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Dr Mohan Z Mani

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Dr Mohan Z Mani,
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Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Year : 2008 | Month : December | Volume : 2 | Issue : 6 | Page : 1215 - 1225 Full Version

Biological Actions And Medicinal Applications Of Tea (Camellia Sinensis)

Published: December 1, 2008 | DOI:

*MD(Prof&Head,Pharmacology)**MD(PostGraduate student,Pharmacology)***MD(Post Graduate student,Pharmacology)Dept of Pharmacology,Assam MedicalCollege&Hospital,Assam.(India)

Correspondence Address :
Thakuria N,Dept of Pharmacology,Assam MedicalCollege&Hospital Dibrugarh,Assam,Pin:786002(India)Ph:+91-9435702938E-mail–


Tea, Flavonoids, Antioxidant, Cardiovascular Diseases, Cancer, Cognitive Function

Tea is an aqueous infusion of dried leaves of the plant Camellia sinensis (family Theaceae) and is the most popular beverage consumed by human society worldwide. Per-capita consumption worldwide averages 4 fluid ounces per day. Tea was discovered in China around 5000 to 6000 years ago (1).

Depending on the manufacturing process tea is classified into three major types (Table/Fig 1):-
• Green (unfermented)
• Oolong (fermented)
• Black (fully fermented)
About 76% to 78% of tea produced and consumed worldwide is black tea, 20% to 22% green and less than 2% is oolong (2).

Tea is a rich source of polyphenols, particularly flavonoids. The major group of flavonoids present in tea is catechins. Principal catechins present in fresh tea leaves are (-)-epicatechin (EC), (-)-epigallocatechin (EGC) and (-)-epigallocatechin-gallate (EGCG)(Table/Fig 2). EGCG is the most abundant catechin in tea leaves of most green, oolong and black teas (1). Green and oolong teas contain 30 to 130 mg of EGCG per cup (237 ml), while black tea may contain 0 to 70 mg of EGCG per cup (3).

The type of processing applied to the fresh tea leaves determines the type and amount of flavonoids present in different types of tea.

During the production of oolong tea, the oxidation period is shortened, resulting in partially oxidized and containing more catechins and fewer theaflavins and thearubigins than black tea (1),(5).

In addition to polyphenols, tea also contains glycosides of flavonol, proanthrocyanidines, caffeine, amino acids (mostly theanine), carbohydrates (glucose, fructose, sucrose etc.), organic acids (di-carboxylic acid, tri-carboxylic acid and fatty acids), saponins, pigments (chlorophyll, carotinoids and others), vitamins (rich in vitamin C also B-complex, E & K), soluble minerals and C, H, N, O, Ph and K, cellulose, lignins, polysaccharides, lipids, insoluble pigments and organic compounds like hydrocarbons, alcohols, aldehydes, ketones, acids, esters, lactones, phenolic compounds, nitrogen compounds, oxygenated compounds and sulphur compounds (6).

Health Benefits Associated With Tea And Its Components
It has been known for a long time that tea may exert a number of physiological effects on human body. Numerous epidemiological studies and clinical trials examining the relationship between tea and its health benefits have proven the same and still many such studies are underway. In this review, we have assessed few recent clinical studies of tea on health and disease in humans.

Antioxidant Activity Of Tea
The role of free radicals and active oxygen in pathogenesis of a number of chronic diseases including cardiovascular diseases, cancer, neurodegenerative diseases and ageing process has been recognized. Green tea is rich in polyphenlos (catechins and gallic acid, particularly), but it also contains carotenoids, tocopherols, ascorbic acid (vitamin C), minerals such as Cr, Mn, Se or Zn, and certain phytochemical compounds.

Using the Oxygen Radical Absorbance Capacity (ORAC) assay, Cao et al. (7) found that both green and black tea have much higher antioxidant activity against peroxyl-radicals than vegetables such as garlic, kale, spinach and Brussels sprouts. Langley-Evans (8) determined the antioxidant potential of green and black tea by using Ferric Reducing Ability of Plasma (FRAP) assay and found that the total antioxidant capacity of green tea was more than black tea. Nanjo et al. (9) using Tocol Equivalent Antioxidant Capacity (TEAC) assay, found catechins to be more effective scavengers of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical than vitamin E or vitamin C. Relative activities of catechins in scavenging DPPH radicals have been found to be EGCG ≈ ECG > EGC > EC (10), (11).

The concentration of phosphatidylcholine hydroperoxide (PCOOH), an index of lipid peroxidation, was found to be decreased by 69%, decreasing copper mediated antioxidation of plasma 60 minutes after consumption of a green tea extract tablet containing EGCG: 82mg, ECG: 38mg, EGC: 27 mg and GCG: 37mg (12). Fe-isoprostanes are established biomarkers for in vivo oxidative stress and have been shown to correlate with conditions of increased lipid peroxidation in animals and humans. Frease R et al. (13) found a significant 22% reduction in plasma TBARs in 20 healthy women of 23 to 50 years of age consuming high linoleic acid diet and administered with green tea extract 3gm/day (equivalent to 10 cups/day of green tea) for 4 weeks; however, no change in urinary levels of 8-iso-PGF2, an F2-isoprostane were found.

Topical EGCG was found to significantly reduce UV induced TBAR formation, H2O2 and Nitrate formation in skin (p < 0.05) after UV light exposure (14). In a study on 10 Type-2 diabetes mellitus patients consuming a high flavonoid diet, including six cups of black tea daily for two weeks was found to reduce the oxidative damage to lymphocyte DNA significantly (15). In another study on smokers it was found that drinking 900ml green tea daily for 7 days reduced 8-OH-dG in urine and WBC nuclear DNA (16). Erba et al. (17) suggest the ability of green tea, consumed within a balanced diet, to improve the overall antioxidative status and to protect against oxidative damage in humans.

Effects Of Tea On Cardio Vascular System
The physiological effects of tea and tea products on cardiovascular system and their potential uses for prevention and treatment of disorders of cardiovascular system have drawn a great deal of interest.

It is one of the most commonly occurring cardiovascular disorders and may induce many serious complications. Association of tea consumption with severity of aortic atherosclerosis was examined in 3454 men and women, 55% of them had some degree of aortic atherosclerosis on X-ray. Calcified plaques in the abdominal aorta were detected radiographically after 2-3 years of follow-up. The risk of aortic atherosclerosis for black tea drinkers was 54% for those who drank 1-2 cups/day (≤ 250ml/day), 47% for those who drank 3-4 cups/day (> 250-≤ 500ml/day) and 35% for those who drank more than 4 cups/day (> 500ml/day) (18) when compared to non-drinkers.

An observational study by Sasazuki et al. (19) on men and women undergoing coronary angiography reported an inverse relation of green tea consumption to coronary artery disease in men but not in women. Endothelial dysfunction is associated with atherosclerosis. Consumption of black tea reverses endothelial dysfunction in patients of CHD (20) and hyperlipidemia (21). Weon Kim et al (22) observed that the number of circulating Endothelial Progenitor Cells (EPCs) and flow-mediated endothelium dependent vasodilation (FMD) was reduced in chronic smokers. A short-term therapy of green tea consumption was found to induce a rapid improvement of EPC levels and FMD and they concluded that green tea consumption might be effective in preventing future cardiovascular events in chronic smokers. Catechin is a major constituent of Japanese green tea and an antioxidant. Lipids and oxidization of low-density lipoprotein cholesterol (LDL-C) play important roles in atherosclerosis. Shigenobu et al (23) documented a novel observation, that cathechins decrease the plasma Ox-LDL concentration without any significant change in plasma LDL concentration. The beneficial effects of green tea on coronary artery disease might result from a decrease in plasma Ox-LDL.

Yang et al. (24) concluded that habitual moderate strength green tea or oolong tea consumption, 120 mL/day or more for 1 year significantly reduces the risk of developing hypertension in Chinese population. Nakachi et al. (25) in a prospective cohort study of 8522 men and women concluded that consuming 10 cups/day is linked with a decreased relative risk (RR) of death from cardiovascular disease in men (RR _ 0.58, 95% CI _ 0.34–0.99) and women (RR _ 0.82, 95% CI _ 0.49–1.38).

Coronary Heart Disease
Several studies indicate an inverse association between tea consumption and coronary heart disease (CHD) mortality.

A cohort study of 8522 Japanese men and women for a period of 13 years found a significant reduction in the risk of death from CHD among men consuming more than 10 cups (1500ml) of green tea, although they failed to find significant reduction of risk in women (26). Geleijnse et al. (27) in their prospective Rotterdam study with 3454 adults, 55 years of age or older, and with a follow-up duration ranging from two to three years, examined aortic atherosclerosis via X-ray measurement of calcified deposits in abdominal aorta. The odds ratio (OR) for drinking 125–250 mL (1–2 cups) of black tea daily was 0.54 (95% CI _ 0.32–0.92) and decreased to 0.31 (95% CI _0.16–0.59) when _500 mL/day (more than four cups) were consumed.

Hertog et al. (28) by conducting a cohort study of 804 men in Netherlands found an inverse association between flavonoid intake and CHD mortality. In this study black tea was the source of 60-80% of total dietary flavonoids.

However, several studies didn’t find any significant relationship between tea consumption and CHD mortality. Rimm et al. (29) employing a cohort of 34,789 men in US followed up for 2 years, reported no significant reduction in the risk of death from CHD mortality, for those consuming > 2 cups of black tea/day. Yokozawa et al. (30) reported that administration of GTP effectively inhibited LDL-cholesterol oxidation and elevated serum antioxidative activity.

Effects On Blood Lipid
Excessive lipid in blood is a common disorder of middle aged and old aged men and women. Several epidemiological studies show that tea drinking decreases serum lipid levels in a large population. Imai et al. (31) conducted a cross sectional study on 1371 Japanese men aged 40 years or more and found that consumption of green tea was associated with significantly lower levels of serum lipid and LDL. Dietary antioxidants may slow atherogenesis by reducing the oxidative modification of LDL cholesterol (32). Several in vitro studies to isolate LDL have shown inhibition of lipid oxidation by tea and tea extracts (33), (34), (35). However, in vivo studies in humans found little or no inhibition of LDL oxidation. Miura et al. (36) also found an increase in lag time among 22 healthy young men after consumption of green tea extract equivalent to 700ml/day (7-8 cups/day) of green tea for 1 week.

Cancer is a serious health problem and cause of global concern. Experimental studies have demonstrated the inhibitory effect of tea infusions and its components, specially, polyphenols on chemical carcinogenesis of various cancers in experimental animals. The chemopreventive effects of green tea depend on: (1) its antioxidant action; (2) specific induction of detoxifying enzymes; (3) its molecular regulatory functions on cellular growth, development and apoptosis; and (4) selective improvement in function of intestinal bacterial flora. An important aspect of cancer risk is related to inflammatory response; currently, antiinflammatory agents are used in chemopreventive strategies. The inflammatory response involves production of cytokines and proinflammatory oxidants such as hypochlorous acid and peroxynitrite produced by neutrophils. Green tea catechins and soy isoflavones have also been shown to be chemopreventive. The aromatic nature of polyphenols makes them potential targets of hypochlorous acid and peroxynitrite, and these reactions may create novel pharmacophores at the site of inflammation. In addition, a major mechanism of the anticarcinogenic activity of green tea in animals is impairment of interaction of carcinogens with DNA leading to mutations.

Oesophageal Cancer
Gao et al. (38) in a case control study found an inverse relationship between tea consumption and oesophageal cancer. They observed that Chinese women who consumed atleast 150 gm/month of green tea were 66% less likely to have oesophageal cancer than women who did not drink tea. Another study in South America by Castellsague et al. (39) reported that men and women who consumed more than 500ml/day of tea were 38% less likely to have oesophageal cancer than those who did not drink tea.

Stomach Cancer
Several studies have shown inverse association between tea consumption and sto-mach cancer. A prospective cohort study conducted by Zhang W et al. (40) on 1,20,852 people in Netherlands found an inverse relationship between black tea and stomach cancer. Another study by Shibata et al. (41) among 636 Japanese in green tea production village observed that consumption of 10 cups of green tea/day reduced the risk of stomach cancer. In contrast, Heilbrun et al. (42) in a cohort study of 7,833 men followed for a period of 20 years in Hawaii, USA did not find any significant association between black tea consumption and gastric cancer risk. On the other hand, Hamajima et al. (43) found that an equivalent of ten cups a day of green tea polyphenols for one year was no more effective than one to two cups a day in improving serum pepsinogen levels (reflecting stomach atrophy), a risk factor for stomach cancer. Sasazuki et al. (44) reported an inverse association between green tea consumption and distal gastric cancer among women; however, these authors indicated that more prospective studies with detailed information were needed to confirm the role of green tea in occurrence of gastric cancer.

Colorectal Cancer
Several experimental studies indicate strong chemopreventive action of tea and tea flavonoids against cancers of gastrointestinal tract, particularly colorectal cancers. In a cohort study of 7,833 men in USA, Heilbrun et al. (42) found a positive association between rectal cancer and black tea consumption. In the same study, they also found no significant association with colon cancer. Another prospective study of 29,133 male smokers in Finland, found a positive association of black tea consumption and colon cancer (> 1 cup vs. 0 cup); in the same study, no significant association was found with occurrence of rectal cancer (45).

Interestingly, green tea polyphenols have been found to reduce prostaglandin E2 synthesis in rectal mucosa by 50% within four hours of consumption (47).

Pancreatic Cancer
Shibata et al. (48) have reported an inverse association between intake of black tea and pancreatic cancer in a cohort study on 13,979 elderly men and women in USA. In contrast, earlier studies show no chemoprotective action by black tea on pancreatic cancer (6, 47,282).

Lung Cancer
A case control study by Mendilaharsu et al. (49) found that consumption of 2 or more cups of black tea reduced the risk of lung cancer by 66% in male smokers in Uruguay. In a cohort study of 58,279 men and 62,573 women in the Netherlands (46) and two cohort studies of 7,533 men and 35,369 post-menopausal women respectively, in USA showed no chemopreventive action by black tea on lung cancer. Laurie SA et al (50) in a Phase I study of green tea extract in patients with advanced lung cancer observed an inverse correlation of lung cancer with green tea consumption.

Urinary Bladder Cancer
A case control study on 4,000 Americans by Bianachi et al. (51) reported that consumption of more than 5 cups of tea a day reduced the risk of bladder cancer by 30%. Significant reduction in risk of bladder cancer was found in a prospective cohort study among 3,123 men and women after 6 years follow-up in Netherlands, who drank more than 2 cups of black tea (52). Conversely, Nagano et al. (53) reported no significant association of tea (both black and green) intake and bladder carcinoma in a prospective cohort study of 38,450 Japanese atomic bombs survivors. In a follow-up study of this cohort, Wakai et al. (54) found that patients who drank green tea had a substantially better five-year survival rate than those who did not.

Prostate Cancer
Heilbrun et al. (42) in a cohort study of 7,833 Hawaiian men of Japanese descent found a significant inverse association between black tea consumption and prostate cancer risk. Jain et al (55) reported 30% reduction in the risk of prostate cancer, in those who drank >500 ml/day of black tea in a case control study of 1,254 Canadians. In vitro, tea inhibits 5-α-reductase mediated conversion of testosterone to 5-α-dihydrotestosterone which suggests a potential mechanism of action in prostate cancer (56).

However, no association between tea intake and prostate cancer was observed in a retrospective cohort study of 1970–1972 Nutrition Canada Survey participants. In this study, subjects who drank 500 mL of tea per day, experienced the same risk for prostate cancer as compared to those who reported no tea consumption (RR-1.02, 95% CI: 0.62–1.65) (57). Although, these observations are most relevant to black tea, a worth noting evidence by Paschka et al. (58) reports that green tea catechin EGCG induces apoptosis in human prostate cancer cells. In same line of research, Yu et al. (59) reported that EGCG inhibits growth of prostate cancer adenoma cells and induces apoptosis. Dose-response relationships were also significant, suggesting that green tea is protective against prostate cancer.

Breast Cancer
In a cohort study, Rosenberg et al. (60) found an inverse association between black tea consumption and breast cancer. Consistent with these data, a Japanese study of 472 stage I & II breast cancer patients, found an inverse correlation between consumption of green tea and rate of recurrence after 7 years. Recurrence rate was 16.7% for patients consuming 5 or more cups a day vs. 24.3% for those drinking 4 or less a day. Green tea may favourably alter oestradiol and sex hormone binding globulin levels associated with risk of breast cancer (61).

In contrast to these observations, two cohort studies, one in Netherlands on 62,573 men (46) and another in USA (42) on 35,369 post-menopausal women found no chemo-preventive action of consumption of more than 4 cups/day of black tea. The relative risk of recurrence was 0.564 (95% CI: 0.350–0.911) and recurrence rate was 16.7% for patients consuming five or more cups a day versus 24.3% for those drinking

Mittal et al. (37) reported that treatment with EGCG decreases cell viability at different stages studied (approx. 80% inhibition) in human breast carcinoma MCF-7 cells, but had no adverse effect on growth of normal mammary cells. These authors found that this treatment inhibited telomerase activity (40–55%); telomerase is elevated in 90% of breast carcinomas and therefore has received much attention as a target for breast cancer therapy and cancer diagnostic research. Two studies in Japanese women diagnosed with breast cancer indicate that green tea consumption is inversely associated with rate of recurrence, especially in early stages of breast cancer (62), (63).

Skin Cancer
Several experimental studies indicate a protective effect of tea polyphenols against chemical and ultraviolet (UV)-induced skin cancer. Hakim et al. (64) reported an inverse association between black tea consumption and occurrence of squamous cell carcinoma of skin in a population based case control study of 450 older adults in Arizona. Katiyar et al. (65) reported that topical application of EGCG (1mg/cm square) inhibits UVB induced infiltration of leucocytes and subsequent generation of reactive oxygen and nitrogen species in animal and human skin as well as prevented UV-induced decrease in skin GPX activity and GSH levels. Zhao et al. (66) reported the topical application of a standardized green tea extract 30 minutes prior to administration of psoralen plus UVA radiation to reduce the photochemical damage associated with this treatment for psoriasis.

Mucosal Leukoplakia
Li et al. (67) conducted a double-blind, placebo-controlled trial in 59 patients with oral mucosa leukoplakia, a pre-cancerous lesion, and found oral and topical administration of black and green tea mixture to partially regress the lesion in 37.9% of treated patients.

Oral Health
In 1981, Onisi et al. (68) conducted a clinical test of effect of drinking green tea extract on dental caries at a primary school for an year. Incidence of dental caries among children who took a cup of tea immediately after lunch was found to be significantly lower. Ooshima et al. (69) investigated the inhibitory effect of Oolong tea extract (OTR- containing 40% polyphenolic compounds) on plaque deposition in 35 human volunteers and found that mouth rinsing with 0.5 mg/ml OTE in 0.2% ethanol significantly reduced plaque deposition when compared with mouth rinsing with 0.2% ethanol (p<0.001).

Rasheed et al. (70) reported that extract of green tea inhibits oral bacteria such as E. coli, Streptococcus salivarius and streptococcus mutans. Mutans streptococci is the primary pathogen responsible for producing caries. These bacteria synthesize extracellular water insoluble glucans on surface of organisms by glucosyl transferase from sucrose. These glucans adhere to tooth surface resulting in formation of dental plaques. Matsumoto et al. (71) reported decreased adherence to tooth surface by reducing the hydrophobicity of streptococci and to inhibit their carcinogenicity by reducing the rate of acid production.

Bone Health
Tea consumption was identified as an independent factor protecting against risk of hip fractures in women and seven men, over the age of 50 years in the Mediterranean Osteoporosis Study (72), (73). Consistent with this observation, Hegarty et al. (74) studied 1,256 British women, 65 to 76 years of age, and found that those who drank tea had greater bone mineral density than those who did not drink tea. Higher mean bone mineral density of the lumbar spine (p _ 0.004), greater trochanter (p _ 0.004) and Ward’s triangle (p _ 0.02) were independent of smoking status, hormone replacement therapy, coffee drinking and addition of milk to tea.

Neurodegenerative Diseases
A case control study of 215 Parkinson’s disease patients and 312 controls in Taiwan by Chan et al. (75) observed that regular tea drinking had protective effect against the disease. Flavonoid intake was inversely related to risk of dementia in a French cohort in which tea provided only 16 % of total flavonoid intake (76). Hindmarch et al. (77) reported that day long consumption of tea improved cognition and psychomotor performance of healthy adults.

Advanced glycation endproducts (AGEs) are believed to be secondary factors in selective neuronal injury associated with several neurodegenerative disorders. Sun-joo Lee et al (78) demonstrated that EGCG may exhibit protective effects against AGE induced injury in neuronal cells through its antioxidative properties, as well as by interfering with AGEs-RAGE interaction mediated pathways, suggesting a beneficial role for this catechin against neurodegenerative diseases.

Duchenne Muscular Dystrophy
Olivier M. Dorchies et al (79), through a pre-clinical study in mice concluded that green tea extract (GTE) polyphenols behave as multitarget agents that are capable of positively altering several of the downstream consequences of dystrophin absence.

Pulmonary Fibrosis
Narayanan Sriram et al (80) confirmed through a pre-clinical study in rats the beneficial use of EGCG (Epigallocatechin-3-gallate) in alleviating the oxidative stress induced during pulmonary fibrosis.


Tea is one of the most popular beverages worldwide. Modern medical research has provided a wide range of evidence that tea may be effective in various chronic disorders like cardiovascular diseases, various carcinomas, skin diseases, neurological disorders etc. as observed in various pre-clinical, clinical and epidemiological studies reviewed above.

Tea is an important dietary source of flavanols and flavonols. In the face of equivocal results from human studies, increasing knowledge about the bioactivity of tea-polyphenols should encourage further clinical investigations to uncover their actual contribution to promotion of health and prevention of chronic disease. Moreover, tea may be used as a biochemical modulator to enhance the therapeutic effectiveness of other drugs. While in totality the evidence from research on tea is very promising, more researches are needed to fully understand its contribution to human health.

Since, beneficial health effects of green tea are being increasingly proven; it would be advisable to encourage regular consumption of this widely available, tasty and inexpensive beverage as an interesting alternative to other drinks, like coffee or cola soft-drinks, which are rich in additives and/or CO2. We can conclude by saying that tea consumption (especially, green tea) is apparently an important means to maintain good health and it would be advisable to consider it for consumption on a regular basis.


The authors acknowledge the help and contributions of Dr. Pradip Kumar Mahanta, Ph.D, Ex–Scientist, Beverages Science & Technology Division (BeST), Unilever Research India, Bangalore– 560 066, Karnataka (India).


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