Assessment of Carcinogenic and Non-carcinogenic Risk of Exposure to Metals via Consumption of Coffee, Tea, and Herbal Tea in Iranians.

In the current study, we assessed health risk posed to Iranian consumers through exposure to metals via oral consumption of coffee, tea, and herbal tea of various trademarks collected from Iran market. Level of As, Cd, Cr, Cu, Fe, Hg, Ni, and Pb in 243 samples was quantified by inductively coupled plasma-optical emission spectrometry (ICP-OES). The metal levels in coffee samples from different trademarks of a specific country had statistically similar levels of metals; however, metal levels differed significantly among brand names form different countries. Metal levels in tea samples differed significantly between domestic and imported products, while different trademarks of similar countries did not show significant variations in this respect. Metal level in herbal tea samples did not show significant variations among different trademarks. Nevertheless, it should be highlighted that mean concentrations of metals statistically differed among different herbal tea samples. Deterministic hazard quotients (HQs) were <1.0 for all non-carcinogenic metals and total hazard index (HI) values indicated no risk; however, probabilistic assessment calculated HI values >1. In both deterministic and probabilistic scenarios, carcinogenic metals As and Ni had an estimated incremental lifetime cancer risk (ILCR) of medium level while that of Pb indicated no cancer risk. Sensitivity analysis showed that the concentration of metals had the most significant effect on non-carcinogenic and carcinogenic risks.

Application of BRAFO-tiered approach for health benefit-risk assessment of dark tea consumption in China.

Dark tea, a unique tea fermented primarily in China, has numerous potential beneficial effects. However, harmful substances present in dark tea have provoked significant concern. To conduct a quantitative benefit-risk assessment of dark tea for Chinese residents and provide guidance on rational consumption, a framework of Benefit-Risk Analysis for Foods (BRAFO) and meta-analysis was applied to construct a disability-adjusted life year (DALY). Based on the BRAFO-tiered approach, a reference scenario (no intake) and an alternative scenario (intake of 3 cups/day) were determined. The overall health impacts of dark tea were simulated by comparing the risks of fluoride and AF with benefits of reduced-risk to coronary heart disease (CHD) and diabetes in different scenarios. Three cups of fermented tea consumed per day decreased risks of CHD and diabetes by 8.16% and 12.77% respectively. After quantitative integration of information, the ultimate net health effect was found to be -1958.827 illustrating that the benefits of drinking three cups of dark tea per day outweigh the risks. However, considering the uncertainties in the process, decision-makers should proceed with caution, consulting additional well-conducted studies and further managing harmful substances in dark tea.

Individual and Combined Effects of Environmental Risk Factors for Esophageal Cancer Based on Results From the Golestan Cohort Study.

BACKGROUND & AIMS: Northeast Iran has one of the highest reported rates of esophageal squamous cell carcinoma (ESCC) worldwide. Decades of investigations in this region have identified some local habits and environmental exposures that increase risk. We analyzed data from the Golestan Cohort Study to determine the individual and combined effects of the major environmental risk factors of ESCC. METHODS: We performed a population-based cohort of 50,045 individuals, 40 to 75 years old, from urban and rural areas across Northeast Iran. Detailed data on demographics, diet, lifestyle, socioeconomic status, temperature of drinking beverages, and different exposures were collected using validated methods, questionnaires, and physical examinations, from 2004 through 2008. Participants were followed from the date of enrollment to the date of first diagnosis of esophageal cancer, date of death from other causes, or date of last follow-up, through December 31, 2017. Proportional hazards regression models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between different exposures and ESCC. RESULTS: During an average 10 years of follow-up, 317 participants developed ESCC. Opium smoking (HR 1.85; 95% CI 1.18-2.90), drinking hot tea (≥60°C) (HR 1.60; 95% CI 1.15-2.22), low intake of fruits (HR 1.48; 95% CI 1.07-2.05) and vegetables (HR 1.62; 95% CI 1.03-2.56), excessive tooth loss (HR 1.66; 95% CI 1.04-2.64), drinking unpiped water (HR 2.04; 95% CI 1.09-3.81), and exposure to indoor air pollution (HR 1.57; 95% CI 1.08-2.29) were significantly associated with increased risk of ESCC, in a dose-dependent manner. Combined exposure to these risk factors was associated with a stepwise increase in the risk of developing ESCC, reaching a more than 7-fold increase in risk in the highest category. Approximately 75% of the ESCC cases in this region can be attributed to a combination of the identified exposures. CONCLUSIONS: Analysis of data from the Golestan Cohort Study in Iran identified multiple risk factors for ESCC in this population. Our findings support the hypothesis that the high rates of ESCC are due to a combination of factors, including thermal injury (from hot tea), exposure to polycyclic aromatic hydrocarbons (from opium and indoor air pollution), and nutrient-deficient diets. We also associated ESCC risk with exposure to unpiped water and tooth loss.

Comparative oesophageal cancer risk assessment of hot beverage consumption (coffee, mate and tea): the margin of exposure of PAH vs very hot temperatures.

BACKGROUND: Consumption of very hot (> 65 °C) beverages is probably associated with increased risk of oesophageal cancer. First associations were reported for yerba mate and it was initially believed that high content of polycyclic aromatic hydrocarbons (PAH) might explain the risk. Later research on other beverage groups such as tea and coffee, which are also consumed very hot, found associations with increased risk of oesophageal cancer as well. The risk may therefore not be inherent in any compound contained in mate, but due to temperature. The aim of this study was to quantitatively assess the risk of PAH in comparison with the risk of the temperature effect using the margin of exposure (MOE) methodology. METHODS: The human dietary benzo[a]pyrene (BaP) and PAH4 (sum of benzo[a]pyrene, benzo[a]anthracene, chrysene, and benzo[b]fluoranthene) exposure through consumption of coffee, mate, and tea was estimated. The oesophageal cancer risk assessment for both PAH and temperature was conducted using the MOE approach. RESULTS: Considering differences in the transfer of the PAH from the leaves of mate and tea or from the ground coffee to the infusion, and considering the different preparation methods, exposures may vary considerably. The average individual exposure in µg/kg bw/day arising from consumption of 1 cup (0.2 L) of infusion was highest for mate (2.85E-04 BaP and 7.22E-04 PAH4). The average per capita exposure in µg/kg bw/day was as follows: coffee (4.21E-04 BaP, 4.15E-03 PAH4), mate (4.26E-03 BaP, 2.45E-02 PAH4), and tea (8.03E-04 BaP, 4.98E-03 PAH4). For all individual and population-based exposure scenarios, the average MOE for BaP and PAH4 was > 100,000 independent of beverage type. MOE values in this magnitude are considered as a very low risk. On the contrary, the MOE for the temperature effect was estimated as < 1 for very hot drinking temperatures, corroborating epidemiological observations about a probable oesophageal cancer risk caused by this behaviour. CONCLUSIONS: The temperature effect but not PAH exposure may pose an oesophageal cancer risk. Consumer education on risks associated with consumption of 'very hot' beverages and policy measures to threshold serving temperatures should be discussed.

Safety assessment of green tea based beverages and dried green tea extracts as nutritional supplements.

The safety of green tea infusions and green tea extract (GTE)-based products is reviewed regarding catechins. Epigallocatechin 3-gallate (EGCG), the major catechin present in green tea, is suspected of being responsible for liver toxicity reported in humans consuming food supplements. Intake of EGCG with green tea infusions and GTE-based beverages is up to about 450mg EGCG/person/day in Europe and higher in Asia. Consumption of green tea is not associated with liver damage in humans, and green tea infusion and GTE-based beverages are considered safe in the range of historical uses. In animal studies, EGCG's potency for liver effects is highly dependent on conditions of administration. Use of NOAELs from bolus administration to derive a tolerable upper intake level applying the margin of safety concept results in acceptable EGCG-doses lower than those from one cup of green tea. NOAELs from toxicity studies applying EGCG with diet/split of the daily dose are a better point of departure for risk characterization. In clinical intervention studies, liver effects were not observed after intakes below 600mg EGCG/person/day. Thus, a tolerable upper intake level of 300mg EGCG/person/day is proposed for food supplements; this gives a twofold safety margin to clinical studies that did not report liver effects and a margin of safety of 100 to the NOAELs in animal studies with dietary administration of green tea catechins.

Critical factors determining fluoride concentration in tea leaves produced from Anhui province, China.

This study investigated the fluoride present in tea plants (Camellia sinensis (L.) O. Kuntze) and its relationship to soils, varieties, seasons and tea leaf maturity. The study also explored how different manufacturing processes affect the leaching of fluoride into tea beverages. The fluoride concentration in the tea leaves was significantly correlate to the concentration of water-soluble fluoride in the soil. Different tea varieties accumulated different levels of fluoride, with varieties, Anji baicha having the highest and Nongkang zao having the lowest fluoride concentration. In eight different varieties of tea plant harvested over three tea seasons, fluoride concentration were highest in the summer and lowest in the spring in china. The fluoride concentration in tea leaves was directly related to the maturity of the tea leaves at harvest. Importantly, the tea manufacturing process did not introduced fluoride contamination. The leaching of fluoride was 6.8% and 14.1% higher in black and white tea, respectively, than in fresh tea leaves. The manufacturing step most affecting the leaching of fluoride into tea beverage was withering used in white, black and oolong tea rather than rolling or fermentation. The exposure and associated health risks for fluoride concentration in infusions of 115 commercially available teas from Chinese tea markets was determined. The fluoride concentration ranged from 5.0 to 306.0mgkg(-1), with an average of 81.7mgkg(-1). The hazard quotient (HQ) of these teas indicated that there was no risk of fluorosis from drinking tea, based on statistical analysis by Monte Carlo simulation.

Coffee and tea consumption in relation to estimated glomerular filtration rate: results from the population-based longitudinal Doetinchem Cohort Study.

BACKGROUND: Although coffee consumption and tea consumption have been linked to diabetes, the relation with kidney function is less clear and is underresearched. OBJECTIVE: We investigated the prospective associations of coffee and tea consumption with estimated glomerular filtration rate (eGFR). DESIGN: We included 4722 participants aged 26-65 y from the Doetinchem Cohort Study who were examined every 5 y for 15 y. Coffee and tea consumption (in cups/d) were assessed at each round. eGFR was assessed by using the Chronic Kidney Disease Epidemiology Collaboration equation based on both plasma creatinine and cystatin C. We determined the association between categories of coffee and tea intake and 1) eGFR and 2) subsequent annual changes in eGFR by using generalized estimating equation analyses. RESULTS: Baseline mean ± SD eGFR was 108.0 ± 14.7 mL · min(-1) · 1.73 m(-2) Tea consumption was not associated with eGFR. Those individuals who drank >6 cups coffee/d had a 1.33 (95% CI: 0.24, 2.43) mL · min(-1) · 1.73 m(-2) higher eGFR than those who drank <1 cup/d (P-trend = 0.02). This association was most apparent among those with a median age of ≥46 y at baseline, with eGFR being 2.47 (95% CI: 0.42, 4.51) mL · min(-1) · 1.73 m(-2) higher in participants drinking >6 cups/d compared with <1 cup/d (P-trend = 0.02). Adjustment for biological risk factors and coffee constituents did not attenuate the associations. Neither coffee nor tea consumption was associated with changes in eGFR. CONCLUSIONS: Coffee consumption was associated with a slightly higher eGFR, particularly in those aged ≥46 y. The absence of an association with eGFR changes suggests that the higher eGFR among coffee consumers is unlikely to be a result of glomerular hyperfiltration. Therefore, low to moderate coffee consumption is not expected to be a concern for kidney health in the general population.

Mutagenicity Assessment of Drinking Water in Combination with Flavored Black Tea Bags: a Cross Sectional Study in Tehran.

Diseases related to water impurities may present as major public health burdens. The present study aimed to assess the mutagenicity of drinking water from different zones of Tehran, and evaluate possible health risks through making tea with tea bags, by Ames mutagenicity test using TA 100, TA 98 and YG1029 strains. For this purpose, 450 water samples were collected over the period of July to December 2014 from 5 different zones of Tehran. Except for one sample, no mutagenic potential was detected during these two seasons and the MI scores were almost normal (≤ 1-1.6) in TA 100, TA 98 and YG1029 strains. Although no mutagenic effects were considered in TA 98 and TA 100 in the test samples of our three evaluated tea bag brands, one sample from a local company showed mutagenic effects in the YG1029 strain (MI=1.7-1.9 and 2) after prolonged (10-15 min.) steeping. Despite the mild mutagenic effect discovered for one of the brand, this cross sectional study showed relative safety of water samples and black tea bags in Tehran. According to the sensitivity of YG1029 to the mutagenic potential of water and black tea, even without metabolic activation by s9 fraction, this metabolizer strain could be considered as sensitive and applicable to food samples for quantitative analysis of mutagens.

Monitoring and risk assessment of 74 pesticide residues in Pu-erh tea produced in Yunnan, China.

A number of 100 Pu-erh tea samples from the 2013 harvest in Yunnan Province (China) were analysed for 74 pesticides. A total of 11 pesticides were detected. At least one pesticide was detected in 56% of the samples. None of these samples contained the 74 monitored pesticides at concentrations above the Chinese maximum residual levels. Imidacloprid, bifenthrin and acetamiprid were most frequently found, with percentages of 53%, 46% and 31%, respectively. These were also the top three pesticides with maximum concentrations of 140, 246 and 672 µg kg⁻¹, respectively. Residual levels of the monitored pesticides showed no significant correlation with the production time or area of Pu-erh tea. Whereas a high incidence of pesticide residues was detected in Pu-erh tea, the contamination levels observed do not pose any serious health risks.

Assessment of dietary exposure to flavouring substances via consumption of flavoured teas. Part 1: occurrence and contents of monoterpenes in Earl Grey teas marketed in the European Union.

Estimations of dietary exposure via the consumption of flavoured foods play a central role in the safety evaluation of flavouring substances. To assess uncertainties, actual data regarding the occurrence and concentration levels of flavouring substances were determined in commercially available flavoured foods, using Earl Grey tea as an example. The contents of the consistently occurring monoterpenes linalyl acetate, linalool, limonene, ß-pinene and γ-terpinene were determined in 90 tea samples purchased in 10 European Union member states. Rather narrow frequency distributions were observed for the major compounds linalyl acetate and linalool. The factors (1) country of purchase, (2) source of the products (national/international brands versus private label brands versus speciality tea shops), and (3) enantiomeric purities of the flavouring substances had no significant impact on the contents of the flavouring substances. Only in teas sold as loose leaves were the median contents of linalyl acetate and linalool (66% and 39%, respectively) higher than in teas offered in tea bags. Significant losses of flavouring substances were observed on storage of teas, indicating an impact of the type of packaging and the flavouring technology on the contents of flavouring substances in the product finally consumed.

Lead, cadmium, arsenic, mercury and copper levels in Chinese Yunnan Pu'er tea.

The Yunnan region of China produces a distinctive variety of Pu'er tea, which is consequently labeled as a Chinese geographic indication product. In this study, the safety of Chinese Yunnan Pu'er tea with regard to heavy metal content was evaluated in 30 different brands of Pu'er tea, including 150 commercial samples. Metal levels in the Pu'er tea samples followed the order: copper (12-22 µg/g) > lead (0.26-3.2 µg/g) > arsenic (0.035-0.24 µg/g) > cadmium (0.0059-0.085 µg/g) > mercury (<0.010 µg/g). Mercury was not detected in 17 of the brands of Pu'er tea. Metal-to-metal correlation studies showed that there were no significant correlation between metal pairs. Based on current safety standards, the low levels of metals detected in these Pu'er tea samples mean they are safe for human consumption.

Topographic and radiographic profile assessment of dental erosion. Part III: Effect of green and black tea on human dentition.

This study compared green and black tea to soda and orange juice in terms of their erosive effect on the human dentition. Vinegar and water were used as active and passive control fluids. An accelerated in vitro test was used to monitor how short- and long-term exposure to these fluids affected the topography and morphology of the coronal segments of the human dentition. This 20-week test was conducted under controlled conditions, independent of the influencing factors of the oral environment. The erosive effects of these fluids were categorized generally into three groups: highly erosive (vinegar), moderately erosive (soda and orange juice), and minimally erosive (black and green tea). The erosive effect of tea was similar to that of water, which has no erosion potential. Given the systemic and dental benefits of tea and the low potential for erosion, green and black tea should be highly encouraged for daily beverage consumption.

[Breast feeding determinants on the first year of life of children in a city of Midwestern Brazil]. / Determinantes da amamentação no primeiro ano de vida em Cuiabá, Mato Grosso.

OBJECTIVE: To assess risk factors for breastfeeding discontinuation and weaning among children less than one year old. METHODS: A cross-sectional study was carried out in children under one year of age brought by their caregivers to immunization units in the city of Cuiabá, Midwestern Brazil, in 2004. Sampling first comprised drawing immunization units and then children in each unit were systematically drawn. Data was collected through semi-structured questionnaires applied to children's caregivers investigating social and demographic variables, as well as variables related to birth and maternal characteristics, pacifier use and feeding on the first day at home. Descriptive statistical and logistic regression analyses of risk factors by age group were conducted and odds ratios and 95% confidence intervals were estimated. RESULTS: A total of 920 children under one year of age were studied, of which 205 were less than 120 days old and 275 were less than 180 days old. Pacifier use, offering tea to children on their first day at home, and being a child of a mother with first or second grade schooling or primapara posed an increased risk for not being on exclusive breastfeeding at the age of 120 days. All these factors were also significantly associated in those under 180 days old, except tea offering, which was not investigated for this age group. Among children less than one year old, pacifier use was the only variable that remained significant. CONCLUSIONS: Social and cultural factors were determinants of breastfeeding status. Maternal education and awareness are crucial to prevent practices that can negatively affect breastfeeding.

Prevalence of iron deficiency among schoolchildren of different socio-economic status in urban Turkey.

OBJECTIVE: To investigate the prevalence of iron deficiency among schoolchildren of different socio-economic status (SES), living in the three largest cities of Turkey. DESIGN: Cross-sectional study. SETTINGS: Primary schools of Istanbul, Ankara and Izmir. SUBJECTS: Schoolchildren aged 12 and 13 y (males: 504; females: 510) from nine primary schools. Inclusion of subjects in the study was on a voluntary basis. METHODS: Data were obtained on children SES, anthropometry, haematological and biochemical indices of iron status and consumption of food items related to dietary iron bioavailability. One-way analysis of variance was mainly applied, for the evaluation of the tested hypotheses, using Bonferroni correction in order to take into account the inflation of Type I error. RESULTS: Iron deficiency (serum ferritin <15 microg/l) prevalence was 17.5% among boys and 20.8% among girls. Furthermore, iron deficiency was significantly more prevalent among boys of lower SES, who were also found to have significantly lower levels of serum iron, serum ferritin, transferrin saturation, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration compared to those of higher SES. In terms of dietary factors affecting iron bioavailability, low SES boys exhibited significantly higher frequency of tea consumption and lower frequency of citrus fruit, red meat and fish consumption, compared to their higher SES counterparts. CONCLUSION: The prevalence of iron deficiency was relatively high, particularly among lower SES schoolboys. Higher tea and lower citrus fruits, red meat and fish consumption by boys of lower SES may provide an indication about the possible role of certain dietary patterns in the different manifestation of this medical condition among the socio-economic groups. However, further research is needed.

Assessment of metal content and toxicity of leachates from teapots.

Metallic teapots traditionally used in Morocco were investigated for release of toxic metals from the teapots and their toxicity, as determined by MetPAD, a bacterial toxicity test that is specific for heavy metal toxicity. Our data show that some teapots were non-toxic while a few others were highly toxic, as shown by MetPAD. Tea addition reduced somewhat heavy metal toxicity due possibly to the complexing ability of tea. Chemical analysis of teapot leachates showed that some contained zinc and copper. Teapot No. 5, which showed the highest toxicity, also displayed the highest Zn concentration (7.39 mg/l), confirming the toxicity data. Based on estimates of tea consumption in Morocco, we showed that the extra daily burden of Zn ranged from 1.75 to 4.2 mg/day, assuming the maximum zinc concentration of 7.4 mg/l, as found in our study. This represents 3.5-8% of the LOAEL for zinc of 50 mg/day and would not be important as compared to other sources zinc intake.

Methylxanthines and breast cancer.

We investigated the relationship between methylxanthine consumption and breast cancer using data from a case-control study which included 1,510 cases and 1,882 controls identified through a nation-wide breast cancer screening program. There was no evidence of a positive association between methylxanthine consumption and risk of breast cancer. In fact, there was some suggestion of a negative association, particularly in women diagnosed after age 50. In addition, there was no evidence of increased risk with past or recent methylxanthine consumption, or with the consumption of caffeine or specific beverages, most notably brewed or instant caffeinated coffee and tea.