Greenteahaus:  The Green Tea Reference Library

Epidemiological and clinical studies on the relationship between cancer risk and the consumption of green tea, its dose and its source

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1 Fluoride content in tea and its relationship with tea quality. J Agric Food Chem. 2004 Jul 14;52(14):4472-6.
2 Fluoride and aluminium concentrations of tea plants and tea products from Sichuan Province, PR China. Chemosphere. 2003 Sep;52(9):1475-82.
3 Prevention and control of brick-tea type fluorosis--a 3-year observation in Dangxiong, Tibet. Ecotoxicol Environ Saf. 2003 Oct;56(2):222-7.
4 Aluminium and fluoride concentrations of three tea varieties growing at Lantau Island, Hong Kong. Environ Geochem Health. 2003 Jun;25(2):219-32.
5 Aluminium and fluoride contents of tea, with emphasis on brick tea and their health implications. Toxicol Lett. 2003 Jan 31;137(1-2):111-20.
6 Brick tea fluoride as a main source of adult fluorosis. Food Chem Toxicol. 2003 Apr;41(4):535-42.
7 Skeletal fluorosis and instant tea. Whyte MP, Essmyer K, Gannon FH, Reinus WR. Am J Med. 2005 Jan;118(1):78-82.

Abstracts
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1

Lu Y, Guo WF, Yang XQ. Fluoride content in tea and its relationship with tea quality. J Agric Food Chem. 2004 Jul 14;52(14):4472-6.

The tea plant is known as a fluorine accumulator. Fluoride (F) content in fresh leaves collected from 14 plantations in China was investigated. The F increased with maturity, and the F variation was remarkable in the tender shoots. Furthermore, significant negative relationships were observed between F content and the content of the quality parameters total polyphenols and amino acids. These substances are rich in young leaves and poor in mature ones. With regard to quality of tea products, the relationship with F content was studied using 12 brands of tea products in four categories: green tea, oolong tea, black tea, and jasmine tea collected from six provinces. The F level increased with the decline in quality and showed good correlation with the quality grades. The results suggest that the F content could be used as a quality indicator for tea evaluation.
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2 Shu WS, Zhang ZQ, Lan CY, Wong MH. Fluoride and aluminium concentrations of tea plants and tea products from Sichuan Province, PR China. Chemosphere. 2003 Sep;52(9):1475-82.

Some Tibetans in Sichuan Province in southwestern China have been suffering from fluorosis, due to drinking and eating tea with high fluoride (F) and aluminium (Al) contents. Tea plants, soils of tea plantations and tea products from Yaan, Gaoxian and Yibin Cities in Sichuan Province were investigated to evaluate the factors affecting F and Al contents in tea products. The F and Al concentrations of four commercial brands of brick teas were significantly higher than those of 11 brands of green teas. Chemical analysis indicated that total and available F and Al concentrations in tea plantation soils in Yaan and Gaoxian were within the normal range compared with acid soils in South China and tea soils in Fujian Province. Edaphic conditions did not contribute to the high F and Al concentrations in brick tea. Analysis of raw materials of brick tea indicated that old leaves were the major contributors to the high F and Al contents contained in brick tea. There were also great variations among different tea varieties in accumulating F and Al, and concentrations of F and Al in tea variety of Qianmei 303 were about 2-3-fold higher than the other three varieties. Selection of appropriate varieties would be important to lower F and Al contents in tea products.
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3 Jin C, Yan Z, Jian-Wei L, Ruoden X, Sangbu D, Zeguo, Zhouma S. Prevention and control of brick-tea type fluorosis--a 3-year observation in Dangxiong, Tibet. Ecotoxicol Environ Saf. 2003 Oct;56(2):222-7.

To evaluate the effects of preventing and controlling brick-tea type fluorosis, we carried out a 3-year field observation and assayed the total daily fluoride intake, urinary and serum fluoride level, and dental fluorosis prevalence and index in a boarding school in Dangxiong, Tibet, in students aged 8-15. We replaced the traditional brick tea with low-fluoride brick tea (LFBT). Reduction in the traditional brick-tea consumption decreased the total daily fluoride intake among the children, which still remained within the level of chronic intoxication but at a safe level. The study suggests that the LFBT is effective in the prevention and control of endemics of brick tea type fluorosis, although further improvement of the LFBT is required.
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4 Fung KF, Zhang ZQ, Wong JW, Wong MH. Aluminium and fluoride concentrations of three tea varieties growing at Lantau Island, Hong Kong. Environ Geochem Health. 2003 Jun;25(2):219-32.

The present project aims to investigate aluminium (Al) and fluoride (F) contents in teas (Camellia sinensis (L.) O. Kuntze). Three different commercial tea varieties: Assam variety and two China sub-varieties, a large leafed variety and small leafed variety, were collected in two tea gardens of Lantau Island tea plantation of Hong Kong. In general, high concentrations of Al and F were accumulated in the mature leaves (15.3 and of 2.07 g kg-1 respectively). Among the three varieties, 'the small leafed' variety exhibited the highest Al and F contents followed by the 'large leafed' variety whereas the Assam variety had the lowest Al and F concentrations in its tea bushes. Tea products from a plantation were also analysed and it was noted that black tea had higher Al and F concentrations than green tea. The amount of Al and F released into tea liquor was also tested and the results showed that higher concentrations of Al and F were released into tea liquor under repeated infusion method than continuous infusion method.
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5 Wong MH, Fung KF, Carr HP. Aluminium and fluoride contents of tea, with emphasis on brick tea and their health implications. Toxicol Lett. 2003 Jan 31;137(1-2):111-20.

Tea plant takes up a large quantity of aluminium (Al) and fluoride (F) from acidic soils. It has been known that fluorosis can be developed for people who consume a large quantity of tea made from brick tea, a low quality tea consisting mainly of old tea leaves in China. In addition, it has been claimed that Alzheimer's disease (AD) is linked with the Al content in the human brain. Therefore, the high Al content in tea, especially brick tea is also a concern. This article reviews the basis background on tea including classification, growth conditions, types of tea leaves and their production, and processing of tea. Special emphasis is made on the transfer of Al and F from soil to tea plant and then to tea liquor. Health implications of drinking a large quantity of tea liquor especially those made from brick tea are discussed. Recommendations are suggested to reduce the uptake of these two elements by tea plant, and lower their contents in tea products.
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6 Cao J, Zhao Y, Liu J, Xirao R, Danzeng S, Daji D, Yan Y. Brick tea fluoride as a main source of adult fluorosis. Food Chem Toxicol. 2003 Apr;41(4):535-42.

An epidemiological survey was conducted in Naqu County, Tibet in September 2001 to investigate the manifestations of fluorosis in adults caused by the habitual consumption of brick tea. Profiles were obtained for the total daily fluoride intake, environmental fluoride levels and average urinary fluoride concentration, and a physical examination and a skeletal radiographic study were conducted. One hundred and eleven 30-78-year-old adults were enrolled. It was found that the fluoride level of water sources in Naqu County was 0.10+/-0.03 mg/l; no evidence of fluoride air pollution was found, but the brick tea water processed foods--zamba and buttered tea--had fluoride contents of 4.52+/-0.74 mg/kg and 3.21+/-0.65 mg/l, respectively. The adult daily fluoride intake reached 12 mg, of which 99% originated from the brick tea-containing foods. The positive rate of clinical symptoms by physical examination was 89%; furthermore, 42 of the 111 subjects were diagnosed by X-ray. The positive examination rate was 83%. Although the osteosclerosis-type skeletal fluorosis (overall increased bone matrix density) affected 74%, arthropathy and arthritis affected a significant number of the patients, resulting in functional disability. The results suggest that this brick tea-type fluorosis had even more severe adverse effects on human health compared with both the water-type and coal combustion-type fluorosis that occurred in other areas of China.
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7 Whyte MP, Essmyer K, Gannon FH, Reinus WR. Skeletal fluorosis and instant tea. Am J Med. 2005 Jan;118(1):78-82.

Development of skeletal fluorosis is known to be associated with consumption of well water containing fluoride concentration in excess of 4 parts per million (ppm) in the United States. Skeletal fluorosis occurs in Asia where inferior quality “brick” tea comprising mature leaves, twigs, and berries of the tea plant Camellia sinensis is drunk. Tea drinking remains popular and is suggested to promote health. The authors reported a 52-year-old white woman who developed neck pain, scapular pain, elbow and knee arthralgias. The authors traced the cause to the high contents of fluoride in the teas which were found to contain as high level as 6.5 ppm, resulting in a daily intake of 37 to 74 mg of fluoride for the patient. The authors caution that skeletal fluorosis can result from consumption of excessive amounts of instant tea because there are substantial fluoride levels in some commercial tea preparations.
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