Abstract
Background
Areca-nut (AN) chewing habit has been associated with oral diseases including oral cancer, oral submucous fibrosis and periodontal disease; however, some authors have reported that the ANchewing abuse may also jeopardize the systemic health among its users.
Objectives
The objective was to review any reported association between AN-chewing and the metabolic syndrome (MetS).
Methods
To address the research question “Is there an association between areca-nut chewing habit and the MetS?” the MEDLINE and PubMed databases were searched from 1991 up to and including April 2010. The search criteria included: human studies, metabolic syndrome, diabetes, areca nut (AN). Only articles published in English were included.
Results
Eight cohort studies were included in the review. The sample size of the selected studies ranged from 210 to 56,116 individuals (age range 15–83 years). The daily frequencies of AN-chewing reported by the users ranged between once a day to 76 times daily. The duration of use ranged from 6 years to ≥ 20 years. Two studies associated AN-chewing habit with hyperglycemia and type 2 diabetes while five studies studies reported an association between AN-chewing and metabolic syndrome. Four studies related AN-chewing with obesity and an increased body mass index. Higher triacylglycerol levels were reported in one study among AN-chewers compared to non-chewers. Though the numbers of publications on this subject are limited, the available studies indicate that AN-chewing could be associated with the metabolic syndrome, and individually with two of the recognized components of the syndrome i.e. diabetes mellitus and central obesity.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
International Agency for Research on Cancer (2004) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol 85: Betel Quid and Areca Nut Chewing and some Areca-nut derived nitrosamines. Lyon: IARC
Gupta PC, Warnakulasuriya S. Global epidemiology of areca nut use. Addict Biol. 2002; 7: 77–83.
Warnakulasuriya S. Areca nut use following migration and its consequences. Addict Biol. 2002; 7: 127–132.
Auluck A, Hislop G, Poh C, Zhang L, Rosin MP. Areca nut and betel quid chewing among South Asian immigrants to Western countries and its implications for oral cancer screening. Rural Remote Health. 2009; 9: 1118.
Strickland SS. Anthropological perspectives on use of the areca nut. Addict Biol. 2002; 7: 85–97
Tilakaratne WM, Klinikowski MF, Saku T, Peters TJ, Warnakulasuriya S. Oral submucous fibrosis: review on aetiology and pathogenesis. Oral Oncol. 2006; 42: 561–568.
Daftary DK, Bhonsle RB, Murti PR, Pindborg JJ, Mehta FS. An oral lichen planuslike lesion in Indian betel -tobacco chewers. Scand J Dent Res. 1980; 88: 244–249.
Javed F, Altamash M, Klinge B, Engström PE. Periodontal conditions and oral symptoms in gutka-chewers with and without type 2 diabetes. Acta Odontol Scand. 2008; 66: 268–273.
World Health Organization. WHO consultation: definition, diagnosis and classification of diabetes mellitus and its complications Geneva: WHO. 1999.
Balkau B, Charles MA. Comment on the provisional report from the WHO consultation. European Group for the Study of Insullin resistance (EGIR) Diabet Med. 1999; 16: 442–443.
Executive Summary of the Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholestrol in Adults (Adult treatment Panel lll). JAMA. 2001; 285: 2486–2497.
Alberti KGMM, Zimmet PZ, Shaw JE. The metabolic syndrome—a new world-wide definition from the International Diabetes Federation Consensus. Lancet. 2005; 366: 1059–1062.
Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C; American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome. Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004; 109: 433–438
Bruce KD, Bryne CD. The metabolic syndrome: common origins of a multifactorial disorder. Postgrad Med J. 2009; 85: 614–621.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27: 1047–1053.
Boucher BJ, Mannan N. Metabolic effects of the consumption of areca catechu. Addict Biol. 2002; 7: 103–110.
Ogunkolade WB, Boucher BJ, Bustin SA, Burrin JM, Noonan K, Mannan N, Hitman GA. Vitamin D metabolism in peripheral blood mononuclear cells is influenced by chewing “betel nut” (Areca catechu) and vitamin D status. J Clin Endocrinol Metab. 2006; 91: 2612–2617.
Holick MF. Vitamin D deficiency. NEJM. 2007; 357: 266–281.
Boucher BJ, Mannan N, Noonan K, Hales CN, Evans SJW. Glucose intolerance and imparement of insulin resistance in relation to vitamin D deficiency in East London Asians. Diabetologica. 1995; 38: 1239–1245.
Mannan N, Boucher BJ, Evans SJ. Increased waist size and weight in relation to consumption of Areca catechu (betel-nut); a risk factor for increased glycaemia in Asians in east London. Br J Nutr. 2000; 83: 267–275.
Strickland SS, Veena GV, Houghton PJ, Stanford SC, Kurpad AV. Areca nut, energy metabolism and hunger in Asian men. Ann Hum Biol. 2003; 30: 26–52.
Boucher B. Diabetes in British South Asians: nature, nurture, and culture. Diabet Med. 1997; 14: 707–708.
Boucher BJ, Ewen SWB, Stowers JM. Betel nut (Areca catechu) consumption and induction of glucose intolerance in adult CD1 mice and their F1 and F2 offspring. Diabetologica. 1994; 37: 49–55.
Lin WY, Pi-Sunyer FX, Liu CS, Li TC, Li CI, Huang CY, Lin CC. Betel nut chewing is strongly associated with general and central obesity in Chinese male middle-aged adults. Obesity (Silver Spring). 2009; 17: 1247–1254.
Lin WY, Chiu TY, Lee LT, Lin CC, Huang CY, Huang KC. Betel nut chewing is associated with increased risk of cardiovascular disease and all-cause mortality in Taiwanese men. Am J Clin Nutr. 2008; 87: 1204–1211.
Chang WC, Hsiao CF, Chang HY, Lan TY, Hsiung CA, Shih YT, Tai TY. Betel nut chewing and other risk factors associated with obesity among Taiwanese male adults. Int J Obes (Lond). 2006; 30: 359–363.
Guh JY, Chuang LY, Chen HC. Betel-quid use is associated with the risk of the metabolic syndrome in adults. Am J Clin Nutr. 2006; 83: 1313–1320.
Yen AM, Chiu YH, Chen LS, Wu HM, Huang CC, Boucher BJ, Chen TH. A population-based study of the association between betel-quid chewing and the metabolic syndrome in men. Am J Clin Nutr. 2006; 83: 1153–1160.
Benjamin AL, Margis D. Betelnut chewing: a contributing factor to the poor glycaemic control in diabetic patients attending Port Moresby General Hospital, Papua New Guinea. P N G Med J. 2005; 48: 174–182.
Tung TH, Chiu YH, Chen LS, Wu HM, Boucher BJ, Chen TH; Keelung Communitybased Integrated Screening programme No. 2. A population-based study of the association between areca nut chewing and type 2 diabetes mellitus in men (Keelung Community-based Integrated Screening programme No. 2). Diabetologia. 2004; 47: 1776–1781
Javed F, Klingspor L, Sundin U, Altamash M, Klinge B, Engström PE. Periodontal conditions, oral Candida albicans and salivary proteins in type 2 diabetic subjects with emphasis on gender. BMC Oral Health. 2009; 9: 12.
Lee CH, Ko AM, Warnakulasuriya S et al. Population Burden of Betel-Quid Abuse and Its Relation to Oral Premalignant Disorders in South, Southeast and Eastern Asia: An Asian Betel-Quid Consortium (ABC) Study. Int J Cancer 2011 [Epub ahead of print]
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Javed, F., Al-Hezaimi, K. & Warnakulasuriya, S. Areca-nut chewing habit is a significant risk factor for metabolic syndrome: A systematic review. J Nutr Health Aging 16, 445–448 (2012). https://doi.org/10.1007/s12603-011-0353-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-011-0353-5