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Unlocking theCardiovascular Benefits ofTeaJanuary 27, 2021

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Today’s SpeakersAlex WhiteJoy Dubost,PhD, RD, LDTaylor C. Wallace,PhD, CFS, FACN

Unlocking the CardiovascularBenefits of Unsweetened TeaUnileverAlex WhiteJoy Dubost PhD comAlex.white.teajoyofnutrition

TEA: No Other Beverage is so Deeply Rooted in theHistorical Heritage and Social Fabric of Humanity2

The rituals: More than just a drink, different tea traditions are now famous aroundits preparation, presentation, and consumption and are deeply rooted in manyworld cultures.

What is tea?There are two broad categories:True TeaTisanes & Non-Tea Made with leaves of the C. Sinensis plant Two main varieties of the C. Sinensis plant exist:var.assamica and var. sinensis Thousands of different cultivars4 Made from flowers, herbs and plants other than C.Sinensis Offer distinct flavors & some are thought to havemedicinal propertiesBlack TeaGreen TeaChamomileMintWhite TeaOolong TeaMateRooibos

TEA FACTS.Most Widely Consumed Beverage inThe World Next to Water60 Billion Servings of Tea,Over 2.8 Billion Gallons*On any given day,127 Million peoplein USA drink Tea70% of TeaConsumed inAmerica is ICED

LOVES: Well drained acid soil Proximity to the equator Lots of rain Clean air Sun1YrHATES: Soggy soil Alkali soil The R&D Lab2-3YrThe Camellia Sinensis is just one plant generating all teas(black, green,white, yellow, oolong, pu-her, Matcha, etc.).Farmed as a bush for easy harvest,it will grow into a tree in the wild.20-30Yr?Yr

R&DGreenhouseNew JerseyTea propagation is achieved either from seed or fromcuttingsCUTTINGS:Pros:One of the main reasons to take cuttings isthat they are identical to the mother plant andcan replicate their most vigorous, high yieldingplants over and over again.Cons: Problems can arise with fighting offenvironmental stresses, diseases and insects, asthe genetics somewhat weaken.SEEDS:Pros: More biodiversity,growing from seedlessens the chances ofinheriting any pests ordiseases from a cutting.Cons: germination rates vary by plant species, harvest times arelonger than when starting from cuttings, and sometimes there arecosts associated with purchasing them (whereas clones taken fromplants are free).

One Plant, many types of tea Owing their definitive differences to: Where they are grown How they are picked How they are processedMAIN TEA TYPES:FLAVORED TEA:ChaiWhiteGreenOolongBlackPu ErhMatchaEarl GreyJasmine tea

WHERE DOES TEA COME FROM (and why does it matter?)Tea estates are often nestled in beautiful pristine preservedenvironments, where soil properties, altitude, latitude, or even proximityto other vegetation, will impart the tea with a pure distinctive signaturecharacter, un-replicable anywhere else. Tea tasters call it “origincharacter”; it is essentially the passing on of those territories andenvironment into the tealeaf itself.

Where true tea is grownArgentinaKenyaWorld production approx. 5M tons

Tea Growing Elevations8,000 ftDarjeelingHigh GrownKenya, Rwanda &BurundiTanzania & UgandaSriLankaIndonesiaMalawi,ZimbabweArgentinaSea LevelNorth India,Vietnam &BangladeshLow GrownBody, Colour4,000 ftMedium GrownFlavor, AromaSouth India (Nilgiris Hills, Munnar)

WHAT DOES EACH PROVENIENCEBRING TO THE TEA?AN EXAMPLE FROM A TYPICAL ICED TEA BLENDTASTEArgentinaMellowness, Clarity and sparkleMalawiColor, deep red huesKenyaTaste, “Briskyness”COLORBITTERNESS

HOW IS TEA HARVESTED?Tea Plucking is together hard work and a skill. Whether by hand or by machine, tea needs to beselectively plucked from an emerging flush, to give the desired results in the blend.

Tea Processing in factories is done in the immediate proximity of the field to maintainthe leaf as fresh and intact as possible and occurs within 24h of picking. The process isreally a craft, requiring nothing more than experience, air and heat.

Tea processing flow diagram

CTC process from field to pack in less than 24hTRANSPORT16RECEPTIONROTOVANEPepsi Lipton ConfidentialWITHERINGCTC

OXIDATION (about 2h)17DRYINGFIBRE EXTRACTION

And finally grading to sort the quality leavesSIEVINGGRADINGQUALITY CTRLCUPPINGDISPATCHING

Once made the Tea samples are lined up for auction. Thousands of cups are tasted and gradedbefore each auction by tea tasters through a steamy and hectic ritual of slurping and spitting sothat they may instruct the auctioneers and select the best.

Sustainability in TeaEconomic FocusProviding jobs and paying a premiumprice for teaSocial FocusProviding workers & families with housing,medical care, clean waterEnvironmental FocusConserving Biodiversity, Protecting soilsand waterways20

Rainforest Alliance 700K estates 2.7Mio acres 99 evaluation criteriaRA COVERS ALL THREE SUSTAINABILITY PILLARSENVIRONMENTAL PROTECTIONSOCIAL EQUITYECONOMIC VIABILITY

EMERGING TRENDS IN TEAOrganicCold BrewMatchaNew unconventional origins: Australia, U.S., Colombia, etcHealth-led benefitsCheese teas/ Boba /Lattes at home café experienceNew cultivars: Purple teaCult teas: Pu-her, HeiCha, Kukicha, HojichaTea and food: food pairings, cooking with tea

Tea - Health andNutrition

TEA FACTSMost Widely Consumed Beveragein The World Next to Water60 Billion Servings of Tea,Over 2.8 Billion GallonsNaturally contains: Caffeine (28 -47mg/8 oz ) - USDA Theanine (20mg/8 oz) Flavonoids (levels vary)

FLAVONOIDSWhat are Flavonoids? Naturally occurring polyphenolic compounds Flavonoids refer to a collective term that includes six groups -ols,anthocyanidins, isoflavones Flavonoids are present in fruits, vegetables, and certain beverages Sources of flavonoids include tea, apples, grapes, red wine andcocoa

TEA CONTAINS FLAVONOIDS Tea is one of the top sources of flavonoids in the diet Flavonoids are responsible for key sensory attributes of tea –color, taste, and astringency Flavonoids in tea can be absorbed into the body regardless ofwhether or not milk is added (up to 25% of milk added)Common Food Sources ofFlavan-3-ols (Catechins)140mg/100 g120100806040200Flavan-3-olsUSDA database, 2011

CARDIOVASCULAR DISEASE Refers to a number of conditions: Heart and Blood Vessel Disease (Heart Disease) Heart Attack Stroke Prevalence* Heart Disease remains the No. 1 cause of death in the U.S. 48% of all adults in the U.S. have some form of cardiovascular disease Cardiovascular disease, listed as the underlying cause of death, accounts for nearly 837,000deaths in the US. That’s about 1 of every 3 deaths in the U.S. Direct and indirect costs of total cardiovascular diseases and stroke are estimated to totalmore than 329.7 billion; that includes both health expenditures and lost productivity. Cardiovascular disease is the leading global cause of death, accounting for more than 17.9million deaths per year in 2015, a number that is expected to grow to more than 23.6 millionby 2030.*American Heart Association

INCREASED CONSUMPTION OF FLAVONOIDS FROM ALL DIETARYSOURCES IS ASSOCIATED WITH A LOWER RISK OF CVDCompared with lowerintake, high consumption oftotal flavonoids wasassociated with decreasedrisk of all-causemortality (RR 0.74,), whilea 100-mg/day increment inintake led to a (linear)decreased risk of 6% and4% of all-cause and CVDmortality, respectively1Higher dietary flavonoidintake is associated witha significantly reducedrisk of stroke.Dose-response analysesindicated a 9% lower riskof stroke per 100 mg/dayincrement in flavonoids.21GrossoAm J Epidemiol. 2017;185(12):1304–13162Tang Z, et al. BMJ Open (2016) 6:e008680

CAN HELP SUPPORT A HEALTHY HEART A substantial amount of consistent scientific evidence demonstrates aninverse relationship between overall flavonoid consumption and at least oneor more cardiovascular endpoints. Front of Pack Claim - “Can Help Support a Healthy Heart” Back of Pack Claim – Daily consumption of 2-3 cups of unsweetenedbrewed tea providing between 200-500mg of flavonoids can help support ahealthy heart as part of a diet consistent with dietary guidelines. One cup of Lipton brewed green and black tea provide 150 and 170 mgflavonoid, respectively Zero Calories No added sugar Flavonoid content can range among tea products

Do unsweetened tea drinkers have healthier diets? The results indicated the diets of daily consumers of unsweetenedtea are significantly higher in protein, dietary fiber, and selectvitamins and minerals, but lower in added sugars and alcohol. Daily unsweetened tea consumption is associated with highergood cholesterol (HDL) and lower body mass index (BMI) values(lower body weight) in adults. Relative to those who do not consume tea, unsweetened teaconsumers generally have healthier beverage choices, includingless high calorie sugar sweetened beverages.30

2020-2025 DIETARY GUIDELINES FOR AMERICANS When choosing beverages in a healthy dietarypattern, both the calories and nutrients theyprovide are important considerations.

CONCLUSIONS Unsweetened tea (green or black, hot or cold) may beconsidered a primary beverage option as noted in theUSDA 2020-2025 Dietary Guidelines for Americans Scientific evidence illustrates an inverse linear doseresponse relationship between consumption offlavonoids and all-cause and CVD mortality Tea is a great option for hydration & can help supporta healthy heartFor additional resources -health/32

THANK YOU

The CardiovascularBenefits of Black andGreen TeaTaylor C. Wallace, PhDThink Healthy GroupGeorge Mason University

DisclosuresA few conflicts of interest related to the presentation up front: Think Healthy Group George Mason University Journal of Dietary Supplements Journal of the American College of Nutrition Annals of Medicine Research funding from Unilever (owns Lipton ) www.drtaylorwallace.com 2020 Dr. Taylor Wallace.07-21-20202

Tea (Camellia sinensis)A little background on tea: Tea is a beverage commonly prepared by pouring hot water overfermented or fresh leaves of the plant Camellia sinensis. Second most widely consumed beverage in the world, next towater. Consumption documented as early as the 3rd century AD inmedical texts written by Chinese physician, Hua Tuo. The plant is native to East Asia and likely originated in theborderlands of north Burma and southwestern China.Nutrition Today. 2018;53(5):213. 2020 Dr. Taylor Wallace.05-07-20203

Medicinal Aspects of TeaTea has been used in traditional eastern medicine for centuries Tea drinking is popular in traditional Chinese medicine.It is alsobelieved that the people of Sichuan used the brewed tea as astimulating beverage, rather than a medicinal concoction. Tea is a major source of flavonoids in the diet.American teadrinkers have been shown to have 20 times higher flavonoidintakes compared to those who do not consume tea.J Nutr. 2008;138(8):1543S. 2020 Dr. Taylor Wallace.05-07-20204

Flavonoids & Flavan-3-olsWhat are flavonoids and flavanols? Flavonoids are healthy polyphenolic compounds foundin plant-derived foods. There are six groups offlavonoids and each is broken down by the body in adifferent way: flavonols, flavanols, flavones,flavanones, anthocyanins, and isoflavones.Structure of a flavanol. Flavanols (also known as flavan-3-ols) in products liketea, cocoa, and cranberry have an abundance researchdemonstrating their potential heart-health effects.Am J Clin Nutr. 2019;110(5):1067. 2020 Dr. Taylor Wallace.05-07-20205