Betel
Nut health benefit and
risk of chewing, side effects by
Ray Sahelian, M.D.
Information on chewing areta catechu
Betel nut side effects can occur with daily use for several years
Risk of betel
nut chewing
Betel nut is chewed regularly by at least 10% of the world
population, imported by immigrant users wherever they settle, and is the fourth
most widely used addictive substance. It is thought, by users, to soothe the
digestion and to be a stimulant and its use has a major role in social
situations. Specific arecal alkaloids act as competitive inhibitors of
GABA
receptors and have widespread effects in the body, including actions on the
brain, cardiovascular system, lungs, gut and pancreas. Nitrosated derivatives of
arecal alkaloids, proven carcinogens inducing tumors throughout the upper gut
and foregut derivatives in animals, are also associated with increased tumor
risks in man. Increased central obesity is found in association with betel usage
in man as well as increases in circulating markers of inflammatory and
cardiovascular damage. The effects of chronic betel usage in man are at least as
diverse as those of smoking and the habit increases the risks of ill health.
Betel Nut and Oral
Cancer
Betel quid chewing is a strong independent risk factor for pharyngeal cancer
(cancer of the back of the throat), but not laryngeal cancer (cancer of the
voice box), according to findings published in the International Journal of
Cancer. Chewing betel quid, which consists of betel leaf from the Piper betle
vine, is popular in many parts of Asia. Betel quid is chewed for its stimulant
effects, to satisfy hunger and as a social and cultural practice.
For centuries, billions of
people across Asia, from Pakistan to Palau, have chewed the spicy date-like
fruit of the betel palm for a quick buzz. However, a World Health Organization
study has found that chewing betel nuts can cause oral cancer and that the rate
of these malignant mouth tumors was highest in Asia where the betel nut is a
widely used stimulant. Betel nut, which contains an addictive stimulant similar
to nicotine, is widely used in parts of Southeast Asia, India, Pakistan and the
South Pacific as a breath freshener, a hunger antidote, a substitute for
cigarettes and as a way to get high. Users often chew it all day long, causing
all sorts of unpleasant side-effects such as red-stained teeth and pavements
covered with red spittle as many users spit out the betel nut's remnants as they
chew.
Betel Nut side effects
Excessive use leads to palpitations, warm sensation, increased pulse
rate, sweating, . Prolonged use for many years may increase the risk for oral
cancers. The regular use of betel will, in time, stain the
mucosa, gums, and teeth. Betel nut is not recommended for those with heart
conditions.
Betel Nut chewing
and transgenerational effect
Exposure to paternal betel quid chewing increases the risk of early
manifestation of
metabolic syndrome x in human offspring in a dose-dependent manner.
Betel chewing and heart
disease
Betel-quid chewing is a contributory cause of metabolic syndrome in humans,
which implies a greater likelihood of developing cardiovascular disease among
those with the betel habit.
Betel quid ( Areca catechu ) is used by close to 10% of the world's population.
Betel quid use is associated with the metabolic syndrome, a risk factor for
heart disease. At least one study has shown that Betel-quid use is independently
associated with heart disease. American Journal of Clinical Nutrition, Vol. 85,
No. 5, 1229-1235, May 2007.
Compounds in Betel nut and
their physiological effects
Betel nut is chewed regularly by at least 10% of the world
population, imported by immigrant users wherever they settle, and is one of the
top
most widely used addictive substance. It is thought to soothe the
digestion and to be a stimulant and its use has a major role in social
situations. Specific arecal alkaloids act as competitive inhibitors of
GABA receptors and have widespread effects in the body, including actions on the
brain, cardiovascular system, lungs, gut and pancreas. Nitrosated derivatives of
arecal alkaloids, proven carcinogens inducing tumours throughout the upper gut
and foregut derivatives in animals, are also associated with increased tumour
risks in man. Increased central obesity is found in association with betel usage
in man as well as increases in circulating markers of inflammatory and
cardiovascular damage. The effects of chronic betel usage in man are at least as
diverse as those of smoking and the habit increases the risks of ill health.
Betel nut contains three major alkaloids: arecoline, pilocarpine, and muscarine.
Betel Nut
research
There's a link between increased betel nut quid nut production and
consumption and a substantial rise in the incidence of head and neck
cancers among Taiwanese men, says a National Taiwan University Hospital
study.
Presence of cholinomimetic and
acetylcholinesterase inhibitory constituents in betel nut.
Life Sci. 2004 Oct 1;75(20):2377-89.
We report the presence of cholinomimetic and
acetylcholinesterase (AChE) inhibitory constituents in betel nut, the most
commonly used drug in the world after tobacco, ethanol and caffeine. The
crude extract of betel nuts or Areca catechu caused a
dose-dependent spasmogenic effect in the isolated
rabbit jejunum. The spasmogenic effect was blocked by atropine, similar to
that of acetylcholine (ACh), suggestive of muscarinic receptor mediated
effect. Both the extract and physostigmine potentiated the effect of a fixed dose of ACh in a
dose-dependent fashion, suggesting acetylcholinesterase (AChE) inhibitory
effect. In
the in vivo model of gastrointestinal transit, betel nut
enhanced the travel of charcoal meal and also exhibited a laxative effect
in mice. The plant extract was subjected to activity-directed
fractionation and all resultant fractions showed atropine-sensitive spasmogenicity in rabbit jejunum and also AChE inhibitory effect at doses
similar to that for the parent crude extract, the ethyl acetate fraction
being slightly less potent. Some of the known constituents of betel nut,
including arecoline, were tested for the possible inhibitory effect on
AChE, none were found active. The study provides first evidence for the
presence of AChE inhibitory constituents in betel nut, though additional
direct muscarinic stimulatory effect cannot be ruled out and this study
provides sound scientific basis for some of the folkloric uses associated
with betel nut chewing.
Areca
nut, energy metabolism and hunger in Asian men.
Ann Hum Biol. 2003 Jan-Feb;30(1):26-52.
The nut of the Areca catechu palm ( betel nut ) has long been
attributed effects on hunger and the digestive process. The
objectives were to assess experimentally effects of areca nut (betel nut)
on fasting and postprandial energy metabolism, substrate utilization and
hunger. Two randomized, placebo-controlled,
double-blind studies were undertaken. In study 1, eight Indian men
received bioadhesive gels delivering 0, 5, 10 or 20 mg arecoline to the
buccal sulcus after an overnight fast. In study 2, 15 Indian
men received gels delivering 0 or 10 mg arecoline after consuming a 2.5 MJ
meal, and the same protocol was then applied as in study 1.
Fasting resting energy expenditures exceeded basal metabolic rate (BMR) by
5.4 after placebo, and 5.1 after 20 mg arecoline, but by
0.9 and 0.7 following 5 mg and 10 mg arecoline,
respectively. Carbohydrate (CHO) utilization rates rose after areca nut
compared to placebo. Hunger varied across doses, being lowest after 10 mg
and highest after 20 mg, and was influenced by interaction of dose with
delta resting energy expenditure. In study 2, areca dose interacted with
fat-free massto lower by 5.4 the thermic effect of a meal, and
retarded peak 'digestive-phase' thermogenesis by 60 min. Postprandial
delta CHO utilization was greater, and hunger was lower, after betel nut.
The betel nut altered relationships of hunger to thermic effects of the
meal, and to delta substrate utilization, in ways consistent with appetite
suppression. Betel nut constituents modulate metabolic signals
regulating appetite in man.
Cerebral hemodynamic responses to betel nut chewing: a Doppler study.
Clin Neuropharmacol. 2002 Sep-Oct;25(5):244-50.
We sought to evaluate cerebral hemodynamic responses to betel nut
chewing. Thirty healthy male volunteers, ten new
betel nut chewers, ten occasional chewers, and ten chronic betel nut
chewers were included in this study. We used carotid duplex sonography and
transcranial Doppler to measure the flow velocities and flow volume (FV)
of the common carotid (CCA), internal carotid (ICA), external carotid (ECA)
arteries, and the flow velocity of middle cerebral artery (MCA). Blood
pressure (BP) and heart rate (HR) were recorded simultaneously. All
subjects were asked to chew fruit-flavored chewing gum for 10 minutes.
Blood flows of the above vessels were measured four times at baseline and
at the 2nd, 6th, and 12th minute after chewing. A repeated study was
followed in the same subject but substituted with betel nut. Chronic
chewers had delayed onset time and shortened vanishing time of
facial-flushing sensation. Systolic and diastolic BPs were mildly elevated
during gum chewing, whereas diastolic BP was dropped during betel nut
chewing. Heart rate increased prominently during betel nut
chewing, especially in new and occasional chewers. The peak systolic, end
diastolic velocities, and FV in ECA and CCA increased significantly during
betel nut chewing. The blood flows in the ICA and MCA had no
significant changes during gum or betel chewing. Betel nut chewing has a
central sympathetic effect resulting in accelerated HR, increased blood
flows in ECA and CCA, but has a peripheral cholinergic effect resulting in
a drop of diastolic BP. Intracranial cerebral hemodynamics is not affected
during betel nut chewing. The inotropic and chronotropic effect to the
heart from betel nut chewing is probably an unfavorable risk for patients
with ischemic heart disease. betel nut beauty betel nut.
Betel nut inquiries
I am discussing the issue of 'tobacco control in India' with my friends.
In this context, we wish to shed some light on the specific effect of 'paan
chewing' or betel leaf chewing. Does the paan leaf per se have any direct
adverse health effect, or is it only what is put inside a betel leaf that
affects health?
Sorry but this is not an area I have studied in detail.
Additional links
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CoQ10 comes in varying
dosages.
Cordyceps is a mushroom
used for immune enhancement.
Deer antler
velvet
is a more potent sexual stimulant.
DHEA can stimulate sex but
there are safer herbs as alternatives.
DMAE is used for
increasing concentration.
This betel nut page was last updated in February 2008.
betel nut