Betel nut

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 29.10.2020

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Synonym(s)

Arecanut; Betel Palm

Definition
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Fruit of the betel palm (Areca catechu). Worldwide, especially in Asia frequently consumed luxury food.

Occurrence
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As a wild plant it is native to South East Asia (India, Philippines, Sunda Islands). Cultivated worldwide in tropical rainforest areas, especially in India, Pakistan, Sri Lanka, Maldives, Madagascar, Egypt, East Africa, Arabia, South China, Taiwan, Indonesia, Philippines, Malaysia, Fiji and Melanesia.

Effects
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  • Betel nuts contain 0.1-0.5% arecolin (main alkaloid) as well as arecain, arecaidin, arecilidin, guvacolin, isoguvacin and guvacin. Tannins (tannins: galotannic acid, gallic acid, D-catechol, phlobatannin), mucilage, resin, carbohydrates (sucrose, galactan, mannan), proteins, saponins, carotenes, minerals (calcium, phosphorus, iron) and fats (sitosteriol) are also contained. When betel nuts are chewed together with some slaked lime, the alkaloid arecolin is converted into arecaidin. The tannins and alkaloids stimulate salivary flow, increase heartbeat and perspiration. In addition, feelings of hunger are suppressed. Some of the ingredients stimulate the central nervous system, have a slightly intoxicating, stimulating and euphoric effect. Frequent use causes dizziness and nausea!
  • Arecolin is able to increase the mRNA expression of TIMP-1 (tissue inhibitor of metalloproteinases), an inhibitor of MMPs (see below matrix metalloproteinases) in patients with oral submucous fibrosis in lesional mucosa. This results in a disturbance of the balance of both enzyme systems with the consequence of an increased collagen content.
  • Areca seeds also contain polyphenolic substances (NPF-861A, NPF86IB, NPF-86IIA, NPF-8611B) which can inhibit a membrane-bound enzyme (5'-nucleotidase) and which are said to have a tumour-inhibiting and immune-strengthening effect.

Field of application/use
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Betel nut is everywhere in Asia mixed with other herbs and chewed or drunk as tea. The hard seed of the betel palm, for example, is slit open, mixed with pieces of lime and spices, wrapped in a leaf of betel pepper (Piper betle) and then chewed. Betel nuts can be bought cheaply in many places in Asian food markets. In some cases, the nuts are offered in processed form, e.g. as "Arekachips".

Undesirable effects
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Betelnut contains a dye which colours the saliva red and, with prolonged use, the teeth black. Since betel nut has a toxic effect on intestinal worms, it is used in veterinary medicine. Long-term use of betelnut can lead to extensive fibrosis of the oral mucosa. As a late consequence, development of a spinocellular carcinoma is possible.

Note(s)
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  • Betel is considered a luxury item and not an intoxicant. No addictive potency! Worldwide, about 400-600 million people use betel products.
  • Due to the increased saliva flow, betel chewers, similar to chewing tobacco consumers, often spit out betel chewers. The transmission of infectious diseases (especially tuberculosis) through infected saliva from betel bites is not uncommon!

Cave! The consumption of large quantities of betel seeds (8-10 g) can be fatal

Literature
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  1. Chang MC et al (2002) Prevention of the areca nut extract-induced unscheduled DNA synthesis of gingival keratinocytes by vitamin C and thiol compounds. Oral Oncol 38: 258-265
  2. Sharma DC (2003) Betel quid and areca nut are carcinogenic without tobacco. Lancet Oncol 4: 587
  3. Stoopler ET et al (2003) Betel quid-induced oral lichen planus: a case report. Cutis 71: 307-311
  4. Wang SC et al (2003) Betel nut chewing and related factors in adolescent students in Taiwan. Public Health 117: 339-345
  5. Wollina U et al (2002) Oral and extraoral disease due to betel nut chewing. dermatologist 53: 795-797