FDA Takes a Tough Stand Against Ephedra • Black, Green Teas May Reduce Risk of Heart Attack

On Feb. 28, 2003, the U.S. Department of Health and Human Services (HHS) released the long-awaited Rand Corporation study on ephedra efficacy and safety, and announced several actions it planned to take regarding the herb. HHS, the department that overseas the Food and Drug Administration (FDA), has indicated there are reasons for heightened concern about dietary supplements that contain ephedra. As a result, it is seeking public input regarding ephedra, and reopening a 30-day comment period for a proposed regulation it first issued in 1997, and modified in 2000.

The FDA is proposing that ephedra products bear a warning label about the risks of serious adverse events, including heart attack, seizure, stroke, and death, and cautions about certain medical conditions and activities under which ephedra should be avoided. Also announced by HHS were enforcement actions against companies marketing ephedra products for sports performance enhancement. Approximately 24 companies were sent warning letters because, in the FDA's judgment, the claims about their products' effects on the structure and function of the body could not be substantiated, according to the findings of the Rand report.

Reference:

• National Nutritional Foods Association announcement, Feb. 28, 2003.

Two recent studies, one from King Saudi University, Saudi Arabia, and one from Japan, suggest that daily consumption of black or green tea is associated with a significant reduction in risk of heart attack, even in the presence of known coronary risk factors. Both black tea (a derivative of green tea) and green tea contain antioxidant flavonoids, shown to reduce the oxidation (free radical attack) of LDL-cholesterol in the bloodstream. It is known that LDL-cholesterol oxidation results in a modified form of LDL, which is more inclined to participate in the atherosclerosis process, narrowing arteries and leading to heart disease and stroke. Consequently, antioxidants, including vitamin E, tea flavonoids and others, demonstrate an ability to quench free radicals, protecting LDL-cholesterol from oxidation as it travels through the bloodstream.

At King Saudi University, researchers interviewed 3,430 Saudis between the ages of 30 and 70. Participants who drank more than six cups of black tea per day reduced their risk of coronary heart disease by more than 50 percent compared with nondrinkers.

Researchers in Japan found that drinking one cup of green tea every day was associated with a 42-percent decreased risk of heart attack. This study was performed on 400 Japanese heart disease patients who were undergoing angiography, due to the presence of known cardiovascular risk factors and other symptoms of heart disease. In spite of the fact that many of the patients had high cholesterol, high blood pressure and diabetes, the consumption of green tea appeared to reduce their risk of heart disease without affecting any of these parameters. In other words, green tea consumption did not lower cholesterol or blood pressure, or alter the diabetic condition.

It is likely that green tea consumption reduced LDL-cholesterol oxidation, which may be an independent and often overlooked risk factor for heart disease. Health practitioners may consider suggesting that patients switch from coffee to tea consumption. It also is noteworthy that green tea is a much more concentrated source of flavonoids than black tea. As such, the daily consumption of green tea (one or two cups per day) may represent an additional intervention individuals can use to help reduce heart disease risk over their lifetimes. Green tea consumption has also been associated with reduction of certain cancers (esophageal, stomach), making it a potentially multifaceted health-promotion beverage.

References

1. Preventive Medicine 2003;36:64-70.
2. American Journal of Cardiology 2002;90(10):1150-3.

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