Skip to main content


Log in

Food and health

Moderate, but not heavy, tea drinking decreased the associated risk of gallstones in a Taiwanese population

  • Article
  • Published:
European Journal of Clinical Nutrition Submit manuscript



The aim of the present study was to investigate the relationship between tea drinking and gallstones, specifically to evaluate the amount and time of tea consumption by gender.


A total of 14,555 eligible adults receiving health examinations were included. The participants were divided into three subgroups with tea consumption of none, <240/day and ≥240 ml/day. We defined 120 ml for each traditional Chinese teapot as a “cup,” and the variable “cup-year” was obtained by multiplying the cups per day by the years of tea consumption. Based on the findings of abdominal ultrasound examination, gallstones was defined by the presence of movable or gravity-dependent intraluminal hyperechoic foci that attenuated ultrasound transmission.


Among the participants, 1040 (7.1%) had gallstones. In multivariate analysis, the inverse relationship between tea drinking habit and gallstones was significant (OR = 0.807; 95% CI = 0.685−0.951, p = 0.010). Daily consumption of 1−240 ml (OR = 0.741; 95% CI = 0.584−0.941, p = 0.014), but not ≥240 ml, was associated with reduced risk of gallstones. In addition, the 1−19 cup-year group had significantly lower associated risk of gallstones (OR = 0.677; 95% CI = 0.534−0.857, p = 0.001), while the ≥19 cup-year group did not. By gender, subjects with tea consumption of 1−19 cup-year exhibited a low associated risk of gallstones in both males (OR = 0.678; 95% CI = 0.504−0.913, p = 0.010) and females (OR = 0.671; 95% CI = 0.453−0.994, p = 0.047), while subjects with ≥19 cup-years did not.


Appropriate tea drinking if less than 240 ml/day or 19 cup-years was associated with a decreased risk of gallstones in both genders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gall bladder disease in the United States. Gastroenterology. 1999;117:632–9.

    Article  CAS  Google Scholar 

  2. Chen CH, Huang MH, Yang JC, Nien CK, Etheredge GD,Yang CC, et al. Prevalence and risk factors of gallstone disease in an adult population of Taiwan: an epidemiological survey. J Gastroenterol Hepatol. 2006;21:1737–43.

    Article  PubMed  Google Scholar 

  3. Liu CM, Tung TH, Chou P, Chen VT, Hsu CT, Chien WS, et al. Clinical correlation of gallstone disease in a Chinese population in Taiwan: experience at Cheng Hsin General Hospital. World J Gastroenterol. 2006;12:1281–6.

    Article  Google Scholar 

  4. Lai SW, Liao KF, Lai HC, Chou CY, Cheng KC, Lai YM. The prevalence of gall bladder stones is higher among patients with chronic kidney disease in Taiwan. Medicine (Baltimore). 2009;88:46–51.

    Article  Google Scholar 

  5. Naeem M, Rahimnajjad NA, Rahimnajjad MK, Khurshid M, Ahmed QJ, Shahid SM, et al. Assessment of characteristics of patients with cholelithiasis from economically deprived rural Karachi, Pakistan. BMC Res Notes. 2012;5:334

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lai SW, Ng KC. Risk factors for gallstone disease in a hospital-based study. South Med J. 2002;95:1419–23.

    Article  Google Scholar 

  7. Misciagna G, Centonze S, Leoci C, Guerra V, Cisternino AM, Ceo R, et al. Diet, physical activity, and gallstones—a population-based, case-control study in southern Italy. Am J Clin Nutr. 1999;69:120–6.

    Article  CAS  Google Scholar 

  8. Misciagna G, Leoci C, Guerra V, Chiloiro M, Elba S, Petruzzi J, et al. Epidemiology of cholelithiasis in southern Italy. Part II: risk factors. Eur J Gastroenterol Hepatol. 1996;8:585–93.

    Article  CAS  Google Scholar 

  9. Ishizuk H, Eguchi H, Oda T, Ogawa S, Nakagawa K, Honjo S, et al. Relation of coffee, green tea, and caffeine intake to gallstone disease in middle-aged Japanese men. Eur J Epidemiol. 2003;18:401–5.

    Article  CAS  Google Scholar 

  10. Chandran AP, Sivarajan RR, Srinivas M, Srinivasan V, Venkataraman J. Risk factors for choledocholithiasis in a south Indian population: a case-control study. Indian J Gastroenterol. 2013;32:381–5.

    Article  PubMed  Google Scholar 

  11. Zhang XH, Andreotti G, Gao YT, Deng J, Liu E, Rashid A, et al. Tea drinking and the risk of biliary tract cancers and biliary stones: a population-based case-control study in Shanghai, China. Int J Cancer. 2006;118:3089–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Chandran AP, Sivarajan R, Srinivasan V, Srinivas M, Jayanthi V. Risk profile for gallstone disease in southern Indian population: is there anything new?. Indian J Gastroenterol. 2014;33:254–7.

    Article  PubMed  Google Scholar 

  13. Yang YC, Lu FH, Wu JS, Wu CH, Chang CJ. The protective effect of habitual tea consumption on hypertension. Arch Intern Med. 2004;164:1534–40.

    Article  PubMed  Google Scholar 

  14. Pan WH, Lee MS, Chuang SY, Lin YC, Fu ML. Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan. Obes Rev. 2008;9(Suppl 1):22–31.

    Article  PubMed  Google Scholar 

  15. Organization WH International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications; 2000.

  16. Saverymuttu SH, Joseph AE, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J (Clin Res Ed). 1986;292:13–5.

    Article  CAS  Google Scholar 

  17. Zhang YP, Li WQ, Sun YL, Zhu RT, Wang WJ. Systematic review with meta-analysis: coffee consumption and the risk of gallstone disease. Aliment Pharmacol Ther. 2015;42:637–48.

    Article  PubMed  Google Scholar 

  18. Nordenvall C, Oskarsson V, Wolk A. Inverse association between coffee consumption and risk of cholecystectomy in women but not in men. Clin Gastroenterol Hepatol. 2015;13:1096–102 e1091.

    Article  CAS  PubMed  Google Scholar 

  19. Leitzmann MF, Stampfer MJ, Willett WC, Spiegelman D, Colditz GA, Giovannucci EL. Coffee intake is associated with lower risk of symptomatic gallstone disease in women. Gastroenterology. 2002;123:1823–30.

    Article  PubMed  Google Scholar 

  20. Douglas BR, Jansen JB, Tham RT, Lamers CB. Coffee stimulation of cholecystokinin release and gallbladder contraction in humans. Am J Clin Nutr. 1990;52:553–6.

    Article  CAS  Google Scholar 

  21. Conter RL, Roslyn JJ, Porter-Fink V, DenBesten L. Gallbladder absorption increases during early cholesterol gallstone formation. Am J Surg. 1986;151:184–91.

    Article  CAS  Google Scholar 

  22. Shan D, Fang Y, Ye Y, Liu J. EGCG reducing the susceptibility to cholesterol gallstone formation through the regulation of inflammation. Biomed Pharmacother. 2008;62:677–83.

    Article  CAS  PubMed  Google Scholar 

  23. Chung JH, Kim S, Lee SJ, Chung JO, Oh YJ, Shim SM. Green tea formulations with vitamin C and xylitol on enhanced intestinal transport of green tea catechins. J Food Sci. 2013;78:C685–90.

    Article  CAS  PubMed  Google Scholar 

  24. Peters CM, Green RJ, Janle EM, Ferruzzi MG. Formulation with ascorbic acid and sucrose modulates catechin bioavailability from green tea. Food Res Int. 2010;43:95–102.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among US adults: the Third National Health and Nutrition Examination Survey (NHANES III). Arch Intern Med. 2000;160:931–6.

    Article  CAS  Google Scholar 

  26. Koch W, Kukula-Koch W, Glowniak K. Catechin composition and antioxidant activity of black teas in relation to brewing time. J AOAC Int. 2017;100:1694–9.

    Article  CAS  PubMed  Google Scholar 

  27. Labbé D, Tremblay A, Bazinet L. Effect of brewing temperature and duration on green tea catechin solubilization: basis for production of EGC and EGCG-enriched fractions. Sep Purif Technol. 2006;49:1–9.

    Article  CAS  Google Scholar 

  28. Bunsawat K, White DW, Kappus RM, Baynard T. Caffeine delays autonomic recovery following acute exercise. Eur J Prev Cardiol. 2015;22:1473–9.

    Article  PubMed  Google Scholar 

  29. Rai G, Baghel V, Rai T, Vyas M. Gall bladder dysfunction in chronic diabetics (type 2): an ultrasonography based prospective study. Int J Res Med Sci. 2016;4:390–97.

    Article  Google Scholar 

  30. Chey WY, Chang T. Neural hormonal regulation of exocrine pancreatic secretion. Pancreatology. 2001;1:320–35.

    Article  CAS  Google Scholar 

  31. Weerawatanakorn M, Hung W-L, Pan M-H, Li S, Li D, Wan X, et al. Chemistry and health beneficial effects of oolong tea and theasinensins. Food Sci Human Wellness. 2015;4:133–46.

    Article  Google Scholar 

  32. Ho KJ, Lin XZ, Yu SC, Chen JS, Wu CZ. Cholelithiasis in Taiwan. Gallstone characteristics, surgical incidence, bile lipid composition, and role of beta-glucuronidase. Dig Dis Sci. 1995;40:1963–73.

    Article  CAS  Google Scholar 

  33. Tsai WL, Lai KH, Lin CK, Chan HH, Lo CC, Hsu PI, et al. Composition of common bile duct stones in Chinese patients during and after endoscopic sphincterotomy. World J Gastroenterol. 2005;11:4246–9.

    Article  Google Scholar 

  34. Chen JY, Hsu CT, Liu JH, Tung TH. Clinical predictors of incident gallstone disease in a Chinese population in Taipei, Taiwan. BMC Gastroenterol. 2014;14:83

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Chen CY, Lu CL, Huang YS, Tam TN, Chao Y, Chang FY, et al. Age is one of the risk factors in developing gallstone disease in Taiwan. Age Ageing. 1998;27:437–41.

    Article  CAS  Google Scholar 

  36. Acalovschi M, Buzas C, Radu C, Grigorescu M. Hepatitis C virus infection is a risk factor for gallstone disease: a prospective hospital-based study of patients with chronic viral C hepatitis. J Viral Hepat. 2009;16:860–6.

    Article  CAS  PubMed  Google Scholar 

  37. Zhang FM, Chen LH, Chen HT, Shan GD, Hu FL, Yang M, et al. Hepatitis C virus infection is positively associated with gallstones in liver cirrhosis. Digestion. 2016;93:221–8.

    Article  PubMed  Google Scholar 

  38. Wijarnpreecha K, Thongprayoon C, Panjawatanan P, Manatsathit W, Ungprasert P. Hepatitis B virus infection and risk of gallstones: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2016;28:1437–42.

    Article  CAS  PubMed  Google Scholar 

  39. Li CH, Yang YC, Wu JS, Huang YH, Lee CT, Lu FH, et al. Increased tea consumption is associated with decreased arterial stiffness in a Chinese population. PLoS ONE. 2014;9:e86022

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references


We thank the clinical staff of the health examination center in National Cheng Kung University Hospital. We are grateful to Chung-Yi Li for providing the statistical consulting services from the Biostatistics Consulting Center, Clinical Medicine Research Center, National Cheng Kung University Hospital.

Author information

Authors and Affiliations


Corresponding authors

Correspondence to Feng-Hwa Lu or Yi-Ching Yang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Su, FL., Li, CH., Chang, YF. et al. Moderate, but not heavy, tea drinking decreased the associated risk of gallstones in a Taiwanese population. Eur J Clin Nutr 73, 401–407 (2019).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

  • Springer Nature Limited