van Woudenbergh, Geertruida J.Kuijsten, AnneleenDrogan, DagmarBoeing, HeinerSchulze, Matthias B.van der A, Daphne L.Bueno-de-Mesquita, H. BasSpijkerman, Annemieke M. W.Romaguera, DoraRiboli, ElioArdanaz, EvaBarricarte, AurelioAmiano, PilarBeulens, Joline W. J.Sluijs, IvonneDahm, Christina COvervad, KimChirlaque, M-DoleresClavel, FrancoiseFagher-azzi, GuyCrowe, Francesca L.Eomois, Piia-PiretTeucher, BirgitFranks, Paul W.Halkjaer, JytteTjonneland, AnneKhaw, Kay T.Masala, GiovannaMattiello, AmaliaQuiros, J. RamonRolandsson, OlovRomieu, IsabelleSacerdote, CarlottaSanchez-Perez, Maria-JoseTagliabue, GiovannaTumino, RosarioForouhi, Nita G.Sharp, StephenLangenberg, ClaudiaWareham, Nicholas J.2013-02-132013-02-132012-05-30van Woudenbergh GJ, Kuijsten A, Drogan D, van der A DL, Romaguera D, Ardanaz E, et al. Tea consumption and incidence of type 2 diabetes in Europe: the EPIC-InterAct case-cohort study. PLoS ONE 2012; 7(5):e36910http://hdl.handle.net/10668/769Journal Article; Research Support, Non-U.S. Gov't;BACKGROUND In previous meta-analyses, tea consumption has been associated with lower incidence of type 2 diabetes. It is unclear, however, if tea is associated inversely over the entire range of intake. Therefore, we investigated the association between tea consumption and incidence of type 2 diabetes in a European population. METHODOLOGY/PRINCIPAL FINDINGS The EPIC-InterAct case-cohort study was conducted in 26 centers in 8 European countries and consists of a total of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,835 individuals from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. Country-specific Hazard Ratios (HR) for incidence of type 2 diabetes were obtained after adjustment for lifestyle and dietary factors using a Cox regression adapted for a case-cohort design. Subsequently, country-specific HR were combined using a random effects meta-analysis. Tea consumption was studied as categorical variable (0, >0-<1, 1-<4, ≥ 4 cups/day). The dose-response of the association was further explored by restricted cubic spline regression. Country specific medians of tea consumption ranged from 0 cups/day in Spain to 4 cups/day in United Kingdom. Tea consumption was associated inversely with incidence of type 2 diabetes; the HR was 0.84 [95%CI 0.71, 1.00] when participants who drank ≥ 4 cups of tea per day were compared with non-drinkers (p(linear trend) = 0.04). Incidence of type 2 diabetes already tended to be lower with tea consumption of 1-<4 cups/day (HR = 0.93 [95%CI 0.81, 1.05]). Spline regression did not suggest a non-linear association (p(non-linearity) = 0.20). CONCLUSIONS/SIGNIFICANCE A linear inverse association was observed between tea consumption and incidence of type 2 diabetes. People who drink at least 4 cups of tea per day may have a 16% lower risk of developing type 2 diabetes than non-tea drinkers.enTéAdultoAncianoEstudios de CohortesDiabetes Mellitus Tipo 2Conducta de Ingestión de LíquidoEuropaFemeninoHumanosMasculinoMediana EdadDinámicas no LinealesCuestionariosRiesgoAdulto JovenMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::AgedMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort StudiesMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus::Diabetes Mellitus, Type 2Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Drinking BehaviorMedical Subject Headings::Geographicals::Geographic Locations::EuropeMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Models, Theoretical::Nonlinear DynamicsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::QuestionnairesMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::RiskMedical Subject Headings::Chemicals and Drugs::Complex Mixtures::Biological Agents::Plant Preparations::TeaMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Young AdultMedical Subject Headings::Named Groups::Persons::Age Groups::Adultresearch article22666334open access10.1371/journal.pone.00369101932-6203PMC3364250