Much about matcha has been said about matcha on the internet, and by now, it is only evident that matcha has garnered its fair share of love and hate. But what is matcha, and how did it become a coffee double?

Well, matcha is a powdered form of green tea made from finely ground Japanese green tea leaves. Packed with antioxidants, these shade-grown plants are a powerhouse of vitamins A, C, & K, according to the National Library of Medicine study of 2020.

Matcha Beyond Trend?

The hype about matcha goes way beyond the devotion to trends. While its wide success is attributed to the Instagram influencers ‘ newfound obsession with ‘Matcha-latte’, its health benefits are beyond any cup. Matcha is found to be one of the highest caffeine sources, while it is also known to have an umami flavour that attracts many. On the other hand, the procaffeinators are staying loyal to their espressos and iced Americanos, casting matcha as a doppleganger of coffee with an earthy taste.

ALSO READ: https://www.onlymyhealth.com/health-benefits-of-matcha-latte-and-how-to-make-it-1707825826 

“The need for higher caffeine content during the day brought Matcha as the new alternative to coffee. Owing to its antioxidant properties, matcha matches its hype and can help people with alertness throughout the day. However, it should be taken seriously as matcha packs tend to contain 19–44 caffeine mg /g per serving,” said expert nutritionist, Varnit Yadav, Institute of Nutrition and Fitness Sciences, India, and JPS Health & Fitness, Australia, certified exercise and nutrition Coach.

“No Compulsion to Consume Matcha Daily”, says the Nutritionist

It’s a slippery slope while trying a new trend, especially if it includes consuming something daily. As for matcha, due to its high caffeine content, it can give a whole lot of attention, but it can also disrupt many rhythmic functions of the body. 

According to coach Varnit, “There’s no compulsion to consume matcha regularly. It is an optional item that can be consumed in the range of 2-5 grams per day. Since per serving can be very high in caffeine content, it is important to keep in mind your tolerance for such beverages.” 

ALSO READ: https://www.onlymyhealth.com/does-match-affect-iron-levels-in-the-body-12977832267

Side Effects of Too Much Matcha

With every trend comes its pros and cons. While matcha offers a one-of-a-kind antioxidant-rich drink and boosts brain function, it is also known to cause many problems for people every day. As per Coach Varnit’s opinion, here are some short-term problems matcha can cause: 

1. Digestive distress: While good in moderation, excessive amounts of matcha can cause an upset stomach. Or if taken on an empty stomach, it can cause flatulence and acid reflux. 
2. Nausea: Due to the high caffeine and catechins content in matcha, it can irritate the stomach lining, causing nausea and vomiting (rarely)
3. Anxiety: Individuals with pre-existing anxiety should steer clear of matcha as its elevated caffeine content might raise anxiety levels.
4. Elevated heart rate: A Large amount of coffee causes a rapid heart rate, and when mixed with matcha, it can exacerbate the heart rate, causing restlessness.
5. Disturbance in sleep: While the  L-theanine improves brain function and memory, it is vital to keep the intake in moderation as the high caffeine content can lead to lack of sleep.

So, what is the alternative? As per Varnit’s advice, “Know your body and its limitations. Moreover, build your tolerance over time, learning if your body is handling it well. Listen to your body and not trends!”

Long-term Side Effects of Matcha

Often, consistency is key, but not when it comes to matcha intake. Matcha, due to its high caffeine content and abundance of Epigallocatechin gallate (EGCG), aka antioxidants, can lead to liver toxicity, especially in people with existing liver problems. “If you are sensitive to caffeine or such products, the effects can be amplified at times. Moreover, excessive Matcha Can disrupt many things,” said Coach Varnit.

1. Excessive Matcha Can Disrupt Sleep: Consuming more than 5–6 grams of matcha daily means a high intake of caffeine and L-theanine, which can interfere with the body’s natural sleep cycles. Over time, this may lead to difficulty falling asleep or experiencing deep, restful sleep
2. Caffeine Buildup Affects Sleep Quality: Matcha contains more concentrated caffeine than regular green tea. Regularly exceeding the recommended limit can lead to overstimulation of the nervous system, making it harder for the body to wind down at night
3. Risk of Heavy Metal Contamination: If the source of the matcha isn’t verified or tested for quality, it could contain heavy metals like lead or arsenic. These can accumulate in the body and may pose long-term health risks, particularly to the liver.
4. Potential Liver Strain: Low-quality or contaminated matcha can negatively impact liver function. Continuous exposure to harmful compounds through unchecked products can overwork the liver and impair its detoxification processes.

Which Group Should Avoid Matcha?

Learning about the many restrictions of Matcha from the aforementioned reasons, one thing is clear: Matcha is not for everyone. It might be an acquired taste, but should it be acquired? The answer is no, and Coach Varnit tells you who should avoid matcha and why.

“People who have high BP are at risk, and people with already existing liver conditions need to be mindful of picking the right extract of matcha. There’s a safe range of caffeine intake for pregnant women (up to 200 milligrams). Also, people belonging to such demographics should always consult their physician before adding a beverage of such kind to their routines.”

ALSO READ: https://www.onlymyhealth.com/tea-or-matcha-which-is-better-for-overall-health-12977829094 

Conclusion: Matcha in Moderation

Matcha is a great new alternative to coffee and people looking to try something new. While it promotes antioxidant levels and boosts brain function, it should be remembered that it should be taken in moderation. As for matcha, try it in small amounts and watch it do wonders for your routine without causing health risks.

Here’s to Much Ado About Matcha!

Psyllium husk, a popular dietary fiber supplement derived from Plantago ovata seeds, is widely used for digestive health and cholesterol management. However, recent incidents highlight significant contamination risks that threaten consumer safety, particularly from Salmonella and heavy metals like lead.   

Salmonella Outbreaks  

In 2021, Denmark experienced a severe Salmonella outbreak linked to psyllium supplements, resulting in 33 illnesses, 19 hospitalizations, and three deaths. The outbreak strain was traced to Husk brand capsules, with contamination confirmed in products recovered from patients’ homes. Those affected, ranging from ages 2 to 92, included immunocompromised individuals using psyllium for pre-existing gastrointestinal conditions, potentially masking early symptoms of infection.  This incident marked the first documented case of a herbal supplement causing a Salmonella outbreak in Denmark, prompting international recalls across Scandinavia.   

Heavy Metal Contamination

Beyond pathogens, lead contamination is prevalent in psyllium products. Independent testing of nine supplements found lead in all samples, with four exceeding safety thresholds. One product contained 38.7 mcg of lead per maximum daily serving, over 60 times California’s Proposition 65 warning level.  Lead accumulates in the body and poses long-term neurological and cardiovascular risks, though manufacturers often attribute its presence to environmental pollution during cultivation.   

Why Psyllium Is Vulnerable  

Several factors increase contamination risks:  

1. Agricultural Sourcing: Psyllium plants absorb heavy metals like lead and arsenic from soil, while exposure to animal feces or contaminated water may introduce Salmonella.   
2. Processing Gaps: Unlike pharmaceuticals, psyllium husk lacks sterilization during grinding or encapsulation. Its powder form provides an ideal environment for pathogens to persist.   
3. Consumer Vulnerability: Typical users include elderly or immunocompromised individuals managing chronic digestive issues, who face higher risks of severe outcomes from infections.   

Regulatory and Consumer Responses  

Authorities now emphasize stricter screening:  

• Manufacturers must test raw materials for pathogens and heavy metals, with recalls initiated at the first sign of contamination.   
• Consumers should discard recalled lots immediately, verify third-party safety certifications (e.g., NSF, USP), and store supplements in cool, dry conditions to prevent microbial growth.   

While psyllium retains proven benefits for heart and digestive health, these incidents underscore that “natural” sourcing does not guarantee safety. Robust quality control remains critical for protecting high-risk populations.

Study design

We will conduct an individually randomized, quadruple-blind (blinded trial participants, investigators, data collectors and data analysts), superiority trial of daily antenatal MMS supplementation containing 60 mg elemental iron or 45 mg elemental iron as compared to MMS containing 30 mg elemental iron. This trial protocol was written in accordance with the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist (see Additional file 1).

Study setting

In Tanzania, an estimated 56% of pregnant women are anemic based on the 2022 Demographic and Health Survey [3]. Two previous trials of MMS versus IFA, in which both groups received 60 mg iron, have been conducted in the country, and both indicated the beneficial effects of MMS [20, 21]. Tanzania is currently considering switching to MMS as the standard of care, but there are concerns about reducing the iron dose from 60 mg in the current IFA to 30 mg in MMS. The study will be conducted at selected public antenatal care clinics in Dar es Salaam, Tanzania. The study clinics currently provide all pregnant women with IFA containing 60 mg iron free of charge as the standard of care. The same study clinics were part of a recent non-inferiority trial of low-dose calcium supplementation in pregnant women [22].

Eligibility criteria and recruitment

The trial flow diagram is shown in Fig. 1. Research staff will assess the eligibility criteria for pregnant women who present for antenatal care at study clinics. The trial inclusion criteria are (i) pregnant women attending their first antenatal care visit, (ii) less than 20 weeks of gestation based on the last menstrual period (LMP), (iii) adult ≥ 18 years old, (iv) intending to stay in the study area until 6 weeks postpartum, and (v) provide written informed consent. Trial exclusion criteria are (i) severe anemia defined as a hemoglobin concentration < 8.5 g/dL per Tanzania standard of care; (ii) sickle cell disease including genotypes HbSS, HbSC or hemoglobin C disease (HbCC); and/or (iii) concurrent enrollment in another nutritional clinical trial. At the screening visit, participants who consent will have a finger prick for the collection of capillary blood that will be used to quantify hemoglobin concentration with the point-of-care HemoCue Hb 301 system (HemoCue AB, Ängelholm, Sweden). The HemoTypeSC test (Silver Lake Research Cooperation, Irwindale, USA) will be used for point-of-care hemoglobinopathy screening. Participants will also be asked to provide written consent for the storage of their data and blood specimens in future studies.

Interventions

Pregnant women will be randomized to one of three trial regimens (i) MMS that contains 15 micronutrients, including 30 mg elemental iron (standard UNIMMAP formulation), (ii) MMS that contains 45 mg elemental iron plus the standard UNIMMAP formulation for the other 14 micronutrients, or (iii) MMS that contains 60 mg elemental iron plus the standard UNIMMAP formulation for the other 14 micronutrients. The only difference between the randomized groups will be the amount of iron contained in the MMS supplements. Iron will be given in the form of ferrous sulfate for all three groups. To ensure blinding, the three MMS supplements will have the same appearance, color, odor, taste, size, and weight. The trial regimen will be manufactured by DSM Nutritional Products South Africa (Gauteng, South Africa).

All participants will be counseled to take one MMS (with IFA) tablet orally per day from randomization until delivery. Participants will receive a 35-day supply of MMS in blister packs at the randomization visit and at each subsequent monthly pregnancy visit (Additional file 2). Multiple strategies will be used to enhance participant adherence to the MMS regimens. At each pregnancy visit, research staff will take a pill count of tablets returned in the regimen blister packs. Study staff will then counsel participants on MMS and provide advice on overcoming side effects and other potential barriers. Text message reminders for adherence and upcoming study visits will also be sent to study participants. Participants who report they plan to travel outside of the study area may be given extra blister packs of the regimen to ensure daily regimen supply.

Concomitant care provided during the trial

At each trial site clinic, all participants will be provided with the standard of care throughout the study according to the national guidelines for antenatal care in Tanzania. Participants will have access to study clinics for post-trial care through the routine health system, and in the case diagnoses such as hypertensive disorders of pregnancy, red blood cell disorders, or depression are diagnosed through study procedures, we will refer participants to appropriate standard care. Any woman who is identified to be severely anemic (Hb < 8.5 g/dL) during the study will be discontinued from taking study supplements and referred for treatment according to the Tanzanian antenatal guideline for the management of severe anemia in pregnancy. We will continue to follow the women with severe anemia per the standard visit schedule according to the protocol, but they will not receive the trial regimen.

Assignment of interventions: allocation and blinding

Pregnant women will be randomized in a 1:1:1 ratio to the three trial groups. The allocation sequence will be generated by two non-study staff at George Washington University through computer-generated randomization lists that will be stratified by the study clinic and block randomization (block sizes of 9). The two non-study staff hold the randomization list codes until completion of the primary trial analysis or as requested by the Data and Safety Monitoring Board (DSMB). An independent study pharmacist will privately prepare regimen blister packs with participant IDs based on the randomization lists for each clinic. At the randomization visit, research staff will assign pregnant women to the next available participant ID, which corresponds to a set of pre-labeled blister packs. The trial statistician and data analysts will be blinded to the treatment allocation for the primary statistical analysis. Therefore, the trial is quadruple blind because all trial participants, investigators, outcome assessors, and trial data analysts will be unable to determine the randomized group for any individual participant and will not be able to determine participants who are in the same randomized group. Furthermore, the randomization procedures will ensure complete allocation concealment.

Sample size

We will perform three statistical tests of superiority for the primary outcome: (i) MMS 60 mg iron versus MMS 30 mg iron; (ii) MMS 45 mg iron versus MMS 30 mg iron; (iii) MMS 60 mg iron versus MMS 45 mg iron. Therefore, to account for multiple testing, the α was set to 0.01667 (0.05/3). Table 2 presents a summary of the outcome prevalence assumptions, relative risks, and power calculations for the trial. Based on data from a prior calcium trial conducted in Tanzania, we expect the prevalence of the primary outcome of maternal third-trimester moderate or severe anemia to be 25% in the MMS 45 mg iron group. A meta-analysis of iron trials and cohort studies suggests that there is a 0.88 relative risk for anemia per 10 mg increase in iron dose [12]. Therefore, we assumed a relative risk of 0.82 for comparisons with a 15 mg difference in iron (MMS 45 mg iron vs MMS 30 mg iron and MMS 60 mg iron vs 45 mg iron) and a relative risk of 0.67 for the comparison with a difference of 30 mg iron (MMS 60 mg iron versus MMS 30 mg iron). Based on these assumptions, we require third-trimester hemoglobin data from 1,808 women per arm. Assuming a conservative 15% of pregnant women will have missing third-trimester hemoglobin data (including 5% fetal loss and 10% missing blood samples), the total sample size for the trial will be 6381 (2,127 participants in each of the three randomization groups). R pwr package version 1.3 was used for sample size calculations [23].

Participant timeline

An overview of screening, randomization, and follow-up is presented in Fig. 2. Study visits include a randomization visit and pregnancy study visits every 4 weeks until delivery. Regardless of pregnancy outcome, we will also conduct a visit around the end of the pregnancy and a postnatal visit scheduled after 42 days postpartum. Participant retention will be promoted at clinic visits and through phone calls and home visits.

Schedule of enrollment, interventions, and assessments (SPIRIT figure)

Pregnancy study visits

Pregnant participants will have a study visit at the time of randomization and monthly follow-up visits until delivery. Starting at 32 weeks of gestation, all participants will also receive weekly phone calls to check their pregnancy status. Participants will be asked to contact the research team at the time of labor onset. All women will receive an ultrasound assessment of fetal biometry around the time of randomization. All ultrasound images will be electronically stored, and a random 10% will be assessed for quality by the study obstetrician and the ultrasound quality control team. Participants will also receive a malaria rapid diagnostic test (RDT) at the first antenatal care visit, the time of randomization, as the standard of care. At pregnancy follow-up visits, participants who report a history of fever during the last month or have a body temperature of > 37.5 ℃ measured at the study visit will also have a malaria RDT performed. At all pregnancy visits, study physicians will perform a clinical exam and treat all comorbidities per Tanzanian standard of care. Blood pressure will be assessed with electronic blood pressure monitors and standardized procedures. Participants will also provide urine samples at each pregnancy visit, and dipsticks will be used to assess proteinuria. Nurses will measure maternal height with stadiometers at the randomization visit. Maternal weight will be taken on digital weighing scales, and the mid-upper arm circumference (MUAC) will be taken with a measuring tape at randomization and each pregnancy visit. A 24-h diet recall will be conducted at the first pregnancy follow-up visit and at 32 weeks of gestation. The Patient Health Questionnaire (PHQ)−9 and FACIT Fatigue Scale [24, 25] will be administered to assess symptoms of depression and symptoms of anxiety and fatigue, respectively, at randomization and at 32 weeks of gestation.

Labor and delivery study visit

Clinic records and interviews with the clinic staff and participants will be used to ascertain labor and delivery information. Participants who deliver outside of the study area will be reached by phone by the research staff to obtain relevant information from the mother and/or facility records. Maternal blood pressure and proteinuria will be assessed by clinic or study staff or collected from clinic records. Infant length and weight will also be taken by study staff or recorded from facility records.

Postpartum study visit

Women or women/infant pairs will have a study visit at 6 weeks postpartum (42 days) and will be discharged from the trial after completion of this visit. At the postpartum visit, research staff will assess maternal and infant morbidity and hospitalization history. Nurses will also collect weight and blood pressure from mothers. Study nurses will assess infant feeding, infant weight with a digital infant balance scale to the nearest gram, and infant length to 1-mm precision with a rigid length board with an adjustable footpiece. Study nurses will measure infant head circumference and MUAC with a flexible measuring tape. All infant anthropometric measurements will be recorded in duplicates. A verbal autopsy will be conducted to ascertain the cause of infant death [21].

Data management

All data will be entered into an electronic data capture system developed in Tanzania, and the program will have in-built skip patterns and range check validations for each variable. All identifiable electronic data will remain in Tanzania and will be stored on secure local servers that are accessible only by the respective study data teams and investigators. Data from the trial will be stored indefinitely on servers in Tanzania and the USA.