Tea Consumption and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study

Geertruida J. van Woudenbergh*, Anneleen Kuijsten, Dagmar Drogan, Daphne L. van der A, Dora Romaguera, Eva Ardanaz, Pilar Amiano, Aurelio Barricarte, Joline W. J. Beulens, Heiner Boeing, H. Bas Bueno-de-Mesquita, Christina C. Dahm, M-Doleres Chirlaque, Fran-coise Clavel, Francesca L. Crowe, Piia-Piret Eomois, Guy Fagher-azzi, Paul W. Franks, Jytte Halkjaer, Kay T. KhawGiovanna Masala, Amalia Mattiello, Peter Nilsson, Kim Overvad, J. Ramon Quiros, Olov Rolandsson, Isabelle Romieu, Carlotta Sacerdote, Maria-Jose Sanchez, Matthias B. Schulze, Nadia Slimani, Ivonne Sluijs, Annemieke M. W. Spijkerman, Giovanna Tagliabue, Birgit Teucher, Anne Tjonneland, Rosario Tumino, Nita G. Forouhi, Stephen Sharp, Claudia Langenberg, Edith J. M. Feskens, Elio Riboli, Nicholas J. Wareham,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: In previous meta-analyses, tea consumption has been associated with lower incidence of type 2 diabetes. It is unclear, however, if tea is associated inversely over the entire range of intake. Therefore, we investigated the association between tea consumption and incidence of type 2 diabetes in a European population.

Methodology/Principal Findings: The EPIC-InterAct case-cohort study was conducted in 26 centers in 8 European countries and consists of a total of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,835 individuals from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. Country-specific Hazard Ratios (HR) for incidence of type 2 diabetes were obtained after adjustment for lifestyle and dietary factors using a Cox regression adapted for a case-cohort design. Subsequently, country-specific HR were combined using a random effects meta-analysis. Tea consumption was studied as categorical variable (0, >0-= 4 cups/day). The dose-response of the association was further explored by restricted cubic spline regression. Country specific medians of tea consumption ranged from 0 cups/day in Spain to 4 cups/day in United Kingdom. Tea consumption was associated inversely with incidence of type 2 diabetes; the HR was 0.84 [95% CI 0.71, 1.00] when participants who drank >= 4 cups of tea per day were compared with non-drinkers (p(linear) (trend) = 0.04). Incidence of type 2 diabetes already tended to be lower with tea consumption of 1-

Conclusions/Significance: A linear inverse association was observed between tea consumption and incidence of type 2 diabetes. People who drink at least 4 cups of tea per day may have a 16% lower risk of developing type 2 diabetes than non-tea drinkers.

Original languageEnglish
Article number36910
Number of pages8
JournalPLoS ONE [E]
Issue number5
Publication statusPublished - 30 May 2012


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