Is green tea good for high blood pressure and cholesterol

Data from 1,536 participants indicated that green tea consumption was associated with an average systolic blood pressure 1.94 mmHg lower than placebo, but no benefits on diastolic blood pressure were observed.

In addition, green tea consumption was also associated with lower total and LDL cholesterol levels, compared to placebo, report scientists from the University of Oxford in the UK and the University of Washington in Seattle in Nutrition, Metabolism and Cardiovascular Diseases​​.

“The available evidence from RCTs suggests that dietary supplementation with green tea generates significant reductions on systolic blood pressure, total and LDL cholesterol,” ​wrote the researchers. “The effect size on systolic blood pressure is small, but the sizes of the effects on total and LDL cholesterol appear moderate.​

“There is some evidence that daily consumption of 5-6 cups of green tea could result in reductions in systolic blood pressure, total cholesterol, and LDL cholesterol,” ​they added. “However, at this time green tea should not be recommended as a substitute for current management of patients with established hypertension or dyslipidaemia.”​

Tea benefits​

The review appears in line with the ever-growing body of science supporting the potential benefits of green tea and its constituents, most notably EGCG (epigallocatechin gallate). To date green tea has been linked to a reduced risk of Alzheimer's and certain cancers, improved cardiovascular and oral health, as well as benefits in weight management.

Green tea contains between 30 and 40 per cent of water-extractable polyphenols, while black tea (green tea that has been oxidized by fermentation) contains between 3 and 10 per cent. Oolong tea is semi-fermented tea and is somewhere between green and black tea.

The four primary polyphenols found in fresh tealeaves are epigallocatechin gallate (EGCG), epigallocatechin (EGC), epicatechin gallate (ECG), and epicatechin (EC).

Review details​

In addition to finding an association between green tea consumption and improved blood pressure and cholesterol levels, the reviewers also identified a significant correlation between the doses of EGCG and a reduction in systolic blood pressure in trials lasting at least 12 weeks. However, no additional benefits were observed for EGCG doses above 200mg (about 5-6 cups of tea).

The source of funding was also noted by the researchers, with manufacturer-funded studies reporting greater benefits than government-funded trials.

“Because of subtle differences in the effects seen on blood pressure and lipid profile between manufacturer- and government-funded studies, more independent clinical trials which are adequately powered to detect such effects are required,” ​they stated.

Biological plausibility?​

Commenting on the potential mechanism of action, the researchers said that there are several different potential mechanisms, including decreasing the action of ACE (angiotensin-converting-enzyme inhibitor), which leads to a relaxation of blood vessels and lowering of blood pressure. Other studies have suggested that EGCG may decrease levels of kallikrein and prostaglandin E2 which can lower blood pressure.

“Green tea also contains gamma-aminobutyric acid (GABA) which may decrease blood pressure by modulating neurotransmitter release,”​ they added. “Indeed, consumption of food enriched with GABA resulted in significant reductions in blood pressure in mildly hypertensive patients.” ​

Finally, they noted that flavan-3-ols from green tea may impact endothelial function.  

Source: Nutrition, Metabolism and Cardiovascular Diseases​​
Published online ahead of print, doi: 10.1016/j.numecd.2014.01.016
“The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials”​
Authors: I. Onakpoya, E. Spencer, C. Heneghan, M. Thompson

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Hsu, C. H., Liao, Y. L., Lin, S. C., Tsai, T. H., Huang, C. J., and Chou, P. Does supplementation with green tea extract improve insulin resistance in obese type 2 diabetics? A randomized, double-blind, and placebo-controlled clinical trial. Altern.Med.Rev. 2011;16(2):157-163. View abstract.

Hsu, C. H., Tsai, T. H., Kao, Y. H., Hwang, K. C., Tseng, T. Y., and Chou, P. Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr 2008;27(3):363-370. View abstract.

Hsu, J., Skover, G., and Goldman, M. P. Evaluating the efficacy in improving facial photodamage with a mixture of topical antioxidants. J Drugs Dermatol. 2007;6(11):1141-1148. View abstract.

Hunt, K. J., Hung, S. K., and Ernst, E. Botanical extracts as anti-aging preparations for the skin: a systematic review. Drugs Aging 12-1-2010;27(12):973-985. View abstract.

Hursel, R. and Westerterp-Plantenga, M. S. Green tea catechin plus caffeine supplementation to a high-protein diet has no additional effect on body weight maintenance after weight loss. Am J Clin Nutr 2009;89(3):822-830. View abstract.

Ichinose, T., Nomura, S., Someya, Y., Akimoto, S., Tachiyashiki, K., and Imaizumi, K. Effect of endurance training supplemented with green tea extract on substrate metabolism during exercise in humans. Scand.J Med Sci.Sports 3-10-2010; View abstract.

Imai, K., Suga, K., and Nakachi, K. Cancer-preventive effects of drinking green tea among a Japanese population. Prev.Med 1997;26(6):769-775. View abstract.

Inami, S., Takano, M., Yamamoto, M., Murakami, D., Tajika, K., Yodogawa, K., Yokoyama, S., Ohno, N., Ohba, T., Sano, J., Ibuki, C., Seino, Y., and Mizuno, K. Tea catechin consumption reduces circulating oxidized low-density lipoprotein. Int Heart J 2007;48(6):725-732. View abstract.

Inoue, M., Robien, K., Wang, R., Van Den Berg, D. J., Koh, W. P., and Yu, M. C. Green tea intake, MTHFR/TYMS genotype and breast cancer risk: the Singapore Chinese Health Study. Carcinogenesis 2008;29(10):1967-1972. View abstract.

Janjua, R., Munoz, C., Gorell, E., Rehmus, W., Egbert, B., Kern, D., and Chang, A. L. A two-year, double-blind, randomized placebo-controlled trial of oral green tea polyphenols on the long-term clinical and histologic appearance of photoaging skin. Dermatol.Surg. 2009;35(7):1057-1065. View abstract.

Jankun, J., Selman, S. H., Swiercz, R., and Skrzypczak-Jankun, E. Why drinking green tea could prevent cancer. Nature 6-5-1997;387(6633):561. View abstract.

Javaid, A. and Bonkovsky, H. L. Hepatotoxicity due to extracts of Chinese green tea (Camellia sinensis): a growing concern. J Hepatol 2006;45(2):334-335. View abstract.

Ji, B. T., Chow, W. H., Hsing, A. W., McLaughlin, J. K., Dai, Q., Gao, Y. T., Blot, W. J., and Fraumeni, J. F., Jr. Green tea consumption and the risk of pancreatic and colorectal cancers. Int J Cancer 1-27-1997;70(3):255-258. View abstract.

Jin, X., Zheng, R. H., and Li, Y. M. Green tea consumption and liver disease: a systematic review. Liver Int 2008;28(7):990-996. View abstract.

Josic, J., Olsson, A. T., Wickeberg, J., Lindstedt, S., and Hlebowicz, J. Does green tea affect postprandial glucose, insulin and satiety in healthy subjects: a randomized controlled trial. Nutr.J. 2010;9:63. View abstract.

Jowko, E., Sacharuk, J., Balasinska, B., Ostaszewski, P., Charmas, M., and Charmas, R. Green tea extract supplementation gives protection against exercise-induced oxidative damage in healthy men. Nutr.Res. 2011;31(11):813-821. View abstract.

Jurgens, T. M., Whelan, A. M., Killian, L., Doucette, S., Kirk, S., and Foy, E. Green tea for weight loss and weight maintenance in overweight or obese adults. Cochrane.Database.Syst.Rev. 2012;12:CD008650. View abstract.

Kakuta, Y., Nakaya, N., Nagase, S., Fujita, M., Koizumi, T., Okamura, C., Niikura, H., Ohmori, K., Kuriyama, S., Tase, T., Ito, K., Minami, Y., Yaegashi, N., and Tsuji, I. Case-control study of green tea consumption and the risk of endometrial endometrioid adenocarcinoma. Cancer Causes Control 2009;20(5):617-624. View abstract.

Kalus, U., Kiesewetter, H., and Radtke, H. Effect of CYSTUS052 and green tea on subjective symptoms in patients with infection of the upper respiratory tract. Phytother.Res. 2010;24(1):96-100. View abstract.

Karth, A., Holoshitz, N., Kavinsky, C. J., Trohman, R., and McBride, B. F. A case report of atrial fibrillation potentially induced by hydroxycut: a multicomponent dietary weight loss supplement devoid of sympathomimetic amines. J.Pharm.Pract. 2010;23(3):245-249. View abstract.

Katiyar, S. K., Matsui, M. S., Elmets, C. A., and Mukhtar, H. Polyphenolic antioxidant (-)-epigallocatechin-3-gallate from green tea reduces UVB-induced inflammatory responses and infiltration of leukocytes in human skin. Photochem.Photobiol. 1999;69(2):148-153. View abstract.

Kato, M. T., Leite, A. L., Hannas, A. R., and Buzalaf, M. A. Gels containing MMP inhibitors prevent dental erosion in situ. J Dent.Res. 2010;89(5):468-472. View abstract.

Key, T. J., Sharp, G. B., Appleby, P. N., Beral, V., Goodman, M. T., Soda, M., and Mabuchi, K. Soya foods and breast cancer risk: a prospective study in Hiroshima and Nagasaki, Japan. Br J Cancer 1999;81(7):1248-1256. View abstract.

Kikuchi, N., Ohmori, K., Shimazu, T., Nakaya, N., Kuriyama, S., Nishino, Y., Tsubono, Y., and Tsuji, I. No association between green tea and prostate cancer risk in Japanese men: the Ohsaki Cohort Study. Br.J Cancer 8-7-2006;95(3):371-373. View abstract.

Kim, W., Jeong, M. H., Cho, S. H., Yun, J. H., Chae, H. J., Ahn, Y. K., Lee, M. C., Cheng, X., Kondo, T., Murohara, T., and Kang, J. C. Effect of green tea consumption on endothelial function and circulating endothelial progenitor cells in chronic smokers. Circ.J 2006;70(8):1052-1057. View abstract.

Kohler, M., Pavy, A., and van den Heuvel, C. The effects of chewing versus caffeine on alertness, cognitive performance and cardiac autonomic activity during sleep deprivation. J Sleep Res. 2006;15(4):358-368. View abstract.

Komatsu, T., Nakamori, M., Komatsu, K., Hosoda, K., Okamura, M., Toyama, K., Ishikura, Y., Sakai, T., Kunii, D., and Yamamoto, S. Oolong tea increases energy metabolism in Japanese females. J Med Invest 2003;50(3-4):170-175. View abstract.

Kristen, A. V., Lehrke, S., Buss, S., Mereles, D., Steen, H., Ehlermann, P., Hardt, S., Giannitsis, E., Schreiner, R., Haberkorn, U., Schnabel, P. A., Linke, R. P., Rocken, C., Wanker, E. E., Dengler, T. J., Altland, K., and Katus, H. A. Green tea halts progression of cardiac transthyretin amyloidosis: an observational report. Clin.Res.Cardiol. 2012;101(10):805-813. View abstract.

Kuo, Y. C., Yu, C. L., Liu, C. Y., Wang, S. F., Pan, P. C., Wu, M. T., Ho, C. K., Lo, Y. S., Li, Y., and Christiani, D. C. A population-based, case-control study of green tea consumption and leukemia risk in southwestern Taiwan. Cancer Causes Control 2009;20(1):57-65. View abstract.

Kurahashi, N., Inoue, M., Iwasaki, M., Sasazuki, S., and Tsugane, S. Coffee, green tea, and caffeine consumption and subsequent risk of bladder cancer in relation to smoking status: a prospective study in Japan. Cancer Sci. 2009;100(2):294-91. View abstract.

Kurahashi, N., Sasazuki, S., Iwasaki, M., Inoue, M., and Tsugane, S. Green tea consumption and prostate cancer risk in Japanese men: a prospective study. Am J Epidemiol. 1-1-2008;167(1):71-77. View abstract.

Kuriyama, S. The relation between green tea consumption and cardiovascular disease as evidenced by epidemiological studies. J Nutr. 2008;138(8):1548S-1553S. View abstract.

Kushima, Y., Iida, K., Nagaoka, Y., Kawaratani, Y., Shirahama, T., Sakaguchi, M., Baba, K., Hara, Y., and Uesato, S. Inhibitory effect of (-)-epigallocatechin and (-)-epigallocatechin gallate against heregulin beta1-induced migration/invasion of the MCF-7 breast carcinoma cell line. Biol.Pharm.Bull. 2009;32(5):899-904. View abstract.

Kushiyama, M., Shimazaki, Y., Murakami, M., and Yamashita, Y. Relationship between intake of green tea and periodontal disease. J Periodontol. 2009;80(3):372-377. View abstract.

Lang, M., Henson, R., Braconi, C., and Patel, T. Epigallocatechin-gallate modulates chemotherapy-induced apoptosis in human cholangiocarcinoma cells. Liver Int 2009;29(5):670-677. View abstract.

Langley, P. C. A cost-effectiveness analysis of sinecatechins in the treatment of external genital warts. J.Med.Econ. 2010;13(1):1-7. View abstract.

Laurie, S. A., Miller, V. A., Grant, S. C., Kris, M. G., and Ng, K. K. Phase I study of green tea extract in patients with advanced lung cancer. Cancer Chemother.Pharmacol. 2005;55(1):33-38. View abstract.

Levites, Y., Amit, T., Mandel, S., and Youdim, M. B. Neuroprotection and neurorescue against Abeta toxicity and PKC-dependent release of nonamyloidogenic soluble precursor protein by green tea polyphenol (-)-epigallocatechin-3-gallate. FASEB J 2003;17(8):952-954. View abstract.

Li, G. X., Chen, Y. K., Hou, Z., Xiao, H., Jin, H., Lu, G., Lee, M. J., Liu, B., Guan, F., Yang, Z., Yu, A., and Yang, C. S. Pro-oxidative activities and dose-response relationship of (-)-epigallocatechin-3-gallate in the inhibition of lung cancer cell growth: a comparative study in vivo and in vitro. Carcinogenesis 2010;31(5):902-910. View abstract.

Li, R., Huang, Y. G., Fang, D., and Le, W. D. (-)-Epigallocatechin gallate inhibits lipopolysaccharide-induced microglial activation and protects against inflammation-mediated dopaminergic neuronal injury. J Neurosci.Res. 12-1-2004;78(5):723-731. View abstract.

Liatsos, G. D., Moulakakis, A., Ketikoglou, I., and Klonari, S. Possible green tea-induced thrombotic thrombocytopenic purpura. Am.J Health Syst.Pharm. 4-1-2010;67(7):531-534. View abstract.

Lin, C. L., Chen, T. F., Chiu, M. J., Way, T. D., and Lin, J. K. Epigallocatechin gallate (EGCG) suppresses beta-amyloid-induced neurotoxicity through inhibiting c-Abl/FE65 nuclear translocation and GSK3 beta activation. Neurobiol.Aging 2009;30(1):81-92. View abstract.

Lonac, M. C., Richards, J. C., Schweder, M. M., Johnson, T. K., and Bell, C. Influence of Short-Term Consumption of the Caffeine-Free, Epigallocatechin-3-Gallate Supplement, Teavigo, on Resting Metabolism and the Thermic Effect of Feeding. Obesity.(Silver.Spring) 8-19-2010; View abstract.

Maeda-Yamamoto, M., Ema, K., Monobe, M., Shibuichi, I., Shinoda, Y., Yamamoto, T., and Fujisawa, T. The efficacy of early treatment of seasonal allergic rhinitis with benifuuki green tea containing O-methylated catechin before pollen exposure: an open randomized study. Allergol.Int 2009;58(3):437-444. View abstract.

Magalhaes, A. C., Wiegand, A., Rios, D., Hannas, A., Attin, T., and Buzalaf, M. A. Chlorhexidine and green tea extract reduce dentin erosion and abrasion in situ. J Dent. 2009;37(12):994-998. View abstract.

Mahmood, T., Akhtar, N., Khan, B. A., Shoaib Khan, H. M., and Saeed, T. Changes in skin mechanical properties after long-term application of cream containing green tea extract. Aging Clin.Exp.Res. 2011;23(5-6):333-336. View abstract.

Maki, K. C., Reeves, M. S., Farmer, M., Yasunaga, K., Matsuo, N., Katsuragi, Y., Komikado, M., Tokimitsu, I., Wilder, D., Jones, F., Blumberg, J. B., and Cartwright, Y. Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults. J Nutr 2009;139(2):264-270. View abstract.

Mangine, G. T., Gonzalez, A. M., Wells, A. J., McCormack, W. P., Fragala, M. S., Stout, J. R., and Hoffman, J. R. The effect of a dietary supplement (N-oleyl-phosphatidyl-ethanolamine and epigallocatechin gallate) on dietary compliance and body fat loss in adults who are overweight: a double-blind, randomized control trial. Lipids Health Dis. 2012;11:127. View abstract.

Martinez-Sierra, C., Rendon, Unceta P., and Martin, Herrera L. [Acute hepatitis after green tea ingestion]. Med Clin (Barc.) 6-17-2006;127(3):119. View abstract.

Matsumoto, K., Yamada, H., Takuma, N., Niino, H., and Sagesaka, Y. M. Effects of green tea catechins and theanine on preventing influenza infection among healthcare workers: a randomized controlled trial. BMC.Complement Altern.Med. 2011;11:15. View abstract.

Matsuyama, T., Tanaka, Y., Kamimaki, I., Nagao, T., and Tokimitsu, I. Catechin safely improved higher levels of fatness, blood pressure, and cholesterol in children. Obesity.(Silver.Spring) 2008;16(6):1338-1348. View abstract.

Melgarejo, E., Medina, M. A., Sanchez-Jimenez, F., and Urdiales, J. L. Epigallocatechin gallate reduces human monocyte mobility and adhesion in vitro. Br.J Pharmacol. 2009;158(7):1705-1712. View abstract.

Meltzer, S. M., Monk, B. J., and Tewari, K. S. Green tea catechins for treatment of external genital warts. Am J Obstet.Gynecol. 2009;200(3):233-237. View abstract.

Miller, R. J., Jackson, K. G., Dadd, T., Mayes, A. E., Brown, A. L., Lovegrove, J. A., and Minihane, A. M. The impact of the catechol-O-methyltransferase genotype on vascular function and blood pressure after acute green tea ingestion. Mol.Nutr.Food Res. 2012;56(6):966-975. View abstract.

Miller, R. J., Jackson, K. G., Dadd, T., Nicol, B., Dick, J. L., Mayes, A. E., Brown, A. L., and Minihane, A. M. A preliminary investigation of the impact of catechol-O-methyltransferase genotype on the absorption and metabolism of green tea catechins. Eur.J.Nutr. 2012;51(1):47-55. View abstract.

Mineharu, Y., Koizumi, A., Wada, Y., Iso, H., Watanabe, Y., Date, C., Yamamoto, A., Kikuchi, S., Inaba, Y., Toyoshima, H., Kondo, T., and Tamakoshi, A. Coffee, green tea, black tea and oolong tea consumption and risk of mortality from cardiovascular disease in Japanese men and women. J Epidemiol.Community Health 7-14-2010; View abstract.

Mnich, C. D., Hoek, K. S., Virkki, L. V., Farkas, A., Dudli, C., Laine, E., Urosevic, M., and Dummer, R. Green tea extract reduces induction of p53 and apoptosis in UVB-irradiated human skin independent of transcriptional controls. Exp Dermatol. 2009;18(1):69-77. View abstract.

Molinari, M., Watt, K. D., Kruszyna, T., Nelson, R., Walsh, M., Huang, W. Y., Nashan, B., and Peltekian, K. Acute liver failure induced by green tea extracts: case report and review of the literature. Liver Transpl. 2006;12(12):1892-1895. View abstract.

Mou, N. Z, Ren, G. L., Mou, L. H., and Lu, C. T. Reasearch on the influence of catechin on fatty liver disease (in Chinese). Shandong J Traditional Chin Med 1998;17:55-56.

Mu, D., Yu, J. X., and Li, D. Obervation on the therapeutic effect in the treatment of 26 patients with fatty liver by tea pigment capsules (in Chinese). J Norman Bethune Univ Med Sci 1997;23:528-530.

Mu, L. N., Zhou, X. F., Ding, B. G., and Wang, R. H. Study on the protective effect of preen tea on gastric, liver and esophageal cancer (in Chinese). Chin J Prev Med 2003;37:171-173.

Mukoyama, A., Ushijima, H., Nishimura, S., Koike, H., Toda, M., Hara, Y., and Shimamura, T. Inhibition of rotavirus and enterovirus infections by tea extracts. Jpn.J Med.Sci Biol. 1991;44(4):181-186. View abstract.

Mulder, T. P., Rietveld, A. G., and Van Amelsvoort, J. M. Consumption of both black tea and green tea results in an increase in the excretion of hippuric acid into urine. Am.J.Clin Nutr. 2005;81(1 Suppl):256S-260S. View abstract.

Muller, N., Ellinger, S., Alteheld, B., Ulrich-Merzenich, G., Berthold, H. K., Vetter, H., and Stehle, P. Bolus ingestion of white and green tea increases the concentration of several flavan-3-ols in plasma, but does not affect markers of oxidative stress in healthy non-smokers. Mol.Nutr.Food Res. 6-10-2010; View abstract.

Myung, S. K., Bae, W. K., Oh, S. M., Kim, Y., Ju, W., Sung, J., Lee, Y. J., Ko, J. A., Song, J. I., and Choi, H. J. Green tea consumption and risk of stomach cancer: a meta-analysis of epidemiologic studies. Int J Cancer 2-1-2009;124(3):670-677. View abstract.

Nagano, J., Kono, S., Preston, D. L., and Mabuchi, K. A prospective study of green tea consumption and cancer incidence, Hiroshima and Nagasaki (Japan). Cancer Causes Control 2001;12(6):501-508. View abstract.

Nagano, J., Kono, S., Preston, D. L., Moriwaki, H., Sharp, G. B., Koyama, K., and Mabuchi, K. Bladder-cancer incidence in relation to vegetable and fruit consumption: a prospective study of atomic-bomb survivors. Int J Cancer 4-1-2000;86(1):132-138. View abstract.

Nagao, T., Hase, T., and Tokimitsu, I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity.(Silver.Spring) 2007;15(6):1473-1483. View abstract.

Nagao, T., Komine, Y., Soga, S., Meguro, S., Hase, T., Tanaka, Y., and Tokimitsu, I. Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr 2005;81(1):122-129. View abstract.

Nagao, T., Meguro, S., Hase, T., Otsuka, K., Komikado, M., Tokimitsu, I., Yamamoto, T., and Yamamoto, K. A catechin-rich beverage improves obesity and blood glucose control in patients with type 2 diabetes. Obesity.(Silver.Spring) 2009;17(2):310-317. View abstract.

Nagata, C., Kabuto, M., and Shimizu, H. Association of coffee, green tea, and caffeine intakes with serum concentrations of estradiol and sex hormone-binding globulin in premenopausal Japanese women. Nutr Cancer 1998;30(1):21-24. View abstract.

Nakachi, K., Matsuyama, S., Miyake, S., Suganuma, M., and Imai, K. Preventive effects of drinking green tea on cancer and cardiovascular disease: epidemiological evidence for multiple targeting prevention. Biofactors 2000;13(1-4):49-54. View abstract.

Nakachi, K., Suemasu, K., Suga, K., Takeo, T., Imai, K., and Higashi, Y. Influence of drinking green tea on breast cancer malignancy among Japanese patients. Jpn J Cancer Res 1998;89(3):254-261. View abstract.

Nakagawa, K., Okuda, S., and Miyazawa, T. Dose-dependent incorporation of tea catechins, (-)-epigallocatechin-3- gallate and (-)-epigallocatechin, into human plasma. Biosci.Biotechnol.Biochem 1997;61(12):1981-1985. View abstract.

Nakayama, M., Suzuki, K., Toda, M., Okubo, S., Hara, Y., and Shimamura, T. Inhibition of the infectivity of influenza virus by tea polyphenols. Antiviral Res. 1993;21(4):289-299. View abstract.

Nance, C. L., Siwak, E. B., and Shearer, W. T. Preclinical development of the green tea catechin, epigallocatechin gallate, as an HIV-1 therapy. J Allergy Clin Immunol. 2009;123(2):459-465. View abstract.

Nantz, M. P., Rowe, C. A., Bukowski, J. F., and Percival, S. S. Standardized capsule of Camellia sinensis lowers cardiovascular risk factors in a randomized, double-blind, placebo-controlled study. Nutrition 2009;25(2):147-154. View abstract.

Netsch, M. I., Gutmann, H., Schmidlin, C. B., Aydogan, C., and Drewe, J. Induction of CYP1A by green tea extract in human intestinal cell lines. Planta Med 2006;72(6):514-520. View abstract.

Nguyen, M. M., Ahmann, F. R., Nagle, R. B., Hsu, C. H., Tangrea, J. A., Parnes, H. L., Sokoloff, M. H., Gretzer, M. B., and Chow, H. H. Randomized, double-blind, placebo-controlled trial of polyphenon E in prostate cancer patients before prostatectomy: evaluation of potential chemopreventive activities. Cancer Prev.Res.(Phila) 2012;5(2):290-298. View abstract.

Ogunleye, A. A., Xue, F., and Michels, K. B. Green tea consumption and breast cancer risk or recurrence: a meta-analysis. Breast Cancer Res.Treat. 2010;119(2):477-484. View abstract.

Okada, N., Tanabe, H., Tazoe, H., Ishigami, Y., Fukutomi, R., Yasui, K., and Isemura, M. Differentiation-associated alteration in sensitivity to apoptosis induced by (-)-epigallocatechin-3-O-gallate in HL-60 cells. Biomed.Res. 2009;30(4):201-206. View abstract.

Osterburg, A., Gardner, J., Hyon, S. H., Neely, A., and Babcock, G. Highly antibiotic-resistant Acinetobacter baumannii clinical isolates are killed by the green tea polyphenol (-)-epigallocatechin-3-gallate (EGCG). Clin Microbiol.Infect. 2009;15(4):341-346. View abstract.

Ostrowska, J. and Skrzydlewska, E. The comparison of effect of catechins and green tea extract on oxidative modification of LDL in vitro. Adv Med Sci 2006;51:298-303. View abstract.

Otake, S., Makimura, M., Kuroki, T., Nishihara, Y., and Hirasawa, M. Anticaries effects of polyphenolic compounds from Japanese green tea. Caries Res 1991;25(6):438-443. View abstract.

Otera, H., Tada, K., Sakurai, T., Hashimoto, K., and Ikeda, A. Hypersensitivity pneumonitis associated with inhalation of catechin-rich green tea extracts. Respiration 2011;82(4):388-392. View abstract.

Oyama, J., Maeda, T., Kouzuma, K., Ochiai, R., Tokimitsu, I., Higuchi, Y., Sugano, M., and Makino, N. Green tea catechins improve human forearm endothelial dysfunction and have antiatherosclerotic effects in smokers. Circ.J 2010;74(3):578-588. View abstract.

Oyama, J., Maeda, T., Sasaki, M., Kozuma, K., Ochiai, R., Tokimitsu, I., Taguchi, S., Higuchi, Y., and Makino, N. Green tea catechins improve human forearm vascular function and have potent anti-inflammatory and anti-apoptotic effects in smokers. Intern.Med. 2010;49(23):2553-2559. View abstract.

Pan, T., Fei, J., Zhou, X., Jankovic, J., and Le, W. Effects of green tea polyphenols on dopamine uptake and on MPP+ -induced dopamine neuron injury. Life Sci. 1-17-2003;72(9):1073-1083. View abstract.

Panza, V. S., Wazlawik, E., Ricardo, Schutz G., Comin, L., Hecht, K. C., and da Silva, E. L. Consumption of green tea favorably affects oxidative stress markers in weight-trained men. Nutrition 2008;24(5):433-442. View abstract.

Papparella, I., Ceolotto, G., Montemurro, D., Antonello, M., Garbisa, S., Rossi, G., and Semplicini, A. Green tea attenuates angiotensin II-induced cardiac hypertrophy in rats by modulating reactive oxygen species production and the Src/epidermal growth factor receptor/Akt signaling pathway. J Nutr. 2008;138(9):1596-1601. View abstract.

Park, C. S., Kim, W., Woo, J. S., Ha, S. J., Kang, W. Y., Hwang, S. H., Park, Y. W., Kim, Y. S., Ahn, Y. K., Jeong, M. H., and Kim, W. Green tea consumption improves endothelial function but not circulating endothelial progenitor cells in patients with chronic renal failure. Int J Cardiol. 12-2-2009; View abstract.

Park, M., Yamada, H., Matsushita, K., Kaji, S., Goto, T., Okada, Y., Kosuge, K., and Kitagawa, T. Green tea consumption is inversely associated with the incidence of influenza infection among schoolchildren in a tea plantation area of Japan. J.Nutr. 2011;141(10):1862-1870. View abstract.

Park, S. K., Jung, I. C., Lee, W. K., Lee, Y. S., Park, H. K., Go, H. J., Kim, K., Lim, N. K., Hong, J. T., Ly, S. Y., and Rho, S. S. A combination of green tea extract and l-theanine improves memory and attention in subjects with mild cognitive impairment: a double-blind placebo-controlled study. J.Med.Food 2011;14(4):334-343. View abstract.

Pavel, L. and Pave, S. [Usefulness of micronutrients in the treatment of periodontitis]. Ned.Tijdschr.Tandheelkd. 2010;117(2):103-106. View abstract.

Pecorari, M., Villano, D., Testa, M. F., Schmid, M., and Serafini, M. Biomarkers of antioxidant status following ingestion of green teas at different polyphenol concentrations and antioxidant capacity in human volunteers. Mol.Nutr.Food Res. 2010;54 Suppl 2:S278-S283. View abstract.

Pietta, P., Simonetti, P., Gardana, C., Brusamolino, A., Morazzoni, P., and Bombardelli, E. Relationship between rate and extent of catechin absorption and plasma antioxidant status. Biochem Mol.Biol Int. 1998;46(5):895-903. View abstract.

Rasheed, Z., Anbazhagan, A. N., Akhtar, N., Ramamurthy, S., Voss, F. R., and Haqqi, T. M. Green tea polyphenol epigallocatechin-3-gallate inhibits advanced glycation end product-induced expression of tumor necrosis factor-alpha and matrix metalloproteinase-13 in human chondrocytes. Arthritis Res.Ther. 2009;11(3):R71. View abstract.

Renouf, M., Guy, P., Marmet, C., Longet, K., Fraering, A. L., Moulin, J., Barron, D., Dionisi, F., Cavin, C., Steiling, H., and Williamson, G. Plasma appearance and correlation between coffee and green tea metabolites in human subjects. Br.J Nutr. 8-9-2010;1-6. View abstract.

Richards, J. C., Lonac, M. C., Johnson, T. K., Schweder, M. M., and Bell, C. Epigallocatechin-3-gallate Increases Maximal Oxygen Uptake in Adult Humans. Med Sci.Sports Exerc. 11-27-2009; View abstract.

Rizvi, S. I., Jha, R., and Pandey, K. B. Activation of erythrocyte plasma membrane redox system provides a useful method to evaluate antioxidant potential of plant polyphenols. Methods Mol.Biol. 2010;594:341-348. View abstract.

Rohde, J., Jacobsen, C., and Kromann-Andersen, H. [Toxic hepatitis triggered by green tea]. Ugeskr.Laeger 1-17-2011;173(3):205-206. View abstract.

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Shimizu, M., Fukutomi, Y., Ninomiya, M., Nagura, K., Kato, T., Araki, H., Suganuma, M., Fujiki, H., and Moriwaki, H. Green tea extracts for the prevention of metachronous colorectal adenomas: a pilot study. Cancer Epidemiol.Biomarkers Prev. 2008;17(11):3020-3025. View abstract.

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Slivova, V., Zaloga, G., DeMichele, S. J., Mukerji, P., Huang, Y. S., Siddiqui, R., Harvey, K., Valachovicova, T., and Sliva, D. Green tea polyphenols modulate secretion of urokinase plasminogen activator (uPA) and inhibit invasive behavior of breast cancer cells. Nutr Cancer 2005;52(1):66-73. View abstract.

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Sonoda, J., Koriyama, C., Yamamoto, S., Kozako, T., Li, H. C., Lema, C., Yashiki, S., Fujiyoshi, T., Yoshinaga, M., Nagata, Y., Akiba, S., Takezaki, T., Yamada, K., and Sonoda, S. HTLV-1 provirus load in peripheral blood lymphocytes of HTLV-1 carriers is diminished by green tea drinking. Cancer Sci 2004;95(7):596-601. View abstract.

Stendell-Hollis, N. R., Thomson, C. A., Thompson, P. A., Bea, J. W., Cussler, E. C., and Hakim, I. A. Green tea improves metabolic biomarkers, not weight or body composition: a pilot study in overweight breast cancer survivors. J.Hum.Nutr.Diet. 2010;23(6):590-600. View abstract.

Stingl, J. C., Ettrich, T., Muche, R., Wiedom, M., Brockmoller, J., Seeringer, A., and Seufferlein, T. Protocol for minimizing the risk of metachronous adenomas of the colorectum with green tea extract (MIRACLE): a randomised controlled trial of green tea extract versus placebo for nutriprevention of metachronous colon adenomas in the elderly population. BMC.Cancer 2011;11:360. View abstract.

Stockfleth, E., Beti, H., Orasan, R., Grigorian, F., Mescheder, A., Tawfik, H., and Thielert, C. Topical Polyphenon E in the treatment of external genital and perianal warts: a randomized controlled trial. Br.J Dermatol. 2008;158(6):1329-1338. View abstract.

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Tatti, S., Swinehart, J. M., Thielert, C., Tawfik, H., Mescheder, A., and Beutner, K. R. Sinecatechins, a defined green tea extract, in the treatment of external anogenital warts: a randomized controlled trial. Obstet.Gynecol. 2008;111(6):1371-1379. View abstract.

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Wu, M., Liu, A. M., Kampman, E., Zhang, Z. F., Van't Veer, P., Wu, D. L., Wang, P. H., Yang, J., Qin, Y., Mu, L. N., Kok, F. J., and Zhao, J. K. Green tea drinking, high tea temperature and esophageal cancer in high- and low-risk areas of Jiangsu Province, China: a population-based case-control study. Int J Cancer 4-15-2009;124(8):1907-1913. View abstract.

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