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Epidemiological Evidence Linking Tea Consumption to Human Health: A Review

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Epidemiological Evidence Linking Tea Consumption to

Human Health: A Review
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Quan V. Vuong
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School of Environmental and Life Sciences, University of Newcastle , Ourimbah , New
South Wales , Australia
Accepted author version posted online: 19 Oct 2012.Published online: 15 Nov 2013.

To cite this article: Quan V. Vuong (2014) Epidemiological Evidence Linking Tea Consumption to Human Health: A Review,
Critical Reviews in Food Science and Nutrition, 54:4, 523-536, DOI: 10.1080/10408398.2011.594184

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 Critical Reviews in Food Science and Nutrition, 54:523–536 (2014)
Copyright C Taylor and Francis Group, LLC
ISSN: 1040-8398 / 1549-7852 online
DOI: 10.1080/10408398.2011.594184

Epidemiological Evidence Linking Tea

Consumption to Human Health:
A Review

QUAN V. VUONG
School of Environmental and Life Sciences, University of Newcastle, Ourimbah, New South Wales, Australia
Downloaded by [University of Newcastle (Australia)] at 21:34 06 March 2014

Tea has been widely consumed around the world for thousands of years and drinking tea is a daily habit for people of all
ages. Tea is a major source of flavanoids, which have become well known as antioxidants. Tea also contains caffeine and
theanine, which have been found to associate with health benefits. Many animal and epidemiological studies have been
conducted to investigate the link between tea consumption and human health. However, common questions that arise about
tea consumption include: whether all teas are the same, why drinking tea is linked with health benefits, how do the different
ways of tea preparation impact on availability of tea components, how much and how long a person should consume tea to
obtain health benefits, and whether there is any negative health effect associated with drinking tea. To answer these questions,
this paper outlines the tea components and their link to human health, discusses major factors affecting availability of tea
components in a tea cup, and reviews the latest epidemiological evidence linking tea consumption to human health.

Keywords Antioxidant, caffeine, flavanoids, human health, tea consumption, theanine

INTRODUCTION theanine, flavonoids, and other substances. Flavonoids are the

most abundant components in the tea leaf, they are comprised
Tea (Camellia sinensis) was first discovered as a drink and of six catechins and their derivatives (Chu and Juneja, 1997).
medicine in China around 2737 B.C. Since then tea has been in- Carbohydrates and protein also account for a large amount of tea
troduced to other countries and is now consumed in every coun- components; however, these components are almost insoluble;
try. Tea has become the second beverage to water in terms of whereas, other components are present in small quantities such
worldwide consumption (Gööck, 1990; Scharbert et al., 2004). as caffeine, theanine, volatiles but they are mostly soluble (Chu
Presently, tea has been cultivated in six continents (Scharbert and Juneja, 1997). The composition of fresh tea leaf varies with
et al., 2004; Vuong et al., 2011b). World tea production in the variety, climate conditions, season, position of leaf, soil,
2006 reached a record of 3.64 million tonnes, of which China, cultivation methods, and age of leaf (Graham, 1992; Balentine
India, and Kenya were the top three biggest producing coun- et al., 1998).
tries (Vuong et al., 2011c). The world tea production has been The sensory quality comprising of taste, color and flavor
continuously increasing; of which black tea production has been is important parameter of tea beverage and is contributed by
projected to grow at 1.9% annually to reach 3.14 million tons by flavonoids, caffeine, theanine, and aromatic volatile components
2017, whereas, the green tea production has been projected to (Ninomiya et al., 1997). Among these components, catechins
grow at annual rate of 3.8% annually to achieve about 1.57 mil- and caffeine contribute the astringency and bitterness, whereas
lion tons for the same period (Vuong et al., 2011c). theaflavins (TF) and thearubigins (TR) contribute color and the
Tea can be prepared by either brewing fresh or dried tea astringent taste (Graham, 1992). Theanine is responsible for
leaves in hot water. Brewing dried tea leaves is the most popular the brothy, sweet, and umami taste (savory taste) of the tea
method to date to prepare a cup of tea (Gööck, 1990; Scharbert beverage (Wan et al., 2009b). Aromatic volatile components
et al., 2004). Dried tea is produced from the fresh tea leaf, which also supplement flavor to the tea infusion (Kato and Shibamoto,
contains chlorophyll, carbohydrates, enzymes, protein, caffeine, 2009).
Numerous studies have investigated the roles of tea con-
stituents in human health and found that the major tea con-
Address correspondence to Quan V. Vuong, School of Environmental and
Life Sciences, University of Newcastle, PO Box 127, Ourimbah, NSW 2258, stituents including flavonoids, caffeine, and theanine are linked
Australia. E-mail: [email protected]; [email protected] to the health benefits such as prevention of cancers and
523
 524 QUAN V. VUONG

cardiovascular diseases, reduction the risks of obesity and di- 2010). Catechins can be classified into two groups including
abetes, and improvement of immune system (Graham, 1992; epistructured catechins and nonepistructured catechins. Epistr-
Khan and Mukhtar, 2007; Basu et al., 2010). Several epidemiol- cutured catechins are major catechins in tea and they comprise
ogy studies have reported the association between tea consump- of Epigallocatechin gallate (EGC), epigallocatechin (EGC), epi-
tion and health benefits (Wu et al., 2003; Zaveri, 2006; Zhang catechin gallate, and epicatechin (EC); whereas, nonepistruc-
et al., 2007). However, the volume of tea required for obtaining tured catechins only account for small composition in tea includ-
health benefits is an area of speculation. This paper outlines the ing gallocatechin gallate (GCG), gallocatechin (GC), catechin
roles of tea constituents in human health, discusses various types gallate (CG), and catechin (C) (Vuong et al., 2010).
of tea and the ways of tea preparation, which generally affect the Catechins are rich in green tea and they not only contribute
availability of the tea constituents, and then reviews the recent to the beverage quality but also promote health benefits to the
epidemiological evidences on the link of tea consumption and consumers. In tea beverage, catechins possess the bitter, astrin-
the health benefits. gent, and slight sweet tastes (Balentine et al., 1998). In the body,
catechins act as antioxidants because they can donate hydrogen
atoms, trap peroxyl radicals, and thus suppress radical chain
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reactions and terminate lipid peroxidation (Terao et al., 1994).

TEA CONSTITUENTS AND THEIR LINK
Their scavenging ability is thought to be more powerful than
TO HUMAN HEALTH
vitamin C, vitamin E, or β-carotene (Vuong et al., 2010). In
addition, catechins have been found to chelate transition metal
Flavanoids
ions, modulate oxidant, and antioxidant enzymes, and affect
gene expression (Vuong et al., 2010). However, catechins are
Flavanoids are the most abundant components in tea and unstable and are sensitive to oxidation by enzymes, moisture
comprise of catechins, TFs, TRs, keamfaron, and quercertin. content, acid, and heat (Balentine et al., 1998; Vuong et al.,
Keamfaron and quercertin only account for a small amount; 2010). In the presence of the enzymes polyphenol oxidase, and
whereas, catechins, TFs, and TRs present in a large quantity in peroxidase, catechins are easily oxidized to form TFs and TRs,
tea (Balentine et al., 1998). Flavanoids have been found to inhibit the reason why the content of catechins is lower in black tea
carcinogenesis in humans (Lin, 2009) and the mechanisms are as compared to green tea or oolong tea (Graham, 1992). Cat-
shown in Figure 1. echins are readily degraded when storing dried tea with high
moisture content (more than 10%) (Robertson, 1993), brewing
tea in alkaline conditions or at high temperature (above 80◦ C)
Catechins
(Vuong et al., 2010). Therefore, care is needed during storage
The catechins have the general structure of C6–C3–C6 with and preparation process of tea to minimize degradation of the
two aromatic rings and several hydroxyl groups (Vuong et al., tea catechins.

Cytochrome P450 (cyp3A, etc) Excretion,

Inactive metabolites tumor
suppression

Stimulation

Conjugation
Pro-carcinogen Tea Stimulation with GSH,
flavanoids glucuronic acid
substrate, etc

Inhibition

Active metabolites
Cytochrome P450 (cyp1-A1, etc)

Tumor
DNA
DNA adduct initiation

Figure 1 Biochemical mechanisms of anticarcinogenesis by tea flavanoids (Lin, 2009).

 LINKING TEA CONSUMPTION AND HUMAN HEALTH 525

Catechins have been linked with cancer prevention. Cate-

chins were found to delay the onset of skin tumor genesis, reduce
the cumulative number of skin tumors and increase the tumor-
free survival of rats (Roy et al., 2009). Catechins were also found
to prevent nitrosamine 4-(methylnitrosamino)-l-(3-pyridyl)-l
butanone-induced lung tumorigenesis and inhibit fumonisin B1
promotion in rat liver utilizing diethylnitrosamine as the cancer
initiator (Xu et al., 1992; Marnewick et al., 2009). Further-
more, catechins were reported to inhibit cyclin-dependent ki-
nases (cdks) and induce cdk inhibitors p21 and p27 in breast and
prostate cancer cells (Gupta et al., 2003; Park and Dong, 2003). Figure 2 Chemical structure of TFs and TRs. R = Galloyl Group (Zijp et al.,
Catechins have been found to lower the level of cholesterol 2000).
and prevent platelet clumping, increase oxidative stress and dys-
function of the endothelium, all of which are related to the devel- to the color and taste of the black tea beverage (Halder et al.,
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opment of coronary artery disease (Sharangi, 2009). Catechins 2006) and their levels have been found to correlate with black
have been associated with reduction of body weight, blood lev- tea quality (Balentine et al., 1998). It is questioned that whether
els of testosterone, insulin, insulin-like growth factor I, glucose, there is any difference in the antioxidative properties between
cholesterol, and triglyceride (Kao et al., 2000). Catechins were TFs and TRs in comparison with catechins. Studies showed that
also found to prevent diet-induce obesity by decreasing energy TFs and TRs in black tea have the same antioxidative proper-
absorption and increasing fat oxidation (Klaus et al., 2005). In ties in comparison with catechins in green tea (Yoshino et al.,
addition, catechins may play a role in preventing microbial dis- 1994; Leung et al., 2001). Several studies have linked TFs and
eases, Parkinson’s diseases, Alzheimer’s diseases, and stroke TRs with health benefits. For example, both TFs and TRs were
(Zaveri, 2006; Khan and Mukhtar, 2007). reported to inhibit lipid peroxidation in vivo (Yoshino et al.,
Catechins have shown synergism with vitamin E, vitamin 1994). In addition, TFs and TRs were found to have significant
C, and some organic acids such as citric, malic, and tartaric anticlastogenic effects in human lymphocytes. However, TFs
(Graham, 1992; Hara, 2001); and also have potential in pro- were found to have more protective effects than TRs (Halder
tecting the deterioration of β-carotene, a vitamin A precursor et al., 2006).
(Hara, 2001). However, catechins can easily form a complex
with other components to reduce their availability. For example,
catechins can interact with caffeine to form precipitate through Caffeine
π –π interaction and lower their availability (Ishizu et al., 2009).
The amount of precipitation is critical to catechin availability There are three methyl xanthines including caffeine, theo-
and varies with extracting temperatures, precipitate is high when phylline, and theobromine in tea. However, theophylline and
tea is brewed at temperature of over 90◦ C and low when tea is theobromine are only found in small quantities (0.2–0.4% and
brewed at temperature of 50◦ C (Liang et al., 2002). 0.02% (w/w), respectively) (Chu and Juneja, 1997). Caffeine
Catechins can also interact with proteins (Vuong et al., 2010), accounts for a large quantity with its maximum level of about
and may inhibit the absorption of food proteins into the body. 5% (w/w) (Chu and Juneja, 1997). It is interesting to note
In addition, catechins can interact with enzymes such as lipoxy- that the level of caffeine in tea is higher than that of coffee
genase, α-amylase, pepsin, trypsin, and lipase and in doing so beans, which actually have only 1.5% (w/w) of caffeine (Chu
may inhibit their activities in the body (Sekiya et al., 1984). and Juneja, 1997). Caffeine is a trimethyl derivative of purine
Catechins also interfere with the emulsification, digestion, and 2,6-diol and its level in tea is also influenced by several fac-
micellar solubilization of lipids (Koo and Noh, 2006). In ad- tors such as season, age of the leaf, variety, and processing
dition, catechins can bind and form a complex with iron, thus methods (Balentine et al., 1998). Caffeine is responsible for the
tend to prevent iron absorption in the body (Zijp et al., 2000). briskness of the black tea beverage because it associates with
Despite these limitations catechins have shown important an- TFs to give the characteristic black tea flavor (Balentine et al.,
tioxidant properties. 1998).
After ingestion in the body, caffeine undergoes demethy-
lation to form paraxanthine, theobromine, and theophylline
Theaflavins and Thearubigins
(Figure 3), which are then broken down in the liver by addi-
Unlike catechins structured as monomers, TFs and TRs are tional demethylations and oxidation to urates (Safranow and
structured of dimers and polymers, respectively (Zijp et al., Machoy, 2005; Heckman et al., 2010). Caffeine has been found
2000; Halder et al., 2006) (Figure 2). TFs and TRs are rich in to link with enhancement of cognitive functioning, improve-
black tea (Vuong et al., 2010). Typically, black tea contains 10% ment of neuromuscular coordination, and elevation of mood
flavonols, 25% catechins, 30% TFs, and 45% TRs (Zijp et al., and relieves anxiety (Glade, 2010). Caffeine was found to asso-
2000). TFs and TRs are astringent compounds which contribute ciate with stimulation of the central nervous system and cardiac
 526 QUAN V. VUONG
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Figure 3 Metabolism of caffeine in humans (Safranow and Machoy, 2005). CYP 450, cytochrome P450; XO, xanthine oxidoreductase; NAT 2, N-acetyltransferase
2; MX, DMX, and TMX, mono-, di-, and trimethylxanthines; MUA, DMU, and TMU, mono-, di-, and trimethyluric acids; AFMU, 5-acetylamino-6-formylamino-
3-methyluracil.

muscle. Caffeine was also found to elevate plasma free fatty Theanine constitutes between 1% and 3% (w/w) of the dry
acids and glucose as well as increase peripheral vascular resis- weight of tea; however, the level of theanine varies in accordance
tance (Harbowy and Balentine, 1997; Griffiths and Woodson, with various factors including growing location and method of
1998). In addition, caffeine was reported to increase cerebrovas- cultivation, tea grade, variety, and time of harvest (Chu, 1997,
cular resistance and increase gastric and other secretions as well Balentine et al., 1998; Vuong et al., 2011a). Theanine varies with
as relax smooth muscle (Harbowy and Balentine, 1997; Grif- different types of tea. Green tea contains lower or similar levels
fiths and Woodson, 1998). However, it should be noted that of theanine as compared to oolong and black teas (Ekborg-
caffeine may cause irritation of the gastrointestinal tract and Ott et al., 1997). Theanine has been reported to facilitate the
sleeplessness in certain people (Chu and Juneja, 1997). Caf- generation of alpha brain waves, which are associated with a
feine may react as a feeble base with acids to form salts, which relaxed but alert mental state and to promote the release of
are very readily hydrolyzed (Stanley et al., 1998). Caffeine may the inhibitory neurotransmitter, γ -aminobutyric acid, which in
also form the precipitate (cream formation) with TFs and ester- turn regulates dopamine and serotonin levels in the brain, thus
forms of the catechins, thus to reduce their availability (Chao theanine is linked with relaxation and improved learning ability
and Chiang, 1999). (Mason, 2001; Cooper et al., 2005).
Recent studies have found evidence linking theanine to can-
cer prevention. Theanine was found to link with the inhibition
Theanine of the in vivo and in vitro growth of human non–small cell
lung cancer and leukemia cell lines (Liu et al., 2009). Theanine
Theanine is a unique amino acid in nature because, with the was also found to induce apoptosis in four cancer cell lines in-
exception of being found in the mushroom Xerocomus badius, cluding breast, colon, hepatoma, and prostate (Friedman et al.,
it is occurrence appears to be limited to the C. genus, mostly 2007). In the normal cells, theanine was found to convert to
the tea plants C. sinensis var. Sinensis and C. scinenisis var. glutamate, thus to increase the intracellular glutamate level and
assamica and some closely related species such as C. japonica lead to increased intracellular glutathione. Therefore, theanine
and C. sasanqua (Juneja et al., 1999; Deng et al., 2008). In was thought to inhibit doxorubicin-induced toxicity (Figure 4)
tea, theanine accounts for about 50% of the free amino acids, (Wan et al., 2009b). In addition, theanine was associated with
which are involved in producing the distinctive aroma of tea. reducing the adverse effects of doxorubicin reactions, provid-
Theanine has been closely linked with tea’s umami taste, the ing protection against tissue damage and acting as a biochem-
sweet and brothy taste of the tea liquor (Balentine et al., 1998; ical modulator to improve therapeutic efficacy (Sugiyama and
Juneja et al., 1999). Theanine has been found to correlate highly Sadzuka, 2004). Theanine has also found to link with provid-
with tea quality and price (Chu, 1997). ing effective prophylaxis and treatment for Alzheimer’s disease,
 LINKING TEA CONSUMPTION AND HUMAN HEALTH 527
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Figure 4 Mechanism of theanine to protect normal tissue from doxorubicin (DOX) toxicity via the changing glutathione (GSH) level (Wan et al., 2009b).

regulating blood pressure, promoting the weight loss and im- However, dried green, oolong, and black teas contain less
proving the immune system (Yokogoshi and Kobayashi, 1998; chlorophyll because it is degraded during withering and drying
Rogers et al., 2007; Di et al., 2010; Takagi et al., 2010). (Jiang, 2009).

Other Tea Constituents MAJOR FACTORS AFFECTING AVAILABILITY OF TEA

CONSTITUENTS IN A TEA CUP
Tea contains a high content of carbohydrates which accounts
for about 40% of dry weight and one third of it is cellulosic fiber. There are two major factors which directly affect the avail-
However, most of the carbohydrates are insoluble and therefore ability of tea constituents in a tea cup including the types of
are not present in tea beverage after brewing (Chu and Juneja, tea and the way of preparing a tea cup. This section describes
1997; Balentine et al., 1998). Although there is only a small differences among various types of tea and how the different
amount of starch in the tea leaf; however, it contributes to the ways of making tea influence the availability of tea components
quality of tea. The synthesis of starch occurs at dawn and at in a tea cup, thus is consequently related to promotion of human
sunset and thus leaf harvested in the morning normally contains health.
more starch and is considered of better quality than tea picked
later on in the same day (Chu and Juneja, 1997).
Tea also contains several vitamins, of which vitamin C Tea Types
is dominant with about 280 mg per 100 g dried green tea.
Green tea has more vitamin C than oolong and black tea be- There are eight different types of tea, which can be produced
cause vitamin C is decomposed during the fermentation pro- from same fresh tea leaves (Cheng, 2006) (Figure 5). However,
cess (Chu and Juneja, 1997). Tea also contains enzymes like for each type of tea, the biochemical quality and sensory can
polyphenol oxidase and peroxidase and some inorganic ele- vary due to the variety, climatic conditions, nutrition of the tea
ments such as calcium, potassium, magnesium, and copper. plant, cultivation method, and the type of leaf (Vuong et al.,
These enzymes and inorganic elements influence the quality 2010). For example, Thea Camellia var. assamica has higher
of the tea infusion (Balentine et al., 1998). In addition, tea catechins than Thea Camellia var. sinensis (Chu, 1997). The
contains some carotenoids and a large number of volatile sub- level of catechins in tea leaves is higher when tea is grown in
stances, which contribute to its flavor (Balentine et al., 1998). an area with more sunlight or higher temperature (Hara, 2001).
Tea also contains chlorophyll, which is high in fresh leaves. Summer leaves have higher levels of catechins than those in
 528 QUAN V. VUONG

Fixed Rolled Dried Green tea

Partially
Withered Bruised Dried Oolong tea
fermented

Fresh Withered Rolled/ Cut Fermented Dried Black tea

tea
leaves
Fixed Rolled Yellowed & Dried Yellow tea

Pile Incubated Pu-erh tea

Fixed
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Rolled Fermented & Dried

Leaves with more White tea

Withered Dried
fine hairs/flosses

Extracted Dried Dried tea Powder Instant tea

Dried tea
(green or
black) Aromatized (flower or artificial flavor) Scented Tea

Figure 5 Processing techniques of dried teas (Balentine et al., 1998; Wan et al., 2009a).

spring leaves (Lin et al., 1996; Hara, 2001). Tea, which is and 3% (w/w) dry weight, respectively (Graham, 1992; Balen-
fertilized with potassium, has higher catechins and theanine tine et al., 1998). When brewing with boiling water, green tea
in the leaves than those without fertilization (Venkatesan et al., produces a green–yellow solution with a fresh and grassy flavor
2004). Tea grown in shade has higher content of theanine and (Wan et al., 2009a). Green tea is more astringent than black and
lower level of catechins than the tea exposing to high levels oolong tea (Balentine et al., 1998). There is a strong association
of sunlight (Hara, 2001). Tea produced from coarse leaves has between sensory quality and tea composition. Green tea with ac-
lower catechins than tea produced from young leaves (apical ceptable sensory quality normally contains a higher amount of
bud and the two youngest leaves) because the young leaves are theanine, which produces brothy, umamy taste. Lower amounts
richer (2.7-fold) in catechins than old leaves (from the 10th to of caffeine and catechins are associated with bitter and astrin-
the 5th leaf) (Chu, 1997; Hara, 2001). gent tastes (Chu and Juneja, 1997).
Green, oolong, and black teas are the major types of tea Unlike green tea, black tea is mostly consumed in West-
(Vuong et al., 2010). In terms of world tea consumption, black ern countries and some Asian countries (Mukhtar and Ahmad,
tea accounts for 78% of total consumed tea in the world, while 2000). Black tea has a low content of catechins with about
20% is green tea and less than 2% is oolong tea (Cheng, 2006). 9% (w/w) dry weight; however, it comprises up to 23% (w/w)
Green tea is known as nonfermented tea; whereas, oolong tea dry weight of TFs and TRs (Graham, 1992; Balentine et al.,
and black tea refer to semifermented tea and fermented tea, in 1998). When brewing in boiling water, black tea produces an
which aerobic oxidation of the tea polyphenols, called catechins, orange–red solution with distinct fragrance and flavor (Wan
is partially and fully promoted and the catechins are enzymati- et al., 2009a). TFs are considered to be the major compounds
cally catalyzed to form TFs and TRs. Therefore, green tea has which are associated with color and taste of the black tea solution
highest content of catechins, followed by oolong tea and black (Graham, 1992). Oolong tea is mainly consumed in Asian coun-
tea has the lowest content of catechins (Vuong et al., 2011b). tries such as China and Taiwan (Mukhtar and Ahmad, 2000).
In contrast, black tea has higher level of TFs and TRs than oo- As it is a partially fermented tea, the chemical composition and
long tea, and green tea has the lowest level of these components the sensory quality are somewhat intermediate between those of
(Vuong et al., 2011b). green and black teas (Balentine et al., 1998). Oolong tea con-
Green tea is mostly consumed in Asian countries and North tains up to 20% (w/w) catechins of its dry matter. Unlike black
Africa (Mukhtar and Ahmad, 2000). Green tea contains up to tea or green tea, oolong tea has a unique combination of the
30% (w/w) catechins of its dry weight. It also contains high freshness of green tea and the fragrance of black tea (Wan et al.,
amount of caffeine and theanine, which account for up to 5% 2009a).
 LINKING TEA CONSUMPTION AND HUMAN HEALTH 529

The Ways of Tea Preparation dermatosis, neoplasms, obesity, acidosis, hypoglycemia, and
dental caries (Wright et al., 2007; Gyntelberg et al., 2009). On
Quality of a tea serving varies with quantity of tea, volume the contrary, addition of lime is thought to benefit human health
and temperature of water, length of brewing time, application because it not only additionally provides vitamin C but also
of agitation, and additional ingredients such as sugar, lime, and helps protect tea components from degradation, tea components
milk (Astill et al., 2001). Preparation of tea differs between are more stable at low pH (Vuong et al., 2010).
countries and individuals within a country. In Asia, green tea is It is questionable whether addition of milk reduces activ-
generally prepared by brewing dried tea with boiling water in a ity of flavonoids in the tea solution. Findings from a study of
tea pot. The first infusion is normally discarded and the subse- nine healthy volunteers showed that the addition of milk re-
quent infusions are consumed (Su et al., 2006). Recently, green duced antioxidant power (Langley-Evans, 2000), another study
tea has been ground and packed in the filter bags (2–4 g/bag) and of 16 healthy female volunteers also found that addition of milk
tea liquor has been prepared by infusing a tea bag in a tea pot or prevented vascular protective effect of black tea (Lorenz et al.,
a cup/mug for a period of time (three minutes). This method of 2007). Evidence on the contrary showed a slightly larger study
preparation has become popular, even in the Western countries, of 21 healthy volunteers found that addition of milk into tea did
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because of its convenience. Oolong tea is generally prepared by not affect its antioxidant properties (Leenen et al., 2000). Other
infusing tea in a tea pot following by stirring and steeping for a studies (n = 9 and n = 18) also found that addition of milk into
period of time (three to five minutes) (Su et al., 2007). In some tea did not affect its antioxidant power (Hollman et al., 2001;
parts of China, oolong tea is prepared by first quick washing Reddy et al., 2005). Therefore, it can be tentatively concluded
with hot water, then brewing with hot water for a certain of time that the addition of milk is unlikely to decrease tea antioxidant
(three minutes) (Su et al., 2006). power.
Black tea is prepared by infusing a quantity of tea (in a tea
bag) with boiling water in a pot or a cup/mug with a period of
less than three minutes. Black tea is usually consumed when it TEA CONSUMPTION AND HUMAN HEALTH
is hot, with or without milk and/or sugar (Astill et al., 2001). In
India, Pakistan, and some Middle Eastern countries, black tea Many animal studies have linked tea components with vari-
is prepared by boiling a quantity of tea in a pan with water for ous health benefits as mentioned previously. However, the im-
several minutes before consumption (Astill et al., 2001). pacts of these tea components might not be the same in human
The weight of tea in a tea bag varies from 1.5 to 3.25 g. body because of species differences in the bioavailability and
Package instruction for brewing time is three minutes with actions of these active components involved (Chen et al., 1997).
the recommended volume of water varying between 200 and The bioavailability between individual tea components might be
235 mL (Astill et al., 2001). Previous studies have demonstrated also different in humans. For example, Yang et al. (1998) found
that conditions for effectively extracting catechins and caffeine that EC and EGC have higher bioavailability than that of EGCG.
from tea with water were: 80◦ C after 20 minutes, 90◦ C after Therefore, it is complex in determining the mechanism as well
15 minutes, and 95◦ C after 10 minutes of brewing (Bond et al., as association between tea consumption and health benefits.
2003; Perva-Uzunalić et al., 2006). For efficient extraction of Many epidemiological studies have been conducted to inves-
theanine, a recent study found that most theanine was extracted tigate the link between tea consumption and human health. This
after brewing tea in water at 80◦ C after five minutes (Keenan section reviews results from previous epidemiological studies
et al., 2010). It appears that household preparation of tea is not published over the last 10 years to provide information relating
efficient for optimal extraction of tea bioactive components and to the link between tea consumption and health benefits.
this is the reason why a large volume of tea (several cups) was
required for obtaining health benefits.
Recent studies have found that microwave-assisted extraction Cancers
of bioactive components was very effective (Pan et al., 2003;
Spigno and Faveria, 2009), because it disrupts the structure of Numerous epidemiological studies have investigated the as-
the cells and thus more tea components are extracted into the sociation between tea consumption and prevention of cancers.
beverage (Vuong et al., 2010). It appears that the use of mi- Findings were inconsistent and contradictory (Table 1). Find-
crowaves for 30 seconds to 1 minute after infusing tea in the hot ings from studies have shown that consumption of green tea
water may help to improve extraction efficiency of tea compo- (three cups per day or more) significantly lowered the risk of
nents. However, further study is needed to provide conclusive lung cancer among nonsmoking women, but not for smoking
evidence. women (Zhong et al., 2001). Intake of tea was found not to
It is common in Western countries to consume black tea with be associated with prevention of lung cancer among smokers
lime, milk, or sugar (Gööck, 1990). There is no evidence show- for both men and women (Baker et al., 2005). Further results
ing an interaction between tea and sugar constituents; however, from studies reported that daily tea consumption was not signifi-
care is needed when adding sugar because of the correlation be- cantly associated with reduction of the lung cancer risk (Bonner
tween sugar consumption and atherosclerosis, heart problems, et al., 2005; Li et al., 2008). Overall, the results show that it is
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530
Table 1 The link between tea consumption and human health

Method for information Volume of tea

Disease Subjects/population and location of tea intake consumed Outcomes Ref.

Lung cancer Study for two years; 649 women with primary In-person interview ≥3 cups/week for at Green tea intake lowered the risk of lung cancer among (Zhong et al., 2001)
lung cancer and 675 controls aged least one year nonsmoking women (odds ratios (OR) = 0.65; 95% CI,
35–69 years; Shanghai, China 0.45–0.93)
Study for seven years; n = 41,440 aged Food frequency ≥5 cups/day Green tea intake was not associated with reduction of lung (Li et al., 2008)
40–79 years, Northeastern Japan questionnaire (FFQ) cancer (The multivariable-adjusted HRs as compared to
≤1 cup/day: 1.17 (95% CI: 0.85–1.61)
Skin cancer Study 1: 2 years; study 2: 3 years; 770 with In-person interview ≥2 cups/day Tea intake was associated with a significantly lower risk of (Rees et al., 2007)
basal cell (BCC), 696 with SCC and 715 SCC (OR = 0.65; 95% CI 0.44-0.96), but not with BCC
controls subjects aged 25–74 years, New (OR = 0.79; 95% CI, 0.63–0.98)
Hampshire
Study on 300 participants with incidence of In-person interview ≥1 L/day (four cups) Hot tea (60–64◦ C) and very hot tea (≥65◦ C) intake was (Islami et al., 2009)
esophageal SCC and 571 controls; Golestan associated with an increased risk of esophageal cancer
province, Iran (OR = 2.07; 95% CI, 1.28–3.35; and
OR = 8.16; 95% CI, 3.93–16.9, respectively)
Liver cancer Hospital-based study for 3.5 years; 185 FFQ ≥1 cup/week No association was found between tea intake and reduction of (Montella et al.,
incidents of hepatocellular carcinoma HCC risk (OR = 1.43; 95% CI, 0.76–2.66) 2007)
(HCC) and 412 controls aged 43–84 years,
Italy
Study for nine years; n = 41,761 aged FFQ ≥5 cups/day Drinking green tea had a significantly lower risk of liver (Ui et al., 2009)
40–79 years, Northeastern Japan cancer among men (HRs = 0.63; 95% CI, 0.41–0.98), and
women (HRs = 0.50; 95% CI, 0.27–0.90)
Gastrointestinal tract Study for four years; 627 with biliary tract In-person interview ≥3 cups/week for at Tea in take significantly reduced risks of biliary stones (Zhang et al., 2006)
cancer cancer, 1,037 with biliary stones and 959 least six months (OR = 0.73; 95% CI, 0.54–0.98) and gallbladder cancer
controls, Shanghai, China (OR = 0.56; 95% CI, 0.38–0.83)
Breast cancer Study for five years; 297 breast cancer and 665 24-hour food recalls ≥1 cups/week There was no association between intake of black tea and (Yuan et al., 2005)
controls aged 45–74 years, Singapore breast cancer. Intake of green tea was not associated with
decrease of breast cancer among women with low-activity
ACE but was strongly associated for women with
high-activity ACE (OR = 0.29; 95% CI, 0.10–0.79)
Study for 9.6 years; n = 27,323 participants, FFQ ≥1 cups/day No association between tea intake and breast cancer in women (Pathy et al., 2010)
Netherlands
Study for three years; 501 breast cancer and In-person interview ≥85.7 mL/day (1/2 Risk of breast cancer was not statistically associated with (Wu et al., 2003)
594 controls aged 25–74 years, Los Angeles cups) black tea intake but with green tea consumption
County (OR = 0.53; 95% CI, 0.35–0.78)
Study for one year; n = 1,009 aged FFQ ≥2 cups/day Green tea consumption was associated with a reduced risk of (Zhang et al., 2007)
20–87 years, Southeast China breast cancer (OR = 0.57; 95% CI, 0.47–0.69)
Pancreatic cancer Study for 11 years; n = 102,137, Japan ≥1 cup/day Tea intake was not associated with reducing the risks of (Luo et al., 2007)
pancreatic cancer
Bladder cancer Study for two years; 927 bladder cancer and Telephone interview ≥1 cup/day Tea intake had no association with bladder cancer (Bianchi et al.,
2,118 controls, Canada 2000)
Prostate cancer Study for one year; 130 prostate cancer and In-person interview ≥3 cups/day Green tea intake lowered the risks of prostate cancer (Jian et al., 2004)
274 controls, Hangzhou, China (OR = 0.27; 95% CI, 0.15–0.48)
 LINKING TEA CONSUMPTION AND HUMAN HEALTH 531

likely that consumption of tea might be linked to prevention of green tea intake. Green tea consumption was also found to limit
lung cancer for healthy people but not for the smokers. Further an antineoplastic activity, as defined by a decline in prostate spe-
epidemiological study in this area is needed. cific antigen levels, among patients with androgen independent
Squamous cell carcinomas (SCC) are a carcinomatous cancer prostate carcinoma (Jatoi et al., 2003).
that occurs in many different organs. A study found that regular Overall, results from epidemiological studies were incon-
drinking tea (at least one cup per day for more than 1 month) was sistent and conflicting. In most of these studies, the data on
associated with a significantly lower risk of SCC (Rees et al., the tea intake were obtained from the dietary questionnaires
2007). It is important to note that tea should not be drunk when to recall the information (Table 1). This is a major limitation
it is hot (more than 60◦ C) because drinking hot tea was found to of the epidemiological studies inferring the relationship of the
strongly associate with a higher risk of esophageal SCC cancer tea intake and cancers. The inevitable question that needs to
development (Islami et al., 2009). be answered is how much of tea should a person drink daily
In vivo studies have linked tea flavanoids with prevention of and for how long to prevent certain types of cancer? In most
liver cancer. Conversely, an epidemiological study found that studies, the tea consumption was recorded in milliliter or cups
frequent drinking tea did not decrease the risk of hepatocellular per day, week, or month for a certain time. Therefore, there
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carcinoma (Montella et al., 2007). Another study found no asso- are many biases which influence the results and conclusions
ciation between regular tea intake and prevention of liver risks drawn. For example, the volume of the tea cup was varied
or hepatitis C and B virus status (Inoue et al., 2009). Contrary among the studies. Furthermore, important parameters such
evidence from a larger population based study (n = 41761, nine as the type of tea, quantity of tea, volume of water, temper-
years follow-up) found that daily consumption of five cups or ature of water, and the length of brewing time, all of which
more could significantly lower the risks of liver cancer (Ui et al., directly affect the availability of the tea constituents and antiox-
2009). A meta-analysis conducted recently by Sing et al. (2011) idant power of the tea beverage have been neglected. There-
provided more evidence for the link between tea consumption fore, consumption of five cups might provide lower levels of
and prevention of the development of primary liver cancer. tea constituents compared to three cups. It is recommended
Findings have shown that consumption of more than three that future epidemiological studies should consider these is-
cups of tea a day for at least three months could significantly sues when designing the methods to minimize bias of the
lower the risk of breast cancer (Zhang et al., 2007; Shrubsole results.
et al., 2009). However, findings of a study conducted in the US
have shown an association between reduction of the breast can-
cer risks and green tea consumption, but not for black tea intake
(Wu et al., 2003). Another study confirmed that black tea con- Coronary Cardiovascular Disease
sumption did not reduce the risk of breast cancer and drinking
green tea could lower the risk of breast cancer among women A population based-control study in Japan of patients with
with high-activity angiotensin-converting enzyme (ACE) but significant coronary stenosis (n = 109, six months) found that
not for those with low-activity ACE (Yuan et al., 2005). A study consumption of at least six cups of tea a day could lower
conducted in the Netherlands found that regular drinking tea has incidence of coronary artery disease (Sano et al., 2004). An-
no link with the reduction of breast cancer (Pathy et al., 2010). other larger study in Japan (n = 13,916, one year) showed that
The results from studies in this area have not been consistent daily consumption of at least 10 cups of tea significantly de-
but there is an association between green tea consumption and creased levels of serum total cholesterol in both men and women
prevention of breast cancer. (Tokunaga et al., 2002). Daily consumption of three cups of tea
Several reviews have summarized findings from previous in or more could reduce the risks of coronary cardiovascular dis-
vivo studies, which reported that tea catechins could prevent ease (CVD) mortality (Gans et al., 2010). The similar findings
pancreatic, bladder, gastrointestinal, and prostate cancers (Za- were observed in a large study (n = 40530, 11 years), where the
veri, 2006; Khan and Mukhtar, 2007; Sharangi, 2009). Recent volume of tea required was higher with at least five cups a day
epidemiological studies found that regular tea intake has no (Kuriyama et al., 2006). The volume of tea intake for obtaining
association with reducing the risks of pancreatic cancer (Luo benefits is clearly inconsistent.
et al., 2007; Lin et al., 2008). No link was found between drink- Overall, tea consumption has been linked with reducing the
ing tea and decreasing the risks of bladder cancer (Bianchi et al., risks of CVD, but it should be noted that tea might interact
2000; Woolcott et al., 2002). Studies showed that tea consump- with cardiovascular medication (Izzo et al., 2005). One study
tion was significantly associated with reduction in the risks of showed that tea intake could antagonize the effect of warfarin,
gastrointestinal and prostate cancers (Jian et al., 2004; Bettuzzi which produces anticoagulation by inhibiting production of the
et al., 2006; Zhang et al., 2006; Kurahashi et al., 2008). Zhang vitamin K-dependent clotting factors and thus drinking tea might
et al. (2006) revealed that consumption of at least 1 cup of reduce the patient’s degree of anticoagulation (Taylor and Wilt,
tea daily for at least six months significantly reduced biliary 1999). Another clinical trial found that tea consumption of at
tract cancer. Jian et al. (2004) reported that prostate cancer risk least three cups a day may augment drug therapy (Bahorun et al.,
decreased with increasing frequency, duration, and quantity of 2010).
 532 QUAN V. VUONG

Obesity and Diabetes tea with sugar is associated with weight control and diabetes
(Gyntelberg et al., 2009), thus the amount of sugar added in tea
Tea is thought to be associated with prevention of obesity and should be minimized.
diabetes. Although the mechanism for this association is com-
plex, bioactive components of tea are thought to play a role in
modulation of energy balance, endocrine systems, food intake, Other Impacts of Tea Intake on Health
lipid and carbohydrate metabolism, the redox status, and activ-
ities of different types of cells (Kao et al., 2006). In addition, In animal studies, tea bioactive components have been found
tea components may affect the sympathetic nervous system ac- to improve the immune system, oral health, and inflamma-
tivity, increase energy expenditure, and promote the oxidation tory processes (Hamer, 2007). Bioactive components have been
of fat (Rains et al., 2011). However, findings from recent stud- found to prevent microbial diseases and oral health (Zaveri,
ies are conflicting. A study on obese Chinese women (BMI ≥ 2006; Khan and Mukhtar, 2007), but there is no epidemiologi-
28 kg/m2) with polycystic ovary syndrome (n = 34, 3 months) re- cal evidence in human studies to confirm these health benefits.
ported that daily consumption of two capsules containing 90 mg Tea intake has been reported to improve bone health. Daily
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EGCG (equivalent to 1.5 cups of tea) did not significantly reduce consumption of two to three cups of tea has been found to
body weight and did not alter the glucose or lipid metabolism associate with higher spinal bone mineral density and daily
(Chan et al., 2006). On the contrary, a study on obese people intake of four cups or more was found to increase total body
in Thailand (BMI > 25 kg/m2) (n = 60, three months) found bone mineral density (Chen et al., 2003). In addition, bone
that consumption of a 250 mg green tea capsule after break- mineral density was found higher in the old women who drank
fast, lunch, and dinner could reduce body weight (Auvichayapat tea in comparison with whom did not drink tea. The inference
et al., 2008). A study in Oklahoma (n = 41, two months) with is that tea consumption might protect against osteoporosis in
metabolic syndrome found that daily consumption of four cups older women (Hegarty et al., 2000). Tea has been found to
(928 mg catechins) of tea or two capsules (870 mg catechins) affect the mood and cognitive performance in humans. Intake of
significantly decreased body weight and BMI and lowered lipid tea caffeine (250 mg) could increase alertness, jitteriness, and
peroxidation (Basu et al., 2010). The positive affect of tea intake blood pressure, whereas, intake of theanine (200 mg) was found
and obesity was obtained when higher amount of tea extract was to antagonize the effect of caffeine on blood pressure but did
taken daily by the participants (750 mg, 870 mg per four cups) not significantly affect jitteriness, alertness, or other aspects of
in comparison with low amount (180 mg per 1.5 cups) in the mood (Rogers et al., 2008). Results from another study found
study which found no link between tea intake and obesity. that intake of two cups of black tea (400 mL) for 24 hours could
In a large study on African American women (n = 46 906, positively affect human mood (Scott et al., 2004).
12 years), results showed that tea consumption was not asso- Tea consumption has been found to associate with various
ciated with reducing the risk of diabetes (Boggs et al., 2010). positive health impacts; however, it is questionable whether
Results from another study (n = 36 908, five years) also re- there is any negative impact of consuming tea. Tea flavanoids
vealed that green tea intake did not associate with prevention interact with proteins and major digestive enzymes such as α-
of type 2 diabetes; however, daily consumption of 1 cup of amylase, pepsin, trypsin, and lipase (Sekiya et al., 1984; He
black tea showed a reduction of 14% in the risk of diabetes in et al., 2007), thus it is thought that tea intake may inhibit ab-
Asian men and Singaporean women (Odegaard et al., 2008). On sorption and digestibility of the dietary proteins and foods but
the contrary, results from a study in Japan (n = 17,413) aged there is limited epidemiological evidence confirming this link.
40–65 years and had no history of type 2 diabetes for five years, Results from a study showed that addition of the tea extract
showed that there was no association between consumption of to the diet did not change protein digestibility of weaning male
black or oolong teas and diabetes. However, daily consumption rats (Chang et al., 1994). Another study also found that polyphe-
of at least six cups of green tea was associated with a reduced nols in tea waste incorporated in the diet did not affect the food
risk for type 2 diabetes (Iso et al., 2006). A meta-analysis also digestibility of goats (Kondo et al., 2004). Therefore, the absorp-
revealed that tea consumption of more than four cups per day tion and digestibility of the dietary proteins and foods might not
(RR, 0.8; 95% CI, 0.7–0.93) may play a role in the prevention of be affected by the tea consumption. Further animal and human
type 2 diabetes (Jing et al., 2009). Consumption of 1500 mL (six studies are needed to investigate this association.
cups) of oolong tea a day significantly lowered concentrations Iron deficient and iron deficiency anemia are major prob-
of plasma glucose and fructosamine, thus drinking oolong tea lems, especially for young women with approximately two bil-
might be an effective adjunct to oral hypoglycemic drugs in the lion and one billion people worldwide affected, respectively
treatment of type 2 diabetes (Hosoda et al., 2003). Again from (Thankachan et al., 2008). Tea polyphenols were found to bind
the findings, it is difficult to draw a conclusion on what kind of with iron (Zijp et al., 2000), and therefore tea consumption
tea, how much and how long a person should consume tea to might decrease the iron absorption and increase risk of iron
obtain the health benefits. However, epidemiological evidence deficiency especially in vulnerable group. However, findings
showed that tea consumption was likely to prevent the risk of from one study found that consumption of decaffeinated black
obesity and diabetes. It should be noted that consumption of tea and green tea (four cups per day) during or immediately
 LINKING TEA CONSUMPTION AND HUMAN HEALTH 533

following the meals did not affect on the absorption of iron and S., Sinawat, S. and Hongprapas, P. (2008). Effectiveness of green tea on
other minerals such as calcium, copper, magnesium, and zinc weight reduction in obese Thais: A randomized, controlled trial. Physiol.
Behav. 93:486–491.
among young adults (Prystai et al., 1999). Another study also
Bahorun, T., Luximon-Ramma, A., Gunness, T. K., Sookar, D., Bhoyroo, S.,
found that tea intake had no association with the risks of iron Jugessur, R., Reebye, D., Googoolye, K., Crozier, A. and Aruoma, O. I.
depletion among healthy adults (Mennen et al., 2007). Tea in- (2010). Black tea reduces uric acid and C-reactive protein levels in humans
take was also not found to be related to iron status in vulnerable susceptible to cardiovascular diseases. Toxicology. 278:68–74.
group who is at risk of iron deficiency (Hogenkamp et al., 2008). Baker, J. A., McCann, S. E., Reid, M. E., Nowell, S., Beehler, G. P. and Moysich,
Conversely, findings from a study revealed that intake of black K. B. (2005). Associations between black tea and coffee consumption and risk
of lung cancer among current and former smokers. Nutr. Cancer. 52:15–21.
tea at one or two cups per day decreased iron absorption by 49% Balentine, D. A., Harbowy, M. E. and Graham, H. N. (1998). Tea: The plant and
(P < .05) or 66% (P < .01), respectively (Thankachan et al., its manufacture; chemistry and consumption of the beverage. In: Caffeine.
2008). Further study defining the link between tea intake and pp. 37–68. Spiller, G. A. Ed., CRC Press, Boca Raton.
iron absorption is necessary. To minimize the negative impact Basu, A., Sanchez, K., Leyva, M. J., Wu, M., Betts, N. M., Aston, C. E. and
Lyons, T. J. (2010). Green tea supplementation affects body weight, lipids,
of tea intake and iron absorption, tea should not be consumed
and lipid peroxidation in obese subjects with metabolic syndrome. J. Am.
during meals (Johnson, 2006).
Downloaded by [University of Newcastle (Australia)] at 21:34 06 March 2014

Coll. Nutr. 29:31–40.

Bettuzzi, S., Brausi, M., Rizzi, F., Castagnetti, G. (2006). Chemoprevention
of human prostate cancer by oral administration of green tea catechins
in volunteers with high-grade prostate intraepithelial neoplasia: A prelim-
CONCLUSIONS inary report from a one-year proof-of-principle study. Cancer Res. 66:
1234–1240.
Tea is a rich source of bioactive constituents such as fla- Bianchi, G. D., Cerhan, J. R., Parker, A. S., Putnam, S. D., See, W. A., Lynch,
vanoids, caffeine, and theanine which have been found to link C. F. and Cantor, K. P. (2000). Tea consumption and risk of bladder and
kidney cancers in a population-based case-control study. Am. J. Epidemiol.
with various health benefits such as prevention of cancers, CVD,
151:377–383.
obesities, and diabetes. However, availability of these compo- Boggs, D. A., Rosenberg, L., Ruiz-Narvaez, E. A. and Palmer, J. R. (2010).
nents in a tea cup varies and depends on the types of tea and the Coffee, tea, and alcohol intake in relation to risk of type 2 diabetes in African
ways of preparation. Eight major types of tea can be produced American women. Am. J. Clin. Nutr. 92:960–966.
from the fresh leaves of C. Sinensis and these teas are different Bond, T. J., Lewis, J. R., Davis, A. and Davies, A. P. (2003). Analysis and
purification of catechins and their transformation products. In: Methods in
in terms of biochemical quality and sensory attributes. Prepar-
Polyphenol Aanalysis. pp. 229–266. Santos-Buelga, C. and Williamson, G.
ing tea with milk or lime with/without sugar does not affect the Eds., The Royal Society of Chemistry, Cambridge.
antioxidant properties of the tea constituents. However, amount Bonner, M. R., Rothman, N., Mumford, J. L., He, X., Shen, M., Welch, R.,
of sugar addition should be controlled if large volume of tea is Yeager, M., Chanock, S., Caporaso, N. and Lan, Q. (2005). Green tea con-
consumed daily. sumption, genetic susceptibility, PAH-rich smoky coal, and the risk of lung
cancer. Mutat. Res./Genet. Toxicol. Environ. Mutagen. 582:53–60.
Results from epidemiological studies were inconsistent and
Chan, C. C. W., Koo, M. W. L., Ng, E. H. Y., Tang, O.-S., Yeung, W. S. B. and
thus it is difficult to conclude how much of tea a day and how Ho, P.-C. (2006). Effects of Chinese green tea on weight, and hormonal and
long a person should consume tea to obtain the health benefits. biochemical profiles in obese patients with polycystic ovary syndrome - A
Most studies confirmed that there is no harm in drinking too randomized placebo-controlled trial. J. Soc. Gynecol. Investig. 13:63–68.
much tea and tea consumption has associated positive health Chang, M. C. J., Bailey, J. W. and Collins, J. L. (1994). Dietary tannins from
cowpeas and tea transiently alter apparent calcium absorption but not absorp-
impacts, and yet, drinking several cups of tea daily can keep the
tion and utilization of protein in rats. J. Nutr. 124:283–288.
doctor away. Chao, Y. C. and Chiang, B. H. (1999). The roles of catechins and caf-
feine in cream formation in a semi-fermented tea. J. Sci. Food and Agric.
79:1687–1690.
Chen, L., Lee, M. J., Li, H., Yang, C. S. (1997). Absorption, distribution, and
ACKNOWLEDGMENTS elimination of tea polyphenols in rats. Drug Metab. Dispos. 25:1045–1050.
Chen, Z., Pettinger, M. B., Ritenbaugh, C., LaCroix, A. Z., Robbins, J., Caan,
Appreciation is expressed to Dr. Mirella Atherton for her B. J., Barad, D. H. and Hakim, I. A. (2003). Habitual tea consumption and
valuable comments and for editing this paper. The author thanks risk of osteoporosis: A prospective study in the women’s health initiative
observational cohort. Am. J. Epidemiol. 158:772–781.
the Australian Government Department of Education, Employ-
Cheng, T. O. (2006). All teas are not created equal: The Chinese green tea and
ment and Workplace Relations (DEEWR) for granting Q. V. V. cardivascular health. Int. J. Cardiol. 108:301–308.
an Endeavour Scholarship. Chu, D. C. (1997). Green tea-its cultivation, processing of the leaves for drinking
materials, and kinds of green tea. In: Chemistry and Applications of Green
Tea. pp. 17–30. Yamamoto, T., Juneja, L. R., Chu, D. C. and Kim, M. Eds.,
CRC Press, Boca Raton.
REFERENCES Chu, D. C. and Juneja, L. R. (1997). General chemical composition of green tea
and its infusion. In: Chemistry and Applications of Green Tea. pp. 13–22.
Astill, C., Birch, M. R., Dacombe, C., Humphrey, P. G. and Martin, P. T. (2001). Yamamoto, T., Juneja, L. R., Chu, D. C. and Kim, M. Eds., CRC Press, Boca
Factors affecting the caffeine and polyphenol contents of black and green tea Raton.
infusions. J. Agric. Food Chem. 49:5340–5347. Cooper, R., Morré, D. J. and Morré, D. M. (2005). Medicinal benefits of green
Auvichayapat, P., Prapochanung, M., Tunkamnerdthai, O., Sripanidkulchai, tea: Part I. review of noncancer health benefits. J. Altern. Complem. Med.
B. O., Auvichayapat, N., Thinkhamrop, B., Kunhasura, S., Wongpratoom, 11:521–528.
 534 QUAN V. VUONG

Deng, W. W., Ogita, S. and Ashihara, H. (2008). Biosynthesis of theanine (γ - C. C., Brennan, P., Møller, H., Saidi, F., Dawsey, S. M., Malekzadeh, R.
ethylamino-l-glutamic acid) in seedlings of Camellia sinensis. Phytochem. and Boffetta, P. (2009). Tea drinking habits and oesophageal cancer in a high
Lett. 1:115–119. risk area in northern Iran: population based case-control study. Br. Med. J.
Di, X., Yan, J., Zhao, Y., Zhang, J., Shi, Z., Chang, Y. and Zhao, B. (2010). 338:876–879.
L-theanine protects the APP (Swedish mutation) transgenic SH-SY5Y cell Iso, H., Wakai, K., Fukui, M., Tamakoshi, A., Mori, M., Motohashi, Y., Tsuji, L.,
against glutamate-induced excitotoxicity via inhibition of the NMDA receptor Nakamura, Y., Mikami, H., Hashimoto, S., Inaba, Y., Hoshiyama, Y., Suzuki,
pathway. Neuroscience. 18:778–786. H., Shimizu, H., Toyoshima, H., Tokudome, S., Ito, Y., Kikuchi, S., Koizumi,
Ekborg-Ott, K. H., Taylor, A. and Armstrong, D. W. (1997). Varietal differences A., Kawamura, T., Watanabe, Y., Miki, T., Sakata, K., Nose, T., Hayakawa,
in the total and enantiomeric composition of theanine in tea. J. Agric. Food N., Yoshimura, T., Fukuda, K., Okamoto, N., Shio, H., Ohno, Y., Kitagawa,
Chem. 45:353–363. T., Kuroki, T. and Tajima, K. (2006). The relationship between green tea and
Friedman, M., Mackey, B. E., Kim, H. J., Lee, I. S., Lee, K. R., Lee, S. U., total caffeine intake and risk for self-reported type 2 diabetes among Japanese
Kozukue, E. and Kozukue, N. (2007). Structure-activity relationships of tea adults. Ann. Intern. Med. 144:554–562.
compounds against human cancer cells. J. Agric. Food Chem. 55:243–253. Izzo, A. A., Carlo, G. D., Borrelli, F. and Ernst, E. (2005). Cardiovascular
Gans, J. M. D. K., Uiterwaal, C. S. P. M., Schouw, Y. T. V. D., Boer, J. M. A., pharmacotherapy and herbal medicines: The risk of drug interaction. Int. J.
Grobbee, D. E., Verschuren, W. M. M. and Beulens, J. W. J. (2010). Tea and Cardiol. 98:1–14.
coffee consumption and cardiovascular morbidity and mortality. Arterioscler. Jatoi, A., Ellison, N., Burch, P. A., Sloan, J. A., Sloan, J. A., Dakhil, S.
Downloaded by [University of Newcastle (Australia)] at 21:34 06 March 2014

Thromb. Vasc. Biol. 30:1665. R., Novotny, P., Tan, W., Fitch, T. R., Rowland, K., Young C. Y. F.,
Glade, M. J. (2010). Caffeine-Not just a stimulant. Nutrition. 26:932–938. Flynn, P. J. (2003). A phase II trial of green tea in the treatment of pa-
Gööck, R. (1990). Tea: With 50 Recipes from Around the World, and Exclusive tients with androgen independent metastatic prostate carcinoma. Cancer. 97:
Photographs by Hans Joachim Dobbelin. Hans Kalis, Rotkreuz. 1442–1446.
Graham, H. N. (1992). Green tea composition, consumption, and polyphenol Jian, L., Xie, L. P., Lee, A. H. and Binns, C. W. (2004). Protective effect of
chemistry. Prev. Med. 21:334–350. green tea against prostate cancer: A case-control study in southeast China.
Griffiths, R. R. and Woodson, P. P. (1998). Caffeine physical dependence: Int. J. Cancer. 108:130–135.
A review of human and laboratory animal studies. Psychopharmacology. Jiang, H. Y. (2009). White tea, its manufacture, chemistry, and health effects.
94:437–451. In: Tea and Tea Products, Chemistry and Health-Promoting Properties. pp.
Gupta, S., Hussain, T. and Mukhtar, H. (2003). Molecular pathway for (−)- 17–30. Ho, C. T., Lin, J. K. and Shahidi, F. Eds., CRC Press, Boca Roton.
epigallocatechin-3-gallate-induced cell cycle arrest and apoptosis of human Jing, Y., Han, G., Hu, Y., Bi, Y., Li, L. and Zhu, D. (2009). Tea consumption
prostate carcinoma cells. Arch. Biochem. Biophys. 410:177–185. and risk of type 2 diabetes: A meta-analysis of cohort studies. J. Gen. Intern.
Gyntelberg, F., Hein, H. O. and Suadicani, P. (2009). Sugar in coffee or tea and Med. 24:557–562.
risk of obesity: A neglected issue. Int. J. Food Sci. Nutr. 60:56–64. Johnson, A. E. (2006). Iron supplementation and the female soldier. Mil Med.
Halder, B., Pramanick, S., Mukhopadhyay, S. and Giri, A. K. (2006). Anti- 171:298–300.
clastogenic effects of black tea polyphenols theaflavins and thearubigins in Juneja, L. R., Chu, D. C., Okubo, T., Nagato, Y. and Yokogoshi, H. (1999). L-
human lymphocytes in vitro. Toxicol. Vitr. 20:608–613. theanine-a unique amino acid of green tea and its relaxation effect in humans.
Hamer, M. (2007). The beneficial effects of tea on immune function and inflam- Trends. Food Sci. Tech. 10:199–204.
mation: A review of evidence from in vitro, animal, and human. Nutr. Res. Kao, Y.-H., Chang, H.-H., Lee, M.-J. and Chen, C.-L. (2006). Tea, obesity, and
27:373–379. diabetes. Mol. Nutr. Food Res. 50:188–210.
Hara, Y. (2001). Green Tea: Health Benefits and Applications. Marcel Dekker, Kao, Y. H., Hiipakka, R. A. and Liao, S. (2000). Modulation of Endocrine Sys-
New York. tems and Food Intake by Green Tea Epigallocatechin Gallate. Endocrinology.
Harbowy, M. E. and Balentine, D. A. (1997). Tea chemistry. Crit Rev. Plant Sci. 141:980–987.
16:415–480. Kato, M. and Shibamoto, T. (2009). Variation of major volatile constituents in
He, Q., Lv, Y. and Yao, K. (2007). Effects of tea polyphenols on the activities various green teas from Southeast Asia. J. Agric. Food Chem. 49:1394–1396.
of α-amylase, pepsin, trypsin and lipase. Food Chem. 101:1178–1182. Keenan, E. K., Finnie, M. D. A., Jones, P. S., Rogers, P. J. and Priestley, C. M.
Heckman, M. A., Weil, J. and Mejia, E. G. (2010). Caffeine (1,3,7- (2010). How much theanine in a cup of tea? effects of tea type and method
trimethylxanthine) in foods: A Comprehensive Review on Consumption, of preparation. Food Chem. 125:588–594.
Functionality, Safety, and Regulatory Matters. J. Food Sci. 75:R77–R87. Khan, N. and Mukhtar, H. (2007). Tea polyphenols for health promotion. Life
Hegarty, V. M., May, H. M. and Khaw, K. T. (2000). Tea drinking and bone Sci. 81:519–533.
mineral density in older women. Am. J. Clin. Nutr. 71:1003–1007. Klaus, S., Pültz, S., Thöne-Reineke, C. and Wolfram, S. (2005). Epigallocat-
Hogenkamp, P. S., Jerling, J. C., Hoekstra, T., Melse-Boonstra, A. and Macin- echin gallate attenuates diet-induced obesity in mice by decreasing energy
tyre, U. E. (2008). Association between consumption of black tea and iron absorption and increasing fat oxidation. Int. J. Obes. 29:615–623.
status in adult Africans in the North West Province: The THUSA study. Br. Kondo, M., Kita, K. and Yokota, H. O. (2004). Feeding value to goats of whole-
J. Nutr. 100:430–437 crop oat ensiled with green tea waste. Anim. Feed Sci. Technol. 113:71–81
Hollman, P. C., VanHetHof, K. H., Tijburg, L. B. and Katan, M. B. (2001). Koo, S. I. and Noh, S. K. (2006). Green tea as inhibitor of the intestinal ab-
Addition of milk does not affect the absorption of flavonols from tea in man. sorption of lipids: Potential mechanism for its lipid-lowering effect. J. Nutr.
Free Radic. Res. 34:297–300. Biochem. 179–183.
Hosoda, K., Wang, M.-F., Liao, M.-L., Chuang, C.-K., Iha, M., Clevidence, B. Kurahashi, N., Sasazuki, S., Iwasaki, M. and Inoue, M. (2008). Green tea
and Yamamoto, S. (2003). Antihyperglycemic effect of oolong tea in type 2 consumption and prostate cancer risk in Japanese men: A prospective study.
diabetes. Diabetes Care. 26:1714–1718. Am. J. Epidemiol. 167:71–77.
Inoue, M., Kurahashi, N., Iwasaki, M., Shimazu, T., Tanaka, Y., Mizokami, M. Kuriyama, S., Shimazu, T., Ohmori, K., Kikuchi, N., Nakaya, N., Nishino, Y.,
and Tsugane, S. (2009). Effect of coffee and green tea consumption on the Tsubono, Y. and Tsuji, I. (2006). Green tea consumption and mortality due
risk of liver cancer: Cohort analysis by hepatitis virus infection status. Cancer to cardiovascular disease, cancer, and all causes in Japan: The Ohsaki study.
Epidemiol. Biomarkers Prev. 18:1746–1753. J. Am Med Assoc. 296:1255–1265.
Ishizu, T., Tsutsumi, H. and Sato, T. (2009). Interaction between gallocatechin Langley-Evans, S. C. (2000). Consumption of black tea elicits an increase in
gallate and caffeine in crystal structure of 1:2 and 2:2 complexes. Tetrahedron plasma antioxidant potential in humans. Int. J. Food Sci. Nutr. 51:309–315.
Lett. 50:4121–4124. Leenen, R., Roodenburg, A. J. C., Tijburg, L. B. M. and Wiseman, S. A. (2000).
Islami, F., Pourshams, A., Nasrollahzadeh, D., Kamangar, F., Fahimi, S., Shak- A single dose of tea with or without milk increases plasma antioxidant activity
eri, R., Abedi-Ardekani, B., Merat, S., Vahedi, H., Semnani, S., Abnet, in humans. Eur. J. Clin. Nutr. 54:87–92.
 LINKING TEA CONSUMPTION AND HUMAN HEALTH 535

Leung, L. K., Su, Y., CHen, R., Zhang, Z., Huang, Y. and Chen, Z. Y. (2001). Prystai, E. A., Kies, C. V. and Driskel, J. A. (1999). Calcium, copper, iron,
Theaflavins in black tea and catechins in green tea are equally effective magnesium and zinc utilization of humans as affected by consumption of
antioxidants. J. Nutr. 131:2248–2251. black, decaffeinated black and green teas. Nutrition Research. 19:167–177.
Li, Q., Kakizaki, M., Kuriyama, S., Sone, T., Yan, H., Nakaya, N., Mastuda- Rains, T. M., Agarwal, S. and Maki, K. C. (2011). Antiobesity effects of green
Ohmori, K. and Tsuji, I. (2008). Green tea consumption and lung cancer risk: tea catechins: A mechanistic review. J. Nutr. Biochem. 22:1–7.
The Ohsaki study. Br. J. Cancer. 99:1179–1184. Reddy, V. C., Sagar, G. V. V., Sreeramulu, D., Venu, L. and Raghunath, M.
Liang, Y., Lu, J. and Zhang, L. (2002). Comparative study of cream in infusions (2005). Addition of milk does not alter the antioxidant activity of black tea.
of black tea and green tea (Camellia sinensis (L.) O. Kuntze). Int. J. Food Sci. Ann Nutr Metab. 49:189–195.
Technol. 37:627–634. Rees, J. R., Stukel, T. A., Perry, A. E., Zens, M. S., Spencer, S. K. and Karagas,
Lin, J. K. (2009). Mechanisms of cancer chemoprevention by tea and tea M. R. (2007). Tea consumption and basal cell and squamous cell skin cancer:
polyphenols. In: Tea and Tea Products Chemistry and Health-Promoting Results of a case-control study. J. Am. Acad. Dermatol. 56:781–785.
Properties. pp. 161–176. Ho, C. T., Lin, J. K. and Shahidi, F. Eds., CRC Robertson, G. L. (1993). Food Packaging: Principles and Practice. Marcel
Press, Boca Raton. Dekker, New York
Lin, Y., Kikuchi, S., Tamakoshi, A., Yagyu, K., Obata, Y., Kurosawa, M., In- Rogers, P. J., Smith, J. E., Heatherley, S. V. and Pleydell-Pearce, C. W. (2007).
aba, Y., Kawamura, T., Motohashi, Y. and Ishibashi, T. (2008). Green tea Time for tea: Mood, blood pressure and cognitive performance effects of
consumption and the risk of pancreatic cancer in Japanese adults. Pancreas. caffeine and theanine administered alone and together. Psychopharmacology.
Downloaded by [University of Newcastle (Australia)] at 21:34 06 March 2014

37:25–30. 195:569–577.
Lin, Y. L., Juan, I. M., Chen, Y. L., Liang, Y. C. and Lin, J. K. (1996). Com- Rogers, P. J., Smith, J. E., Heatherley, S. V. and Pleydell-Pearce, C. W. (2008).
position of polyphenols in fresh tea leaves and associations of their oxygen- Time for tea: Mood, blood pressure and cognitive performance effects of
radical-absorbing capacity with antiproliferative actions in fibroblast cells. J. caffeine and theanine administered alone and together. Psychopharmacology.
Agric. Food Chem. 44:1387–1394. 195:569–577.
Liu, Q., Duan, H., Luan, J., Yagasaki, K. and Zhang, G. (2009). Effects of Roy, P., Nigam, N., George, J., Srivastava, S. and Shukla, Y. (2009). Induction
theanine on growth of human lung cancer and leukemia cells as well as of apoptosis by tea polyphenols mediated through mitochondrial cell death
migration and invasion of human lung cancer cells. Cytotechnology. 211–217. pathway in mouse skin tumors. Cancer Biol. Therapy. 8:1281–1287.
Lorenz, M., Jochmann, N., Krosigk, A. V., Martus, P., Baumann, G., Stangl, K. Safranow, K. and Machoy, Z. (2005). Methylated purines in urinary stones.
and Stangl, V. (2007). Addition of milk prevents vascular protective effects Clin. Chem. 51:1493–1498.
of tea. Eur. Heart J. 28:219–223. Sano, J., Inami, S., Seimiya, K., Ohba, T., Sakai, S., Takano, T. and Mizuno,
Luo, J., Inoue, M., Iwasaki, M., Sasazuki, S., Otani, T., Ye, W. and Tsugane, S. K. (2004). Effects of green tea Intake on the development of coronary artery
(2007). Green tea and coffee intake and risk of pancreatic cancer in a large- disease. Circ. J. 68:665–670.
scale, population-based cohort study in Japan (JPHC study). Eur. J. Cancer Scharbert, S., Jezussek, M. and Hofmann, T. (2004). Evaluation of the taste con-
Prev. 16:542–548. tribution of theaflavins in black tea infusions using the taste activity concept.
Marnewick, J. L., Westhuizen, F. H., Joubert, F. H. V. D., Swanevelder, S., Eur. Food Res. Technol. 218:442–447.
Swart, P. and Gelderblom, W. C. A. (2009). Chemoprotective properties of Scott, D., Rycroft, J. A., Aspen, J., Chapman, C. and Brown, B. (2004). The
rooibos (Aspalathus linearis), honeybush (Cyclopia intermedia) herbal and effect of drinking tea at high altitude on hydration status and mood. Eur. J.
green and black (Camellia sinensis) teas against cancer promotion induced Appl. Physiol. 91:493–498.
by fumonisin B1 in rat liver. Food Chem. Toxicol. 47:220–229 Sekiya, J., Kajiwara, T., Monma, T. and Hatanaka, A. (1984). Interaction of tea
Mason, R. (2001). 200 mg of zen: L-Theanine boosts alpha waves, promotes catechins with proteins: Formation of protein precipitate. Agric. Biol. Chem.
alert relaxation. Altern. Complement. Ther. 7:91–95. 48:1963–1967
Mennen, L., Hirvonen, T., Arnault, N., Bertrais, S., Galan, P. and Hercberg, S. Sing, M. F., Yang W. S., Gao, S., Gao, J., Xiang, Y. B. (2011). Epidemiological
(2007). Consumption of black, green and herbal tea and iron status in French studies of the association between tea drinking and primary liver cancer: A
adults. Eur. J. Clin. Nutr. 61:1174–1179. meta-analysis. Eur. J. Cancer Prev. 20:157–165.
Montella, M., Polesel, J., Vecchia, C. L., Maso, L. D., Crispo, A., Crovatto, M., Sharangi, A. B. (2009). Medicinal and therapeutic potentialities of tea (Camellia
Casarin, P., Izzo, F., Tommasi, L. G., Talamini, R. and Franceschi, S. (2007). sinensis L.) - A review. Food Res. Int. 42:529–535.
Coffee and tea consumption and risk of hepatocellular carcinoma in Italy. Int. Shrubsole, M. J., Lu, W., Chen, Z., Shu, X. O., Zheng, Y., Dai, Q., Cai, Q.,
J. Cancer. 120:1555–1559. Gu, K., Ruan, Z. X., Gao, Y.-T. and Zheng, W. (2009). Drinking green tea
Mukhtar, H. and Ahmad, N. (2000). Tea polyphenols: Prevention of cancer and modestly reduces breast cancer risk. J. Nutr. 139:310–316
optimizing health. Am. J. Clin. Nutr. 71:1698S–1702S. Spigno, G. and Faveria, D. M. D. (2009). Microwave-assisted extraction of tea
Ninomiya, M., Unten, L. and Kim, M. (1997). Chemical and physiochemical phenols: A phenomenological study. J. Food Eng. 93:210–217.
properties of green tea polyphenols. In: Chemistry and Application of Green Stanley, M., Tarka, J. and Hurst, W. J. (1998). Introduction to the chemistry,
Tea. pp. 23–36. Yamamoto, T., Juneja, L. R., Chu, D. C. and Kim, M. Eds., isolation, and biosynthesis of methylxanthines. In: Caffeine. Spiller, G. A.
CRC Press, Boca Raton. Ed., CRC Press, Boca Raton.
Odegaard, A. O., Pereira, M. A., Koh, W.-P., Arakawa, K., Lee, H.-P. and Yu, M. Su, X., Duan, J., Jiang, Y., Duan, X. and Chen, F. (2007). Polyphenolic pro-
C. (2008). Coffee, tea, and incident type 2 diabetes: The Singapore chinese file and antioxidant activities of oolong tea infusion under various steeping
health study. Am. J. Clin. Nutr. 88:979–985 conditions. Int. J. Mol. Sci. 8:1196–1205.
Pan, X., Niu, G. and Liu, H. (2003). Microwave-assisted extraction of tea Su, X., Duan, J., Jiang, Y., Shi, J. and Kakuda, Y. (2006). Effects of soaking
polyphenols and tea caffeine from green tea leaves. Chem. Eng. Process. conditions on the antioxidant potentials of oolong tea. J. Food Comp. Anal.
42:129–133. 19:348–353.
Park, A. M. and Dong, Z. (2003). Signal transduction pathways: Targets for Sugiyama, T. and Sadzuka, Y. (2004). Theanine, a specific glutamate derivative
green and black tea polyphenols. J. Biochem. Mol. Biol. 36:66–77. in green tea, reduces the adverse reactions of doxorubicin by changing the
Pathy, N. B., Peeters, P., Gils, C. v., Beulens, J. W. J., Graaf, Y. V. D., Bueno- glutathione level. Cancer Lett. 212:177–184.
de-Mesquita, B., Bulgiba, A. and Uiterwaal, C. S. P. M. (2010). Coffee and Takagi, Y., Kurihara, S., Higashi, N., Morikawa, S., Kase, T., Maeda, A., Arisaka,
tea intake and risk of breast cancer. Breast Cancer Res. Treat. 121:461–467. H., Shibahara, S. and Akiyama, Y. (2010). Combined administration of L-
Perva-Uzunalić, A., Škerget, M., Knez, Ž., Weinreich, B., Otto, F. and Grüner, Cystine and L-Theanine enhances immune functions and protects against
S. (2006). Extraction of active ingredients from green tea (Camellia sinen- influenza virus infection in aged mice. J. Vet. Med. Sci. 72:157–165.
sis): Extraction efficiency of major catechins and caffeine. Food Chem. Taylor, J. R. and Wilt, V. M. (1999). Probable antagonism of warfarin by green
96:597–605. tea. Ann Pharmacother. 33:426–428.
 536 QUAN V. VUONG

Terao, J., Piskula, M. and Yao, Q. (1994). Protective effect of epicatechin, epi- Wright, E. M., Hirayama, B. A. and Loo, D. F. (2007). Active sugar transport
catechin gallate, and quercetin on lipid peroxidation in phospholipid bilayers. in health and disease. J. Intern. Med. 261:32–43.
Arch. Biochem. Biophysics. 308:278–284. Wu, A. H., Yu, M. C., Tseng, C.-C., Hankin, J. and Pike, M. C. (2003). Green tea
Thankachan, P., Walczyk, T., Muthayya, S., Kurpad, A. V. and Hurrell, R. and risk of breast cancer in Asian Americans. Int. J. Cancer. 106:574–579.
F. (2008). Iron absorption in young Indian women: The interaction of iron Xu, Y., Ho, C.-T., Amin, S. G., Han, C. and Chung, F.-L. (1992). Inhi-
status with the influence of tea and ascorbic acid1-3. Am. J. Clin. Nutr. 87: bition of tobacco-specific nitrosamine-induced lung tumorigenesis in A/J
881–886. Mice by green tea and its major polyphenol as antioxidants. Cancer Res.
Tokunaga, S., White, I. R., Frost, C., Tanaka, K., Kono, S., Tokudome, S., 52:3875–3879.
Akamatsu, T. and Zakouji, H. (2002). Green tea Consumption and serum Yang, C., Chen, L., Lee, M. J., Balentine, D., Kuo, M., Schantz, S. P. (1998).
lipids and lipoproteins in a population of healthy workers in Japan. Ann. Blood and urine levels of tea catechins after ingestion of different amounts
Epidemiol. 12:157–165. of green tea by human volunteers. Cancer Epidemiol. Biomarkers Prev.
Ui, A., Kuriyama, S., Kakizaki, M., Sone, T., Nakaya, N., Ohmori-Matsuda, 7:351–354.
K., Hozawa, A., Nishino, Y. and Tsuji, I. (2009). Green tea consumption and Yokogoshi, H. and Kobayashi, M. (1998). Hypotensive effect of γ -
the risk of liver cancer in Japan: The Ohsaki Cohort study. Cancer Causes glutamylmethylamide in spontaneously hypertensive rats. Life Sci.
Control. 20:1939–1945. 62:1065–1068.
Venkatesan, S., Murugesan, S., Ganapathy, M. N. and Verma, D. P. (2004). Yoshino, K., Hara, Y., Sano, M. and Tomita, I. (1994). Antioxidative ef-
Downloaded by [University of Newcastle (Australia)] at 21:34 06 March 2014

Long-term impact of nitrogen and potassium fertilizers on yield, soil nutrients fects of black tea theaflavins and thearubigin on lipid peroxidation of rat
and biochemical parameters of tea. J. Sci. Food Agric. 84:1939–1944. liver homogenates induced by tert-butyl hydroperoxide. Biol. Pharm. Bull.
Vuong, Q. V., Golding, J. B., Nguyen, M. and Roach, P. D. (2010). Extraction 17:146–149.
and isolation of catechins from tea. J. Sep. Sci. 33:3415–3428. Yuan, J.-M., Koh, W.-P., Sun2, Can-Lan, Lee, H.-P. and Yu, M. C. (2005). Green
Vuong, Q. V., Bowyer M. C. and Roach, P. D. (2011a). L-Theanine: Properties, tea intake, ACE gene polymorphism and breast cancer risk among Chinese
synthesis and isolation from tea. J. Sci. Food Agric. 91:1931–1939. women in Singapore. Carcinogenesis. 26:1389–1394.
Vuong, Q. V., Nguyen, V., Golding, G. B. and Roach, P. D. (2011b). The content Zaveri, N. T. (2006). Green tea and its polyphenolic catechins: Medicinal uses
of bioactive constituents as a quality index for Vietnamese teas. Int. Food Res. in cancer ad noncancer applications. Life Sci.. 78:2073–2080.
J. 18:329–336. Zhang, M., D’Arcy, C., Holman, J., Huang, J.-P. and Xie, X. (2007). Green tea
Vuong, Q. V., Stathopoulos, C. E., Nguyen, M., Golding, J. B. and Roach, and the prevention of breast cancer: A case–control study in Southeast China.
P. D. (2011c). Isolation of green tea catechins and their utilisation in the food Carcinogenesis. 28:1074–1078.
industry. Food Rev. Int. 27:227–247. Zhang, X.-H., Andreotti, G., Gao, Y.-T., Deng, J., Liu, E., Rashid, A., Wu, K.,
Wan, X., Li, D. and Zhang, Z. (2009a). Green tea and black tea manufacturing Sun, L., Sakoda, L. C., Cheng, J.-R., Shen, M.-C., Wang, B.-S., Han, T.-
and consumption. In: Tea and Tea Products Chemistry and Health-Promoting Q., Zhang, B.-H., Gridley, G., Jr., Fraumeni, JF and Hsing, A. W. (2006).
Properties. pp. 1–8. Ho, C. T., Lin, J. K. and Shahidi, F. Eds., CRC Press, Tea drinking and the risk of biliary tract cancers and biliary stones: A
Boca Raton. population-based case–control study in Shanghai, China. Int. J. Cancer. 118:
Wan, X., Zhang, Z. and Li, D. (2009b). Chemistry and biological properties 3089–3094.
of theanine. In: Tea and Tea Products: Chemistry and Health-Promoting Zhong, L., Goldberg, M. S., Gao, Y.-T., Hanley, J. A., Parent, M.-É. and Jin,
Properties. pp. 255–274. Ho, C. T., Lin, J. K. and Shahidi, F. Eds., Taylor and F. (2001). A population-based case-control study of lung cancer and green
Francis Group, Boca Raton. tea consumption among women living in Shanghai, China. Epidemiology.
Woolcott, C. G., King, W. D. and Marrett, L. D. (2002). Coffee and tea con- 12:695–700.
sumption and cancers of the bladder, colon and rectum. Eur. J. Cancer Prev. Zijp, I. M., Korver, O. and Tijburg, L. B. M. (2000). Effect of tea and other
11:137–145. dietary factors on iron absorption. Crit. Rev. Food Sci. Nutr. 40:371–398.

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