A review of the systemic adverse effects of areca nut or betel nut

Abstract

Areca nut is widely consumed by all ages groups in many parts of the world, especially south-east Asia. The objective of this review is to systematically review and collate all the published data that are related to the systemic effects of areca nut. The literature search was performed by an electronic search of the Pubmed and Cochrane databases using keywords and included articles published till October 2012. We selected studies that covered the effect of areca nut on metabolism, and a total of 62 studies met the criteria. There is substantial evidence for carcinogenicity of areca nut in cancers of the mouth and esophagus. Areca nut affects almost all organs of the human body, including the brain, heart, lungs, gastrointestinal tract and reproductive organs. It causes or aggravates pre-existing conditions such as neuronal injury, myocardial infarction, cardiac arrhythmias, hepatotoxicity, asthma, central obesity, type II diabetes, hyperlipidemia, metabolic syndrome, etc. Areca nut affects the endocrine system, leading to hypothyroidism, prostate hyperplasia and infertility. It affects the immune system leading to suppression of T-cell activity and decreased release of cytokines. It has harmful effects on the fetus when used during pregnancy. Thus, areca nut is not a harmless substance as often perceived and proclaimed by the manufacturers of areca nut products such as Pan Masala, Supari Mix, Betel quid, etc. There is an urgent need to recognize areca nut as a harmful food substance by the policy makers and prohibit its glamorization as a mouth freshener. Strict laws are necessary to regulate the production of commercial preparations of areca nut.

The pharmacology, toxicology and potential applications of arecoline: a review

“…Areca catechu L. (Arecaceae) is the fourth most commonly used drug after tobacco, alcohol and caffeine in the world (Garg et al 2014). It is used to treat tapeworm infestation, abdominal distension, diarrhoea and edema in China (Liu et al 2011;Cai et al 2012;Peng et al 2015a).…”

Betel nut use and hyperglycemia

“…4 Reports are also available for acute toxic symptoms if betel nut is consumed in increased quantity; manifestations include palpitations, chest tightness, dyspnea, tachycardia and even MI and coma. (5,6) In addition to commonly known risk factors of obesity, ethnicity, positive family history for diabetes mellitus type 2, smoking and sedentary life style, betel nut use should be considered an associated modifiable risk factor for diabetes mellitus type 2 diagnosis and treatment.…”

Reply to Warnakulasuriyaet al.

“…During the last few years, phenacetin has been detected as an adulterant to paco. Some of these adulterants pose the threat of serious short-and long-term health consequences independent of the negative health effects of cocaine, although there is insufficient research to quantify the nature and extent of such effects for most of these adulterants, phenacetin being an exception [2][3][4][5][6].…”

“…It is often used as an ingredient in betel quid and its use is widespread, from countries of South Asia to the Pacific Islands of Saipan and Guam. A spectrum of health problems has been identified linked to areca nut, and systemic adverse effects have been reviewed [3]. In particular, the evidence for carcinogenicity of areca nut among humans has been evaluated as 'sufficient' [4].…”