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American Journal of Epidemiology Advance Access originally published online on December 20, 2007
American Journal of Epidemiology 2008 167(5):553-560; doi:10.1093/aje/kwm338
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Differential Effects of Black versus Green Tea on Risk of Parkinson's Disease in the Singapore Chinese Health Study

Louis C. Tan1, Woon-Puay Koh2, Jian-Min Yuan3, Renwei Wang3, Wing-Lok Au1, June H. Tan4, Eng-King Tan1 and Mimi C. Yu3

1 Department of Neurology, National Neuroscience Institute, Singapore
2 Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
3 Cancer Center, University of Minnesota, Minneapolis, MN
4 Department of Medicine, National University Hospital, Singapore

Correspondence to Dr. Woon-Puay Koh, Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597, Singapore (e-mail: cofkwp{at}nus.edu.sg).

Received for publication July 21, 2007. Accepted for publication October 23, 2007.

Data from Asian populations on dietary and lifestyle factors associated with Parkinson's disease are sparse. In 1993–2005, the authors examined these factors in relation to Parkinson's disease in the Singapore Chinese Health Study, a prospective cohort of 63,257 Chinese men and women. Baseline data were collected through in-person interviews using structured questionnaires. All 157 incident Parkinson's disease cases were identified either through follow-up interviews or via linkage with hospital discharge databases and Parkinson's disease outpatient registries and were confirmed by review of medical records. Current versus never smokers exhibited a reduced risk of Parkinson's disease (relative risk = 0.29, 95% confidence interval: 0.16, 0.52). Total caffeine intake was inversely related to Parkinson's disease risk (p for trend = 0.002); the relative risk for the highest versus lowest quartile was 0.55 (95% confidence interval: 0.35, 0.88). Black tea, a caffeine-containing beverage, showed an inverse association with Parkinson's disease risk that was not confounded by total caffeine intake or tobacco smoking (p for trend = 0.0006; adjusted relative risk for the highest vs. lowest tertile of intake = 0.29, 95% confidence interval: 0.13, 0.67). Green tea drinking was unrelated to Parkinson's disease risk. Diet had no strong influence on risk. Ingredients of black tea other than caffeine appear to be responsible for the beverage's inverse association with Parkinson's disease.

Asian continental ancestry group; coffee; food and beverages; Parkinson disease; Singapore; smoking; tea


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