The Cleveland Clinic, one of the world’s most respected academic medical centers, is also a leader in implementing wellness programs that aggressively advocate healthy living.
Ten years ago, under the guidance of New York Times best-selling author and wellness authority Dr. Michael Roizen, the hospital implemented an Employee Wellness Program. This program offers reduced health insurance premiums to employees who pass a positive health threshold. But the program doesn’t exclude those who don’t pass. They can also qualify for a premium discount if they choose to participate in a disease management program for their particular chronic condition that prevented them from passing the threshold. The program pays for employees to participate in activities ranging from Weight Watchers to tobacco treatment, and even offers yoga classes and a running club.
When asked whether the program showed any quantifiable benefits, David Pauer, Director of Wellness for Employee Health at the Cleveland Clinic said, “Absolutely! Employee Wellness has saved about 85 million dollars in healthcare costs over the life of the program. We can feel confident in this estimate because the program was designed such that cost wouldn’t be a barrier to the utilization of health services—employees have no deductibles and no co-insurance payments.” In their dedication to helping their 90,000 employees achieve optimal well-being and a higher quality of life, the Cleveland Clinic is demonstrating the consequences of certain preventable conditions and their effects on the healthcare system.
“The biggest value of the program is in that it actually motivates people to do something about their health,” asserts Pauer. “Employees can earn a 30 percent discount on premiums by participating, which for a family of four can add up to about $1,400 a year. Our activity device program is extremely popular. Only a certain population will join a fitness center, because it’s limiting. Think about what it would be like if you had to have all your meals in one building. The activity device program motivates you to be active all the time, and people will actually do that to qualify for the discount.” In addition, Pauer says that just offering a stimulus for program participants to get in and see the doctor for checkups has uncovered 50 to 60 cases of cancer which might otherwise have gone untreated far longer.
One: All teas come from 1 single plant species (Camellia sinensis).
Two: Tea is the 2nd most consumed beverage worldwide, behind water.
Three: Worldwide, people drink 3 times more tea than coffee, but in the U.S., people drink 3 times more coffee than tea.
Four: Basic tea types:
• Green/White (Not oxidized)
• Oolong (Partially Oxidized)
• Black (Fully Oxidized)
• Pu-erh (Oxidized and Aged)
Five: 5 cups (1.2 L) of fresh tea per day to get you into a routine that maximizes cancer prevention.
Six: Tea is the 6th most consumed beverage in the U.S., behind water, carbonated soft drinks, beer, milk and coffee.
Seven: In the top tea drinking nations the average tea drinkers use 7 pounds (3.2 kg) of tea leaves annually. In the U.S., the average is ½ pound (250 g) of tea leaves.
Eight: 80 billion servings of tea are consumed in the U.S. annually. The vast majority of these are iced, sweet tea and bottled. Only a tiny fraction is freshly steeped, as opposed to the rest of the world, who tend to steep their own tea.
Nine: The average amount of tea consumed annually per capita in the U.S. is 9 gallons (34 L). By contrast, the average number of gallons of carbonated soft drinks consumed annually in the U.S. is 45 gallons (170 L).
Ten: The number of different teas in the cupboard of a U.S. tea lover, on average, is 10.
Fifteen: A cup of high-end loose leaf tea you steep yourself costs about 15 cents.
Many population-based research studies inform us that cancer rates tend to be lower in countries where people regularly consume tea. On a global scale, we are tea dilettantes here in the U.S. The average American drinks the equivalent of just over a half pound (250 g) of tea per year. That barely breaks us into the top 35 tea-drinking nations. The top tea drinkers by comparison are countries which include the Middle East, North Africa, Turkey and the British Isles who consume the equivalent of nearly 7 pounds (3.2 kg) per person per year. Based on a standard serving of 1 teaspoon (about 2 g) of leaves, that amounts to an average of between four and five servings of tea every single day, compared with a person in the U.S. drinking just one serving every three days. We’re a coffee-drinking nation, which if you examine beverage preferences worldwide, makes us an exception. In most countries, 3 cups (720 ml) of tea are drunk for every cup (240 ml) of coffee, whereas in this country, it’s exactly the opposite. Tea is far more universal and it’s not limited to exclusive segments of society. Rich or poor, warm climates or cold, in happy or sad times, tea is the beverage that most people on this planet reach for. After water, it’s the second most consumed drink in the world. Billions of people start and often continue their days with this hot and stimulating beverage.
Tea drinking habits in the U.S. are beginning to change and evolve into some healthier choices. Tea is hot. Conversely, sodas are under scrutiny and trending downward and so is fruit juice. It’s a dramatic time in the U.S. beverage industry, with the biggest carbonated soft drinks manufacturers expanding their product lines to highlight teas, all kinds of colors and flavors of waters and energy drinks. Regardless of how much sugar and caffeine they may contain, these are all boldly referred to as healthy beverages. There’s a lot of hypocrisy and mislabeling here, and many of those wholesome-looking bottles and cans screaming TEA can barely qualify as either healthy or tea. Small batch and quality craft manufacture are also beverage categories on a rapid rise, especially in the alcoholic beverage space, and this will likely have a positive ripple effect in non-alcoholic single-serving drinks, hopefully leading to more quality selections in the future. Even as we start to move in the right direction, as a nation we still drink about four times as much soda pop as we do tea. Not a great endorsement for taking wellness into our own hands.
The Irish have a long-standing love affair with “tay,” as they call it, out-drinking all their neighbors in the British Isles. The average tea consumption in Ireland per citizen is four to six cups per day—an excess of a quart (1 L) per day. It’s quite the treat, as a tea lover, to be asked at least half a dozen times each day, “Time for a Cuppa?” (Cupan Tae in Gaelic). There’s no need for cafés in a place chock-full of comfy, friendly pubs which open well before noon, when almost everyone’s sitting at the bar with a pot of tea in front of them. Later in the afternoon, the stout starts pouring. Now how cool is that?
Unfortunately, there are no full leaves in sight (well over 90 percent of the teas are in bags), and I’ve yet to run into a green tea on the Emerald Isle. Assam, the largest tea-producing region in India, is who’s supplying the base tea for these parts. It’s the heartiest and most well known black tea. As the saying goes, “If strength is your weakness, Assam is your tea.” Ever tried Irish Breakfast Tea? An absolute eye-opener tea, it’s perfect for that first cup of the day. Strong and dark, it’s served hot, with milk and sugar as options more often than not. I don’t know if it’s the tea, the gorgeous countryside or the amazing warmth and hospitality, but the Irish brand Barry’s Tea is one of my very favorite black teas.
How much tea does it take for an anti-cancer effect? That’s the million dollar question. We all want to know just how much tea we need to drink to get our “I’ll crush you, cancer!” posture on, and help reduce our risk of onset, progress or relapse of disease. In looking to tea for its therapeutic benefits, we need to take into account all of the most current quantitative scientific data available. Not all potential health problems can be averted, of course, but we all have a great deal more control over our wellness than we might be acting on. Tea is not the silver bullet panacea. It won’t wipe out the effects of a pack-a-day smoking habit, hormone replacement therapy or any other risk patterns which have been indicated to increase the risk of disease, but drinking tea daily can help fuel your immune system to a better state of readiness for whatever curve balls might come your way.
The good news is that the research indicates you only need to consume 1 to 1.2 L (a little more than one quart) of freshly steeped whole leaf tea each day to bask in its therapeutic benefits. That’s a five-cup-a-day tea habit, or in today’s “bigger is better” society, just three mugs of tea. If you drink this much throughout the day, every day, your body could enjoy a significant increase in plasma antioxidant capacity, which can mean the beginning of a reduction in DNA damage in your cells. Some studies have shown those benefits being measurable in as little as one week of drinking 6 cups (1.4 L) of tea a day. Remember, your body is stunningly amazing, and it’s just waiting to respond positively to every advantage you bring its way. And guess what? The higher per capita tea drinking nations consume on the average of four to six servings throughout the day. I find it interesting that those tea drinkers naturally nail the recommended amount right on the head. Keep in mind that too much of anything turns out to be not such a good thing, and that anything in excess won’t be good for you. As positive as your five servings of tea are for maintaining wellness, doubling or tripling that amount isn’t a good idea, and can start to become toxic to your cells.
Your total caffeine intake is also an important thing to keep tabs on. Each 8 ounce (240 ml) serving of white or green tea will give you between 10 mg and 35 mg of caffeine. Black tea will provide 40 mg to 50 mg of caffeine per 8 ounce (240 ml) serving. Pu-erh tea can get up as high as 60 mg of caffeine per serving, which is approximately half as much caffeine as a same-size cup of coffee. Note that some of those imposter ready-to-drink energy beverages are packing more than 200 mg of caffeine. The Academy of Nutrition and Dietetics says that 300 mg of caffeine per day won’t have any negative effects on most people. Some negative side effects of having too much caffeine aren’t fun, and can include anxiety, fast breathing, difficulty sleeping, headache, irregular heartbeat, nausea, vomiting and tremors.
Your body absorbs tea nutrients best when you drink them on an empty stomach. EGCg has a better chance of making it into your bloodstream without degradation when it doesn’t come into contact with local bacteria in your gut. This makes tea a perfect pre-breakfast drink, but you may have some difficulty sucking down green tea on an empty stomach. Make sure you try teas from different regions, as they’ll likely all work differently on your gut. If you’re obsessed with drinking green teas and they just aren’t working out for you, give yourself a break and start with a big mug of a favorite black tea in the morning. Remember, they’re all good.
You want to keep a high tea polyphenol level in your bloodstream at all times. Studies show that timing is important in getting this right. When you drink tea, the peak concentrations of polyphenols in your cells happen one and two hours later. Those levels then come down gradually, and come down to essentially nil within 24 hours. So sip your tea consistently throughout the day—the benefits can be observed in improved blood vessel function in as quickly as a half hour after you drink it.
After six weeks of tea consumption, your body may show lower levels of the stress hormone cortisol and greater subjective relaxation, together with reduced platelet activation. Translation: Drinking tea helps you recover more rapidly from stress. This extends to when you drink tea immediately post-exercise, its rich antioxidant content can help boost recovery and limit oxidative stress to muscles. Observers of the athletic scene sometimes wonder if it’s more than a coincidence that some of the best endurance athletes in the world—the Kenyan runners—sip tea throughout the day. And FYI, they always drink it hot.
So to get the full benefits bang from your tea, start with it early in the day and sip often, between meals and especially pre- and post-exercise.
Morocco and tea go hand in hand. Like with almost every strong tea-drinking culture, tea is considered a gesture of hospitality in Morocco and is almost always offered as a welcome to guests, traditionally prepared by the male head of the family. Just as in China, there’s no such thing as getting through a business discussion or negotiation session in Marrakesh without taking some time to sit down for glass of delicious hot and sweet Moroccan mint Nana tea. The glasses are small (about 4 ounces [120 ml]), straight and cylindrical in design with elaborate ornamentation (think henna). You may have seen images of tea being poured by Moroccans using the ragwa method, from way up high. Many will tell you that’s done to aerate the tea and create some delightful aroma and foam on top of the tea, but I’ve also heard that since it’s the male head of household pouring the tea, that this gesture came from an intention to lift and flaunt the teapot higher than any neighbors’ teapots. Bottom line—the teapots are indeed sexy and beautiful, and taking tea Moroccan-style can feel like restorative aromatherapy.
Moroccan-style green tea is served hot, with fresh mint leaves added. This makes it light and refreshing, even if you’ve just finished a hot day’s trek through the mountains or desert. It’s surprising, but hot beverages can actually cool you down. When your brain gets the message “TOO HOT” from sipping a warm beverage, it sets in motion the mechanisms to help cool you off, which causes you to begin to sweat. If you’re not wearing massive layers of clothing, the sweat has somewhere to evaporate to, thus cooling you down. I always wondered why Russian ballet dancers would gather around their steaming thermos after rehearsals. Same goes for the Kenyan runners you see in my hometown of Boulder, Colorado, who are often sipping hot tea after a workout. Both cases made me wonder if they didn’t trust the water without boiling it, but as turns out, they probably just knew more than I did about how to keep cool. Note: When you’re sipping hot tea on a winter hike, it’s actually warming you up. Your body is cold and doesn’t get to the point where it sends that “TOO HOT” message to your brain.
You can find the recipe for Unsweetened Moroccan Mint in Chapter 10.
According to numbers released by the American Cancer Society (ACS), cancer’s price tag is upwards of $895 billion, a sum that represents 1.5 percent of the world’s gross domestic product (GDP). This is just its toll in terms of disability and productive years of life lost and doesn’t even begin to take into account the cost of curing and managing the disease from a medical perspective. The ACS report claims that cancer’s cost to society is more than that of human immunovirus (HIV), malaria, the flu and all other communicable diseases combined. Of course, further research is needed to continue to seek more effective ways of combating cancer, but so many straightforward, and even cost-saving measures can be taken to set many potential patients on the road to prevention.
If we look at this issue from a global economic perspective, the impetus in favor of encouraging and enabling simple preventive measures seems clear. Just imagine if you could take one percent of the GDP lost to cancer in the U.S. and use that to replace less-healthy beverages in public high schools with fresh whole-leaf tea—it would save money in the end, right? But is it realistic to expect that a premium cup of tea can wean people off sweetened, carbonated, chemically enhanced and frozen creamy and fatty beverages? Does this translate to an equally smart investment on a personal level? Ultimately, we are responsible for our own wellness. What’s it worth to you?
Let’s take a look at this from both ends of the spectrum: luxury-loving wellness lady and frugal health fanatic. Most of us will probably fall somewhere in between, so this will give us the upper and lower bounds by which to understand what a tea habit will cost.
Luxury tea lady wants to treat herself to only the highest quality teas. After all, if she’s going to become a regular tea drinker she may as well become a connoisseur. She might choose to start her mornings with a fine Japanese gyokuro green tea of fine deep emerald leaves grown at the base of Mount Fuji. Mid-morning, she’s going to whip up a latte with ceremonial-grade matcha green tea (half an hour before her workout), giving her a boost and maximizing the burn from her gym time. With lunch, she’ll enjoy some freshly brewed iced ginger peach black tea. Mid-afternoon, this lucky lady is going to break into an aged pu-erh tea from Yunnan, China, because she wants to work off whatever fat she can from her lunch, without needing to head back to the gym. And then there’s tea time with her girlfriends. The hip come to sip at her place now, so she’d better treat them to something special, so let’s make it a Taiwanese oolong.
| Gyokuro green tea | $160/lb, or $0.70/serving |
| Ceremonial grade matcha | $20/oz, or $0.70/serving |
| Gourmet ginger peach tea | $35/lb, or $0.15/serving |
| Aged pu-erh tea | $57/lb, or $0.25/serving |
| Oolong tea | $115/lb, or $0.50/serving |
| Daily tea expense: $2.30 | |
Frugal tea fanatic just wants to get the job done. His preference would be to get an equivalent (or better) dose of tea polyphenols as the fancy lady, without all the fancy flavors, names and price tags. He’s starting the day with a strong mug of gunpowder green tea. Next, he too will be downing some matcha green tea, maybe in a homemade energy drink. Let’s make it a double dose—frugal’s not really up for taking five tea timeouts a day if he can get it done in fewer steeps. Mid-afternoon, he’ll have an iced sencha green tea to avoid the afternoon slump. He’ll finish up with an Assam black tea in the late afternoon.
| Gunpowder green tea | $23/lb, or $0.10/serving |
| Matcha green tea | $66/half-lb, or $0.60/2 servings |
| Sencha green tea | $34/lb, or $0.15/serving |
| Assam black tea | $23/lb, or $0.10/serving |
| Daily tea expense: $0.95 | |
Bottom line: You can get an amazingly diverse and healthful mix of five servings of tea daily for as little as $30 a month, and beyond that, you can splurge as little or as much as you’d like and your budget will allow. Even the most lavish tea habit, if you steep the tea yourself, amounts to less than the cost of a couple of shots of espresso or a coffee from your local coffee shop.
Begin your day with tea, as this is the best time of day for your body to absorb its benefits. Even if you need to grab a coffee an hour later, you’re rousing your cells with tea polyphenols, which you can’t get anywhere else.
Cold brew, and sip throughout the day. Get a large water bottle, and fill it with your favorite cold brew every morning. Choose a low-caffeine tea, and this becomes your new enriched water.
Keep calm, as the British say, and get an afternoon tea habit going.
Anna, the seventh Duchess of Bedford, was apparently a woman unwilling to accept the afternoon doldrums. As was the custom in 18th century England, Anna would have a huge breakfast, a meal hardly worth calling lunch and then wait until 8 o’clock or later before sitting down to a substantial dinner. Those of us who eat a snack at our desks and then rush off after work to pick up kids, the dry cleaning and groceries and then begin cooking dinner at 7 o’clock know exactly how she felt when she described the sinking feeling she got around 5 o’clock.
Today, many of us would reach for a smoothie or an energy bar. Being a Duchess, however, Anna chose to combat this lull in energy and spirit by sitting down to a nice cup of tea accompanied by sandwiches and cakes. The idea was such a good one that soon her friends and acquaintances began joining her, and afternoon tea became a ritual. Over time, the staff caught on as well, and eventually two very distinct versions came into being. High tea was embraced by the working class who served up whopping plates of food alongside a nice strong cuppa. It was a more substantial meal, essentially dinner. Low tea, quite contrary to its title, was the showy, ostentatious and rather less nutritious version of tea that was served to the aristocrats. Here the emphasis was more on the linens and china than on the beverage or accompanying foods. No doubt this low tea is where the stiff pinky finger first began poking out from the side of teacups. The names derive from the height of the tables on which the meals were served. High tea was served on higher (working) tables and low tea was on tables that we would call coffee tables.
Whether high or low, afternoon tea became as much a social phenomenon as it was a culinary trend. Today’s re-emerging interest in afternoon tea is also a social movement, a revolt against the high-octane beverages and fast-paced living in which too many of us find ourselves enmeshed. For both our physical and spiritual well-being, an afternoon tea break is an inviting and joyful luxury. As Henry James said in his novel Portrait of a Lady, “There are few hours in my life more agreeable than the hour dedicated to the ceremony known as afternoon tea.”
