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Asian Paradox

Why do people living in Asia have lower heart disease and lung cancer rates than would be expected given their level of smoking?

October 28, 2010 |
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Supplementary Info

Sources Cited

“What’s So Special About Green Tea?” Special Report. Tufts University Health and Nutrition Letter. February 2010.

W. Liang, A. H. Lee, C. W. Binns, R. Huang, D. Hu, and Q. Zhou. Tea consumption and ischemic stroke risk: A case-control study in southern china. Stroke, 40(7):2480-2485, 2009.

I. Watanabe, S. Kuriyama, M. Kakizaki, T. Sone, K. Ohmori-Matsuda, N. Nakaya, A. Hozawa, and I. Tsuji. Green tea and death from pneumonia in japan: The ohsaki cohort study. Am. J. Clin. Nutr., 90(3):672-679, 2009.

Y. Koyama, S. Kuriyama, J. Aida, T. Sone, N. Nakaya, K. Ohmori-Matsuda, A. Hozawa, and I. Tsuji. Association between green tea consumption and tooth loss: Cross-sectional results from the ohsaki cohort 2006 study. Prev Med, 50(4):173-179, 2010.

The efficacy of early treatment of seasonal allergic rhinitis with benifuuki green tea containing O-methylated Catechin before pollen exposure: an open randomized study. M. Maeda-Yamamoto, K. Ema, M. Monoba, I. Shibuichi, Y. Shinoda, T. Yamamoto, T. Fujisawa. Allergology international. 2009; 58:437-444.

Y. Jing, G. Han, Y. Hu, Y. Bi, L. Li, and D. Zhu. Tea consumption and risk of type 2 diabetes: A meta-analysis of cohort studies. J Gen Intern Med, 24(5):557-562, 2009.

K. A. Grove and J. D. Lambert. Laboratory, epidemiological, and human intervention studies show that tea (camellia sinensis) may be useful in the prevention of obesity. J. Nutr., 140(3):446{453, 2010.

M. S. Butt and M. T. Sultan. Green tea: Nature's defense against malignancies. Crit Rev Food Sci Nutr, 49(5):463{473, 2009

P. Pithayanukul, J. Leanpolchareanchai, and R. Bavovada. Inhibitory effect of tea polyphenols on local tissue damage induced by snake venoms. Phytother Res, 24 - Suppl - 1:56, 2010.


Image thanks to Alain Limoges.


What’s so special about green tea asked my medical alma mater in their health and nutrition newsletter. Well, in just the last 12 months we’ve learned 2 cups a day may drop our stroke risk 70%, may halve our risk of dying from pneumonia, And keep us from losing our teeth. Three cups a day started 6 weeks before pollen season significantly reduces allergy symptoms. And four cups a day may decrease our risk of diabetes, in part because tea may be useful in the prevention of obesity. Considered nature’s defense against malignancies, at least according to Dr. Butt… and it may, even help if we’re bitten by a venomous snake. Can your coffee do all that?
According to the head of Tufts’ antioxidant research laboratory, we can think of tea as a plant food, much like fruits and vegetables. In fact, green tea may explain the so-called "Asian paradox": Why do people in Asian countries, where smoking remains more popular, suffer heart disease and lung cancer at the same rate as Americans? The phytonutrients in green tea, may be partly responsible, by maintaining artery function, inhibiting clots, and blocking tumor growth.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

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Dr. Michael Greger

Doctor's Note

Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other videos on green tea. Also, there are 1,686 other subjects covered in the rest of my videos--please feel free to explore them as well!

For some context, please check out my associated blog post: Why Less Breast Cancer in Asia? and The Best Way to Prevent the Common Cold?

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  • Michael Greger M.D.

    Please feel free to post any ask-the-doctor type questions here in the comments section and I’d be happy to try to answer them. And check out the other videos on green tea. Also, there are 1,449 other subjects covered in the rest of my videos–please feel free to explore them as well!

  • DanielFaster

    But China has just surpassed the US in the T2D rates:

    Experts have blamed many factors: the introduction of high-calorie Western diets and fast food, more travel by car, sedentary factory jobs replacing farm labor, and families who spoil the one child that most are allowed to have. Less green tea and more Coke?

    • Don Forrester MD

      The science supports that it is the fats in the diet that contribute to the most the development of type two diabetes. The sugar contains one molecule of glucose (our cells primary fuel source) and one molecule of fructose (metabolized almost exclusively by the liver to fats, uric acid, inflammatory aldehydes and glycogen). So sugar can be a contributing factor along with Exercise. They are only secondary to fat consumption… both animal and plant fat. In my clinical experience patients with type two diabetes who remove fats from their diet have the best results.

      • DanielFaster

        So you are saying to cut down on fat most importantly, but also on added fructose and sucrose (fructose+glucose). Whole fruit is okay? Or do you recommend that T2D patients also cut this out or down?

  • tavit

    I would love to get rid of my per-hipertension, so I could drink green tea all day long, because I live green tea, unfortunately that may never happen.

  • Gina

    Green tea on an empty stomach makes me nauseous. I’ve searched the internet for explanations, but all the results turn up unsatisfying answers, like that it’s the tannins. I drink a ton of red wine, which is full of tannins, and experience no nausea. And it’s not the caffeine, because coffee and soda don’t cause the problem. It’s something specific to green tea. This is, from what I surmise from internet searches, a common problem.