Associations Between Tea Consumption and Musculoskeletal Health Among Taiwanese Older Adults: A Sex-Stratified Analysis
Chun-Yung Chang, Nain-Feng Chu, Yi-Chen Liu, Der-Min Wu, Wen-Chen Liang, Shu-Chuan Yeh, Cheng-Hsin ChuangIntroduction:
Sarcopenia and osteoporosis are critical public health issues contributing to frailty and disability in aging populations. While tea consumption is a significant cultural habit in Taiwan, its independent association with musculoskeletal health remains controversial. This study aimed to specifically analyze the independent associations of tea consumption with bone mineral density (BMD) and with the appendicular muscle mass-to-body weight ratio (AMM/W) among Taiwanese older adults.
Methods:
A cross-sectional survey of 3,621 community-dwelling older adults (1,552 males and 2,069 females) was conducted in Chiayi County, Taiwan. Tea intake frequency was assessed via structured interviews. BMD was measured using calcaneal quantitative ultrasound. Appendicular muscle mass (AMM) was estimated using a validated prediction formula for the Taiwanese population, and muscle mass was represented by AMM/W to adjust for body size. Hierarchical multivariable linear regression was used to adjust for lifestyle and metabolic confounders.
results:
Daily tea drinkers exhibited a significantly higher prevalence of low AMM/W compared to non-drinkers (males: 53.2% vs. 47.8%, p = 0.034; females: 57.1% vs. 48.5%, p = 0.003). In the crude models (Model I), tea consumption was negatively associated with AMM/W in both sexes (males: β = -0.564, p = 0.001; females: β = -0.457, p = 0.002). However, after adjusting for metabolic factors, including waist circumference, hypertension, and diabetes (Model IV), these associations became statistically insignificant (males: β = -0.186, p = 0.055; females: β = -0.095, p = 0.351). No significant association was found between tea consumption and BMD in either sex across all models.
Results:
Daily tea drinkers exhibited a significantly higher prevalence of low AMM/W compared to non-drinkers (males: 53.2% vs. 47.8%, p = 0.034; females: 57.1% vs. 48.5%, p = 0.003). In the crude models (Model I), tea consumption was negatively associated with AMM/W in both sexes (males: β = -0.564, p = 0.001; females: β = -0.457, p = 0.002), and positively associated with BMD in males (β = 0.187, p = 0.017). However, after adjusting for metabolic factors, including waist circumference, hypertension, and diabetes (Model IV), these associations became statistically insignificant (males: β = -0.186, p = 0.055; females: β = - 0.095, p = 0.351). No significant association was found between tea consumption and BMD in either sex across all models.
Discussion:
The observed negative trend between tea consumption and AMM/W in initial models was largely driven by a clustering of metabolic risk factors among tea drinkers, such as larger waist circumferences and higher rates of diabetes. The attenuation of these associations suggests that metabolic health may act as a primary confounder or mediator. These findings underscore the importance of dietary quality and metabolic screening, rather than beverage habits alone, in maintaining musculoskeletal health.
Conclusions:
Habitual tea consumption is not independently associated with AMM/W or BMD after full adjustment for metabolic status. Future longitudinal research incorporating detailed tea types, brewing methods, and nutritional data is warranted to clarify these complex interactions.