Written by Tabish Mehraj, PhD. In this study, participants were observed for whole-body, lumbar spine, and femoral neck BMD and whole-body BMC (P-interaction ranged from < 0.001 to 0.022). Moderate-frequency tea drinkers generally had the highest visit-averaged adjusted marginal mean Z-scores, including 0.107 (95% CI: 0.025, 0.190) for whole-body BMD, 0.090 (0.012, 0.168) for lumbar spine BMD, and 0.108 (0.029, 0.187) for femoral neck BMD (P-diff ranged from < 0.001 to 0.017).

Tea is an important dietary source of flavonoids, including epicatechin gallate (ECG), epigallocatechin (EGC), epicatechin (EC), catechin, and epigallocatechin gallate (EGCG). In green tea, catechins account for approximately 30–42% of dry leaf weight, with EGCG comprising 50–70% of total catechins. Experimental evidence suggests that these compounds may influence bone metabolism by suppressing osteoclast activity, promoting osteoblast differentiation, and modulating signaling pathways involved in bone remodeling. Experimental research suggests that these compounds may influence bone remodeling, but prospective evidence linking tea consumption and circulating tea-derived compounds with long-term changes in bone mineral status remains limited. This prospective cohort study examined whether habitual tea consumption and circulating tea biomarkers were associated with bone mineral density (BMD) and bone mineral content (BMC) over time.

Investigators used data from the Guangzhou Nutrition and Health Study, which was a community-based prospective cohort of middle-aged and older Chinese adults. The analysis included 1,708 participants, comprised of 537 non-tea drinkers, 543 low-frequency tea drinkers, 522 moderate-frequency tea drinkers, and 106 high-frequency tea drinkers. Bone mineral measurements were obtained at multiple visits over a 13-year follow-up period using dual-energy X-ray absorptiometry (DEXA). BMD and BMC were analyzed for the whole body, lumbar spine, total hip, and femoral neck. Moreover, baseline serum concentrations of several tea-derived flavan-3-ols were measured using UHPLC–MS/MS in 1,461 participants.

Results/Significant Findings

• Tea consumption was significantly associated with longitudinal changes in whole-body, lumbar spine, and femoral neck BMD and whole-body BMC.
• Moderate tea drinkers had the most favorable adjusted BMD Z-scores: 0.107 (95% CI 0.025–0.190) for whole-body, 0.090 (95% CI 0.012–0.168) for lumbar spine, and 0.108 (95% CI 0.029–0.187) for femoral neck.
• Higher circulating tea-derived flavan-3-ols were generally associated with more favorable BMD and BMC measures.
• ECG and EGCG showed particularly strong associations with bone measures.
• Several biomarkers showed non-linear associations, suggesting that greater exposure may not provide progressively greater skeletal benefits.

There were several noteworthy strengths to this study. Its 13-year prospective follow-up and repeated DEXA measurements allowed researchers to evaluate longitudinal changes rather than relying on a single assessment of bone health. Assessing BMD and BMC at multiple skeletal sites also provided a more comprehensive picture of bone mineral status than studies examining only fracture outcomes or a single anatomical location. Another important strength was the combination of self-reported tea consumption with objective serum flavan-3-ol biomarkers, providing complementary information about habitual intake and internal exposure. The use of linear mixed-effects models also allowed the investigators to account for repeated bone measurements over time.

The findings should nevertheless be interpreted cautiously. As an observational study, residual confounding and reverse causality cannot be excluded. Tea consumption was self-reported and may have been misclassified, while serum tea biomarkers were measured only once. The high-frequency tea group was relatively small. Moreover, the study involved numerous biomarkers, skeletal sites, and visit-specific comparisons, and no formal adjustment for multiple comparisons. Finally, participants were recruited from Guangzhou, and the results may not generalize to other populations worldwide with different tea-drinking habits.

The findings suggest that moderate tea consumption may be associated with better long-term bone mineral status, while higher circulating concentrations of certain tea-derived flavan-3-ols, particularly ECG and EGCG, were generally linked with more favorable bone measures. However, the study does not establish that tea prevents osteoporosis or determine an optimal amount of tea consumption or serum flavan-3-ol concentration. Further research using repeated biomarker measurements, more detailed information on tea dose and preparation, and controlled intervention studies is needed to determine whether these associations are causal.

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Posted August 25, 2026.

Dr. Tabish Mehraj is a pharmaceutical scientist with expertise in pharmaceutics, drug delivery, and formulation development. She earned her PhD in Pharmaceutical Sciences from the University of Mississippi, where her research focused on the formulation, optimization, and characterization of lipid-based nanocarriers for targeted liver delivery of antimalarial therapeutics. Dr. Mehraj has also served as an ORISE Fellow at the U.S. Food and Drug Administration (FDA), where she evaluated the effects of formulation and process design on the quality and performance of intravaginal drug delivery systems and developed bio-relevant in vitro drug release testing methods. She has teaching experience in pharmaceutical and life sciences courses and has authored peer-reviewed publications, book chapters, and conference presentations. Dr. Mehraj is an active member of the American Association of Pharmaceutical Scientists and has been recognized by honor societies including Rho Chi and Gamma Beta Phi.

Reference:

1. He, S., Yan, Y., Zhou, S., Hong, Z., Huang, S., Liu, Y., … & Zhang, Z. (2026). Relationship of Tea Consumption and its Circulating Biomarkers with Longitudinal Bone Mineral Changes: A Prospective Cohort Study With Repeated Measurements. The American Journal of Clinical Nutrition, 101466.