title: Catechin intake might explain the inverse relation between tea consumption and ischemic heart disease: the Zutphen Elderly Study.
abstract: BACKGROUND
  Epidemiologic studies suggest that tea consumption may reduce the risk of cardiovascular diseases, but results are inconsistent. Catechins, which belong to the flavonoid family, are the main components of tea and may be responsible for the alleged protective effect. Taking catechin sources other than tea into account might clarify the reported associations.
  
  
  OBJECTIVE
  The objective was to evaluate the association between catechin intake and the incidence of and mortality from ischemic heart disease and stroke.
  
  
  METHODS
  We evaluated the effect of a high catechin intake by using data from the Zutphen Elderly Study, a prospective cohort study of 806 men aged 65-84 y at baseline in 1985.
  
  
  RESULTS
  The mean (+/-SD) catechin intake at baseline was 72 +/- 47.8 mg, mainly from black tea, apples, and chocolate. A total of 90 deaths from ischemic heart disease were documented. Catechin intake was inversely associated with ischemic heart disease mortality; the multivariate-adjusted risk ratio in the highest tertile of intake was 0.49 (95% CI: 0.27, 0.88; P for trend: 0.017). After multivariate adjustment, catechin intake was not associated with the incidence of myocardial infarction (risk ratio in the highest tertile of intake: 0.70; 95% CI: 0.39, 1.26; P for trend: 0.232). After adjustment for tea consumption and flavonol intake, a 7.5-mg increase in catechin intake from sources other than tea was associated with a tendency for a 20% reduction in ischemic heart disease mortality risk (P = 0.114). There was no association between catechin intake and stroke incidence or mortality.
  
  
  CONCLUSIONS
  Catechins, whether from tea or other sources, may reduce the risk of ischemic heart disease mortality but not of stroke.
authors.affiliation: National Institute of Public Health and the Environment (RIVM), Division of Public Health Research, Department of Chronic Diseases Epidemiology, Bilthoven, Netherlands. i.c.w.arts@rikilt.wag-ur.nl
authors.forename: I C
authors.initials: IC
authors.lastname: Arts
authors.forename: P C
authors.initials: PC
authors.lastname: Hollman
authors.forename: E J
authors.initials: EJ
authors.lastname: Feskens
authors.forename: H B
authors.initials: HB
authors.lastname: Bueno de Mesquita
authors.forename: D
authors.initials: D
authors.lastname: Kromhout
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002392:Catechin / Q000008:administration & dosage*; D015331:Cohort Studies; D015444:Exercise; D005419:Flavonoids / Q000008:administration & dosage; D044948:Flavonols; D006801:Humans; D015994:Incidence; D008055:Lipids / Q000097:blood; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality*; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D013662:Tea / Q000737:chemistry*
chemical_list: D005419:Flavonoids; D044948:Flavonols; D008055:Lipids; D013662:Tea; D002392:Catechin