ReviewMaté drinking and oral and oro-pharyngeal cancer: A systematic review and meta-analysis
Introduction
Cancers of the lip, tongue, and mouth (ICD-10: C00–06), oropharynx (ICD-10: C09–10), and other pharyngeal sites (ICD-10: C11–13) are among the most common cancers in the world.1 Annually 275,000 new oral cancer cases and 130,300 new pharyngeal cancer cases are expected globally. Among the areas of high incidence of oral and oro-pharyngeal cancer are parts of Latin America. Cancers of mouth and pharynx rank fifth in men and sixth in women in South America and the Caribbean. In this region, Argentina, Southern Brazil, and Uruguay show the highest rates of oral and oro-pharyngeal cancers. Brazilian males only fall behind males of France and India in terms of the highest risk in the world for cancer of mouth.2 It is conceivable that certain specific life-style related risk factors in these populations play a role in the etiology of oral and oro-pharyngeal cancer. Maté drinking could be one such factor.
Dried leaves and stemlets of the perennial tree Ilex paraguarensis (or Yerbe-Maté, Jesuit’s tea, Chimarrao, or Paraguayan tea) are brewed and consumed as a beverage in many countries in South America. An aqueous infusion is prepared by repeatedly adding almost boiling water to about 50 g of dried I. paraguarensis leaves. The quechua word ‘maté’ means a cup or a vessel used for drinking. In Latin America, maté is often drunk out of a dried gourd using a metal straw called ‘bombilla;. Hot maté is mainly consumed in Argentina, Bolivia, Brazil, Chile, Ecuador, Paraguay, and Uruguay, and cold maté is consumed in Paraguay, and southwestern Brazil. Maté drinking is also common in other countries such as Germany, Syria, Lebanon, and northern Israel. This product is now penetrating other markets including the United States, mostly in the form of commercially packed individual tea bags of 1–2 g. South American gauchos used maté as a stimulant and a vital part of their diet.[3], [4], [5] Maté is now gaining recognition as a nutraceutical for its antioxidant properties as well as the perceived hypocholesterolemic, hepatoprotective, diuretic, central nervous system stimulant properties.6 Over 50% of adult males and females in some countries are known to consume maté and the average annual consumption of maté is estimated to be over 5 kg per person.7
Even though maté contains useful minerals such as phosphorous, iron, and calcium, and vitamin C, B1 and B2, hot maté is considered carcinogenic to humans.8 Several epidemiological studies have shown that maté drinking is a risk factor for a number of cancers. These include laryngeal cancer,9 lung cancer,10 esophageal cancer,[11], [12] renal and bladder cancer,13 and oro-pahryngeal cancer.[3], [14], [15] On the other hand, maté is shown to demonstrate anticancer properties as well. Proteosome inhibitors such as 3,5-dicaffeoylquinic acid that are found in maté may offer some of this anticancer effect.6 Maté also attenuates the DNA damage caused by thermal injury and nitrosamines in rats16 and inhibits proliferation of oral cancer cells in vitro that is potentially mediated via inhibition of topoisomerase II.17 If epidemiological evidence suggests that maté drinking is associated with oral and oro-pharyngeal cancer while maté is also cancer protective and is capable of inhibiting tumor cell proliferation, it is important to further examine the nature of this association between maté drinking and oral and oro-pharyngeal cancer. With this objective in mind, we conducted a systematic review of the studies that were related to maté drinking and oral cancer and also performed a meta-analysis using the limited relevant published studies.
Section snippets
Materials and methods
We conducted a comprehensive systematic bibliographic search using the search terms maté, maté drinking, maté beverage, cancer, oral cancer, tongue cancer, and oro-pharyngeal cancer. Medilne, and Pubmed databases were searched up to June 2009. If there were additional articles listed in the reference sections of those articles, these additional articles were also obtained and reviewed. Inclusion criteria used were the availability of original data from epidemiological studies, data on primary
Results
Database search resulted in 18 articles. Eleven of those were related to esophageal cancer, five oral and oro-pharyngeal cancer, and one each related to bladder or lung cancer. Of the five oral and oro-pharyngeal cancer related articles, one article did not have sufficient data on the exposure assessment (Fig. 1). Remaining articles were included in the meta-analysis.[14], [15], [19], [20]
De Stefani et al. 15 conducted a case–control study of oral and pharyngeal cancer (excluding lip, salivary
Discussion
In 1991, International Agency for Research on Cancer (IARC) considered the carcinogenic risk of maté to humans as of Group 3 evidence (not classifiable as to its carcinogenicity to humans) and hot maté as of Group 2A evidence (probably carcinogenic to humans).8 Since then, there has been one other case–control study15 on this topic which is included in this review. Our objective was to evaluate all available evidence using both a systematic review and meta-analysis. As we discussed earlier,
Conflict of Interest Statement
None declared.
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Cited by (32)
Insights into yerba mate components: chemistry and food applications
2023, Studies in Natural Products ChemistryFractionated extraction of polyphenols from mate tea leaves using a combination of hydrophobic/ hydrophilic NADES
2022, Current Research in Food ScienceCitation Excerpt :The most used technologies for decaffeination are the extraction processes by organic solvents (ethyl acetate and dichloromethane) and supercritical extraction, a method of separation and purification, that uses carbon dioxide (CO2) and water as solvents (Cassel et al, 2010). Another drawback of mate tea leaves is the fact that recently, they started to be associated to cancers cases, leading to questioning the real benefits of the tea (Dasanayake et al., 2010; Okaru et al., 2018; Ronco et al., 2017). However, it was proven that the actual cause for the cancer cases was the temperature at which the tea was consumed.
Functional and medicinal properties of caffeine-based common beverages
2019, Caffeinated and Cocoa Based Beverages: Volume 8. The Science of BeveragesMaté consumption association with upper aerodigestive tract cancers: A systematic review and meta-analysis
2018, Oral OncologyCitation Excerpt :The Duval and Tweedie’s analysis suggested that the overall OR adjusted for publication bias would be 1.74 (95%CI = 1.35–2.25). Two previous systematic reviews published data on the association of maté consumption and oral and esophageal cancer [21,22]. These reviews reported a significant association between maté intake and occurrence of oral and esophageal cancer.
Antiproliferative and cytotoxic effects of green coffee and yerba mate extracts, their main hydroxycinnamic acids, methylxanthine and metabolites in different human cell lines
2017, Food and Chemical ToxicologyCitation Excerpt :Mate, a beverage prepared from the leaves of Ilex paraguariensis widely consumed in South America, has shown antimutagenic effects in cell culture and animal models (Nkondjock, 2009; Bracesco et al., 2011). However, epidemiological studies have described a link between yerba mate consumption and oral cavity, pharynx, oesophagus, and oropharyngeal cancers (Goldenberg, 2002; Dasanayake et al., 2010). This has been associated to the high temperature mate is traditionally consumed in South America, adding boiling water to mate leaves in a “calabaza” recipient, drinking the hot brew through a metallic straw-like implement called “bombilla” and repeating the process adding more boiling water into the “calabaza” several times.
Characterization of volatile fractions in green mate and mate leaves (Ilex paraguariensis A. St. Hil.) by comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC × GC/TOFMS)
2016, Microchemical JournalCitation Excerpt :Because epidemiological data indicate that green mate users have an increased risk of oral and esophageal cancer, contamination with PAHs might influence these increased rates of cancer with mate drinking. However, little is known if this increased risk is due to the high temperature of the beverage when consumed or if it is due to the carcinogenic components present in green mate [33]. Thus, green mate consumption has health benefits as well as health risks.
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