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Int J Epidemiol. 2018 Dec 1;47(6):1887-1896. doi: 10.1093/ije/dyy173.

Green tea consumption and risk of type 2 diabetes in Chinese adults: the Shanghai Women's Health Study and the Shanghai Men's Health Study.

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Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Department of Epidemiology, Shanghai Jiaotong University Renji Hospital, Shanghai, China.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Division of Cardiovascular Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Division of Cardiovascular Medicine, Beth Israel Deaconess Hospital, Boston, MA, USA.



Epidemiological evidence on the association between tea consumption and the risk of type 2 diabetes (T2D) is inconsistent. This study prospectively investigated whether green tea drinking affects the risk of T2D.


This study included participants from the Shanghai Women's Health Study (N = 67 058) and the Shanghai Men's Health Study (N  =  52 315) without diabetes at study enrolment. Details of tea consumption, including types and amounts, were collected at the baseline and follow-up survey. Incident T2D was identified through follow-up surveys. Plasma level of caffeine metabolite was measured in a nested case-control study involving 592 diabetes case-control pairs. Cox regression analysis, with tea drinking as a time-dependent variable and covariates adjusted for by a propensity score, was applied to estimate the hazard ratio (HR) and 95% confidence interval (CI) for T2D risk. Logistic regression analysis was applied to evaluate the association between caffeine metabolites and T2D risk.


Current green tea drinkers had an increased risk of T2D compared with non-current drinkers [HR = 1.20 (95% CI = 1.14-1.27)], and a dose-response relationship was observed for duration of drinking tea and the amount of tea consumed [P for trend <0.001]. The increased risk associated with green tea drinking was observed in both women and men, across the entire period of follow-up, with HR (95% CI) of 1.08 (0.97-1.19) within 5 years of follow-up, 1.22 (1.12-1.32) during the period of 5-10 years of follow-up and 1.16 (1.03-1.30) after 10 years of follow-up. This association did not vary significantly by body mass index, waist-to-hip circumference ratio or smoking status. Plasma level of caffeine was also associated with increased diabetes risk (P  =  0.03), confirming the results based on self-reported tea drinking.


Green tea drinking was associated with an increased risk of T2D in Chinese adults. The mechanisms underlying the association need to be elucidated.

[Available on 2019-12-01]

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