Betel quid is traditionally prepared with areca nut, betel
leaf, and slaked lime. The habit of betel quid chewing has existed for
millennia and until recently, has been largely centered around cultural,
medicinal, and ceremonial activities, particularly in South Asian countries.
However, discovery of its psychoactive, euphoric, and aphrodisiac properties
contributed to the global spread and abuse of betel quid, which now is widely
consumed as a social lubricant and source of financial profit. Unfortunately,
victims of the profit motive include young girls and boys who get addicted due
to high rates of habitual consumption. Furthermore, the alarming practice of
incorporating tobacco in quid preparations has grown and is particularly
problematic for pregnant women. Long-term serious health concerns linked to
habitual quid chewing include increased rates of malignancy, oral pathology,
and cardiovascular, hepatic, fertility, metabolic, and neuropsychiatric
disorders. Metabolic disorders and insulin resistance disease states such as
type 2 diabetes, obesity, and metabolic syndrome have significant adverse
effects due to their contributions to cognitive impairment and
neurodegeneration. Mechanistically, the areca nut/betel quid constituents are
metabolized to N-nitroso compounds, i.e., nitrosamines, which at high doses are
carcinogenic, but at chronic lower levels, they cause insulin resistance
diseases. Epidemiological data have highlighted rising tides of obesity,
diabetes, and dementias, each of which has been linked to insulin resistance
states that now disproportionately burden poor countries. Public health
measures are needed to impose socially and ethically responsible barriers that
curb commercialization strategies to enhance betel quid access and thereby reinforce
practices that contribute to global health disparities.
Author(s) Details:
Suzanne M. de la Monte,
Department of Pathology and Laboratory Medicine, Providence VA
Medical Center, Providence, RI 02808, USA, Women & Infants Hospital of
Rhode Island, Providence, RI 02808, USA, Alpert Medical School, Brown
University, Providence, RI 02808, USA, Departments of Medicine, Rhode Island
Hospital, Providence, RI 02808, USA and Department of Neurology, Neurosurgery
and Neuropathology, Rhode Island Hospital, Alpert Medical School of Brown
University, Providence, RI 02903, USA.
Natalia Moriel,
Department
of Molecular Pharmacology and Physiology, Brown University, Providence, RI
02912, USA.
Amy Lin,
Department of Molecular Pharmacology and Physiology, Brown University,
Providence, RI 02912, USA.
Nada Abdullah Tanoukhy,
Department of Molecular Pharmacology and Physiology, Brown
University, Providence, RI 02912, USA.
Camille Homans,
Department of Neuroscience, Brown University, Providence, RI 02912,
USA.
Gina Gallucci,
Departments
of Medicine, Rhode Island Hospital, Providence, RI 02808, USA.
Ming Tong,
Departments of Medicine, Rhode Island Hospital, Providence, RI
02808, USA.
Ayumi Saito,
Department of Epidemiology, School of Public Health, Brown
University, Providence, RI 02912, USA.
Please see the link here: https://stm.bookpi.org/RUDHR-V3/article/view/13711
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