Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women: safety and quality of life report

Chwan-Li Shen, Ming-Chien Chyu, Barbara C Pence, James K Yeh, Yan Zhang, Carol K Felton, Susan Doctolero, Jia-Sheng Wang, Chwan-Li Shen, Ming-Chien Chyu, Barbara C Pence, James K Yeh, Yan Zhang, Carol K Felton, Susan Doctolero, Jia-Sheng Wang

Abstract

Background: Evidence suggests that both green tea polyphenols (GTP) and Tai Chi (TC) exercise may benefit bone health in osteopenic women. However, their safety in this population has never been systematically investigated. In particular, there have been hepatotoxicity concerns related to green tea extract. This study was to evaluate the safety of 24 weeks of GTP supplementation combined with TC exercise in postmenopausal osteopenic women, along with effects on quality of life in this population.

Methods: 171 postmenopausal women with osteopenia were randomly assigned to 4 treatment arms for 24 weeks: (1) Placebo (500 mg starch/day), (2) GTP (500 mg GTP/day), (3) Placebo + TC (placebo plus TC training at 60 min/session, 3 sessions/week), and (4) GTP + TC (GTP plus TC training). Safety was examined by assessing liver enzymes (aspartate aminotransferase, alanine aminotransferase), alkaline phosphatase, and total bilirubin at baseline and every 4 weeks. Kidney function (urea nitrogen and creatinine), calcium, and inorganic phosphorus were also assessed at the same times. Qualify of life using SF-36 questionnaire was evaluated at baseline, 12, and 24 weeks. A mixed model of repeated measures ANOVA was applied for analysis.

Results: 150 subjects completed the study (12% attrition rate). The compliance rates for study agents and TC exercise were 89% and 83%, respectively. Neither GTP supplementation nor TC exercise affected liver or kidney function parameters throughout the study. No adverse event due to study treatment was reported by the participants. TC exercise significantly improved the scores for role-emotional and mental health of subjects, while no effect on quality of life was observed due to GTP supplementation.

Conclusions: GTP at a dose of 500 mg/day and/or TC exercise at 3 hr/week for 24 weeks appear to be safe in postmenopausal osteopenic women, particularly in terms of liver and kidney functions. TC exercise for 24 weeks (3 hr/wk) significantly improved quality of life in terms of role-emotional and mental health in these subjects. ClinicalTrials.gov identifier: NCT00625391.

Figures

Figure 1
Figure 1
Study flow chart.

References

    1. Shen CL, Yeh JK, Cao JJ, Wang J-S. Green tea and bone metabolism (review) Nutr Res. 2009;29(7):437–456. doi: 10.1016/j.nutres.2009.06.008. Review.
    1. Shen CL, Wang P, Guerrieri J, Yeh J, Wang J-S. Protective effect of green tea polyphenols on bone loss in middle-aged female rats. Osteoporosis Int. 2008;19(7):979–990. doi: 10.1007/s00198-007-0527-5.
    1. Shen CL, Yeh JK, Cao JJ, Tatum OL, Dagda RY, Wang J-S. Green tea polyphenols mitigate bone loss of female rats in a chronic inflammation-induced bone loss model. J Nutr Biochem. 2009. in press .
    1. Qin L, Au S, Choy W, Leung P. et al.Regular Tai Chi Chuan exercise may retard bone loss in postmenopausal women: a case-control study. Arch Phys Med Rehabil. 2002;83(10):1355–1359. doi: 10.1053/apmr.2002.35098.
    1. Wang C, Collet JP, Lau J. The effect of Tai Chi on health outcomes in patients with chronic conditions. Arch Intern Med. 2004;164:493–501. doi: 10.1001/archinte.164.5.493.
    1. Qin L, Choy W, Leung K. et al.Beneficial effects of regular Tai Chi exercise on musculoskeletal system. J Bone Miner Metab. 2005;23(2):186–190. doi: 10.1007/s00774-004-0559-2.
    1. Chan K, Qin L, Lau M. et al.A randomized, prospective study of the effects of Tai Chi Chuan exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil. 2004;85:717–722. doi: 10.1016/j.apmr.2003.08.091.
    1. Stickel F, Patsenker E, Schuppan D. Herbal hepatotoxicity. J Hepatol. 2005;43:901–910. doi: 10.1016/j.jhep.2005.08.002.
    1. Sarma DN, Barrett ML, Chavez ML. et al.Safety of green tea extracts: a systematic review by the US Pharmacopeia. Drug Saf. 2008;31(6):469–484. doi: 10.2165/00002018-200831060-00003.
    1. Mazzanti G, Menniti-Ippolito F, Moro PA. et al.Hepatotoxicity from green tea: a review of the literature and two unpublished cases. Eur J Clin Pharmacol. 2009;65(4):331–341. doi: 10.1007/s00228-008-0610-7. Review.
    1. Nagao T, Komine Y, Soga S. et al.Ingestion of a tea rich in catechins leads to a reduction in body fat and malondialdehyde-modified LDL in men. Am J Clin Nutr. 2005;81(1):122–129.
    1. Hsu CH, Tsai TH, Kao YH. et al.Effect of green tea extract on obese women: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr. 2008;27(3):363–370. doi: 10.1016/j.clnu.2008.03.007.
    1. Hsu SP, Wu MS, Yang CC. et al.Chronic green tea extract supplementation reduces hemodialysis-enhanced production of hydrogen peroxide and hypochlorous acid, atherosclerotic factors, and proinflammatory cytokines. Am J Clin Nutr. 2007;86(5):1539–1547.
    1. Matsuyama T, Tanaka Y, Kamimaki I. et al.Catechin safely improved higher levels of fatness, blood pressure, and cholesterol in children. Obesity (Silver Spring) 2008;16(6):1338–1348. doi: 10.1038/oby.2008.60.
    1. Janjua R, Munoz C, Gorell E. et al.A two-year, double-blind, randomized placebo-controlled trial of oral green tea polyphenols on the long-term clinical and histologic appearance of photoaging skin. Dermatol Surg. 2009;35(7):1057–1065. doi: 10.1111/j.1524-4725.2009.01183.x.
    1. Jahnke R, Larkey L, Rogers C. et al.A comprehensive review of health benefits of qigong and tai chi. Am J Health Promot. 2010;24(6):e1–e25. doi: 10.4278/ajhp.081013-LIT-248.
    1. Shen CL, Chyu MC, Yeh JK. et al.Green tea polyphenols and Tai Chi for bone health: designing a placebo-controlled randomized trial. BMC Musculoskeletal Disorders. 2009;10:110. doi: 10.1186/1471-2474-10-110.
    1. Yesavage JA, Brink TL, Rose TL. et al.Development and validation of a geriatric depression scale: a preliminary report. J Psychiatr Res. 1982;17:37–49. doi: 10.1016/0022-3956(82)90033-4.
    1. Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–233. doi: 10.1097/00005650-199603000-00003.
    1. Pickard AS, Jeffrey AJ, Penn A. et al.Replicability of SF-36 Summary Scores by the SF-12 in Stroke Patients. Stroke. 1999;30:1213–1217.
    1. Ware J, Snow KK, Kosinski M, SF-36 health survey manual and interpretation guide. Boston, MA: Health Institute, New England Medical Center Hospital; 1993.
    1. Hennig SM, Fajardo-Lira C, Lee HW. et al.Catechin content of 18 teas and a green tea extract supplement correlates with the antioxidant capacity. Nutr Cancer. 2003;45:226–235. doi: 10.1207/S15327914NC4502_13.
    1. Federico A, Tiso A, Loguercio C. A case of hepatotoxicity caused by green tea. Free Radic Biol Med. 2007;43(3):474. doi: 10.1016/j.freeradbiomed.2007.05.010.
    1. Jimenez-Saenz M, Martinez-Sanchez Mdel C. Acute hepatitis associated with the use of green tea infusions. J Hepatol. 2006;44(3):616–617. doi: 10.1016/j.jhep.2005.11.041.
    1. Gloro R, Hourmand-Ollivier I, Mosquet B. et al.Fulminant hepatitis during self-medication with hydroalcoholic extract of green tea. Eur J Gastroenterol Hepatol. 2005;17(10):1135–1137. doi: 10.1097/00042737-200510000-00021.
    1. Molinari M, Watt KD, Kruszyna T. et al.Acute liver failure induced by green tea extracts: case report and review of the literature. Liver Transpl. 2006;12(12):1892–1895. doi: 10.1002/lt.21021.
    1. Hsu SP, Wu MS, Yang CC. et al.Chronic green tea extract supplementation reduces hemodialysis-enhanced production of hydrogen peroxide and hypochlorous acid, atherosclerotic factors, and proinflammatory cytokines. Am J Clin Nutr. 2007;86(5):1539–1547.
    1. Nagao T, Hase T, Tokimitsu I. A green tea extract high in catechins reduces body fat and cardiovascular risks in humans. Obesity (Silver Spring) 2007;15(6):1473–1483. doi: 10.1038/oby.2007.176.
    1. Imai K, Nakachi K. Cross sectional study of effects of drinking green tea on cardiovascular and liver disease. BMJ. 1995;310:693–696.
    1. Tanaka K, Tokunaga S, Kono S. et al.Coffee consumption and decreased serum gamma-glutamyltransferase and aminotransferase activities among male alcohol drinkers. Int J Epidemiol. 1998;27(3):438–443. doi: 10.1093/ije/27.3.438.
    1. Ingelman-Sundberg M, Oscarson M, McLellan RA. Polymorphic human cytochrome P450 enzymes: an opportunity for individualized drug treatment. Trends Pharmacol Sci. 1999;20(8):342–349. doi: 10.1016/S0165-6147(99)01363-2. Review.
    1. Ko GT, Tsang PC, Chan HC. A 10-week Tai-Chi program improved the blood pressure, lipid profile and SF-36 scores in Hong Kong Chinese women. Med Sci Monit. 2006;12(5):CR196–CR199.
    1. Abbott RB, Hui KK, Hays RD, Li MD, Pan T. A Randomized Controlled Trial of Tai Chi for Tension Headaches. Evid Based Complement Alternat Med. 2007;4(1):107–113. doi: 10.1093/ecam/nel050.
    1. Rayman M, Thompson A, Warren-Perry M, Galassini R, Catterick J, Hall E, Lawrence D, Bliss J. Impact of selenium on mood and quality of life: a randomized, controlled trial. Biol Psychiatry. 2006;59(2):147–154. doi: 10.1016/j.biopsych.2005.06.019.
    1. Galbussera A, Tremolizzo L, Brighina L, Testa D, Lovati R, Ferrarese C, Cavaletti G, Filippini G. Vitamin E intake and quality of life in amyotrophic lateral sclerosis patients: a follow-up case series study. Neurol Sci. 2006;27(3):190–193. doi: 10.1007/s10072-006-0668-x.

Source: PubMed

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