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

Xiaona Liu, Wanghong Xu, Hui Cai, Yu Tang Gao, Honglan Li, Bu Tian Ji, Xiang Shu, Thomas Wang, Robert E. Gerszten, Wei Zheng, Yong Bing Xiang, Xiao Ou Shu

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


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

Original languageEnglish (US)
Pages (from-to)1887-1896
Number of pages10
JournalInternational Journal of Epidemiology
Issue number6
StatePublished - Dec 1 2018
Externally publishedYes


  • Chinese
  • Cohort study
  • Green tea
  • Type 2 diabetes

ASJC Scopus subject areas

  • Epidemiology


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