as body mass index).
• Safe level consumers were more in the normal waist circumference range than unsafe level consumers, whereas they were less in the waist-hip ratio normal range.
• There was an association between the level of caffeine consumption and blood pressure:
• Among users who were consuming within the safe level they were more in the normal blood pressure range and more in hypotensive range, whereas the unsafe level consumers were more in the pre-hypertensive and the hypertensive ranges, thus the caffeine intake has affected the blood pressure of the studied sample.
• Students with withdrawal symptoms were less likely to be safe consumers compared to students without withdrawal symptoms, because the more caffeine is consumed the more dependent is the consumer the more symptoms they encounter on abstaining from it.
• Unexpectedly intoxication symptoms were encountered more in safe level consumers, while there was no intoxication symptom at all in the unsafe level consumers, that’s explained by their tolerance to the substance.
Based on this study, we would recommend the following:
• Use Caffeine in moderation.
• Adopting healthy eating habits and life style which can help in reducing overweight and obesity:
1. Perform regular and adequate daily physical activity to maintain healthy body weight.
2. Do not skip meals especially breakfast.
• Nutrition education programs are suggested to increase awareness of the amount of caffeine consumed of Alexandria University students especially females about the impact of high consumption of caffeine containing food and beverages on their health, in order to avoid adverse physiological symptoms.
• Large epidemiological studies must be done to investigate caffeine consumption pattern among different age groups especially in Arab countries.
• Further follow up researches are needed to emphasize more strongly on proven side effects of long term caffeine usage.
• Encourage theAlexandria University students to reduce the intake of caffeine containing drinks, and have healthier snacks.