Tea consumption and long-term risk of type 2 diabetes and diabetic complications: a cohort study of 0.5 million Chinese adults

ABSTRACT Background Evidence from epidemiological studies remains inconsistent or limited about the associations of tea consumption with incident diabetes and risk of diabetic complications and death among patients with diabetes. Objectives We aimed to investigate the associations of tea consumption with long-term risk of developing type 2 diabetes (T2D) and risks of diabetic complications and death among patients with diabetes. Methods This study included 482,425 diabetes-free participants and 30,300 patients with diabetes aged 30–79 y at study enrollment from the China Kadoorie Biobank. Tea consumption information was collected at baseline by interviewer-administered questionnaires. Incidences of diabetes, diabetic complications, and death were identified by linkages to the National Health Insurance system, disease registries, and death registries. Cox proportional hazard regression models were used to estimate HRs and 95% CIs. Results The mean ± SD age of participants free of diabetes was 51.2 ± 10.5 y and 41% were male. The mean ± SD age of patients with diabetes was 58.2 ± 9.6 y and 39% were male. Of all daily tea consumers, 85.8% preferred green tea. In the diabetes-free population, 17,434 participants developed incident T2D during 11.1 y of follow-up. Compared with participants who never consumed tea in the past year, the HR (95% CI) of T2D for daily consumers was 0.92 (0.88, 0.97). In patients with diabetes, we identified 6572 deaths, 12,677 diabetic macrovascular cases, and 2441 diabetic microvascular cases during follow-up. Compared with patients who never consumed tea in the past year, the HRs (95% CIs) of all-cause mortality and risk of microvascular complications for daily consumers were 0.90 (0.83, 0.97) and 0.88 (0.78, 1.00), respectively. Tea consumption was not associated with risk of macrovascular complications among patients with diabetes. With regard to tea consumed, the inverse associations between daily tea consumption and risks of T2D and all-cause mortality in patients with diabetes were only observed among daily green tea drinkers. Conclusions In Chinese adults, daily green tea consumption was associated with a lower risk of incident T2D and a lower risk of all-cause mortality in patients with diabetes, but the associations for other types of tea were less clear. In addition, daily tea consumption was associated with a lower risk of diabetic microvascular complications, but not macrovascular complications.

[1]  G. Ning,et al.  Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study , 2020, BMJ.

[2]  Hongbing Shen,et al.  Tea consumption and risk of stroke in Chinese adults: a prospective cohort study of 0.5 million men and women. , 2019, The American journal of clinical nutrition.

[3]  R. Collins,et al.  Adherence to a healthy lifestyle and all-cause and cause-specific mortality in Chinese adults: a 10-year prospective study of 0.5 million people , 2019, International Journal of Behavioral Nutrition and Physical Activity.

[4]  Michael J. González,et al.  The effect of green tea on C-reactive protein and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. , 2019, Complementary therapies in medicine.

[5]  J. Shaw,et al.  Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. , 2019, Diabetes research and clinical practice.

[6]  R. Gan,et al.  Effects and Mechanisms of Tea for the Prevention and Management of Diabetes Mellitus and Diabetic Complications: An Updated Review , 2019, Antioxidants.

[7]  A. Goto,et al.  Effects of Coffee and Tea Consumption on Glucose Metabolism: A Systematic Review and Network Meta-Analysis , 2018, Nutrients.

[8]  Thomas J. Wang,et al.  Green tea consumption and risk of type 2 diabetes in Chinese adults: the Shanghai Women's Health Study and the Shanghai Men's Health Study. , 2018, International journal of epidemiology.

[9]  Yuerong Liang,et al.  Antidiabetic Effects of Tea , 2017, Molecules.

[10]  William Herrington,et al.  Association Between Diabetes and Cause-Specific Mortality in Rural and Urban Areas of China , 2017, JAMA.

[11]  Zhengming Chen,et al.  Tea consumption and risk of ischaemic heart disease , 2017, Heart.

[12]  R. Feng,et al.  Effects of tea or tea extract on metabolic profiles in patients with type 2 diabetes mellitus: a meta‐analysis of ten randomized controlled trials , 2016, Diabetes/metabolism research and reviews.

[13]  C. Pan,et al.  Regular Chinese Green Tea Consumption Is Protective for Diabetic Retinopathy: A Clinic-Based Case-Control Study , 2015, Journal of diabetes research.

[14]  P. Gilon,et al.  Can Tea Extracts Exert a Protective Effect Against Diabetes by Reducing Oxidative Stress and Decreasing Glucotoxicity in Pancreatic β-Cells? , 2015, Diabetes & metabolism journal.

[15]  Md. Musfiqur Rahman,et al.  Residues and contaminants in tea and tea infusions: a review , 2014, Food additives & contaminants. Part A, Chemistry, analysis, control, exposure & risk assessment.

[16]  Wan-shui Yang,et al.  Tea consumption and risk of type 2 diabetes: a dose–response meta-analysis of cohort studies , 2013, British Journal of Nutrition.

[17]  Ka Chen,et al.  Effect of green tea on glucose control and insulin sensitivity: a meta-analysis of 17 randomized controlled trials. , 2013, The American journal of clinical nutrition.

[18]  J. Manson,et al.  Caffeinated and caffeine-free beverages and risk of type 2 diabetes. , 2013, The American journal of clinical nutrition.

[19]  D. van der A,et al.  Tea Consumption and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study , 2012, PloS one.

[20]  R. Collins,et al.  China Kadoorie Biobank of 0.5 million people: survey methods, baseline characteristics and long-term follow-up. , 2011, International journal of epidemiology.

[21]  S. Fukuhara,et al.  High oolong tea consumption predicts future risk of diabetes among Japanese male workers: a prospective cohort study , 2011, Diabetic medicine : a journal of the British Diabetic Association.

[22]  Vilmundur Gudnason,et al.  Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death , 2011 .

[23]  J. Palmer,et al.  Coffee, tea, and alcohol intake in relation to risk of type 2 diabetes in African American women. , 2010, The American journal of clinical nutrition.

[24]  F. Clavel-Chapelon,et al.  Differential effects of coffee on the risk of type 2 diabetes according to meal consumption in a French cohort of women: the E3N/EPIC cohort study. , 2010, The American journal of clinical nutrition.

[25]  C. Nagata,et al.  Consumption of coffee, green tea, oolong tea, black tea, chocolate snacks and the caffeine content in relation to risk of diabetes in Japanese men and women , 2009, British Journal of Nutrition.

[26]  D. van der A,et al.  Coffee and tea consumption and risk of type 2 diabetes , 2009, Diabetologia.

[27]  M. Marmot,et al.  Prospective study of coffee and tea consumption in relation to risk of type 2 diabetes mellitus among men and women: the Whitehall II study. , 2008, The British journal of nutrition.

[28]  Mark A Pereira,et al.  Coffee, tea, and incident type 2 diabetes: the Singapore Chinese Health Study. , 2008, The American journal of clinical nutrition.

[29]  Jen-kun Lin,et al.  Epigallocatechin gallate (EGCG) attenuates high glucose-induced insulin signaling blockade in human hepG2 hepatoma cells. , 2008, Molecular nutrition & food research.

[30]  J. Tuomilehto,et al.  Joint association of coffee consumption and other factors to the risk of type 2 diabetes: a prospective study in Finland , 2006, International Journal of Obesity.

[31]  A. Tamakoshi,et al.  The Relationship between Green Tea and Total Caffeine Intake and Risk for Self-Reported Type 2 Diabetes among Japanese Adults , 2006, Annals of Internal Medicine.

[32]  Walter C Willett,et al.  Coffee, caffeine, and risk of type 2 diabetes: a prospective cohort study in younger and middle-aged U.S. women. , 2006, Diabetes care.

[33]  R. Collins,et al.  Cohort profile: the Kadoorie Study of Chronic Disease in China (KSCDC). , 2005, International journal of epidemiology.

[34]  C. Boozer,et al.  Coffee, tea and diabetes: the role of weight loss and caffeine , 2005, International Journal of Obesity.

[35]  Frank Hu,et al.  Coffee Consumption and Risk for Type 2 Diabetes Mellitus , 2004, Annals of Internal Medicine.