Friday, August 15, 2014

Honest Tea Teaches Coke a Lesson

http://www.cssp.com/CD0611a/TraditionalGoToMarketNicheMarketApproach/


Denise Harrison
Executive Vice President & COO, CSSP, Inc.

Denise Harrison
Coca Cola, known for its marketing prowess, does not always get it right. Yes, everyone knows about the Coke Classic/New Coke mistake, but what about its entry into the health conscious and environmental space?

What Went Right

Growth goals are often met by identifying new market trends and emerging market segments during the development of a strategic plan. Coke correctly identified an emerging segment in the beverage market: health conscious consumers, to whom high fructose corn syrup was an anathema. Coke decided the best way to enter the segment was through acquisition. Honest Tea, an organic tea, was already entrenched in this segment, which in addition to meeting the health conscious requirements, also appealed to the social responsibility and environmental preferences of this segment. It was a no-brainer that Honest Tea's organic roots, when combined with Coke's production and distribution infrastructure, would be a winning combination - but wait, what really happened?

What Went Wrong

Coke took a page out of its successful brand management book and applied its traditional marketing formula to Honest Tea's brand and launched the brand nationally. This launch included:
  • National advertising campaign
  • Shelf placement at retail outlets
  • Deep discounts
The result: a flop. The traditional approach, which had worked well with well-known brands that appealed to the mass market, did not necessarily work with niche brands. Rather, a grass roots, bottom-up approach was required. Honest Tea's success had been built by in-store promotions and local marketing, which gave the brand an elite following that said, "We are not like everyone else - we require something special".
A guerilla marketing campaign called Honest Cities worked particularly well; Honest Tea set up displays with bottles of tea with a $1 collection barrel next to the pallets- purchase on the honor system. They promoted Earth Day by handing out reusable shopping bags with each purchase of Honest Tea. The brand built its presence first in a local market, then spread out to the region, and then moved to the next local market, then positioned itself to grow into the next region. In addition, the brand continued to focus on the health food chain channel - not a stronghold for the traditional Coke beverages.

Lessons Learned

  • After you have achieved significant market penetration in your traditional markets, you often need to find emerging niches in order to meet your growth objectives
  • Assuming that the target audience for the niche business can be reached through the same "go to market" strategy that you use successfully with your traditional markets, may be a mistake
  • In order to truly understand an emerging market niche, you not only need to understand the product or service requirements, but also how to reach these niche customers. You may be able to leverage some of your competencies but you may need to develop other competencies, to fully realize the market potential.
As Coke moves forward, it expects to apply these lessons to revive some of its past healthy beverage launches, as well as to future niche product launches. These lessons will enable Coke to raise its batting average when launching niche products. Leveraging "lessons learned" is an important part of strategic planning - to read more about how to learn from your mistakes please click on: Mistakes Happen: But Did You Learn from Them?
Denise Harrison is Executive Vice President and COO at the Center for Simplified Strategic Planning, Inc. She can be reached at harrison@cssp.com.

Thursday, August 14, 2014

13 Reasons to Have Tea

Put down those saucer cups and get chugging — tea is officially awesome for your health. But before loading up on Red Zinger, make sure that your “tea” is actually tea. Real tea is derived from a particular plant (Camellia sinensis) and includes only four varieties: green, black, white, and oolong. Anything else (like herbal “tea”) is an infusion of a different plant and isn’t technically tea.
But what real tea lacks in variety, it makes up for with some serious health benefits. Researchers attribute tea’s health properties to polyphenols (a type of antioxidant) and phytochemicals. Though most studies have focused on the better-known green and black teas, white and oolong also bring benefits to the table. Read on to find out why coffee’s little cousin rocks your health.
  1. Tea can boost exercise endurance. Scientists have found that the catechins (antioxidants) in green tea extract increase the body’s ability to burn fat as fuel, which accounts for improved muscle endurance.
  2. Drinking tea could help reduce the risk of heart attack. Tea might also help protect against cardiovascular and degenerative diseases.
  3. The antioxidants in tea might help protect against a boatload of cancers, including breast, colon, colorectal, skin, lung, esophagus, stomach, small intestine, pancreas, liverovarianprostate and oral cancers. But don’t rely solely on tea to keep a healthy body — tea is not a miraclecure, after all. While more studies than not suggest that tea has cancer-fighting benefits, the current research is mixed.
  4. Tea helps fight free radicals. Tea is high in oxygen radical absorbance capacity (“ORAC” to its friends), which is a fancy way of saying that it helps destroy free radicals (which can damage DNA) in the body. While our bodies are designed to fight free radicals on their own, they’re not 100 percent effective — and since damage from these radical oxygen ninjas has been linked to cancer, heart disease and neurological degeneration, we’ll take all the help we can get.
  5. Tea is hydrating to the body (even despite the caffeine!).
  6. Drinking tea is linked with a lower risk of Parkinson’s disease. When considered with other factors like smoking, physical activity, age and body mass index, regular tea drinking was associated with a lowered risk of Parkinson’s disease in both men and women.
  7. Tea might provide protection from ultraviolet rays. We know it’s important to limit exposure to UV rays, and we all know what it’s like to feel the burn. The good news is that green tea may act as a back-up sunscreen.
  8. Tea could keep waist circumference in check. In one study, participants who regularly consumed hot tea had lower waist circumference and lower BMI than non-consuming participants. Scientists speculate that regular tea drinking lowers the risk of metabolic syndrome (which increases the risk of diabetes, artery disease and stroke), although it’s important to remember that correlation does not equal causation.
  9. Regular tea drinking might also counteract some of the negative effects of smoking and might even lessen the risk of lung cancer (good news, obviously, but not a justification for cigs).
  10. Tea could be beneficial to people with Type 2 diabetes. Studies suggest that compounds in green tea could help diabetics better process sugars.
  11. Tea can help the body recover from radiation. One study found that tea helped protect against cellular degeneration upon exposure to radiation, while another found that tea can help skin bounce backpostexposure.
  12. Green tea has been found to improve bone mineral density and strength.
  13. Tea might be an effective agent in the prevention and treatment of neurological diseases, especially degenerative diseases (think Alzheimer’s). While many factors influence brain health, polyphenols in green tea may help maintain the parts of the brain that regulate learning and memory.
Though most research on tea is highly positive, it’s not all definitive — so keep these caveats in mind before stocking up on gallons of the stuff:
  1. Keep it cool. Repeatedly drinking hot beverages may boost the risk of esophageal cancer. Give tea several minutes to cool off before sipping.
  2. The studies seem convincing, but a rat does not a human make. Chemicals in tea may react differently in thelab than they do in the human body. Tannins (and the other good stuff in green tea) may not be bioavailablefor humans, meaning tea might not always benefit human health to the same degree as in lab studies suggest.
  3. All tea drinks are not created equal. The body’s access to the good stuff in tea might be determined by the teavariety, canning and processing, and the way it was brewed.
The takeaway: at the very least, tea should be safe to consume — just not in excessive amounts. So brew up a batch of the good stuff — hot or cold — and enjoy.
Do you drink tea regularly? Have you noticed any health benefits? Let us know in the comments below!

Thursday, August 7, 2014

8 Healthy Steps to a great life

http://www.cooperaerobics.com/Health-Tips/8-Healthy-Steps.aspx

Get Cooperized. It’s a phrase you may have seen and heard by now. So, where did we come up with this tagline and what does it mean? We’re so glad you asked.

As you may know, Dr. Cooper coined a word in 1968 that he used to describe a new exercise program to improve heart health. Little did he know that he would spark a global fitness revolution! That word was aerobics.

More than 40 years later, we are at it again, but this time coining the phrase Get Cooperized. It encompasses the fitness movement Dr. Cooper started, but also expands the movement to encompass eight areas that make up a well-rounded, healthy life. Being Cooperized means living a healthy life, the Cooper way.

Get Cooperized is the heart of our mission. It’s the sum of our eight entities. And it’s a set of eight general guidelines to achieve and maintain health. Each one can be and should be customized to fit you—your body, your health, your interests, your life.

Maintain a healthy weight. One method to determine if you’re at a healthy weight is to measure your Body Mass Index or BMI. You can determine your BMI by following this calculation:
BMI-Formula_bw.jpg
You are considered normal weight if your BMI is 18.5-24.9, overweight at 25-29.9 and obese if it’s 30 or higher. BMI may be inaccurate if you are highly muscular; in that case measurement of body fat by calipers may be more accurate.

Maintaining a healthy weight is one of the most important things you can do to prevent illness and disease, enjoy a higher quality of life and live longer.

But we know that it takes a combination of good nutrition and consistent exercise to do this. Read some of our health tips on weight loss, and check the Get Cooperized guidelines on eating healthy most of the time and exercising most days of the week.

Eat healthy most of the time. We like to say it’s about moderation, not deprivation. Or eat healthy 80% of the time and have that cookie the other 20% of the time.

We know that’s a big bite to swallow, so what’s the first step to build healthy nutrition habits? We’d say eat more fruits and vegetables daily. There is an adage, “Five is fine, but nine is divine.” That’s talking about servings (one serving is half a cup) of fruits and veggies to consume every day. If you’re not getting five servings in a day, start there, then work your way to nine.

Research shows that by doing this, you can lower your blood pressure and cholesterol and are at a lower risk of stroke, heart failure, osteoporosis and kidney stones.

Check out the Nutrition Bites section for great articles by our registered dietitians on a host of topics. We also offer some of our favorite healthy recipes. But if you need individualized, expert advice, learn more about our Cooper Clinic Nutrition Services.

Exercise most days of the week. This health guideline is how Cooper got started. It’s our claim to fame. Drum roll, please… Participate in moderate physical activity a collective 30 minutes a day, five days a week. That’s it. Now let’s break it down:

“Moderate physical activity” – Moderate intensity should get your heart rate elevated to where you can talk but you’re winded. There are many types of cardiovascular exercise: take a brisk walk or go jogging, kick the soccer ball with the kids, play a game of touch football, swim some laps, jump rope, hop on an elliptical machine. Whatever you choose, just get moving!

“A collective 30 minutes a day” – Here’s the good news. You don’t have to exercise for 30 minutes straight if your schedule doesn’t work or those bad knees won’t last. You can do three spurts of activity for 10 minutes each or break it into two, 15 minute intervals. It all ads up and it all counts! And a total of 30 minutes is realistic amount of time to fit into your schedule. Put it on your calendar like it’s an appointment and stick to it.

“Five days a week.” – This is important because if you do 30 minutes of moderately intense cardio over five days you will have logged 150 minutes of exercise. This is the magic number to reap the benefits of heart health, prevent diabetes, cancer and other diseases, and improve quality and quantity of life.

For some great articles by our professional fitness trainers, check out our Fitness Files or watch videos of our Exercise Moves. Of course, if you want to work directly with one of our trainers or sport professionals, visit Cooper Fitness Center in Dallas or McKinney.

Take the right supplements for you. Supplements are just that, they are supplements and not replacements. You have to start with a good, balanced diet and then think of supplements as an insurance policy.

No matter how hard we try, most people are not getting the proper amounts of vitamins and minerals their body needs through diet alone. Generally, we just don’t eat very well. Less than a third of Americans are getting at least five servings of fruits or vegetables a day. Our diets are incomplete. That’s why we created Cooper Complete® nutritional supplements.

So start with a good multivitamin that is taken with meals. This will cover a lot of your basic supplement needs.

Then get your blood levels checked to understand if you are deficient and need additional supplementation. Research shows the majority of people are vitamin D deficient, which has been linked to diseases such as: hypertension, depression, diabetes, certain cancers and arthritis, to name a few. Studies have also shown benefits of omega-3 in blood pressure, triglycerides, cholesterol, metabolic syndrome and cognitive health.

Since 1997 Dr. Kenneth Cooper and a team of expert consultants from four leading universities have been studying nutritional supplements and what role they play in health and preventive medicine. That research led to the formulation of Cooper Complete. No matter what brand you choose, make sure your vitamins and supplements are pure and potent.

Visit our Vitamin Aisle section for the latest research and recommendations on supplementation. You can purchase our vitamins on our website, coopercomplete.com.

Stop smoking. We all know that smoking is “bad” for you, and a leading cause of lung cancer. But all tobacco products, not just cigarettes, can threaten your health.

Tobacco is associated with a number of different types of cancers, including esophageal, cervical, stomach, kidney, pancreatic and more. On top of that, tobacco is the number one treatable cause of cardiovascular disease, which is the leading cause of death in America.

We strongly recommend not using any form of tobacco. Research shows that if you smoke a pack of cigarettes a day, you have a 20-fold increased risk of developing lung cancer. And it doubles the risk for heart attacks compared to a nonsmoker.

People tend to think that smoking simply shortens your lifespan—that you may die a few years earlier due to your habit. But the bigger problem is the 10 to 15 years before death where you suffer the terrible health effects of smoking—dealing with cancer or lugging around an oxygen tank to help you breathe.

It’s never too late to quit using tobacco. And the sooner you quit, the better your long-term prognosis. If you’re looking for support to help quit smoking, these organizations may offer personalized help or listings of classes and support groups in your community.

Control alcohol. This one is always a mixed bag. There are both benefits and drawbacks to consider when it comes to alcohol.

Among other things, excessive alcohol can cause weight gain, damage your liver and your heart and increase the risk of developing some types of cancer. Yet for some people, moderate alcohol intake may also have a benefit for the heart.

If you sum up the benefits of other healthy lifestyle changes, such as exercising, alcohol consumption as a health benefit would be considered minor. Dr. Cooper always says, if you don’t drink, don’t start. There is no research to say that you should.

But if you do enjoy alcohol, moderation is key. Men should have no more than 10 drinks per week and women should have no more than six drinks per week. You need to stretch those drinks out over the course of a week, not pile them up on one weekend. And, as always, keep in mind portion size. One drink is the equivalent of a 12 ounce beer, 5 ounce glass of wine or 1.5 ounces of liquor, which has approximately 15 grams of alcohol.

Read more about the effects of alcohol on blood pressure, cardiovascular disease and your overall health.

Manage your stress. We all get “stressed out” at some point. It’s part of life. Yet you may not realize how dangerous it can be to your heath – both physically and emotionally.

Stress can raise blood pressure and resting heart rate and lead to weight gain. Every single one of these things can cause cardiovascular disease. And if it goes untreated, long-term stress can cause even more medical problems.

But, as Dr. Cooper says, it’s not stress that kills, it’s the way you handle it.

The best way to control stress? Exercise. Physical activity reduces stress and improves health in so many different ways. It can boost the mood, improve energy and significantly improve both quality and quantity of sleep. In fact, a study by The Cooper Institute showed that doses of physical activity were as effective as taking prescription drugs for mild to moderate depression.

Taking time to relax should not be a luxury! It’s important to find something that works for you, and helps you balance your life. Take a deep breath and say, “ahhh.”

Get ideas for how you can relax and de-stress in our Stress Less section. If you’re in the DFW area, visit Cooper Spa inDallas or McKinney for a therapeutic, relaxing massage.

Get a regular, comprehensive physical exam. Our philosophy is simple: It’s easier to maintain good health than to regain it once it's lost. The only way you can improve your health is if you have a comprehensive, in-depth picture of the current state of your health. And that starts with a preventive physical exam.

At a minimum you should “know your numbers.” These are your laboratory results from your blood work, and they contain vital information for your health. To start, make sure you know your cholesterol, blood sugar and blood pressure.

At Cooper Clinic, we look at the whole person including lifestyle and health behaviors to inform and direct medical care.

Our physical exams are unlike any other. Completely customized based on your needs, all tests are onsite, giving you same-day results. Patients also receive an in-depth consultation with their physician—up to one hour—to go through any questions and develop an action plan.

We recommend a baseline comprehensive physical exam between the ages of 35 and 40. Between ages 40 and 50, you should receive an exam every 12-18 months depending on risk and ongoing health or behavior issues. Annual exams should begin at age 50.

Many medical issues are completely preventive. Our physicians offer free health tips in our Prevention Plus section. If you’d like to schedule an appointment at Cooper Clinic, fill out this form or call us at 972.560.2667 (COOP).

Effects of Catechin Enriched Green Tea on Body Composition

http://onlinelibrary.wiley.com/doi/10.1038/oby.2009.256/full

Abstract

Obesity is a major health problem in the developed and developing world. Many “functional” foods and ingredients are advocated for their effects on body composition but few have consistent scientific support for their efficacy. However, an increasing amount of mechanistic and clinical evidence is building for green tea (GT). This experiment was therefore undertaken to study the effects of a high-catechin GT on body composition in a moderately overweight Chinese population. In a randomized placebo-controlled trial, 182 moderately overweight Chinese subjects, consumed either two servings of a control drink (C; 30 mg catechins, 10 mg caffeine/day), one serving of the control drink and one serving of an extra high-catechin GT1 (458 mg catechins, 104 mg caffeine/day), two servings of a high-catechin GT2 (468 mg catechins, 126 mg caffeine/day) or two servings of the extra high-catechin GT3 (886 mg catechins, 198 mg caffeine/day) for 90 days. Data were collected at 0, 30, 60, and 90 days. We observed a decrease in estimated intra-abdominal fat (IAF) area of 5.6 cm2 in the GT3 group. In addition, we found decreases of 1.9 cm in waist circumference and 1.2 kg body weight in the GT3 group vs. C (P < 0.05). We also observed reductions in total body fat (GT2, 0.7 kg, P < 0.05) and body fat % (GT1, 0.6%, P < 0.05). We conclude that consumption of two servings of an extra high-catechin GT leads to improvements in body composition and reduces abdominal fatness in moderately overweight Chinese subjects.

Introduction

Tea is the most widely consumed beverage in the world, second only to water. The three kinds of true tea—green, black, and oolong—are all derived from the Camellia sinensis plant. At harvest tea leaves contain high levels of catechins, a particular class of polyphenols (1). After harvest catechins may be rapidly converted by enzymatic oxidation to a complex mixture of other derivatives, thearubigins and theaflavins, responsible for the characteristic color of oolong and black tea. Green tea (GT), however, is produced by heat-treating leaves soon after harvest, thereby preserving the catechins from oxidation.
The amount of catechins in a cup of GT is highly variable, depending on the precise type of tea, the ratio of dry tea to water and on the time that the leaves are infused before consumption. An average serving of 250 ml of GT contains between 50 and 100 mg of catechins. In addition, GT contains a variable amount (typically around 30 mg/serving) of caffeine (2).
Studies in humans and experimental animals provide epidemiological, mechanistic, and experimental evidence linking regular tea consumption to several health benefits (1,2,3). Most research has focused on the function of the antioxidant components found in tea and the potential of these to reduce the risk of cardiovascular disease and cancer (1,4). In addition, a number of reports have been published showing that regular consumption of GT, or catechins extracted from GT (with or without added caffeine), may influence energy metabolism, body weight and body fat content (for reviews see refs. 1,2,5,6). Furthermore, there is some evidence suggesting that consumption of GT, or catechins extracted from green or oolong tea may have a particular influence on subcutaneous abdominal fat and on fat depots surrounding the abdominal organs; also known as visceral fat (7,8,9).
In this large, double-blind placebo-controlled trial we investigated the effects of consuming GT with different amounts of catechins on measures of body weight, total body fat mass and the distribution of fat between abdominal and other depots. The study was carried out in an urban setting in a moderately overweight, free-living, Chinese population.

Methods and Procedures

Subjects

From an initial respondent pool of 435 subjects living in Shanghai, 205 moderately overweight subjects (according to the World Health Organization guidelines for this population (10)) met the screening criteria below and entered the trial.
The criteria for inclusion in the trial were: (i) age between 18 and 55 years; (ii) BMI between 24 and 35 kg/m2; (iii) body fat >25% for males and >30% for females; (iv) waist circumference >85 cm for males and >80 cm females; (v) normal liver function, as assessed by plasma enzyme profile and total bilirubin levels; (vi) low caffeine consumption (<200 mg/day); (vii) low tea consumption (<2 tea bags/day or <4 g loose tea/day); (viii) nonsmoking; (ix) zero or moderate (i.e., <14/week for women and <21/week for men) alcohol consumption.
The criteria for exclusion from the trial were: (i) use of any medication, apart from over the counter and oral contraceptives; (ii) suffering from any medical or psychiatric condition; (iii) actively following a weight loss regimen or a medically prescribed dietary regime; (iv) losing or gaining >2 kg body weight in the 3 months before the start of the trial.
The study protocols and informed consent documents were approved by the Unilever R&D ethics committee in June 2006, which was formed by a number of external and independent experts from universities and hospitals in Shanghai, and a consumer representative. This study was carried out according to the guidelines of Good Clinical Practice and in accordance with the declaration of Helsinki.
The response variable of main interest was body weight. Based on an estimated within subject variance of body weight of about 1.5 kg; we calculated that 205 subjects should be sufficient to detect a difference of at least 0.716 kg with a power of 80%, α = 0.05 (one sided).

Study design

This randomized, placebo-controlled study used a between-subject design, and was comprised of 3 phases: phase 1: recruitment and screening of volunteers; phase 2: 2 week run-in period during which subjects consumed one serving of control beverage per day at the study site to test adherence to GT drinking and protocol compliance; phase 3: 90 days of intervention period during which the subjects consumed one of four test treatments described in the section on test drinks.
Subjects were randomly allocated to one of four groups. Randomization of subjects into experimental groups was based on stratification by BMI, waist circumference/height, and gender. Subjects attended the study centre two times every day, at the same time of morning and afternoon, to consume their designated test beverages containing defined amounts of catechins and caffeine. An interval of at least 4 h was required between the two visits, and the subjects were required to take a meal (breakfast with the first supplement, and lunch òr dinner with the second), before they took their beverage. They were instructed not to consume any other beverages containing catechins, or caffeine during the intervention period and they were asked to use the same mode of transportation to report to the research facility throughout the intervention.
On days 0, 30, 60, and 90 of the intervention period, subjects completed a schedule of anthropometric measures, blood draws, and questionnaires, as described below.

Test drinks

The beverages were prepared by adding 250 ml of hot water to the test teas contained in a tea bag, following a standard infusion protocol. Test teas were: control drink C: prepared from GT leaf (1.5 g) from which the catechins had been extracted. To ensure that subjects would not know they were consuming a control treatment, a small amount of unextracted green leaf (0.5 g) and tea powder perfume were added. High-catechin drink H: prepared from green leaf tea (2.5 g); extra high-catechin drink EH: prepared from green leaf tea (1.25 g), enriched with catechin powder (0.3 g) and 0.45 g GT powder.
The caffeine and catechin concentrations of our test drinks were analyzed using a Luna 5 µ phenyl-Hexyl high performance liquid chromatography Column (Torrance, CA) coupled with a Waters 2695 pump at a wave length of 278 nm. Data were collected using a Masslynx 4.1 collection system (Waters, Milford, MA). Total catechin was determined by the addition of EGC, GC, EC, C, EGCG, GCG, ECG, and CG. CG was below detection limit in all our samples. EGC, C, EGCG, EC, ECG, and caffeine were quantified by a high performance liquid chromatography standard curve drawn from caffeine (at 4, 10, 20, 40, 100, 200, 300, 400 ppm) multiplied by relative response factors. GC and GCG were quantified by their standard solutions at 1, 2.5, 5, 10, 25, 50, 75, and 100 ppm.
An average 250 ml cup of GT from commercial products in the Chinese market when prepared according to the instructions given on their packaging contains on average 83 mg of catechins and 42 mg caffeine (11). Therefore, the amounts consumed by the subjects in this study were equivalent to 6–10 cups of a regular Chinese type of GT per day, depending on the treatment group.
For further details about the administration of the test drinks, see Table 1.
Table 1.  Test drink composition
inline image

Anthropometric measures

Anthropometric measurements were performed in the morning after a 12-h fast and after voiding. These included waist and hip circumference, sagittal diameter, body weight, whole body fat mass, and height. In addition, body fat % was measured at 0, 60, and 90 days with a QDR4500W Dexa (fan beam) (Hologic, Waltham, MA). Intra-abdominal fat (IAF) was estimated from segmental DXA analyses of trunk fat and sagittal diameter (using a Holtain-Kahn abdominal calliper; Holtain, Dyfed, Wales) by the equation of Treuth et al. (12):
  • image

Health, lifestyle, product liking, and dietary questionnaires

At the study visits at t = 0 and 90 days, the subjects filled out general questionnaires about dietary and lifestyle habits, self perceived health status and product liking. English translations of these questionnaires are available from the authors upon request. Although food intake was not a key variable in this study, a 3-day food intake questionnaire was also used to assess general food intake patterns. Although this method will provide us with an estimate of the food intake of our subjects, it should be noted that any type of dietary intake assessment is prone to systemic bias, most usually in the direction of underreporting (13).

Blood parameters

Blood samples were taken at intervention days 0, 60, and 90 for the analysis of lipids (triglycerides, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol), and blood glucose, and at days 0 and 90 for the determination of alanine aminotransferase, aspartate aminotransferase; alkaline phosphatase; γ-glutamyltransferase; lactate dehydrogenase to assess liver function. Immediately, after the blood sample was obtained, plasma was separated by centrifugation and stored appropriately for the further analysis.
Glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol and the various liver function parameters were all analyzed with an enzymatic colorimetric test on a Hitachi 7170A automatic analyser (Hitachi Corporation, Tokyo, Japan). Glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and the liver function parameters alanine aminotransferase, alkaline phosphatase, and γ-glutamyltransferase were analyzed with reagents from KBH (Shanghai, China). Liver function parameters Aspartate aminotransferase and lactate dehydrogenase were analyzed with reagents from AusBio Laboratories (Yanthai, China). High-density lipoprotein cholesterol was analyzed with reagent from Roche Diagnostics (Basel, Switzerland).

Statistical analysis

Statistical analyses were performed using SAS software (version 9.1; SAS Institute, Cary, NC). An ANOVA-based linear model was used to analyse the results. The model accounted for treatment group, subjects and time points as factors.
A repeated measures variance structure was used to accommodate repeated testing of the same subjects and baseline values were included as covariates. All statistical tests were performed 2-sided with a significance level of 5%.

Results

Out of the 205 subjects randomized to treatments, 13 dropped out for various personal reasons unrelated to the trial, and 192 completed the study. A further 10 subjects were excluded during blind review because of poor compliance (i.e., missing intermediary study visits (n = 3), not adhering to the fasting regime the night before study visits (n = 5), change in diet or lifestyle habits (n = 2)). Analyses were therefore carried out and reported on the remaining 182 subjects (133 women, 49 men).
Baseline demographic and anthropometric characteristics of all intervention groups were similar (Tables 2 and 3). Relative to the control (group C), body weight and waist circumference in group GT3 were significantly reduced at the end of the 90 day intervention. We observed significant differences as well with respect to the DXA body composition measurements at 90 days (Table 4). Relative to group C, there were significant decreases in calculated IAF and a small but statistically significant decrease in total lean mass in group GT3 (P < 0.05). Although the data might appear suggestive of a possible time × treatment interaction for the effect of GT on IAF, this did not approach statistical significance (P = 0.17). Significant decreases in total fat mass and % fat relative to the change in control were observed in groups GT2 and GT1, respectively but total fat mass and % fat was not changed in GT3.
Table 2.  Subject characteristics at baseline
inline image
Table 3.  Changes in anthropometric values after consumption of green tea beverages with different compositions or a control beverage
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Table 4.  Changes in body composition after consumption of green tea beverages with different compositions or a control beverage
inline image
The average reported energy intake in all groups and time points ranged from 7.9–8.4 MJ/day; reported energy and macronutrient intakes did not differ between groups nor change during the course of intervention (Supplementary Table S1 online).
The plasma high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels, plasma triglycerides, and glucose measures, and the responses to questionnaires did not differ between the treatments (Supplementary Table S2 online). The baseline covariate was statistically significant for all of these plasma measures, indicating a general regression toward the mean for all groups, unrelated to treatment. Liver function tests did not show any treatment-related differences (Supplementary Table S3 online). The test drinks were generally well tolerated and no adverse events were reported.

Discussion

This investigation shows that regular consumption of a very-high catechin GT over 90 days leads to significant reductions in measures such as body weight, waist circumference and IAF in a population of moderately overweight Chinese males and females. The treatment with the highest daily intake of catechins and caffeine had the most consistent effects on IAF, and the pattern of response to the different tea products and regimens in this study is suggestive of a possible dose–response effect on IAF, although this was not consistent across the other measures. This raises the possibility that a very high-catechin GT could have a disproportionate effect on reducing fat mass in visceral and abdominal adipose depots, fat storage sites which may be particularly associated with metabolic disease risk (14). As has been described previously (see ref. 15 for a review), caloric restriction leading to weight loss will always affect all tissue types, i.e. next to a decrease in fat stores, a certain net decrease in protein degradation leading to a decrease in lean tissue may also be expected.
There is a strong body of evidence for beneficial effects on body composition of consumption of high-catechin GT in particular from trials with Japanese adults (7,8,9,16,17,18). These trials were all rather similar in design (i.e., they compared the effects of a placebo to 1–2 daily servings of a GT beverage containing 550–900 mg of catechins, the subjects in these experiments were overweight or obese, and the intervention period was around 12 weeks). The effects of GT supplementation on visceral adipose tissue and abdominal obesity in these trials have been particularly consistent. Significant improvements in body composition parameters have also been observed in some (19,20), though not all (21) studies of other Asian populations. The subjects in those studies were instructed to follow their habitual patterns of food intake and exercise, so effects were measured against the background of habitual levels and variation in energy intake and energy expenditure. These experimental designs and the amounts, frequencies and beverage (or pill) forms of catechins consumed have typically reflected a realistic consumer situation.
There are fewer and less consistent data from studies in western populations. Kovacs et al. (22) found no overall effect of a GT-caffeine mixture (270 mg epigallocatechin gallate, 150 mg caffeine) on weight regain in Dutch subjects, following a period of weight loss on a very low energy diet. However, in a separate analysis of the same data, Westerterp-Plantenga et al. (23) observed that in subjects with a low habitual caffeine intake, those who received the GT extract continued to lose body weight, waist circumference and body fat, compared with controls. This treatment effect was not apparent amongst high habitual caffeine consumers. In a separate study of Dutch subjects (24) GT extracts did not add to rates of weight loss with meal replacements. The effects of active weight loss may have obscured an additional effect of GT, subjects' caffeine intake also was standardized at 300 mg per day in that study. It is possible that GT-caffeine mixtures may be more likely to significantly affect energy balance in subjects who consume low amounts of caffeine. The subjects in our study were all selected to have a low habitual caffeine intake, and this may have had a favorable effect on the results.
Recent studies have explored whether the benefits of GT are more apparent in more active individuals. Hill et al. (25) observed no added benefit of 300 mg EGCG as part of an activity programme in Australian women. However, Maki et al. more recently reported that consumption of 625 mg of GT catechins per day for 12 weeks enhanced the effects of an exercise intervention in overweight and obese North-American adults (26).
There are several potential mechanisms of action for an effect of GT catechins on body composition. First, it has been demonstrated that short-term supplementation with GT (26,27,28) or catechins alone (29) at rest (27,28) and in combination with light to moderate physical activity (29) can increase fat oxidation. In line with these observations, there is evidence for a chronic stimulating effect of catechin-enriched beverages on particular aspects of energy metabolism from Asian populations. For example, Harada et al. (30) and Ota et al.(31) report both acute and chronic effects on energy metabolism during exercise and postprandially.
Caffeine has been shown to inhibit the intracellular activity of phosphodiesterase, which decreases the breakdown of cyclic adenosine monophosphate (1) and could also act on the sympathetic nervous system through an antagonism of the negative modulatory effect of adenosine on noradrenalin release (32), thus causing increased sympathetic nervous system activity. Interestingly, physical activity also causes an increase in sympathetic nervous system activity, stimulating fat and carbohydrate oxidation to meet altered energy requirements (33).
Catechins in GT could act synergistically with either or both of these mechanisms because they may inhibit the activity of catechol-o-methyltransferase. This enzyme catalyzes the breakdown of noradrenalin in neural synapses. Inhibition of catechol-o-methyltransferase could increase the wash-out time of noradrenalin, causing a more prolonged stimulation of the sympathetic nervous system, thus increasing energy expenditure (34). In support of this hypothesis, GT intervention studies in which a small to moderate amount of physical activity was incorporated into the design, have consistently shown a decrease in visceral fat and/or other measures of body composition (26,35,36). Furthermore, GT supplementation has also been shown to increase mRNA expression of enzymes related to β-oxidation in muscle and liver tissue in animal studies (37,38,39,40).
Another mechanism potentially contributing to the beneficial effects of GT on body composition is a decreased nutrient absorption. Although most evidence comes from animal studies (41,42,43), there is also some evidence of small but consistent effects of oolong tea, which is also rich in catechins, on fat absorption in humans (44).
Overall, the literature suggests several plausible mechanisms by which GT may influence energy balance and body composition. These may each be of a relatively small absolute magnitude in the short-term, but nevertheless relevant. The additional 0.6 kg loss of fat mass observed in the tea treatment groups relative to control over the course of this study would reflect a negative energy balance of ∼0.25 MJ/day over 90 days. Given that we have observed previously that GT does not affect appetite-related parameters and/or food intake (E.M.R. Kovacs and J.A. Rycroft, unpublished data), and also found no evidence for such effects on energy intake in the present study, this negative energy balance in most likely attributable to increased energy expenditure or decreased nutrient absorption. Acute increases in 24-h energy expenditure of ∼0.3–0.4 MJ have previously been observed in humans (27,28) and increases in fecal fat excretion of around 3 g or ∼0.12 MJ have been shown as well (44) so effects could be explained by these mechanisms. This level of effect would be very difficult to measure in any acute experiment, but the sustained, cumulative effect could be significant and meaningful.
One of the strengths of the present study is that we are sure to have 100% compliance because the test products were consumed at the research facility. Furthermore, we chose to study moderately overweight subjects, which is an important target group for delivering improved metabolic health. The study was sufficiently powered to detect significant differences between the treatment groups in the relevant time frame. Finally, it is a strength of this study that we instructed our subjects to use the same mode of transportation to report to the research facility throughout the intervention.
A potential weakness is that we did not have full control of the dietary intake and physical activity of the subjects during the intervention. It is possible that the GT interventions caused a selective change in eating patterns, energy intake or activity patterns. Questionnaire measures of dietary intake did not change throughout the study, but this was a relatively crude instrument. Moreover, in contrast to other proposed mechanisms noted here, there is no previous clinical or mechanistic support that would lead us to hypothesize behavioral effects such as effects on dietary intake or physical activity. Furthermore, this study was also not intended to study these behavioral effects as potential mechanisms, but to evaluate the effects of GT against the background of normal daily patterns.
It should also be noted that the Treuth formula used to calculate IAF was validated in a western female population. However, to our knowledge, there is no similar equation available for use in overweight Asian populations. Any uncertainty that may arise as a consequence of using the Treuth formula, should be similar across the entire study population, and would not be expected to be biased in favor of one specific treatment.
Furthermore, it would have been very informative to be able to correlate increases in plasma catechins and changes in fat mass (although there is still some question over whether catechins themselves or metabolites—not fully known—may be the primary mediators or best biomarkers of biofunctionality), but measurements of plasma catechin levels were not performed in this experiment.
Moreover, we obtained blood samples at ∼18 hours after consumption of the last treatment in each condition. According to earlier studies (45,46), the plasma peak of catechins is reached during the first hours postingestion, so the timing of our blood sampling would not have allowed us to draw correlations between the bioavailability of the catechins and the main outcome measures.
Finally, this study and most others have focused on Asian subjects, so it may be argued that further research is needed to substantiate and generalize these results to western populations. Results could vary as a function of population differences in genetic background and heterogeneity, body composition, and dietary habits.
In conclusion, the results from the present investigation build upon existing evidence for the beneficial effects of GT on body composition in overweight Asian populations. These consistently suggest that daily consumption of 500–900 mg of GT catechins with low-to-moderate amounts of caffeine (i.e., <200 mg) for at least 90 days can exert a positive effect on body composition, and abdominal fat mass in particular, in Asian populations.