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Green Tea Extract May Reduce Obesity and Cardiovascular Risks; More Study Needed
Nagao T, Hase T, Tokimitsu I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity. June 2007; 15(6): 1473-1482.
Studies have recently been published linking green tea (Camellia sinensis) extract and its catechins to weight loss. However, the studies had critical limitations, namely, (1) small sample size (n < 100), (2) conducted with a hypocaloric diet, or (3) gender-biased. The purpose of the present study was to re-examine the fat reducing properties of continuous green tea extract in a larger sample size of men and women who were maintaining their usual lifestyle.
Women and men (n = 270) 25 to 55 years of age with a body mass index (BMI) of 24 to 30 kg/m2 and/or a waist circumference of 80 to 94 cm who were considered to be visceral fat-type obese were recruited. The subjects were not previously treated at an outpatient department and had no serious liver or renal disease. This randomized, double-blind, controlled, parallel-design study was conducted at 7 medical institutions in the Kanto District of Japan. After a 2-week run-in period, for the next 12-weeks subjects consumed 1 can of a beverage containing brewed green tea extract (9 g of green tea leaves with 1 L of distilled water at 80 ?C for 5 minutes) that was high in catechins (approximately 600 mg of catechins/340 mL and 70 mg of caffeine/340 mL) or low in catechins (approximately 100 mg of catchins/340 mL and 70 mg of caffeine/340 mL). The canned beverages were made specifically for the study; they were not a commercial product. Subjects were instructed to maintain their usual dietary intake and physical activity. Tea and coffee consumption were not limited during the study. Weight, BMI, circumference, blood pressure, and level of abdominal fat were recorded at 4-week intervals. Blood was drawn. Daily diet and activity were recorded.
Compliance was close to 100% in both groups. Baseline daily energy intake, fat intake, and fat/energy ratio were similar between the groups. Over time both groups had a significant decrease in fat intake and fat/energy ratio (P < 0.05), but there was no significant difference between groups. Likewise, baseline coffee intake, and tannin and caffeine intake from coffee was equivalent at baseline but significantly decreased over time in both groups (P < 0.05). There was no significant difference between groups in tea intake. Exercise levels were maintained.
Body weight, BMI, body fat ratio, body fat mass, waist circumference, hip circumference, total fat area, and visceral fat area decreased significantly over time (P < 0.05). Lean body mass increased significantly over time (P < 0.05). When comparing the change at 12 weeks between groups, the magnitude of the decrease was significantly greater in the catechin group than in the control group for body weight, BMI, body/fat ratio, body fat mass, waist circumference, hip circumference, total fat area, and visceral fat area (P < 0.05). There was no significant effect on systolic blood pressure unless the baseline systolic pressure was 130 mmHg or higher, in which case, the magnitude of the decrease was greater in the catechin group (P < 0.05). Low-density lipoprotein (LDL) cholesterol decreased over time and the magnitude of the decrease was significantly greater at 12-weeks in the catechin group than the control group (P < 0.05).
The authors conclude that under the study conditions the ingestion of green tea high in catechins for 12 weeks led to significant decreases in body weight, BMI, body fat ratio, body fat mass, waist circumference, hip circumference, total fat area, and visceral fat area, and subcutaneous fat area. They also state that the results confirmed results of previous studies. However, the study has some statistical concerns. The authors disclose that there were no treatment effects for any parameter when the two-factor repeated measures ANOVA statistical test was conducted. No treatment effect means that there was no statistically significant effect of the treatment. It appears that the authors went "fishing" for statistical significance. They found a statistically significant effect in the "magnitude of decrease" from baseline to 12 weeks. This statistical analysis was conducted with a simple t-test and it does not appear that the authors made a correction for multiple comparisons. If they took this correction, then it appears unlikely that the findings would be statistically significant. Further the magnitude of decrease data is not the primary efficacy variable; the lack of a statistical effect for the primary efficacy variable (treatment difference at 12 weeks) weakens the data. The goal of this study was to confirm previous studies and improve the methodology; however, this study falls short from a statistical perspective.