What is betel nut?
- Betel nut is the seed of a type of palm tree.
- It has a long history of being chewed for its mood-enhancing effects in many parts of Asia and the Pacific.
- Modern research shows many health risks associated with its use, including oral cancer, an incurable jaw disorder, and reproductive issues.
A deep red or purple smile is a common sight in many parts
of Asia and the Pacific. But what’s behind it?
This red residue is the telltale sign of the betel nut,
which is chewed by millions of people across the globe. In its most basic form,
betel nut is a seed of the Areca catechu, a type of palm tree. It’s
commonly chewed after being ground up or sliced and wrapped in leaves of the Piper
betle vine that have been coated with lime. This is known as a betel quid.
Tobacco or flavorful spices may also be added.
History of a habit
Betel nut has a long history in South and Southeast Asia and
the Pacific Basin. In Guam and other Pacific islands, its use can be traced
back as far as 2,000 years. A habit passed down through generations, chewing
betel nut is a time-honored custom for 10–20 percent of the world’s population.
Today, the World Health Organization (WHO) estimates that around 600
million people use some form of betel nut. It is one of the most popular
psychoactive substances in the world, in fourth place after nicotine, alcohol,
and caffeine. But while betel nut is an important cultural and social tradition
in many countries, growing evidence points to serious health effects from
A burst of energy
Many people chew betel nut for the energy boost it produces.
This is likely due to the nut’s natural alkaloids, which release adrenaline. It
may also result in feelings of euphoria and well-being.
Some traditional beliefs hold that it may offer relief for a
range of ailments, from dry mouth to digestive problems. However, the drug has
not been well tested in clinical trials, and evidence of any health benefits is
According to one study published in the journal Cancer
Prevention Research, betel nut has cancer-fighting properties. An Indian study
suggests it may help with cardiovascular and digestive issues and have
anti-inflammatory and wound-healing properties. However, a study in the South East Asia
Journal of Cancer points to the lack of follow-up studies. It also says
that more research is needed to confirm any of the betel nut’s benefits. A
medical review of the nut’s effects published in the Indian Journal of
Medical and Paediatric Oncology concludes that it’s an addictive substance
with many more harmful effects than benefits.
Oral cancer and
Research has revealed some serious health risks of betel
nut. The WHO classifies betel nut as a carcinogen. Many studies have shown a
convincing link between betel nut use and cancer of the mouth and esophagus. A
study in the Journal of
the American Dental Association reports that betel nut users are at a higher
risk for oral submucous fibrosis. This incurable condition can cause stiffness
in the mouth and eventually the loss of jaw movement. Regular chewing of betel
nut can also cause gum irritation and tooth decay. Teeth may become permanently
stained deep red or even black.
An early study published in the American Society for
Clinical Nutrition found a strong connection between betel nut and an
increased risk of cardiovascular disease, metabolic syndrome, and obesity.
Betel nut may interact with other drugs or herbal
supplements. It could cause toxic reactions in the body or reduce the effects
of medications. More testing is needed to determine just how betel nut affects
other drugs. Regular betel nut use may also lead to dependency and withdrawal
The U.S. Food and Drug Administration (FDA) does not
consider betel nut safe for chewing or eating. It has placed the nut on its Poisonous
Plants Database. A fact
sheet on betel nut with tobacco issued by the Centers for Disease Control
and Prevention (CDC) warns of the following medical conditions associated with
betel nut use with tobacco:
issues, including low birth weight in newborns
Health organizations and governments around the globe are
taking steps to increase awareness of betel nut risks. Taiwan has declared an
annual “Betel Nut Prevention Day.” City officials in Taipei now fine anyone
seen spitting betel nut juice and require them to attend withdrawal classes. In
2012, the WHO released an action
plan designed to reduce betel nut use in the Western Pacific. It calls for
a combination of the following measures to curb the practice:
Chewing betel nut has a long history reaching back 2,000
years, and some cultures claim to have found benefits associated with it. However,
modern research shows many health risks associated with the practice. Regular
chewing of the betel nut has been linked to cancer of the mouth and esophagus,
oral submucous fibrosis, and tooth decay. The WHO has classified betel nut as a
carcinogen and initiated an action plan to reduce its use. In the United States,
both the FDA and the CDC have issued alerts on health risks associated with betel
nut chewing. Reducing risk factors such as those presented by betel nut chewing
is important for public health around the globe.