European Journal of Epidemiology

, Volume 31, Issue 9, pp 853–865 | Cite as

Association of green tea consumption with mortality from all-cause, cardiovascular disease and cancer in a Chinese cohort of 165,000 adult men

  • Junxiu Liu
  • Shiwei Liu
  • Haiming Zhou
  • Timothy Hanson
  • Ling Yang
  • Zhengming Chen
  • Maigeng Zhou


Tea is the most ancient and popular beverage in the world, and its beneficial health effects has attracted tremendous attention worldwide. However, the prospective evidence relating green tea consumption to total and cause-specific mortality is still limited and inconclusive. We recruited 164,681 male participants free of pre-existing disease during 1990–1991, with green tea consumption and other covariates assessed by the standardized questionnaire and mortality follow up continued until 2006 (mean 11 years; total person-years: 1,961,791). Cox regression analyses were used to quantify the associations of green tea consumption with all-cause (n = 32,700), CVD (n = 11,839) and cancer (n = 7002) mortality, adjusting simultaneously for potential confounders. At baseline, 18 % reported regular consumption of green tea. Compared with non-green tea drinkers, regular drinkers had significantly lower all-cause mortality, with adjusted hazard ratios (HRs) being 0.94 (95 % CI 0.89, 0.99) for ≤5 g/day, 0.95 (0.91, 0.99) for 5–10 g/day and 0.89 (0.85, 0.93) for >10 g/day. For CVD mortality, the corresponding HRs were 0.93 (0.85, 1.01) 0.91 (0.85, 0.98) and 0.86 (0.79, 0.93), respectively, while for cancer they were 0.86 (0.78, 0.98), 0.92 (0.83, 1.00) and 0.79 (0.71, 0.88), respectively. The patterns of these associations varied by smoking, alcohol drinking and locality. This large prospective study shows that regular green tea consumption is associated with significantly reduced risk of death from all-cause, CVD and cancer among Chinese adults.


Green tea consumption Mortality Cardiovascular disease Cancer Smoking Alcohol drinking 



The original survey and subsequent follow-up were supported by the Chinese Ministry of Health; the UK Medical Research Council, British Heart Foundation and Cancer Research UK; the World Bank loan to China; and the Canadian International Development Research Centre. We thank Gonghao Wang and Xinzhou He for their collaboration in the initial survey, the China DSP staff for their continuing effort and cooperation with long-term follow-up of study participants, and Peilong Liu, Chunming Chen, Richard Bumgarner, and Don de Savigny for help getting funding for the initial survey. Dr. Shiwei Liu was supported by a postdoctoral fellowship from the Sino-British fellowship trust. We would also give our special thanks to Dr. Barbara Bolt at the University of South Carolina for assistance in revision of this manuscript.

Supplementary material

10654_2016_173_MOESM1_ESM.tiff (408 kb)
Supplemental Figure 1a Spline curves for the multivariate-adjusted association of green tea consumption and CVD mortality across whole population, current smokers and never smokers. (TIFF 407 kb)
10654_2016_173_MOESM2_ESM.tiff (409 kb)
Supplemental Figure 1b Spline curves for the multivariate-adjusted association of green tea consumption and CVD mortality across whole population, non-regular alcohol drinkers, moderate alcohol drinkers and heavy drinkers. (TIFF 408 kb)
10654_2016_173_MOESM3_ESM.tiff (401 kb)
Supplemental Figure 1c Spline curves for the multivariate-adjusted association of green tea consumption and CVD mortality across whole population, urban residents and rural residents. (TIFF 401 kb)
10654_2016_173_MOESM4_ESM.tiff (412 kb)
Supplemental Figure 2a Spline curves for the multivariate-adjusted association of green tea consumption and cancer mortality across whole population, current smokers and never smokers. (TIFF 411 kb)
10654_2016_173_MOESM5_ESM.tiff (422 kb)
Supplemental Figure 2b Spline curves for the multivariate-adjusted association of green tea consumption and cancer mortality across whole population, non-regular alcohol drinkers, moderate alcohol drinkers and heavy drinkers. (TIFF 421 kb)
10654_2016_173_MOESM6_ESM.tiff (400 kb)
Supplemental Figure 2c Spline curves for the multivariate-adjusted association of green tea consumption and cancer mortality across whole population, urban residents and rural residents. (TIFF 400 kb)
10654_2016_173_MOESM7_ESM.docx (16 kb)
Supplementary material 7 (DOCX 15 kb)


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Junxiu Liu
    • 1
  • Shiwei Liu
    • 2
    • 5
  • Haiming Zhou
    • 3
  • Timothy Hanson
    • 4
  • Ling Yang
    • 5
  • Zhengming Chen
    • 5
  • Maigeng Zhou
    • 2
  1. 1.Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  2. 2.National Center for Chronic and Non-communicable Disease Control and PreventionChinese Center for Disease Control and PreventionBeijingChina
  3. 3.Division of StatisticsNorthern Illinois UniversityDekalbUSA
  4. 4.Department of StatisticsUniversity of South CarolinaColumbiaUSA
  5. 5.Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population HealthUniversity of OxfordOxfordUK

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