Objective: To consider whether consumption of black tea has a positive or negative impact on health. Design: Databases were searched for relevant epidemiological and clinical studies published between 1990 and 2004. Results: Clear evidence was found for coronary heart disease (CHD), where an intake of X3 cups per day related to risk reduction. The mechanism could involve the antioxidant action of tea polyphenols. While experimental models have suggested that flavonoids attenuated cancer risk, epidemiological studies failed to demonstrate a clear effect for tea, although there is moderate evidence for a slightly positive or no effect of black tea consumption on colorectal cancer. Studies on cancer were limited by sample sizes and insufficient control of confounders. There is moderate evidence suggestive of a positive effect of black tea consumption on bone mineral density although studies were few. There is little evidence to support the effect of tea on dental plaque inhibition but evidence to support the contribution of tea to fluoride intakes and thus theoretical protection against caries. There was no credible evidence that black tea (in amounts typically consumed) was harmful. Normal hydration was consistent with tea consumption when the caffeine content was o250 mg per cup. A moderate caffeine intake from tea appeared to improve mental performance, although sample sizes were small. There was no evidence that iron status could be harmed by tea drinking unless populations were already at risk from anaemia. Conclusions: There was sufficient evidence to show risk reduction for CHD at intakes of X3 cups per day and for improved antioxidant status at intakes of one to six cups per day. A maximum intake of eight cups per day would minimise any risk relating to excess caffeine consumption. Black tea generally had a positive effect on health. Sponsorship: The Tea Council. The authors confirm that the sponsors played no role in the writing of this review.

While it is widely accepted that fruit and vegetables (F&V) lower the risk of cancer, and cardiovascular disease (CVD), the role of pure fruit and vegetable (PFV) juices is often downplayed. This review poses two questions: Are the protective benefits of F&V dependent upon constituents lacking in PFV juices (e.g. fibre)? Do PFV juices impact on disease risk when considered separately from F&V? Studies comparing the effects of fibre and antioxidants were reviewed, yielding the finding that the impact of F&V may relate more strongly to antioxidants, than to fibre. For the second question, high-quality published studies that considered PFV juices were reviewed. The impact of PFV juices on cancer risk was weakly positive, although a lack of human data and contradictory findings hampered conclusions. For CVD, there was convincing evidence from epidemiological and clinical studies that PFV juices reduced risk via a number of probable mechanisms. It was concluded that the view that PFV juices are nutritionally inferior to F&V, in relation to chronic disease risk reduction, is unjustified.

Many countries set quantitative targets for added sugars, justifying this by expressing concern about the likely impact of sugar on weight control, dental health, diet quality, or metabolic syndrome. This review considers whether current intakes of sugar are harmful to health, and analyses recent literature using a systematic approach to collate, rank, and evaluate published studies from 1995-2006. Results from high quality obesity studies did not suggest a positive association between body mass index and sugar intake. Some studies, specifically on sweetened beverages, highlighted a potential concern in relation to obesity risk, although these were limited by important methodological issues. Diet adequacy appeared to be achieved across sugar intakes of 6 to 20% energy, depending on subject age. Studies on metabolic syndrome reported no adverse effects of sugar in the long-term, even at intakes of 40-50% energy. The evidence for colorectal cancer suggested an association with sugar, but this appeared to have been confounded by energy intake and glycemic load. There was no credible evidence linking sugar with attention-deficit, dementia, or depression. Regarding dental caries, combinations of sugar amount/frequency, fluoride exposure, and food adhesiveness were more reliable predictors of caries risk than the amount of sugar alone. Overall, the available evidence did not support a single quantitative sugar guideline covering all health issues.

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Purpose -Over-the-counter (OTC) weight management products are popular with the public. Manufacturers frequently claim beneficial effects of these products, however current legislation does not compel them to support these claims with research. This paper identifies the key ingredients of OTC weight management products and evaluates evidence for their safety and efficacy. Design/methodology/approach -Using Medline, published evidence on key ingredients and formulations was gathered. Contact was also made with manufacturers to ascertain whether unpublished data were available. All studies were assessed for quality. The efficacy and safety of the ingredients and formulations were then reviewed. Findings -The results showed little evidence for most weight loss claims, with the exception of a formulation containing Yerba maté, Guarana and Damiana. In addition, studies on pyruvate, conjugated linoleic acid, and Citrus aurantium demonstrated positive effects on weight loss, suggesting that they may be useful in future formulations. Safety implications were noted for ephedrine. Practical implications -Better labelling and supporting literature should be introduced by reputable manufacturers and retailers to help the public assess the efficacy of weight loss aids. Research limitations/implications -Given the popularity of self-treatment, there is a need for more manufacturers to submit their products to impartial clinical trials. OTC weight management products could be useful in addressing obesity, but most still need scientific evidence to demonstrate safety and effectiveness. Originality/value -This review reviews the available evidence on ingredients of OTC weight management products, providing a unique guide to what works, and what doesn't.

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