Areca nut
The areca nut or betel nut is the fruit of the areca palm. The palm is originally native to the Philippines, but was carried widely through the tropics by the Austronesian migrations and trade since at least 1500 BCE due to its use in betel nut chewing. It is widespread in cultivation and is considered naturalized in much of the tropical Pacific, South Asia, Southeast Asia, and parts of east Africa. It is not to be confused with betel leaves that are often used to wrap it. The practice of betel nut chewing, often together with other herbs as a stimulant drug, dates back thousands of years, and continues to the present day in many countries.
Betel nut chewing is addictive due to the presence of the stimulant arecoline and causes adverse health effects—mainly oral and esophageal cancers, as well as cardiovascular disease. When chewed with additional tobacco in its preparation, there is an even higher risk, especially for oral and oropharyngeal cancers. With tobacco it also raises the risk of fatal coronary artery disease, fatal stroke, and adverse reproductive effects, including stillbirth, premature birth, and low birth weight.
Consumption by hundreds of millions of people worldwide—mainly of South and Southeast Asian origin—has been described as a public health emergency.
Etymology
The term areca originated from Dravidian languages, cognates of which are:Description
The areca nut is not a true nut, but rather the seed of a fruit categorized as a berry. It is commercially available in dried, cured, and fresh forms. When the husk of the fresh fruit is green, the nut inside is soft enough to be cut with a typical knife. In the ripe fruit, the husk becomes yellow or orange, and as it dries, the fruit inside hardens to a wood-like consistency. At that stage, the areca nut can only be sliced using a special scissors-like cutter.Usually, for chewing, a few slices of the nut are wrapped in a betel leaf along with calcium hydroxide and may include clove, cardamom, catechu resin, or other spices for extra flavouring. Betel leaf has a fresh, peppery taste, but it can also be bitter to varying degrees, depending on the variety.
Areca nuts are chewed for their effects as a mild stimulant, causing a warming sensation in the body and slightly heightened alertness, although the effects vary from person to person.
In parts of India, Sri Lanka, and southern China, areca nuts are not only chewed along with betel leaf, but are also used in the preparation of Ayurvedic and traditional Chinese medicines. Powdered areca nut is used as a constituent in some dentifrices. Other traditional uses include the removal of tapeworms and other intestinal parasites by swallowing a few teaspoons of powdered areca nut, drunk as a decoction, or by taking tablets containing the extracted alkaloids. According to traditional Ayurvedic medicine, chewing areca nut and betel leaf is a good remedy against bad breath. Diplomat Edmund Roberts noted that Chinese people would mix areca nut with Uncaria gambir during his visit to China in the 1830s. After chewing a betel nut, the red residue is generally spat out. Accordingly, places have banned chewing this nut to avoid eyesores.
Chemistry
The major alkaloid in betel nut is arecoline. There are other compounds, such as arecaidine, guvacine, isoguvacine, and guvacoline. Tannins present in betel nut are mainly proanthocyanidins along with catechins and arecatannin. Two new alkaloids were recently discovered and named acatechu A and acatechu B. Several non-alkaloid compounds including benzenoids, terpenes, carboxylic acids, aldehydes, alcohols, and esters were also identified.Toxicity
Chewing areca nut increases the risk of multiple forms of cancer and cardiovascular disease, with or without added tobacco.Betel nut chewing causes an increased risk of head and neck cancers and esophageal cancer. Betel quid affects almost all parts of the human body, including the brain, heart, lungs, gastrointestinal tract and reproductive organs. It can cause myocardial infarction, cardiac arrhythmias, liver damage, asthma, type II diabetes, hyperlipidemia, metabolic syndrome, hypothyroidism, prostate hyperplasia and infertility. Habitual chewing of areca nuts increases the risk of cirrhosis and hepatocellular carcinoma. Chewing areca nuts is a cause of oral submucous fibrosis, a condition which may progress to mouth cancer. It has also been linked to throat cancer.
When chewed with additional tobacco in its preparation, there is an even higher risk for cancer, especially for oral and oropharyngeal cancers. With tobacco, it also raises the risk of fatal coronary artery disease, fatal stroke and non-fatal ischemic heart disease
The harm caused by consumption of areca nuts worldwide was classified in 2017 as a "neglected global public health emergency".
During pregnancy
Women who chew areca nut formulations, such as paan, during pregnancy significantly increase adverse outcomes for the baby. Betel quid chewing can cause stillbirth, premature birth, and low birth weight.Using tobacco or areca nuts during pregnancy significantly increases adverse outcomes for the baby. The habit is associated with higher incidences of preterm birth and low birth weight and height. Biologically, these effects may be a consequence of the arecoline that is found in areca nuts. The habit also exposes the fetus to various other toxic components linked to cancer.
Production
In 2023, world production of areca nuts was 2.3 million tonnes, with India providing 60% of the total and Bangladesh and Myanmar as major secondary producers.Consumption
South Asia
In India and the rest of the Indian subcontinent, the preparation of nut with or without betel leaf is commonly referred to as paan. It is available practically everywhere and is sold in ready-to-chew pouches called pan masala or supari, which is the dried form of the areca nut, as a mixture of many flavours whose primary base is dried areca nut crushed into small pieces. Poor people, who may eat only every other day, use it to stave off hunger pangs. Pan masala with a small quantity of tobacco is called gutka. The easily discarded, small plastic supari or gutka pouches are a ubiquitous pollutant of the South Asian environment. Some of the liquid in the mouth is usually disposed of by spitting, producing bright red spots wherever the expectorate lands.In the Maldives, areca nut chewing is very popular, but spitting is frowned upon and regarded as an unrefined, repulsive way of chewing. Usually, people prefer to chew thin slices of the dry nut, which is sometimes roasted. Killi, a mixture of areca nut, betel, cloves, cardamom and sugar is sold in small home-made paper pouches. Old people who have lost their teeth keep "chewing" by pounding the mixture of areca nut and betel with a small mortar and pestle.
Southeast Asia
In Thailand, the consumption of areca nut has declined gradually in the last decades. The younger generation rarely chews the substance, especially in the cities. Most of the present-day consumption is confined to older generations, mostly people above 50. Even so, small trays of betel leaves and sliced tender areca nut are sold in markets and used as offerings in Buddhist shrines.In the northern Philippines, particularly the Cordillera Administrative Region, betel nut chewing remains prominent to the point that restrictions and fines have been established in urban areas such as Baguio City in the Benguet province. These restrictions were made under the idea that momma or moma chewing and spitting are improper during public transportation drivers' work hours and are considered stains to the city roads and sidewalks. Despite these restrictions, betel nut thrives across the Cordilleran market. An example of its commerciality can be observed in Ifugao, one of the provinces of the Philippine Cordilleras, where betel nuts are high-demand products sourced from the province's different cities and municipalities.
In Bahasa Indonesia, the betel nut is known as makan pinang, while in the Papua Province of Indonesia, it is known simply as pinang. The Pinang scissor was developed specifically for cutting it.
Oceania
In Papua New Guinea, betel nuts are referred to in Tok Pisin as buai, and grow abundantly on the northern coast, in Wewak and Madang. A controversial ban on selling and chewing betel nut in public places in Port Moresby, introduced in 2014 by the governor, was lifted in 2017. Because the popular nut continued to be smuggled in, prices rose dramatically. Police enforced the ban rigorously, and in 2015 two betel nut sellers died in Hanuabada after police reservists fired on a crowd. The governor of Port Moresby introduced another ban on the nut, restricted to an area in the business district of the city in July 2023. However many people make a living out of selling betel nut, so are resistant to bans in their areas. On Manus Island, young men are exposed to piracy when they use small boats to travel to the northern coast to purchase betel nuts to trade, and several have disappeared.In Australia, the importation, use, and sale of areca nut is banned, but it has been sold illegally in several South Asian supermarkets.
East Asia
In Hainan and Hunan Province, China, where Xiangtan is a center of use and processing, a wide range of old and young people consume areca nut daily. Most, though, consume the dried variety of the nut by itself, without the betel leaves. Some people also consume the areca nut in its raw, fresh form with or without the betel leaves. Betel nuts are sold mostly by old women merchants, but the dried version can be found in shops that sell tea, alcohol, and cigarettes.In Taiwan, bags of 20 to 40 areca nuts are purchased fresh daily by a large number of consumers. To meet the steady year-round demand, two kinds of betel-nut shops sell betel and nuts, as well as cigarettes and drinks, including beer: small mom and pop shops, often poorly maintained and with unassuming façades, and shops which will often consist of nothing more than a single, free-standing room, or booth. The latter is usually elevated one meter above the street, and measures less than 3 by 2 m. Large picture windows comprise two or more of the walls, allowing those who pass by a complete view of the interior. The interior is often painted brightly. Within such a shop, a sexily dressed young woman, a "betel nut beauty", can be seen preparing betel and areca nuts. Shops are often identified by colorful LED lamps or neon lights that frame the windows or that are arranged radially above a store. Customers stop on the side of the road and wait for the girls to bring their betel and areca nut to their vehicles. The habit of chewing betel nut is often associated with blue-collar labor industries such as long-haul transportation, construction, or fishing. Workers in these labor-intensive industries use betel nut for its stimulating effect, but it also becomes a tool for socializing with coworkers. For example, studies have shown chewing betel nut is prevalent among taxi, bus and truck drivers, who rely on the stimulating effect of betel nut to cope with long work hours. For these reasons, oral cancer has been identified as a leading cause of death in professions with high betel nut-chewing rates.