EGCG Found in Green Tea Could Improve MS Symptoms

05 Aug 2015 --- A recently published randomized, double-blind, placebo-controlled, crossover study by German investigators has tested the hypothesis that (-) epigallaocatechin-3-gallate (EGCG) treatment improves energy metabolism and substrate utilization in male and female Multiple Sclerosis patients during exercise.

Multiple sclerosis (MS) is an autoimmune disease that causes nerve demyelination, axonal and neuronal damage leading to neurologic disability and atrophy of the brain, the spinal cord and the retina. Common symptoms in MS patients are muscle weakness and excessive fatigue leading to reduced activity. Previous studies have suggested that drinking green tea can have preventive and therapeutic effects on a number of neurodegenerative diseases. It is believed that the salutary effects of drinking green tea are due to tea polyphenols, such as (-) epigallaocatechin-3-gallate (EGCG), that make up 50-80% of total green tea catechins. Previous work has found that patients with MS have differences in fat and carbohydrate oxidation kinetics during exercise compared to healthy controls, which may contribute to exercise intolerance.

Eighteen patients with relapsing-remitting MS were recruited and randomly allocated to one of two treatment sequences: patients started with either 600 mg EGCG/day or placebo treatment, for four weeks.

The first treatment sequence period was followed by a 4-week washout period, which was then followed by the alternate treatment for 4 weeks. This dose of EGCG was equivalent to drinking about 1.2 liters of green tea. The primary outcome of this study was the postprandial increase in fat oxidation assessed by indirect calorimetry, and the secondary outcome was improved efficiency of muscle work during moderate-intensity exercise. After each intervention, fasting and postprandial energy expenditure and fat and carbohydrate oxidation were measured.

The investigators found that there was no overall significant effect of EGCG on fat oxidation when all subjects were combined. However, they did observe an interaction between gender and EGCG response. In men, studied at rest, fasting energy expenditure was lower after EGCG treatment compared to placebo. In contrast, in women’s energy expenditure was higher with EGCG treatment compared to placebo. In men, postprandial triglyceride level was lower after EGCG compared to placebo, while in women there was no EGCG effect. During exercise, energy expenditure was lower in men after EGCG treatment, but not in women. Lower postprandial energy expenditure after EGCG treatment suggests improved working efficiency. After placebo treatment, exercise energy expenditure was primarily fueled by fat oxidation in both men and women. After EGCG treatment, men – but not women – experienced a shift to a higher and more stable carbohydrate oxidation during exercise.

These observations need to be confirmed in additional studies, but they present promising findings, at least in men, that EGCG treatment in MS patients improves muscle metabolism during exercise. To what extent these effects translate into reduced muscle fatigue and increased exercise tolerance needs further investigation.

Reference: Mahler A et al. Metabolic response to epigallocatechin-3-gallate in relapsing-remitting multiple sclerosis: a randomized clinical trial. American Journal of Clinical Nutrition 2015; 101:487-495.