Catechin intake might explain the inverse relation between tea consumption and ischemic heart disease: the Zutphen Elderly Study

Am J Clin Nutr. 2001 Aug;74(2):227-32. doi: 10.1093/ajcn/74.2.227.


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.

Design: 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.

Conclusion: Catechins, whether from tea or other sources, may reduce the risk of ischemic heart disease mortality but not of stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Catechin / administration & dosage*
  • Cohort Studies
  • Exercise
  • Flavonoids / administration & dosage
  • Flavonols
  • Humans
  • Incidence
  • Lipids / blood
  • Male
  • Myocardial Ischemia / epidemiology
  • Myocardial Ischemia / etiology*
  • Myocardial Ischemia / mortality*
  • Netherlands / epidemiology
  • Prospective Studies
  • Risk Factors
  • Smoking
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / mortality
  • Tea / chemistry*


  • Flavonoids
  • Flavonols
  • Lipids
  • Tea
  • Catechin