White tea, camellia sinensis, classification, varieties, health benefits, meta-analysis of clinical studies, toxicity of supplements

1. WHITE TEA AS MEDICINE:
CAMELIA SINENSIS
CURRENT EVIDENCE
By
Kevin KF Ng MD, PhD
Former Associate Professor of Medicine
Division of Clinical Pharmacology
University of Miami, Miami, FL, USA
Email: kevinng68@gmail.com
A slide presentation for HealthCare Provider Seminar March 2019

2. TEA
IS THE MOST CONSUMED BEVERAGE
IN THE WORLD AFTER WATER

3. America is slowly—but surely—becoming a
nation of tea drinkers
https://www.washingtonpost.com/news/wonk/wp/2014/09/03/america-is-slowly-but-surely-becoming-a-nation-of-tea-
drinkers/?noredirect=on&utm_term=.18d3eb22e14f

4. Six Different types of tea

5. Source of varieties of tea leaves
white tea
green tea
black tea

6. Milestones in the History of Tea Drinking
https://woley.wordpress.com/tag/tea-origins/

7. Definition of White Tea
▪ There is no official definition of white tea ; some sources use the term to refer to tea
that is merely dried with no additional processing.
▪ Most definitions agree, however, that white tea is not rolled or oxidized, resulting in a
flavor characterized as "lighter" than most green or black teas.
▪ Brewed white tea is pale yellow. Its name derives from the fine silvery-white hairs on
the unopened buds of the tea plant, which give the plant a whitish appearance.
▪ It is harvested primarily in China, mostly in the Fujian province, but more recently
produced in Eastern Nepal, Taiwan, Thailand, Galle (Southern Sri Lanka) and
northeast India.
https://en.wikipedia.org/wiki/White_tea

8. Origin of White Tea
White tea is derived from the species
of tea plant (camellia sinensis) which
by different manufacturing processes
gives rise to white tea, green tea,
yellow tea, oolong tea and Pu-erh
tea

9. Number of scientific articles on white tea and green tea
in PubMed from 1980 to 2018
https://www.ncbi.nlm.nih.gov/pubmed/?term=white+tea
white tea

10. Number of scientific articles on white tea and green tea
in PubMed from 1980 to 2018
https://www.ncbi.nlm.nih.gov/pubmed/?term=white+tea
white tea green tea

11. Scientific classification of tea plant (Camellia sinesis)
https://plants.usda.gov/java/ClassificationServlet?source=profile&symbol=CASI16&display=31

12. The Meaning of Camellia sinensis
▪ The name Camellia is taken from the Latinized name of
Rev. Georg Kamel (1661–1706), a Moravian-born Jesuit
lay brother, pharmacist, and missionary to the
Philippines.
▪ Carl Linnaeus chose his name in 1753 for the genus to
honor Kamel's contributions to botany
▪ The name sinensis means "from China" in Latin.
https://en.wikipedia.org/wiki/Camellia_sinensis

13. Tea Producing Countries and Regions in 2019
https://www.pinterest.com/pin/378865387381609211/?autologin=true

14. Leading tea exporting countries worldwide in 2016
(in million US dollars)
https://brandongaille.com/24-tea-industry-statistics-trends-analysis/

15. Per capita consumption of tea in selected countries:
U.S. ranks 20th in the world
https://slideplayer.com/slide/5281249/

16. Total consumption of tea in U.S. in 2017:
84 billion servings or 3.8 billion gallons
Adapted from http://www.teausa.com/14655/tea-fact-sheet
white tea
Oolong tea
Black tea
Green tea

17. Two varieties of Tea Plant
https://www.teatulia.com/tea-varieties/what-is-black-tea.htm

18. Anatomy of a Tea Plant
https://www.pinterest.com/shawnbeleaves/tea-plant-anatomy/?lp=true

19. Manufacturing Process of White Tea
White tea
Plug
terminal
buds

20. Manufacturing Process of Black Tea
Plug 2
mature
leaves
Roll the
leaves
Oxidize
fully
Fired/driedBlack tea

21. Varieties of tea made from Camellia sinesis
Brewed teas
Tea leaves
White tea Green tea Oolong tea Black tea Pu-erh

22. Chemical alterations of bioactive compounds in tea leaves
during manufacturing process
Adapted from http://flipper.diff.org/app/items/3111
http://file.scirp.org/Html/4-8202076_29878.htm

23. Characteristics of white tea leaf
▪ White tea leaf is plugged mainly in the Fujian province of China.
▪ It is usually harvested from the terminal buds of the stem.
▪ It is covered with silvery hairs.
▪ It is picked during 3 days of early spring.
▪ It is the least processed of all varieties of teas.
▪ It contains the highest amount of polyphenols.
▪ It is best brewed with boiled water at temperature 158° to 167° F
for 5-8 minutes.
▪ It has a mild and sweet flavor.

24. Varieties of white tea leaf
▪ Silver Needle (Bai Hao Yinzhen): usually buds only
▪ White Peony (Bai Mu Dan): buds and young leaves.
▪ Tribute Eyebrow (Gong Mei): leaves after harvest of silver
needle.
▪ Long Life Eyebrow (Shou Mei): leaves after harvest of
silver needle and white peony.
▪ Other White Teas use different varieties of tea plants and
some experts do not classify them as true white teas:
.
▪ Ceylon white
▪ Africa white
▪ Darjeeling white
▪ Himalayan white tea
https://www.cupandleaf.com/blog/best-white-tea

25. Chemical Compounds in Tea leaf
▪ Polyphenols: catechins
▪ Amino Acids: theanine
▪ Carbohydrates
▪ Vitamin C, E, carotene
▪ Minerals: K, Ca, P, Mg
▪ Methylxanthines: caffeine
▪ Enzymes: polyphenol oxidase
▪ Pigments: theaflavins
▪ Volatiles: terpinoids
https://specialtyteaalliance.org/world-of-tea/tea-chemistry/
Epigallocatechin gallate (ECGC)
Theanine

26. How many calories are there in a cup of white tea?
▪ An 8-oz. cup of tea served without
anything added to it contains 2 calories.
▪ Adding 1 teaspoon or 1 lump of sugar
adds 16 calories.
▪ Adding 1 tablespoon of whole milk adds
9 calories.

27. What does a Tea Leaf Contain?
http://greentealovers.com/greenteahealthcatechin.htm

28. Bioactive compounds in a tea leaf
https://www.bematcha.com/pages/matcha-science

29. Mean content of gallic acid and catechins in different types of tea (n=45)
data referred to dry weight of commercial products
https://10poundsin10days.wordpress.com/2012/01/02/beneficial-effects-of-green-tea-a-review-part-3-green-tea-composition/

30. Polyphenols in white tea and green tea
Data on green and white teas are average in g/100 g.
Adapted from https://www.tu-braunschweig.de/Medien-DB/ilc/w_t.pdf

31. Polyphenols in white tea and green tea
Data on green and white teas are average in g/100 g.
Adapted from https://www.tu-braunschweig.de/Medien-DB/ilc/w_t.pdf

32. The mean plasma EGCG concentration-time curves for the
three different methods of oral delivery
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665468/
T½ = 3.4 h
Most of the ingested EGCG apparently does not get into the blood, since absorption takes place in the small gut and substantial
quantities pass from the small to the large intestine where it undergoes further degradation by the action of local microbiota

33. Factors influencing EGCG bioavailability (2011)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189735/
n

34. Bioavailability of catechins from tea leaves:
Prebiotic?
Adapted from https://cdn.intechopen.com/pdfs/60659.pdf
5-10%
90-95%
microbiome

35. Varieties of commercial tea products

36. Health benefits of white tea
1. Antibacterial
2. Anti-oxidant
3. Anti-inflammatory
4. Anti-hyperglycemia
5. Anti-hyperlipidemia
6. Anti-hypertension
7. Anticancer
8. Anti-obesity
9. Anti-stress
10. Anti-aging
11. Immuno-modulatory

37. Anti-inflammatory actions of ECGC on
Pro-inflammatory mediators

39. Effect of green tea on body weight.
https://medium.com/@drjasonfung/green-tea-and-disease-prevention-df65ca28addc
green tea
control

40. Effects of a catechin enriched green tea in a randomized
placebo controlled trial in type 2 diabetic patients.
https://medium.com/@drjasonfung/green-tea-and-disease-prevention-df65ca28addc

41. Effects of black tea on concentrations of total
cholesterol (TC) (2014)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4169558/
favorable result

42. Effects of green tea on systolic and diastolic blood pressure (2014)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150247/
Systolic BP Diastolic BP
favorable resultfavorable result

43. White tea (Camellia sinensis) inhibits proliferation of the colon
cancer cell line, HT-29, activates caspases and
protects DNA of normal cells against oxidative damage (2014)
https://www.sciencedirect.com/science/article/pii/S0308814614010280

44. White tea consumption restores sperm quality in prediabetic
rats preventing testicular oxidative damage (2015)
https://www.sciencedirect.com/science/article/pii/S1472648315003570

45. Nanoparticles derived from tea leaves destroy lung cancer cells:
Quantum dots have great potential (2018)
https://www.sciencedaily.com/releases/2018/05/180521092720.htm
Nanoparticles derived from tea leaves inhibit
the growth of lung cancer cells, destroying up
to 80% of them, new research by a joint
Swansea University and Indian team has
shown.

46. Varieties of commercial White Tea that are
processed by the same method
https://draxe.com/white-tea-benefits/

47. Effects of consumption of white/green tea on human disease
Condition Result
▪ Obesity favorable
▪ Type 2 Diabetes favorable
▪ High blood cholesterol favorable
▪ High blood pressure favorable
▪ Cardiovascular disease favorable
▪ Neurodegenerative disease non-conclusive
▪ Cancer non-conclusive

48. Effect of Green Tea on obesity:
International Journal of Obesity (2009) 33, 956
favorable result

49. Consumption of green tea reduced levels of blood glucose in
1,190 elderly patients (2018).
The MEDIS studystudied 1,190 elderly patients in
the Mediterranean Islands of Greece, Cyprus and
Crete. Once again, moderate (1–2 cups) long term
consumption of green tea significantly reduce
levels of blood glucose. In these elderly people
with a high risk of disease, the consumption of 1
additional cup of tea per day was associated with
a 70% lower likelihood of developing diabetes.
https://medium.com/@drjasonfung/green-tea-and-disease-prevention-df65ca28addc
Favorable result

50. Tea consumption and risk of type 2 diabetes mellitus:
a systematic review and meta-analysis update (2014)
>3-4 cups a day was associated with a lower T2DM risk by approx. 15%

51. Effect of green tea consumption on blood pressure:
A meta-analysis of 13 randomized controlled trials (2014)
systolic BP diastolic BP
https://www.nature.com/articles/srep06251
The meta-analysis suggested that green tea consumption had a favorable effect on decrease of BP.

52. Cholesterol-lowering effect of a theaflavin-enriched green tea extract:
a randomized controlled trial.
Archives of Internal Medicine 163.12 (2003): 1448-1453.

53. Effects of supplementation with green tea catechins on
plasma C-reactive protein concentrations:
A systematic review and meta-analysis of randomized controlled trials. 2015
https://www.sciencedirect.com/science/article/pii/S0899900715000726
No significant effect

54. Tea consumption and risk of gallbladder cancer:
A meta-analysis of epidemiological studies (2015)
https://www.spandidos-publications.com/mco/3/3/613
according to the currently available epidemiological studies, tea consumption may reduce the
risk of gallbladder cancer in women, but not in men

55. Association of tea intake and the risk of cognitive disorders:
meta-analysis of 26 studies (2016)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100989/
The study suggests that daily tea drinking is associated with decreased risk of CoI, MCI and cognitive decline in the elderly.
However, the association between tea intake and Alzheimer’s disease remains elusive.

56. The effect of green tea intake on risk of liver disease:
a meta analysis (2015)
http://www.ijcem.com/files/ijcem0008508.pdf
Green tea intake reduces the risk of liver disease.

57. Green Tea Consumption and Risk of Pancreatic Cancer:
A Meta-analysis (2014)
https://www.mdpi.com/2072-6643/6/11/4640/xml
Cumulative epidemiologic evidence suggests that green tea consumption is not associated with pancreatic cancer

58. Tea Consumption and Risk of Bladder Cancer:
A Dose-Response Meta-Analysis (2017)
https://www.frontiersin.org/articles/10.3389/fphys.2016.00693/full
non-conclusive

59. Varieties and qualities of white teas

60. Note the difference between the common name for white tea
and the variety name of white tea.
which variety ?

61. How to brew a cup of white tea
▪ Select the best variety of white tea leaf.
▪ Boil the water, then cool it to 170 – 185O F.
▪ Pour water on the tea : 2 teaspoons for 1 cup (8 oz).
▪ Steeping time is 5 to 8 minutes.

62. EGCG warning: European Safety Food Authority (EFSA) suggests
green tea supplements should come with warning on liver toxicity if dose
exceeds 800 mg per day (2018)
https://www.nutraingredients.com/Article/2018/04/19/EGCG-warning-EFSA-
safety-assessment-suggests-green-tea-supplements-should-come-with-warning
Average daily intake of EGCG from green tea
infusions ranges from 90 to 300mg/day

63. Summary
▪ All teas come from the leaves of the plant called Camellia sinesis.
▪ White tea, green tea, black tea, oolong tea and pu-erh tea are processed
differently.
▪ White tea is the least processed of all the teas.
▪ Several varieties of white tea are available and they vary according to the
quality and taste.
▪ White teas have the highest concentration of anti-oxidant polyphenols or
EGCG.
▪ There are many health benefits associated with the bioactive compounds in
the white tea.
▪ Average (1-3 cups) daily intake of white tea or green tea infusions provide
ECGC from 90 to 300mg/day.
▪ Consumption of tea supplement with more than 800 mg of ECGC a day is
known to cause liver toxicity.

64. ANY QUESTION?
Please contact
Kevin KF Ng, MD, PhD
Email: kevinng68@gmail.com