Betel Quid Health Risks of Insulin Resistance Diseases in Poor Young South Asian Native and Immigrant Populations

Suzanne M. de la Monte, Natalia Moriel, Amy Lin, Nada Abdullah Tanoukhy, Camille Homans, Gina Gallucci, Ming Tong and Ayumi Saito
Additional contact information
Suzanne M. de la Monte: Department of Pathology and Laboratory Medicine, Providence VA Medical Center, Providence, RI 02808, USA
Natalia Moriel: Department of Molecular Pharmacology and Physiology at Brown University, Providence, RI 02912, USA
Amy Lin: Department of Molecular Pharmacology and Physiology at Brown University, Providence, RI 02912, USA
Nada Abdullah Tanoukhy: Department of Molecular Pharmacology and Physiology at 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 in the School of Public Health, Brown University, Providence, RI 02912, USA

IJERPH, 2020, vol. 17, issue 18, 1-21

Abstract: Betel quid, traditionally prepared with areca nut, betel leaf, and slaked lime, has been consumed for thousands of years, mainly in the form of chewing. Originally used for cultural, medicinal, and ceremonial purposes mainly in South Asian countries, its use has recently spread across the globe due to its psychoactive, euphoric, and aphrodisiac properties. Now it is widely used as a social lubricant and source of financial profit. Unfortunately, the profit motive has led to high rates of habitual consumption with eventual conversion to addiction among young girls and boys. Moreover, the worrisome practice of including tobacco in quid preparations has grown, particularly among pregnant women. Major health concerns 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 contribute to cognitive decline and neurodegeneration. Mechanistically, the constituents of areca nut/betel quid are metabolized to N-nitroso compounds, i.e., nitrosamines, which are carcinogenic at high doses and cause insulin resistance following chronic low-level exposures. From an epidemiological perspective, the rising tide of insulin resistance diseases including obesity, diabetes, and dementias that now disproportionately burden poor countries has been propagated by rapid commercialization and enhanced access to betel quid. Public health measures are needed to impose socially and ethically responsible barriers to yet another cause of global health disparity.

Keywords: betel quid; arecoline; diabetes; dementia; tobacco; nitrosamine (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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