The Science of Tea: Green Tea in Risk of Life Style Related Diseases

Kyle J. Norton

Green tea, is a precious drink processes numbers of health benefit known to

almost everyone in Asia and Western world.

Lifestyle diseases are a class of diseases associated with the way a person or
group of people lives, including atherosclerosis, heart disease, and stroke;
obesity and type 2 diabetes....and diseases precipitated by smoking and alcohol
and drug abuse.

Epidemiological studies suggested that lifestyle-related diseases may be

preventable with the change of lifestyle accompanied with intake of some
nontoxic agents.

Differentiation of the effect of green tea in attenuated risk and treatment of

lifestyle related diseases was found to associate to some mechanisms involving
numbers of aspect(1), particularly, in gene facilitation.

For examples, in animal model, green tea administration inhibited risk and
symptoms and progression of chronic inflammatory diseases such as
rheumatoid arthritis and multiple sclerosis(1), through regulation of tumor
necrosis factor (TNF-alpha) gene(2) in expression of inflammatory cytokines in
promoted systematic inflammation in the acute phase of infection caused by
damage and injure tissues, in modulated the activation of NF-kappaB(2)
signalling pathway related to cellular response in induction of anti and pro
inflammatory stimulation and transcription factor complex (AP-1) in initiation
of inflammation against foreign invasion.

The inhibition of inflammatory cytokines expression reduced symptoms of

pain, reddish skin, swelling without limiting the protective effect of the immune
system to prevent damage tissues against invasion of foreign substances.

1. Dementia
Dementia is the loss of mental ability severed enough to interfere with people's
every life.

Alzheimer's disease is the most common type of dementia in aging people.

About 5-8% of all people over the age of 65 have some form of dementia, and
this number doubles every five years above that age.
According to the 5.7-year prospective cohort study, using a questionnaire,
information on daily green tea consumption and other lifestyle factors collected
from elderly Japanese individuals aged 65 years or more, green tea
consumption is associated to reduce risk of dementia with a incidence of rate of
occurrence of 8.7%(3).

In intracerebroventricular (ICV) infusion of streptozotocin (STZ) animal model

explicited chronic brain dysfunction involved long-term and progressive
deficits in learning, memory, and cognitive behavior, along with a permanent
and ongoing cerebral energy deficit, mice treated with green tea EGCG at a
dose of 10mg/kg/day for 4 weeks, showed a significant improvement in
reduced oxidative stress parameter against production of inflammatory and free
radical expression(4).

These inhibitions can be seen in the diminished AChE activity, glutathione

peroxidase activity as well as NO metabolites, and reactive oxygen species
contents

The enhanced antioxidants status induced neuroprotective effect was result of

EGCG injection in ameliorated inflammatory and free radical causes of cell
death in brain of treated mice.

Dr. Tomata Y, the lead author(4) of the study said, "The lower risk of incident
dementia was consistent even after selecting participants who did not have
subjective memory complaints at the baseline."

More explicitly, in the finding of a natural food for reverse or delay of risk
factors of dementia and AD, vascular, metabolic, and lifestyle-related factors
involved development of dementia and late-life cognitive disorders, green tea
with high amount of caffeine stimulate the psychoactive effects in attenuated
cognitive impairment/decline and dementia through heightened alertness and
arousal and improvement of cognitive performance(5).

Promisingly, such results have been proposed by several cross-sectional and

longitudinal population-based studies, particular in patients with mild cognitive
impairment and progression to dementia.

2. Alzheimer's disease
Alzheimer's disease is a neuro-degenerative condition of loss or decrease of
cognitive and memory functions due to aging.
According to the Maternal and Infant Health, ASL NA 3 SUD, epigallocatechin
and gallic acid, (-)-Epigallocatechin-3-Gallate (EGCG), found in green tea
exerted a strong anti-inflammatory and anti oxidative properties in protection
against neuronal damage and brain edema(6).

The study also stated that green tea may also contribute to reduced risk and
treatment of AD by ameliorated chronic viral infection, one of the cause in
responsible for AD's neuropathology.

Dr. Mandel SA(7). the lead author and expert in green tea study said, "tea
drinking may decrease the incidence of dementia, AD, and PD. In particular, its
main catechin polyphenol constituent (-)-epigallocatechin-3-gallate (EGCG)
has been shown to exert neuroprotective/neurorescue activities in a wide array
of cellular and animal models of neurological disorders".

Other researchers suggested that the efficacy of epigallocatechin and gallic

acid, (-)-Epigallocatechin-3-Gallate (EGCG) in reduced risk of AD may be
attributed to
* The antioxidant activity(7) in ameliorate production of ROS in induced risk
of oxidative stress which has been found to associate to production of lipid
peroxidation, leading to abnormal deposition of amyloid β (Aβ) peptide(7)
* Free radical over expression in aging people also vulnerable to imbalance of
antioxidant and ROS
may have a negatively direct interaction with proteins, nucleic acids, and other
molecules and may also alter their structures and functions in inducing risk AD.

As a single ingredient isolated from green tea, epigallocatechin and gallic acid,
(-)-Epigallocatechin-3-Gallate (EGCG) have been found to cause toxicity in
some cases in medical literature. Therefore taking the ingredient in long term
and overdoses may have a implication of liver damage.

In a animal study to evaluate the efficacy of Caffeic acid(8) in AD, mice rats
randomly divided into three groups: i) control group, ii) AD model group and
iii) caffeic acid group, mice fed with the phytochemical expressed a significant
in increased learning deficit and cognitive function demonstrated by the Morris
water maze task in compared control.

Fed mice also displayed of attenuated oxidative stress, inflammation, nuclear

factor-κB-p65 protein expression (8)involved inflammatory cytokines
production and suppressed caspase-3 activity induced cell death and other
mechanisms in the rats with AD.

The inflammatory process has shown to have an negative role in increased risk
of AD, by causing neuroinflammation(8), including brain cells such as
microglia and astrocytes and subsequently in promoted dysfunction and
neuronal death. Therefore by suppressing production of inflammatory cytokins,
caffeic acid expressed a significant reduction of AD risk.

The efficacy in contribution of cognitive improvement following caffeic acid(8)

(9) application may be due to its antioxidant activity and restoration of
cholinergic functions, as deficiency of cholinergic function has shown to effect
cognition, behavior and activities of daily living.

3. Arthritis
Arthritis is a chronic condition characterized by painful inflammation and
stiffness of the joints.

According to statistic, arthritis is the common autoimmune disorder affected

over 50 millions world wide.

According to the College of Pharmacy, green tea epigallocatechin 3-gallate

(EGCG) in preclinical studies displayed a significant effect in treatment of
arthritic disease(12).

In vitro, application of green tea extract EGCG demonstrated activities in

cartilage-preserving and chondroprotective action through reduced expression
of proinflammatory IL-1β, TNFα, and IL-6
and modulated extracellular matrix (ECM)(11) turnover induced changes of the
biomechanical environment of chondrocytes and accelerate the degradation of
cartilage as well driving the progression of the disease in the presence of
inflammation.

Normal extracellular matrix (ECM) is a composed collagen type II with

function to provide tensile support for the tissue.

In expression of proinflamatory factors researchers found that the over

expression of proinflammatory cytokines IL-1 and IL-6 were associated
correlatively in knee joints in arthritis and inhibition of IL-1 snd IL-6 by green
tea EGCG IL-1 showed to reduce joint damage.
Some researchers also suggested that Interleukin 1 (IL-1)(11) is a crucial
mediator of the inflammatory response, playing an important part in the body's
natural responses and the development of pathological conditions leading to
chronic inflammation.

In expression of tumor necrosis factor (TNF, tumor necrosis factor alpha,TNFα,

cachexin, or cachectin), application of green tea inhibited the levels of TNFα in
induction of synovial fibroblast cytotoxicity.

In the study to evaluate the possible effects of the administration of a green tea
extract on the oxidative state of the liver and brain of adjuvant-induced arthritic
rats, researchers indicated that green tea daily doses of 250 mg kg(-1) (59.8 mg
catechins per kg) for 23 days displays a strong effect in decreased symptoms of
arthritis by ameliorated diminutions in protein and lipid damage in liver, brain
and plasma, through antioxidant effect in reduced levels of ROS(10) in
stimulated free radical chain reaction to initiate production of pro inflammatory
cytokines to precipitate chronic diseases.

Rats treated with green tea EGCG also showed a significant improvement in
restored natural antioxidant glutathione (GSH) and protein thiol(10) levels
produced by the body, by exhibiting the activities of the antioxidant enzymes.

Green tea injection also normalized the activity of glucose 6-phosphate

dehydrogenase(10), which is increased in the liver of arthritic patients and
considered as a risk factor for the development of arthritis. Increased activity
glucose 6-phosphate dehydrogenase was associated to r eactive oxygen
species (ROS) generated in oxidative metabolism in inflicted damage
on all classes of macromolecules.

Additional differentiation of green tea EGCG immunomodulatory effects and

mechanisms on experimental arthritis induced by collagen-induced arthritis
(CIA) in mice in compared to control received phosphate buffered saline
(PBS), researchers found that application of green tea EGCG at dose of 10
mg/kg demonstrated a strong effect in ameliorated clinical symptoms and
reduced histological scores in arthritic mice, through modulated the immune
activity by induced over expression of the Nrf-2 antioxidant pathway(11), a
major mechanism in the cellular defense against oxidative or electrophilic
stress through detoxication and elimination.

EGCG also ameliorated experimental arthritis in mice by eliciting indoleamine-

2,3-dioxygenase (IDO) through inhibition of pro-inflammatory cytokine
interferon-gamma, astrocytes and microglia in facilitated production of
dendritic cells (DCs)(11) in activation of the immune system to attack the
dendritic cell located on surface on the joint tissue.

Application of the EGCG also increased frequencies of T regs(11) which plays

a dominant role in suppression of autoimmune pathology.

Some researchers suggested that increased Treg number and/or function in

model systems may have a significant effect in both prevent and reverse
arthritis disease.

4. Atherosclerosis
Atherosclerosis is medical condition characterized by the deposition of plaques
of fatty material on the inner walls, causing to hardening of the arterial vessels.

According to statistic, mortality rate of coronary heart disease was about 60%
in 2010 in compared to 30% of stroke and heart failure.

In the study to determine the effect of green tea bioactive epigallocatechin-3-

gallate (EGCG) in ameliorated Porphyromonas gingivalis -induced
atherosclerosis in a murine model, after injection of the extract EGCG, the
tested mice than fed high-fat diets and injected with P. gingivalis three times a
week for 3 weeks, observation at weeks 15 displayed a significant reduction of
atherosclerotic plaques(14) accumulated in the branches of arteries, observed
by Oil Red O staining

Polyphenol extract decreased infection of atherosclerotic lesion areas in the

anatomic dilations of the ascending aorta through decreased expression of C-
reactive protein, in regulated the acute phase of infection and monocyte
chemoattractant protein-1 (MCP-1/CCL2) chemokines(14) in regulated
migration and infiltration of monocytes/macrophages.of immune system in
induced production of cytokines to counter foreign substances.

Green tea bioactive epigallocatechin-3-gallate (EGCG) not also improved

LDL/very LDL cholesterol but also ameliorated ROS activity via antioxidant in
induced low-density lipoprotein (LDL) oxidation(14), a leading indication of
plague accumulation.

The efficacy of green tea epigallocatechin-3-gallate (EGCG) in reduced

expression of atherosclerosis due to bacterial P. gingivalis was attributed to
decrease secreted proteins with functions in stimulated inflammatory effects,
such as chemokines (CCL2)(14) involv)ed in immunoregulatory and
inflammatory processes, matrix metallopeptidase 9 (MMP-9)(14 in regulated
pathological remodeling processes that involve inflammation, ICAM-1
(Intercellular Adhesion Molecule 1)(14) involvesd inflammation of capillary
vessel walls, the mitochondrial chaperonin hsp60 in induction of
inflammation,......

In the process to prevent plague to initiation of development of atherosclerosis

through above implications, green tea epigallocatechin-3-gallate (EGCG) also
increased levels of antioxidant defense enzyme (heme oxygenase-1 mRNA)
HO-1 mRNA(14) levels in reduced expression of oxidative stress in induction
of pathogenic inflammatory diseases.

The effect of epigallocatechin-3-gallate (EGCG) in inhibit the formation and

development of atherosclerosis via its anti inflammatory capability also
restricts the function of IL6 (interleukin 6)(16) in induced over expression of
pro inflammatory cytokines and Angiotensin (Ang) II functions(16) in
stimulated and increased vascular permeability through production of vascular
endothelial cell growth factor CRP in initiated the pro inflammatory process.

Interleukin 6 is an interleukin with duo functions of pro inflammatory

cytokines and anti inflammatory mytokines.

Antioxidant activities of EGCG also acted as free radical scavengers to prevent

ROS to establish a chain reaction in induction of inflammatory effect in
encouraging lipid accumulation in the inner wall of arteries, the leading cause
of atherosclerosis.

ROS are free radical with function to mediate many pathophysiological

processes, such as growth, migration, apoptosis and secretion of inflammatory
cytokines,

Angiotensin is a hormone with function in regulated vasoconstriction in

increased blood pressure.

Application of combined (-)-Epigallocatechin gallate (EGCG) +chitosan (CS)

and aspartic acid (PAA)(16) demonstrated a significant effect in reduced risk
and treatment of atherosclerosis through ameliorated lipid deposition in tested
animals.
In compared to the effects of conventional medicine simvastatin with
approximately successful treatment rate of lipid deposition of 15.6%, injection
of (-)-Epigallocatechin gallate (EGCG) +chitosan (CS) and aspartic acid
(PAA).exhibited over all treatment rate of 16.9%(15).

5. Asthma
Asthma is a chronic inflammatory disease affecting the air way of the lung with
recurring symptoms, such as wheezing, chest tightness, shortness of breath, and
coughing.

According to the joint study lead by the Ben Gurion University of the Negev,
Kaempferol (3,5,7-trihydroxy-2-(4-hydroxyphenyl)-4H-1-benzopyran-4-one), a
flavonoid found in green tea exhibited anti-oxidant/anti-inflammatory effects
against various diseases, including asthma(17).

The study also demonstrated that the function of Kaempferol reduces oxidative
stress through scavenging free radicals and superoxide radicals effects(17) and
preserves the activity of various anti-oxidant enzymes(17) in attenuated
production of pro inflammatory cytokines.

Evidence from in vitro and in vivo assays, postulated that aqueous fraction of
green tea also exerts anti-asthmatic signaling activity in ovalbumin-induced
asthmatic model(18).

In the study of mice induced asthma by an ovalbumin, aqueous extract of green

tea displayed a potent anti-asthmatic activity by increasing the expression level
of tumor necrosis factor-beta,(18) (a protein involved production of one of the
inflammatory cytokine in the acute phase) and interferon-gamma(18) in
displacement of immune function against microbial infection and decreased
expression of anti-asthmatic cytokines in the lung.

Green tea alleviated asthmatic symptoms by increasing the expression of Th1

cell(18) in regulated the production of interferon-gamma and interleukin (IL)-2,
proinflammatory cytokines and tumor necrosis factor.

Another green tea constituent, namely Chafuroside A (CFA), water-soluble

flavone C-glycoside, in an experimental asthma/chronic obstructive pulmonary
disease (COPD)-rat model, treatment with Chafuroside A at 0.5mg/kg,
1.0mg/kg could attenuate inflammatory symptoms and ameliorate antigen-
induced airway inflammation, respectively(19).
Dr, Onoue S(19), the lead author in above study said, " A self-assembled
micellar (SAM) formulation might be an efficacious approach for enhancing
the therapeutic potential of CFA for treatment of inflammatory diseases".

Unfortunately, there are few reports suggested that green tea-induced asthma in
tea-sensitive patients, as epigallociatechin gallate induced histamine release
through IgE-mediated response

6. Chronic liver disease or cirrhosis

Liver cirrhosis is a condition of abnormal function of liver due to damage liver
tissue replaced by scar tissue.
According to statistic, risk of liver cirrhosis is 1.6% in adult population.

Green tea polyphenols in reduced risk and treatment of patients with liver
cirrhosis was found to associate to numbers of implication, involving various
mechanisms.

In male SD rats model induced liver cirrhosis through carbon

tetrachloride(CCL4), randomly assigned to 3 groups, including normal group,
green tea extract (GTE) group and cirrhosis group, with GTE group and the
cirrhosis group were injected subcutanuously 2 times/wk over 9 weeks with
40% Carbon tetrachloride (CCl4), researcher found that green tea treatment
groups displayed a significant reduction of concentration of
hydroxyproline(21), an amino acid produced during the hydrolysis of collagen
initiate scar accumulation(21) in the liver damage tissue caused by CCl4) in
compared to cirrhosis group.

Green tea exhibited antioxidant activities in decreased expression of

malondialdehyde (MDA)(21), a highly toxic reactive species in precipitated
liver damage induced by application of carbon tetrachloride(CCL4) and its
extract ameliorated the liver damage cell in formation of cirrhosis through
attenuating the expression of transforming growth factor beta 1 or TGF-β1(21)
in initiated cell growth, cell proliferation.

In differentiation of 11 patients with hepatitis C and detectable viremia of 4

Child-Pugh (CP) class A cirrhosis, 4 Child-Pugh class B cirrhosis, and 3
noncirrhotic, researchers at the Thomas Jefferson University indicated that
injection of a single oral dose of green tea extract 400 mg containing 94% pure
EGCG demonstrated a strong effect in reduced cirrhosis over expression in
induction of liver tumor growth by inhibiting the virus hepatitis in facilitate the
production of ROS species(22) through chronic liver inflammation, according
to the blood sample withdrawn from the patients without inducing liver
toxicity.

Dr. Halegoua-De Marzio D(22), after taking into account of other con founders
said, "A single 400-mg oral dose of EGCG was safe and well tolerated by all of
the patients in the study" and disposition of EGCG was not significantly altered
in these patients with cirrhosis".

In the concern of abnormal angiogenesis in patients with liver cirrhosis in

induction of severe complications such as variceal haemorrhage and
encephalopathy, Dr. Hsu SJ and colleges conducted a study to investigate the
effect of green tea extract in Spraqtue-Dawley rats liver induced in by common
BDL (bile duct ligation) in compared to control given distill water for 28 days
and found that group treated with green tea extract expressed a strong
implication in ameliorated the severity of portosystemic shunting, a rare
malformation of the vessels supplying blood to the liver(20) caused by
excessive shunting of blood from the liver portal vein to the lower and middle
body into the right atrium of the heart due to liver cirrhosis in induction portal
hypertension and one of complication of variceal haemorrhage in patient with
chronic liver cirrhosis and mesenteric angiogenesis(20) in development of new
blood vessels to supply oxygen and nutrients to initiate liver cancer.

The effect of green tea GTP extract in reduced progression of liver cirrhosis
was attributed to the suppression of hypoxia-inducible factor 1-alpha (HIF-1α)
(20)in expression of liver disease of diverse etiologies, including chronic liver
diseases caused by viral infection, excessive alcohol consumption and
activation of protein kinase B (Akt)(20) in regulated infectious liver cell
survival, cell-cycle progression,... and levels of VEGF(20) in reflection of
increased portal hypertension or decreased hepatic regenerative activity or the
combination of both.

Dr.Hsu SJ(20), the lead author said after the conclusion, "GTP appears to be an
appropriate agent in controlling portal hypertension-related complications via
anti-angiogenesis.

7. Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a condition of lung disease
caused by obstruction of air flow in normal breathing.

In a total of 13,651 adults from three Dutch cities examined from 1994 to 1997.
observation of dietary intake estimated using a food frequency questionnaire,
and flavonoid(23)(24) intake calculated using specific food composition tables,
showed a significant effect of flavonoid intake regularly in reduced risk
COPD(24).

According to the returned questionnaire, total catechin, flavonol, and flavone

intake was positively associated with FEV1 in air flow of a deep breath(24) and
inversely associated with chronic cough and breathlessness(24), common
symptoms of chronic obstructive pulmonary disease (COPD).

More specified, Dr. Tabak C(24), the lead author said, "Flavonol and flavone
intake was independently associated with chronic cough only".

Chafuroside A (CFA), a water-soluble flavone C-glycoside(25), isolated from

oolong tea, in oral administration exhibited at 0.5mg/kg or higher exhibited a
profound effect in attenuated inflammatory symptoms in a dose-dependent
manner, in experimental asthma/chronic obstructive pulmonary disease
(COPD)-like model.

Biomarker profiling revealed that the CFA/SAM at 0.1mg CFA/kg equipotent

to CFA at 1.0mg/kg testing result also expressed protective activity against
antigen-induced airway
inflammation(25).

8. Type 2 diabetes

Diabetes is a condition characterized with insufficient insulin entering the

bloodstream to regulate the glucose, caused by cells in pancreas dying off or
receptor sites clogged up by fat and cholesterol. In some cases, diabetes is also
caused by allergic reactions of cells in the immune system.

According to the Third Military Medical University(26), regular consumption

of green tea or green tea extract improved insulin sensitivity and glycaemic
control in populations with diabetics.

In the review of literature found in data base of PUBMED, The Cochrane

Library, EMBASE, ISI Web of Knowledge, Chinese Biomedical Literature
Database and Chinese Scientific Journals Fulltext of 17 trials comprising a total
of 1133 subjects suggested that green tea consumption significantly reduced the
fasting glucose and hemoglobin A1c (Hb A1c) concentrations by -0.09 mmol/L
and -0.30%, respectively(26).
Observed by the high Jadad score studies, green tea significantly reduced
fasting insulin concentrations -1.16 μIU/mL in compared to non green tea
drinker group(26).

The evaluation of green tea drink (T2 and T3) prepared by adding catechins and
epigallocatechin gallate, major constituents isolated from green tea (EGCG) @
550 mg/500 mL against non drinker group acted as control (T1), mice fed with
T2 and T3 expressed a significant reduced cholesterol and LDL levels and
serum glucose and insulin levels(27) with no difference in all functional drink
groups but control.

Dr. Ahmad RS(27), the lead author said, "In contrast to lipid profile,
experimental drink containing EGCG reduced the trait better than catechins
based functional drink".

The compared diabetic effects of 3 selected tea water extracts (TWE) and tea
pomace extracts (TPE) and by on rat intestinal α-glucosidase activity in vitro as
well as hypoglycemic effects in vivo, insisted that in male Sprague-Dawley
(SD) rats fed with tea extracts improved levels of blood glucose level at 30 min
after oral intake (0.5 g/kg body wt) in compared to the control in sucrose-
loaded SD rat, probably through activation of antioxidants properties in free
radical scavenging(28).

Indeed, tea pomace extract in the study exerted a significantly inhibition of

intestinal α-glucosidase, in delayed glucose absorption resulting in suppressing
postprandial hyperglycemia(28).

9. Cardiovascular disease
Cardiovascular disease are chronic medical condition characterized of
narrowed or blocked blood vessels that can lead to a heart attack including
chest pain (angina).

According to statistic, heart disease is the second leading cause of death,

claiming more than 48,000 lives every year.in Canada.

The differentiation of green tea bioactive polyphenols epigallocatechin gallate

or EGCG in risk of cardiovascular disease researchers at the joint study lead by
the Colorado State University found that application of EGCG activated the
expression of the nuclear erythroid-2 like factor-2 (Nrf2) transcription
factor(30) in stimulated transcription of antioxidative genes in protection of cell
against oxidative stress in induction of CVD.
In compared to statins, the conventional medicine may be effective in reduced
heart attacks and strokes(30) in people at moderate and high risk but it can also
cause cancers and multi-drug resistance cancer, EGCG ameliorated risk of
CVD without giving rise to adverse effects.

In EGCG efficacy in risk of cardiovascular disease and metabolic syndrome by

searching literature published online of major scientific databases, from 1995 to
2017, scientists found that EGCG exhibits a wide range of therapeutic
properties including associated with the inhibition of LDL cholesterol in
reduced risk of plague accumulated in the arterial wall in elevated risk of
atherosclerosis, attenuated angiotensin II (AngII)(29) through inhibiting
transcription factor NF-κB(29) in induced abnormal enlargement, or thickening
of the heart muscle, and reduced risk of highly oxidative enzyme
myeloperoxidase(MPO)(29) activity in promoted myocardial infarction, as
level of myeloperoxidase(MPO) is considered as a biomaker used in
assessment of risk of heart attack.

EGCG also exerted significant and profound effects in ameliorated risk of

diabetes through lowering plasma glucoses and gycated haemoglobin level,
inhibited pro inflammatory factors in elevated inflammation in the early phase
of acute infection and chronic infection as well as blocking expression of
ROS(29) in stimulated free radical chain reaction through its antioxidant
activity.

Dr. Eng QY(29), after taking into account of other con founders, siad, "EGCG
shows different biological activities and in this review, a compilation of how
this bioactive molecule plays its role in treating cardiovascular and metabolic
diseases".

In a total of 9 studies including 259,267 individuals satisfied the criteria and

guideline included in the meta-analysis.by examining published literature in
evaluated the association between green tea consumption, CVD, and ischemic
related diseases. up to October 2014, researchers indicated that for non green
tea drinker, risk of CVD was 1.19, intracerebral hemorrhage was 1.24 and
cerebral infarction was 1.15 in compared to people who drank <1 cup green tea
per day(31).

People who drank 1-3 cups of green tea per day had a reduced risk of
myocardial infarction 0.81, and stroke 0.64 in compared compared to those
who drank <1 cup/day and who drank ≥4 cups/day had a reduced risk of
myocardial infarction of 0.68 in compared to those who drank <1 cup/day(31).

And for people who consumed ≥10 cups/day of green tea were also shown to
have lower LDL in compared to group who drank <3 cups/day(31).

Dr. Pang J, the lead author at the final stage of the experiment said, "(The)
meta-analysis provides evidence that consumption of green tea is associated
with favorable outcomes with respect to risk of cardiovascular and ischemic
related diseases".

The results finding of all studies confirmed that consumption of green tea is
associated with favorable outcomes with respect to risk of cardiovascular
disease as well as expression of various serum markers in compilation of how
green tea initiated protective activity against CVD.

10. Metabolic syndrome

Metabolic Syndrome is a group of risk factors used to calculate the incidence of
early onset of diabetes and cardiovascular diseases.

In a total of 35 obese participants with metabolic syndrome randomly assigned

to receive one of the following for 8 weeks: green tea (4 cups per day), control
(4 cups water per day), or green tea extract (2 capsules and 4 cups water per
day), blood samples collected from green tea and green tea extract treated
groups showed a significantly increased plasma antioxidant capacity (1.5 to 2.3
μmol/L and 1.2 to 2.5 μmol/L, respectively in compared to control group(33).

The study also found that the efficacy of green tea in ameliorated early
progression of metabolic syndrome is attributed to the improved expression of
serum antioxidant enzymes(33) (glutathione peroxidase, glutathione, catalase)
and plasma antioxidant capacity(33) in inhibited free radicals in exhibition of
pro inflammatory cytokins.

Furthermore, in the total of 55 obese men and women recruited, injection of

280 and 360 g GTRB provided daily totals of 123.2 and 158.4 mg caffeine, and
188.3 and 242.1 mg of epigallocatechin gallate significantly reduced expression
of metabolic syndrome(33) in attenuated weigh gain, high-density lipoprotein-
cholesterol, triglycerides, and glucose concentrations(33).
More importantly, the study also found that administration of green tea also
reduced levels of blood pressure in obese subjects but can not maintain the
weigh loss after study.

Other researchers in the investigation of decaffeinated green tea extract (GTE)

and voluntary running exercise (Ex) alone or in combination against obesity
and metabolic syndrome in high fat (HF) fed C57BL/6J mice, insisted that
combination of green tea injection and exercise treatment reduced final body
mass (27.1% decrease)(34) and total visceral fat mass (36.6% decrease)(33),
levels of fasting blood glucose (17% decrease)(34), plasma insulin (65%
decrease)(34), and insulin resistance (65% decrease)(34) compared to HF-fed
mice.

11. Renal disease

Renal Disease is an impaired function in toxin elimination for more than a
specific time as a result of kidney damage or injure.

In mice fed with a powdered diet containing green tea polyphenolic extract
(0.1%) starting 3 days prior to CsA treatment (25 mg/kg, i.g. daily for 3
weeks).showed a decreased renal nuclear DNA-encoded oxidative
phosphorylation (OXPHOS) protein ATP synthase-β (AS-β)by 42%,
mitochondrial DNA (mtDNA)-encoded OXPHOS protein NADH
dehydrogenase-3 (ND3) involved oxidize nutrients for energy conversion by
87%(36).

Flavanols (polyphenols) are rich phytochemicals isolated from green tea,

particularly in the expression in form of most bioactive flavanol EGCG.

Oxidative phosphorylation (OXPHOS) protein ATP synthase-β (AS-β)(36)

plays a key role in energy production and regulated the generation of free
radicals, and apoptosis through respiratory chain.

Mitochondrial DNA (mtDNA)-encoded OXPHOS protein NADH

dehydrogenase-3 (ND3) in reduced risk of gene mutation through oxidative
phosphorylation (OXPHOS)(36)

Dr. Rehman H(36), the lead author said," Green tea polyphenols markedly
attenuated CsA-induced renal injury and improved renal function. Together,
these results demonstrate that green tea polyphenols attenuate CsA-induced
kidney injury, at least in part, through the stimulation of MB".
In support of the efficacy of green tea for treatment of renal disease, the study
of F40 rats randomly divided into 4 groups. Group 1 acted as control; group 2
received contrast medium (intravenous iodixanol, 10 mL/kg, as a single dose);
group 3 received contrast medium and then green tea extract for 3 days (10
mg/kg/d, intraperitoneal); and group 4 first received green tea and then contrast
medium, researchers showed that group treated with green tea had significantly
higher overall scores than the control group(37).

Treatment group also expressed a significant improvement in progression of

renal degeneration caused by nephrotoxicity of contrast media.

Unfortunately, according to the joint study lead by the China Medical

University, GT inhibited the elimination of indoxyl sulfate (IS) and p-cresyl
sulfate (PCS), a highly protein-bound nephro-cardiovascular toxins may
deteriorate the renal function in CRF rats(35)

Indoxyl sulfate(IS), a circulating uremic toxin has found to associate to the

development of glomerular sclerosis and interstitial fibrosis.

P-Cresyl sulfate (pCS) is also an uremic toxin generated by intestinal bacteria

which has an implication to worsen outcome of patients with chronic kidney
disease and increased cardiovascular burden.

Iin experiment mice also showed a significantly increased the levels of serum
creatinine (Cr) and blood urea nitrogen (BUN), an indication of further kidney
damage after ingestion of green tea catechin(36).

Dr. Peng YH(36), the lead author said, "GT consumption might also exacerbate
the pathologies of CKD and CVD in end-stage CKD patients even under
hemodialysis treatment. Therefore, we suggest that CKD patients should avoid
drinking large quantity of tea beverages before benefits or risks to CKD
patients assessed by future clinical studies. In conclusion".

12. Stroke
Stroke is a medical condition of emergency caused by reduced or interrupted
blood circulation to the brain, such as blocking artery induced ischemic stroke
and leaking or bursting of a blood vessel precipitated hemorrhagic..

According to statistic, in US, every year, approximately 795,000 people suffer a

stroke, a leading cause of serious and long-term disability.
The review of medical literature published online suggested that green tea with
strong inhibition of high blood pressure, a primary risk factor of stroke through
its antioxidant and vasodilative activities induced by phytochemical flavonoids
in improved blood circulation to the brain. Although increased acute blood
pressure was found in some studies, this acute effect did not translate into
significant alterations in ambulatory blood pressure during regular tea
consumption(41).

The impact of tea or catechin consumption precipitated nitric oxide formation,

as an essential gas signal molecule to protect the brain against in facilitated
ischemic stroke and hemorrhagic stroke by relaxed vascular smooth muscle
cells(41) and induced vasodilatation through regulating network of blood vessel
and peripheral nerve tissues.

Amazingly, catechin also reduced NO levels through endothelial function by

increased platelets aggression in post stroke.

In fact, green tea theanine, a bioactive chemical constituents also found to

process anti stroke development through stimulating NO production of the cells
in the inner wall of arteries in reduced risk of vascularconstrction and promoted
blood circulation, thus decreasing risk of an artery-blocking clot, a major cause
of stroke,

Glutamate molecule found in theanine may also play an important role in

attenuated risk of stroke through neuroprotective effect(41)by decreased middle
cerebral artery occlusion and cerebral infarction caused by blocking or
narrowing the arteries in supplying blood and oxygen to the brain.

According to the study of 82 369 Japanese (aged 45-74 years; without

cardiovascular disease [CVD] or cancer in 1995 and 1998 for Cohort I and II,
respectively) received 13 years of mean follow-up through the end of 2007.
green tea consumption of green tea 2 to 3 and ≥ 4 cups/d showed a significant
effect in reduced risk of stroke with the multivariable-adjusted hazard ratios of
0.86 (0.78-0.95) and 0.80 (0.73-0.89), respectively in compared to non
drinkers(38). And Higher green tea consumption reduced the risks of stroke
subtypes, especially in intracerebral hemorrhage(38).

Other researchers suggested that green tea efficacy in reduced risk of stroke
may be also associated to antioxidant effect in protection of endothelial
function in blood circulation by reduced high blood cholesterol induced plaque
build-up in the arteries(41) in blocking blood flow to the brain, particularly in
reactive oxygen species (ROS) precipitation of lipid peroxidation.

The effect of green tea in reduced insulin resistance in healthy adults may also
contribute to lower risk of stroke, according to the cohort of 1509 nondiabetic
participants from the Northern Manhattan Study (mean [SD] age, 11 [10] years;
64.2% women; 58.9% Hispanics)(42).

Dr. Arab L (41)said, "Regardless of their country of origin, individuals

consuming >or=3 cups of tea per day had a 21% lower risk of stroke than those
consuming <1 cup per day (absolute risk reduction, 0.79; CI, 0.73 to 0.85). The
proportion of heterogeneity not explained by chance alone was 23.8%".

13. Depression
Depression is a normal response as part of our daily lives such as the loss of s
job, the death of a love one, and illness, affecting the way you eat, sleep, and
the way you feel about yourself.

Over 30 million Americans suffer from depression and the amount is increasing
in an alarming rate.

In a cross-sectional study of consumption of green tea and coffee ascertained

with a validated dietary questionnaire and the amount of caffeine intake
estimated from these beverages, green tea consumption is associated to reduce
symptoms of depression, depending to amount of intake(43).

In comparison to amount intake of participants, the study also found that

participants consumed ≥4 cups green tea/d had a 51% significantly lower
prevalence odds(43)of having depressive symptoms than those consumed less
than 1 cup/d.

Dr. Pham NM(43), the lead author in the study said, "higher consumption of
green tea, coffee and caffeine may confer protection against depression".

In vivo, green tea(GT) and GABA green tea (GGT) also expressed a protective
activity of against post-stroke depression (PSD)(44), a common consequence of
stroke, according to joint study lead by the Pavia University.

In a mouse model of post-stroke depression, GGT and GT enhance the activity

in the modulation of depressive symptoms(44) through decrease oxidative
stress, increased antioxidant endogenous defenses, including polyphenol,
theanine, glutamine, etc......

The review of Embase, PubMed, and Chinese National Knowledge

Infrastructure databases from their inception through August 2014, tea
consumption of more than 3 cups a day showed a significant decrease in the
risk of depression of 37% (RR = 0.63, 95% CI: 0.55-0.71)(45), in compared to
individuals with lower tea consumption and those with higher tea consumption.

14. Obesity
Obesity is a medical condition of excess body fat accumulated overtime. A
person is considered an obese if excess body weight relatively to the height is
over 30 in BMI index.

According to the University of the Punjab, Epigallocatechin gallate, a

polyphenol found in tea plants exhibited anti obesity effect(46) through
modulation of the PPAR[gamma] pathway in metabolism involved fat
cells/adipose tissues.

In animal study, the chemical constituent stopped the adipogenic cell

differentiation through different proteins and transcription factors in expression
of adipocyte formation(47) which is considered as fat cell development in
contribution to obesity.

Dr. Javaid MS(47), the lead author in the study said, "Docking analysis of
PPAR gamma and epigallocatechin gallate demonstrated that epigallocatechin
gallate binds with PPAR gamma at its active site and blocks its activity".

Animal induced by high fat diet, green tea Epigallocatechin 3-gallate

(EGCG),exerted anti obesity effects through reduced plasma glucose and
alleviate complications of diabetes(47) by attenuating advanced glycation end
products (AGEs) formation involved proteins or lipids expression.

Dietary EGCG tested in C57BL/6 mice induced by high-fat diet with or without
ECGC for 17 weeks and compared to a control group placed on low-fat diet for
the same period, also showed a significanty reduced weight gain, plasma
glucose, insulin level, liver and kidney weight, which can be seen in obesity in
compared control mice(48).

Green tea Epigallocatechin 3-gallate (EGCG fed mice novally decreased the
levels of AGEs(advanced glycation end product)(48) in both plasma and liver
while inhibiting the receptor for AGE (RAGE) expression(48) of activating
Nrf2, antioxidant response and enhanced anti oxidative stress ratio of
GSH/GSSG.

Other searchers opinionated that the effect of green tea in reduced fat/adipose
tissues accumulation in obese subject is a result of the pro-oxidant action of
EGCG, in de activated cellular production of reactive oxygen species(49),
through indication of adenosine monophosphate-activated protein kinase in
suppressed gene and protein expression of enzymes and transcription factors
involved in adipogenesis and lipogenesis(fat and adiposed metabolism).

16. Cancers
The Science of Tea: Green Tea in Risk of Cancers

Take together, there is no doubt that green tea with abundantly bioactive
phytochemicals may be considered as a functional food to reduce risk,
progression and treatment of lifestyle related diseases, but change of lifestyle is
always recommended. However, intake of green extract should be taken with
extreme care as some cases of acute liver toxicity were reported.

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Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca

Author Biography
Kyle J. Norton (Scholar, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers
have been written and published on line, including world wide health, ezine
articles, article base, healthblogs, selfgrowth, best before it's news, the karate
GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ
by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington
Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as
international journal Pharma and Bio science, ISSN 0975-6299.

Sources
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diseases by Maeda-Yamamoto M1.(PubMed)
(2) A new function of green tea: prevention of lifestyle-related diseases by
Sueoka N1, Suganuma M, Sueoka E, Okabe S, Matsuyama S, Imai K, Nakachi
K, Fujiki H.(PubMed)
(3) Green Tea Consumption and the Risk of Incident Dementia in Elderly
Japanese: The Ohsaki Cohort 2006 Study by Tomata Y1, Sugiyama K2, Kaiho
Y2, Honkura K2, Watanabe T2, Zhang S2, Sugawara Y2, Tsuji I2(PubMed)
(4) Green tea (-)epigallocatechin-3-gallate reverses oxidative stress and reduces
acetylcholinesterase activity in a streptozotocin-induced model of dementia by
Biasibetti R1, Tramontina AC, Costa AP, Dutra MF, Quincozes-Santos A,
Nardin P, Bernardi CL, Wartchow KM, Lunardi PS, Gonçalves CA.(PubMed)
(5) Coffee, tea, and caffeine consumption and prevention of late-life cognitive
decline and dementia: a systematic review by Panza F1, Solfrizzi V, Barulli
MR, Bonfiglio C, Guerra V, Osella A, Seripa D, Sabbà C, Pilotto A, Logroscino
G.(PubMed)
(6) The efficacy of Epigallocatechin-3-gallate (green tea) in the treatment of
Alzheimer's disease: an overview of pre-clinical studies and translational
perspectives in clinical practice by Cascella M#1, Bimonte S#1, Muzio MR2,
Schiavone V3, Cuomo A1.(PubMed)
(7) Simultaneous manipulation of multiple brain targets by green tea catechins:
a potential neuroprotective strategy for Alzheimer and Parkinson diseases by
Mandel SA1, Amit T, Weinreb O, Reznichenko L, Youdim MB.(PubMed)
(8) Effects of caffeic acid on learning deficits in a model of Alzheimer's disease
by Wang Y1, Wang Y2, Li J1, Hua L3, Han B1, Zhang Y1, Yang X3, Zeng Z3,
Bai H3, Yin H1, Lou J3.(PubMed)
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intra-cerebroventricular streptozotocin induced experimental dementia in rats
by Deshmukh R1, Kaundal M2, Bansal V2, Samardeep(PubMed)
(10) Green tea extract improves the oxidative state of the liver and brain in rats
with adjuvant-induced arthritis by de Almeida Gonçalves G1, de Sá-Nakanishi
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(PubMed)
(11) Green Tea Epigallocatechin-3-Gallate Suppresses Autoimmune Arthritis
Through Indoleamine-2,3-Dioxygenase Expressing Dendritic Cells and the
Nuclear Factor, Erythroid 2-Like 2 Antioxidant Pathway by Min SY1, Yan M1,
Kim SB2, Ravikumar S1,3, Kwon SR1,4, Vanarsa K1,3, Kim HY4, Davis
LS#1, Mohan C(PubMed)
(12) Green tea polyphenol epigallocatechin 3-gallate in arthritis: progress and
promise by Ahmed S1.(PubMed)
(13) Is IL-1 a good therapeutic target in the treatment of arthritis? by Burger
D1, Dayer JM, Palmer G, Gabay C.(PubMed)
(14) Green tea epigallocatechin-3-gallate attenuates Porphyromonas gingivalis
-induced atherosclerosis by Yu Cai Tomoko Kurita-Ochiai Tomomi Hashizume
Masafumi Yamamoto(Pathogen and Disease)
https://academic.oup.com/femspd/article/67/1/76/2367414
(15) Improving the effectiveness of (-)-epigallocatechin gallate (EGCG) against
rabbit atherosclerosis by EGCG-loaded nanoparticles prepared from chitosan
and polyaspartic acid by Hong Z1, Xu Y, Yin JF, Jin J, Jiang Y, Du Q.(PubMed)
(16) Epigallocatechin-3-gallate inhibits interleukin-6- and angiotensin II-
induced production of C-reactive protein in vascular smooth muscle cells by
NingPeng, Jun-tian Liu Fang. Guo. Rui Li(Science Direct)
(17) Kaempferol, a potential cytostatic and cure for inflammatory disorders by
Rajendran P1, Rengarajan T1, Nandakumar N2, Palaniswami R3, Nishigaki
Y1, Nishigaki I4.(PubMed)
(18) An aqueous extract of green tea Camellia sinensis increases expression of
Th1 cell-specific anti-asthmatic markers by Heo JC1, Rho JR, Kim TH, Kim
SY, Lee SH.(PubMed)
(19) Self-assembled micellar formulation of chafuroside A with improved anti-
inflammatory effects in experimental asthma/COPD-model rats by Onoue S1,
Matsui T, Aoki Y, Ishida H, Nukaya H, Kou K, Yamada S.(PubMed)
(20) Green tea polyphenol decreases the severity of portosystemic collaterals
and mesenteric angiogenesis in rats with liver cirrhosis by Hsu SJ, Wang SS,
Hsin IF, Lee FY, Huang HC, Huo TI, Lee WS, Lin HC, Lee SD.(PubMed)
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liver damage and cirrhosis].[Article in Chinese] by Xiao J1, Lu R, Shen X, Wu
M.(PubMed)
(22) Limited sampling estimates of epigallocatechin gallate exposures in
cirrhotic and noncirrhotic patients with hepatitis C after single oral doses of
green tea extract by Halegoua-De Marzio D1, Kraft WK, Daskalakis C, Ying X,
Hawke RL, Navarro VJ.(PubMed)
(23) Phytoceuticals: the new 'physic garden' for asthma and chronic obstructive
pulmonary disease by Grandhi S1, Donnelly LE, Rogers DF.(PubMed)
(24) Chronic obstructive pulmonary disease and intake of catechins, flavonols,
and flavones: the MORGEN Study by Tabak C1, Arts IC, Smit HA, Heederik
D, Kromhout D.(PubMed)
(25) Self-assembled micellar formulation of chafuroside A with improved anti-
inflammatory effects in experimental asthma/COPD-model rats by Onoue S1,
Matsui T, Aoki Y, Ishida H, Nukaya H, Kou K, Yamada S.(PubMed)
(26) Effect of green tea on glucose control and insulin sensitivity: a meta-
analysis of 17 randomized controlled trials by Liu K1, Zhou R, Wang B, Chen
K, Shi LY, Zhu JD, Mi MT.(PubMed)
(27) Preventive role of green tea catechins from obesity and related disorders
especially hypercholesterolemia and hyperglycemia by Ahmad RS1, Butt MS2,
Sultan MT3, Mushtaq Z4, Ahmad S5, Dewanjee S6, De Feo V7, Zia-Ul-Haq
M8.(PubMed)
(28) Selected tea and tea pomace extracts inhibit intestinal α-glucosidase
activity in vitro and postprandial hyperglycemia in vivo by Oh J1, Jo SH2, Kim
JS3, Ha KS4, Lee JY5, Choi HY6, Yu SY7, Kwon YI8, Kim YC9(PubMed)
(29) Molecular understanding of Epigallocatechin gallate (EGCG) in
cardiovascular and metabolic diseases by Eng QY1, Thanikachalam PV1,
Ramamurthy S2.(PubMed)
(30) The Role of the Nrf2/ARE Antioxidant System in Preventing
Cardiovascular Diseases.
Smith RE1, Tran K2, Smith CC3, McDonald M4, Shejwalkar P5, Hara K6.
(PubMed)
(31) Green tea consumption and risk of cardiovascular and ischemic related
diseases: A meta-analysis by Pang J1, Zhang Z2, Zheng TZ3, Bassig BA4, Mao
C5, Liu X5, Zhu Y4, Shi K6, Ge J7, Yang YJ8, Dejia-Huang5, Bai M9, Peng
Y9.(PubMed)
(32) Green tea supplementation increases glutathione and plasma antioxidant
capacity in adults with the metabolic syndrome by Basu A1, Betts NM,
Mulugeta A, Tong C, Newman E, Lyons TJ.(PubMed)
(33) Effects of rye bread enriched with green tea extract on weight maintenance
and the characteristics of metabolic syndrome following weight loss: a pilot
study by Bajerska J1, Mildner-Szkudlarz S2, Walkowiak J1,3.(PubMed)
(34) Voluntary exercise and green tea enhance the expression of genes related
to energy utilization and attenuate metabolic syndrome in high fat fed mice by
Sae-Tan S1, Rogers CJ, Lambert JD.(PubMed)
(35) Green tea inhibited the elimination of nephro-cardiovascular toxins and
deteriorated the renal function in rats with renal failure by Yu-Hsuan Peng,1
Douglas H. Sweet,2 Shiuan-Pey Lin,1 Chung-Ping Yu,1 Pei-Dawn Lee
Chao,1and Yu-Chi Houa(PMC)
(36) Green tea polyphenols stimulate mitochondrial biogenesis and improve
renalfunction after chronic cyclosporin a treatment in rats by Rehman H1,
Krishnasamy Y, Haque K, Thurman RG, Lemasters JJ, Schnellmann RG,
Zhong Z.(PubMed)
(37) Ameliorative effect of green tea against contrast-induced renal tubular cell
injury by Nasri H, Hajian S, Ahmadi A, Baradaran A, Kohi G, Nasri P,
Rafieian-Kopaei M1.(PubMed)
(38)The impact of green tea and coffee consumption on the reduced risk of
strokeincidence in Japanese population: the Japan public health center-based
study cohort by Kokubo Y1, Iso H, Saito I, Yamagishi K, Yatsuya H, Ishihara J,
Inoue M, Tsugane S.(PubMed)
(39) The Impact of Green Tea Consumption on the Prevention of Hemorrhagic
Stroke by Lee SM1, Choi NK, Yoon BW, Park JM, Han MK, Park BJ.
(PubMed)
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Lenore Arab, PhD; Weiqing Liu, MS; David Elashoff, PhD(Stroke.
2009;40:1786-1792.)
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individuals from the northern Manhattan study by Rundek T1, Gardener H, Xu
Q, Goldberg RB, Wright CB, Boden-Albala B, Disla N, Paik MC, Elkind MS,
Sacco RL.(PubMed)
(43) Green tea and coffee consumption is inversely associated with
depressivesymptoms in a Japanese working population by Pham NM1, Nanri
A1, Kurotani K1, Kuwahara K1, Kume A1, Sato M2, Hayabuchi H3, Mizoue
T1.(PubMed)
(44) Antidepressive-like effects and antioxidant activity of green tea and GABA
green tea in a mouse model of post-stroke depression by Di Lorenzo A1,
Nabavi SF2, Sureda A3, Moghaddam AH4, Khanjani S4, Arcidiaco P5, Nabavi
SM2, Daglia M1.(PubMed)
(45) Effect of green tea on reward learning in healthy individuals: a
randomized, double-blind, placebo-controlled pilot study by Zhang Q1, Yang
H, Wang J, Li A, Zhang W, Cui X, Wang K.(PubMed)
(46) Epigallocatechin Gallate as an anti-obesity therapeutic compound: an in
silico approach for structure-based drug designing by Javaid MS1, Latief N1,
Ijaz B1, Ashfaq UA2(PubMed).
(47) Green tea epigallocatechin 3-gallate alleviates hyperglycemia and reduces
advanced glycation end products via nrf2 pathway in mice with high fat diet-
induced obesity by Sampath C1, Rashid MR1, Sang S2, Ahmedna
M3(PubMed)
(48) Beneficial Effects of Tea and the Green Tea Catechin Epigallocatechin-3-
gallate on Obesity by Suzuki T1, Pervin M2, Goto S3, Isemura M4, Nakamura
Y5.(PubMed)
(49) Novel insights of dietary polyphenols and obesity by Shu Wang,1,* Naima
Moustaid-Moussa,1 Lixia Chen,2 Huanbiao Mo,3 Anuradha Shastri,1 Rui
Su,1Priyanka Bapat,1 InSook Kwun,4 and Chwan-Li Shen5(PMC)