Why drinking `noon chai’ is fraught with danger

Srinagar: If our “Noon-chai” isn’t steaming hot, there are chances we will throw it away. However, health experts in Kashmir don’t approve of drinking “very hot beverages” as they associate it with the risk of developing esophageal cancer.

Kashmir valley is known for consuming salt tea aka noon chai which is prepared in a very unique way. The addition of baking soda makes it a very alkaline type of tea. Once we brew this in a vessel for a long period, it is usually served piping hot.

“Studies have shown that drinking very hot beverages can put you at risk of developing esophageal cancer. The esophagus is a hollow tube that functions as a carrier of liquids, saliva, and chewed-up food from the mouth to your stomach. Cancer of the esophagus or esophageal cancer results from the growth of tumor cells in the esophagus or the lining of the esophagus change. But this type of cancer has been mostly found in people who consume 4 to 5 cups of “very hot and alkaline salt tea” over a long period,” Professor of Surgery, Government Medical College, Srinagar, Dr. Iqbal Saleem told The Kashmir Monitor.

Saleem added that drinking hot tea alone, however, will not cause cancer. “According to studies, drinking very hot tea combined with other risk factors might raise your chances of developing some types of cancer. These risks include: smoking cigarettes, chewing tobacco, drinking alcohol, obesity, gastro-esophageal reflux disease (GERD), and exposure to air pollution.

“It’s always better to limit your tea intake and allow it to cool for some time before consuming it,” he said.

This idea is not new. It goes back to at least the 1930s. The theory has been that hot liquids such as coffee or tea could destroy the inner lining of the esophagus, requiring the cells to continually regenerate. During this process, there is a greater chance that something can go wrong and turn normal cells into cancer cells. A long time ago, animal studies suggested that very, very hot beverages could cause this damage. But this was at higher temperatures than people would usually drink liquids.

More recently, the connection was suggested in a 2016 statement from the World Health Organization (WHO), a study from China published in 2018, and a study from Iran published in 2019.

Published in The Lancet Oncology, the study mentioned that in countries like China, Iran, and Turkey where traditionally tea is drunk very hot (at about 70 °C), the risk of oesophageal cancer increased with the increase in temperature.

Surgical Oncologist ( Breast, Colorectal & Peritoneal Surface Cancers) at New City Hospital, Srinagar, Dr. Shabnum Bashir said tea, is a popular beverage worldwide, & is made usually using dried leaves of the plant Camellia sinensis, & mainly consumed as black or green tea.

“Green tea is rich in polyphenols, which have been extensively studied as a cancer chemo-preventive agent. Epigallocatechin gallate, the most abundant and active compound in tea, was reported to block cancer progression in some studies,” Bashir said.

She explained that, however, opposite conclusions were reported in a Meta-analysis, especially when drinking tea at higher temperatures which showed an increased risk of “Squamous Cell type Esophageal Cancer.”

“So, the potential thermal injury should be considered because very hot beverages are identified by the International Agency for Research on Cancer (IARC) as Category 2A carcinogens for ESCC,” she said.