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Table of Contents
ORIGINAL ARTICLE
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 159-164

Saudi knowledge and awareness of drinking tea as natural fighter against COVID-19: A cross-sectional study


Department of Human Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh, Saudi Arabia

Date of Submission06-Aug-2020
Date of Decision12-Sep-2020
Date of Acceptance27-Sep-2020
Date of Web Publication13-Apr-2021

Correspondence Address:
Ghalia Shamlan
Department of Human Nutrition, College of Food Science and Agriculture, King Saud University, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JNSM.JNSM_93_20

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  Abstract 


Objective: Stressful period as COVID-19 pandemic and quarantine affect human health indirectly by weakening the immune system which lead to increase the risk of having viral infection. Tea in all its kind considered as a strong antioxidant that helps to enhance the immune system and body defense against COVID-19 infection. The aim of this study is to assess the knowledge of participants toward the benefits of drinking tea during COVID-19 pandemic. Methodology: A cross-sectional study including 2368 participants who answered a structured survey. The survey had some information about basic demographic characteristics including age, education, gender, physical examination level, and place of residence. The second part of the survey will be measuring knowledge about drinking different kind of tea to booster immunity against COVID-19. Results: Both gender have participate in this study with a ratio of 2:1 female more than male both within the age group of 30–50 years and 76.4% have higher educational level, 78.2% married and majority 55.8% and 30.4% from central and western areas of Saudi, respectively. The majority 69% consider drinking tea is part of their daily habit and mostly 44.3% drinking black tea, with 15% increase of tea consumption during the quarantine and that consumption increased to more than five cups a day by 2.2%. Regarding the source of knowledge about immune boosting benefits of tea majority specified their source is self-developed, family tradition and media during the quarantine period. The association between body mass index (BMI) and drinking tea showed strong significance among normal overweight groups and statistical significance of increase consumption related to high BMI categories. Conclusion: Saudi traditional tea drinking habit and knowledge of health benefits of such a routine have helped them during the threatening time as COVID-19 pandemic and stressing time of quarantine.

Keywords: COVID-19, immunity booster, respiratory infection, Saudi Arabia, tea


How to cite this article:
Shamlan G. Saudi knowledge and awareness of drinking tea as natural fighter against COVID-19: A cross-sectional study. J Nat Sci Med 2021;4:159-64

How to cite this URL:
Shamlan G. Saudi knowledge and awareness of drinking tea as natural fighter against COVID-19: A cross-sectional study. J Nat Sci Med [serial online] 2021 [cited 2021 Jun 13];4:159-64. Available from: https://www.jnsmonline.org/text.asp?2021/4/2/159/313651




  Introduction Top


Tea is one of the highly consumed refreshing drinks throughout the whole world. Green, oolong, and black are the one of the most accepted variants of tea that differ in color, taste resulted due to several levels of fermentation. There are different kind of teas; black tea green tea and oolong tea.[1] Tea production is widely spread around the world,[2],[3],[4] were quality and flavor of tea are directly depended on the processing of tea leaves obtained from Camellia sinensis plant. Green tea was first documented nearly 4000 years back, which was prepared for the medical purpose.[3] Green tea undergoes no fermentation process whereas oolong tea is processed for partial fermentation that results in different form and flavor and black tea is fermented tea that contains less polyphenols and flavonoids.[3],[4] Oxidation is the crucial step to produce tea variants, higher the oxidation period lesser the polyphenolic compound.[5] The catechins, i.e., epigallocatechin (EGC), epicatechin (EC), and EGC gallate (EGCG). EC gallate and catechin are essential flavonoids present in teas.[6],[7] Recently, various studies have indicated that green tea helps in curing various diseases such as diabetes, urolithiasis, skin damages, obesity, oral health, prevents hair loss, protects against cardiovascular diseases, improves insulin sensitivity boosts the body's defenses against infection.[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19] Many degenerative and chronic diseases such as cancer, inflammation, cardiovascular diseases caused by oxidative damage, which occurs due to oxidant-antioxidant imbalance.[12],[15] Recent studies have confirmed that tea contains components that are prime the immune system to attack invading bacteria, viruses, and fungi.[17] In the experiment, human volunteers were grouped as tea drinker and coffee drinker, the results showed that immune system blood cells from tea drinkers responded five times faster to germs than did the blood cells of coffee drinkers. In the study, the isolated components from ordinary black tea was a substance called L-theanine.[17] L-theanine is broken down in the liver to ethylamine, a molecule that primes the response of an immune system element called the gamma-delta T cell.[17],[18] These gamma-delta T cells in the blood are the first line of defense against many types of bacteria, viral, fungal, and parasitic infections, even have some anti-tumor activity.[18],[19] In addition, the T cells prompt the secretion of interferon, a key part of the body's chemical defense against infection.[17],[18],[19] Currently, a new strain of coronavirus, designated as the 2019 novel coronavirus (2019-nCoV), emerged during the third outbreak in Wuhan, China, at the end of 2019.[20] Symptoms of pneumonia with unknown etiology were reported in several patients. COVID-19 is a deadly contagious disease, which has a faster incidence upsurge globally.[21] Currently, it is the most important problems in the world that need the public to understand human-to-human transmission involves multiples routes of transmission, including droplet transfer, direct contact, and indirect contact.[20],[21],[22] Healthy individuals should improve the immune system by taking various nutritional supplements as recent theoretical developments have revealed that supplying the COVID-19 patients with this food supplement might be a decent approach.[21] It should be noted that various researchers have found, herbal medicines (plants roots, leaves, flowers, bark, berries, and seeds),[23] were used in some of health and psychiatric issues, and -communicable diseases, injuries in addition to treating a microbial and viral infections, and immune disorders.[19],[23] One the other hand, a number of scientific publications and reviews explained the effect of a diet that has a specific nutrients on respiratory viral infections and the immune system.[24] The aim of this study is to assess the knowledge and behavior of Saudi regarding drinking tea during COVID-19 pandemic and quarantine.


  Methodology Top


This is a cross-sectional study design; all participants will require to complete survey. A structured questionnaire was self-administered and will take about 10 min to complete. The survey had some information about basic demographic characteristics including age, education, gender, physical examination level, and place of residence. The second part of the survey will be measuring knowledge about drinking different kind of tea to booster immunity against COVID-19. Furthermore, to determine participation in specific behaviors about increasing consuming the tea during lockdown in Saudi Arabia.

Participants

Sample size calculation was based on existing literature.[15] Written informed consent was obtained before taking the survey. A questionnaire was developed and self-administered in English as well as being translated into mother languages (Arabic). Translation into Arabic was undertaken by different professional translators to verify accuracy of both words and concepts. Data were collected included demographic information, tea drinking habits, and types of tea and if there are any habitual changes during quarantine.

Statistical analysis

All statistical analysis was carried out using IBM SPSS version 22 (SPSS Inc., Chicago, IL, USA). Demographic characteristics were generated using frequency analysis and descriptive statistics. A Chi-square test was calculated to determine the significance of the association between drinking tea and dependable variables such as the behaviors and attitudes toward COVID-19.


  Results Top


[Figure 1] demonstrates all the demographical characteristics of all participants who agree to be involved in this study. Both gender participate in this study with 33% males and 66% females in 2 times female higher ratio than male, mostly 78.2% married and majority 57% were within age group of 30–50 years old, and 76.4% having higher educational level. Most responses were from central area around 56% followed by 30.4% from western area then smaller percentage from other areas of Saudi Arabia.
Figure 1: Sociodemographic analysis of respondent

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The knowledge and behavior of 2368 participants toward drinking tea is assessed and analyzed as shown in [Table 1]. Around 29% of respondents consider tea as an herbal drink while the majority 71% replayed the opposite. The majority 69% consider drinking tea is part of their daily habit and mostly 44.3% drinking black tea, while 31.1% imply drinking all kind of tea. When participants assessed if they drink tea to boost their immunity only 10% replay positively and around 5% increase the habit of drinking tea during COVID-19 pandemic and quarantine time to make total of 15% participants drinking the tea to booster their immune system. The rate of daily consumption of tea to enhance immunity against corona during the quarantine period increased to more than 5 cups a day by 2.2% while the majority 85% specified no change in their daily consumptions. Regarding the knowledge of the participants about their source of information regarding the health benefits of tea 50% did not specify a source while the other 50% divided their answers between self-acquired information (17.7%), family tradition (12.5%), from social media (9.7%), (9%) replayed the community around them and (0.4%) from seller's advice. All P values of all analyzed aspects were > 0.05, which considered not statistically significance.
Table 1: Knowledge and behaviour of participants toward drinking different kind of tea and immunity benefits

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The association between the habit of drinking tea and body mass index (BMI) is analyzed and shown in [Table 2]. BMI is used as a screening tool for weight either healthy or overweight or obesity. Among all different types of BMIs, around 69.1% of participants replayed as drinking tea is part of their daily habit, of them 36.4% were underweight, 55.5% have normal range BMI, 67.5%–78.1% range within the overweight categories. There is a strong association between BMI and drinking tea χ2 (5) = 41.510, P = 0.000. Regarding the type of tea the participants drink as their daily habit within all BMI categories around 13.2% specify preferring green tea, the majority 44.3% favoring black tea, were 31.1% drink all kind of teas, and 7.6% prefer herbal teas. There is strong association between BMI and the type of tea preferred χ2 (20) = 40.910, P = 0.004.
Table 2: Association of body mass index and drinking different kind of tea during COVID-19 quarantine

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[Table 3] illustrates responses about participants changing the frequency of drinking tea during quarantine and its relation to BMI, however, only 15% indicate increasing the tea amount they drink during quarantine and majority were obese, the results shows strong association between BMI and increasing the amount of tea drunk during quarantine χ2 (5) = 11.264, P = 0.046. Moreover, the frequency of increased daily consumption of tea to enhance immunity against corona during the quarantine period was analyzed and results showed that the increased amount range from one cup to more than five cups. Around 3.4% of participants have increased consumption be one extra cup to their daily habit while 4.3% specify their increase consumption be two cups extra, the majority 5.2% have increased their consumption by three extra cups and only 2.2% have increased consumption by more than 5 cups a day. There is a significant association between BMI and the rate of increased consumption of tea χ2 (20) = 39.425, P = 0.006.
Table 3: Association of body mass index and frequency of increased consumption of drinking Tea during COVID-19 quarantine

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  Discussion Top


Tea is a powerful antioxidant and consumed in large amounts by people worldwide for pleasure and cure of some disease.[3],[4] Scientific data indicate that theaflavins have both antibacterial and antiviral activities.[4],[5] Different kind of tea vary in their amount of theaflavin concentration.[5] During the recent world COVID-19 pandemic that enforced not only a serious illness but also a stressful time that lead to lowering immunity. So to enhance the immunity, drinking tea play vital role by promoting beneficial antioxidant and antibacterial and antiviral effects in the body.[17],[25],[26] Our study have revealed that Saudi knowledge of the beneficial effect of tea on the body and immune system were pleasing and some participants indicate that their drinking habit have increased during the quarantine to boost their immunity. In additional, their source of knowledge varies from different sources between media community or self-developed and tradition while few depends on the seller advice. All P values of all analyzed aspects were >0.05, which considered not statistically significance, however, the results in this study have highlighted very interesting evidence about the knowledge of Saudi and how their knowledge raised during COVID-19 pandemic and particularly the quarantine period.


  Conclusion Top


Saudi traditional tea drinking habit and knowledge of health benefits of such a habit have helped them during the threatening time as COVID-19 pandemic and stressing time of quarantine.

BMI is used as a screening tool for weight either healthy or overweight or obesity. It is well documented,[27] that BMI categorized as underweight if <18.5, if BMI is 18.5 to <25, it falls within the normal range, If BMI is 25.0 to <30, it falls within the overweight range and if BMI is 30.0 or higher, it falls within the obese range. Obesity is frequently subdivided into categories; (Class 1): BMI of 30 to <35, (Class 2): BMI of 35 to <40 and (Class 3): BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity.[27] The association between BMI and either drinking tea as daily habit showed strong significance (P = 0.000), and significant association found between BMI and the kind of tea they drink, were majority specify drinking black tea. The association between BMI and increasing the consumption of tea showed strong significance among overweight categories were drinking increased from 2 cups to over 5 cups per day during quarantine, while normal weight category either follow same routine before quarantine or increase to 1 cup extra per day. The habit of drinking tea among obese people have been reported previously were majority of people believe that drinking tea helps to reduce obesity and control body weight.[28] A number of reports scientifically proved the effects of drinking tea on particular green tea on controlling the overweight and obesity.[28] Many human epidemiological studies, demonstrated useful properties of green tea or its content of catechins which is rich in EGCG in overweight management.[28] In conclusion, Saudis' demonstrated good knowledge of the beneficial effect of drinking teas in all kind to enhance immunity, and this study provide data that their practice of drinking more tea have increased during COVID-19 pandemic and quarantine period.

Limitations of the study

The only limitation is not including if the participants have or had COVID-19 infection and this question was not included as a respect of the patient's privacy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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