**3. Tea and lipid profile**

Hyperlipidemia, characterized by increased levels of total cholesterol (TC) and low-density lipoprotein (LDL-C), is a major risk factor for CVD. Several clinical trials demonstrated that the ingestion of polyphenols such as flavonoids and phenolic acids can improve the concentrations of TC, LDL-C, and high-density lipoprotein (HDL-C) [8].

Green tea beverage consumption and green tea extract supplementation can also improve lipid profile, reducing blood TC and LDL-C concentrations, especially when used for a long time. These changes are due to the presence of major tea polyphenols, namely, the catechins [27, 28]. A study conducted on rats fed with atherogenic diet demonstrated that the supplementation with green tea preparation consisting of 66.5% EGCG and other catechins could decrease plasma TC and LDL-C levels and increase plasma HDL-C levels [29]. Another study on rats and atherogenic diet indicated that EGCG can significantly reduce TC, LDL-C, very low-density lipoprotein cholesterol (VLDL-C), triacylglycerols (TG), and cardiac risk ratio values while increasing the concentration of HDL-C [30].

Studies on humans also reported that EGCG can improve lipid profile. Its mechanisms may be associated with decreasing the absorption of lipids, inhibiting the lipogenesis pathway, and attenuating inflammation [23, 24, 31] (**Table 1**).

Other green tea catechins may have a beneficial effect on plasma TC and LDL-C levels in humans. Kim et al. [32] reviewed 20 trials and verified that the intake of green tea catechins, at doses of 145 to 3.000 mg per day, reduced TC by 5.5 mg/dL and LDL-C by 5.3 mg/dL, while there were no changes in plasma HDL-C levels.

More importantly, green tea can decrease plasma TC and LDL-C levels in overweight or obese people with no side effects, especially with long-term consumption [23].

Consumption of green tea extract catechin complex (843 mg of EGCG, 202 mg of ECG, 107 mg of EGC, and 107 mg of EC), for 12 months, significantly reduced (compared with the placebo group) plasma TC, LDL-C, and non-HDL-C levels in postmenopausal women. In hypercholesterolemic participants, green tea extract supplementation resulted in a reduction of 8.5% in TC and 12.4% in LDL-C concentrations. This study suggests that green tea extract, with high concentrations of catechins, may be recommended for lowering cholesterol, especially in those with high cholesterol concentrations [33].
