BETEL NUT: HISTORY, USE, BUZZ, BOTANY, PRODUCTION AND HEALTH

BETEL NUT

Betel (Areca) Nut Palm and Seeds

Betel net is a mildly narcotic seed that comes from the areca nut palm (“Areca catechu”, or A. catechu L.). Used for thousands of years and properly known as areca nut, it is popular in India, South Asia, China, the Pacific and Southeast Asia. The ancient Greek physician and scientist Theophratus discussed it but it was largely unknown in the West until the first Portuguese, Spanish and Dutch explorers to Asia described it in the 16th century. There are references to it in ancient Sanskrit texts. Archaeological evidence of its use dates back 13,000 years

An estimated that 600 million to 700 million people — a tenth of humanity — regularly chews betel nut. In many places, everybody chews it, even children and it can be bought at almost any store. Many people grow it in their backyards. Some people even believe that ghosts chew it. Others regard it as magical and offer it gods and use it to ward off the evil eye.

The olive-size betel nuts are usually cut into pieces and sucked on or chewed like chewing tobacco, in conjunction with lime and betel leaf, which are necessary to release the nuts’ stimulating effect. It is consumed as a hunger suppressant, breath freshener and tobacco substitute as well as a stimulant. Betel (areca) nut should not to be confused with betel (Piper betle, or P. betle L) leaves that are often used to wrap it (a preparation known as a quid). In his book on the natural history of Southeast Asia, Rumphius (1627-1702) portrays betel chewing as an example of human ingenuity as all three components — areca nut, lime and betel leaf, each one unpleasant when consumed by itself — have to be combined to release its effect. [Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

Some reports have listed betel nut as the “fourth most popular” recreational drug. Others worry about its negative health impact — which include mouth and throat cancer — as it is so popular. “It is largely people in the lower educational and economic groups — farmers, fishermen, truckers — who chew areca nut since it is a cheaper alternative to cigarettes. Additionally, in societies where cigarette smoking is “socially unacceptable” for women, “chewing tobacco is seen as traditional and accepted,” says Pankaj Chaturvedi, a head and neck surgeon at leading public cancer hospital Tata Memorial in Mumbai, told Quartz. [Source: Ananya Bhattacharya, Quartz, January 18, 2022]

Cindy Sui and Anna Lacey of the BBC wrote: "Such is its effectiveness, that alongside nicotine, alcohol and caffeine, betel nuts are believed to be one of the most popular mind-altering substances in the world...It gives people a buzz equivalent to six cups of coffee and is used variously as a symbol of love, marriage and a cure for indigestion and impotence. But it is also leading tens of thousands to an early grave. Although used by women and children, the nuts are especially popular among working-age men, who chew to stay awake through long hours of driving, fishing or working on construction sites. High rates of oral cancer are destroying the lives of many who buy betel nuts, often decades after their first taste. [Source: Cindy Sui and Anna Lacey, BBC, March 22, 2015]

Among the places betel nut is widely consumed are India, Nepal, Sri Lanka, Bhutan, Pakistan, the Maldives, Bangladesh, Iran, Myanmar, China, Laos, Thailand, Brunei, Malaysia, Indonesia, Cambodia, Vietnam, Taiwan, the Philippines, Palau, Yap, Guam, Papua New Guinea, the Solomon Islands, Vanuatu, and even Madagascar, Kenya and Tanzania in Africa and places in the Middle East. Maybe many of the users in the Middle East and Africa are of south Asian descent.

Origin of Betel Nut Chewing

How or when the areca nut and the betel leaf were first combined into one psychoactive drug is not known. Archaeological evidence from Thailand, Indonesia, and the Philippines suggests they have been used together for at least 4000 years. The earliest archaeological evidence of A. catechu palm is found at Spirit Cave in Thailand and dated to 10,000 years ago and eastern Timor, dated to 13,000-4000 years ago, but it is not clear what it was used for. Betel-stained teeth were first documented in the Philippines in 3000 B.C.

Thomas J. Zumbroich wrote: For the origins of the betel habit and arboriculture of the areca nut palm in Southeast Asia and beyond, surprisingly early dates as far back as 13000 before present have been presented. Those claims are based on archaeobotanical evidence reported over the last “ several decades “from sites in New Guinea to southern India. Excavations in caves in eastern Timor were reported to have yielded remains of Areca sp. and seeds of Piper sp. in the layers dated before 3000 B.C., representing ‘the two ingredients of betel chewing’. However, a later publication shows the identification of Areca sp. seeds merely as ‘possible’ or ‘fair’, and only so in layers dated 2500 before present. [Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

During excavations of the Spirit Cave in northwestern Thailand at levels corresponding to about 9000 to 7600 before present uncarbonized and carbonized fruit fragments were identified as belonging to Areca sp. Taking into account five uncarbonized Piper sp. seeds from that same time horizon the conclusion was drawn that betel chewing could have been part of the repertoire of the Hoabinhian culture. Gorman also raised the issue of possible domesticity of the presumed areca nut palms at Spirit Cave. Not only must questions be raised about the antiquity of the uncharred botanical remains, but given the uncertainty about the actual species of the remnants, it would be difficult to infer betel chewing, let alone cultivation of A. catechu L. from these findings.

Betel Nut Chewing in Ancient Southeast Asia

Betel nut user in the Hill Tribe area of Thailand

Thomas J. Zumbroich wrote: Dental remains from archaeological contexts are important indicators of life style and diet of prehistoric populations. Reddish-brown, so-called ‘betel stains’ on dentitions have been adduced as evidence for the use of the areca nut with lime if other dietary components or post mortem conditions were unlikely causes. Confounding this type of evidence is a practice called ‘teeth blackening’ that involves the purposeful staining of the visible surfaces of previously etched permanent teeth with a variety of agents. Teeth dyeing can be performed for aesthetic reasons and as a rite of passage, such as puberty or marriage. The custom is documented ethnohistorically in many betel chewing cultures of Southeast Asia and the Pacific Islands. Therefore, depending on the type of stain observed on teeth, different causes have been implied. Relatively indiscriminant discolouration is thought to be caused by incidental staining from casually chewing a mixture of areca nut with lime, whereas staining focussed on the facial aspect of anterior teeth might be due to deliberate staining. [Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

The oldest evidence from dentitions comes from a burial site in the Duyong Cave on Palawan island in the southern Philippines that contained skeletal remains with visible stains on teeth compatible with those observed after betel chewing. The skeletons were accompanied by six Anadara shells that appeared to be lime containers as one was still filled with lime. This burial pit was dated to about 2660 B.C., with evidence pointing to the occupation of the cave by an indigenous community of hunter-gatherers at least one thousand years prior. Stained teeth and containers for lime were also found in other caves in the area corroborating the suggestion that betel chewing was practiced. Other evidence for the Philippines dates from the considerably later Metal Age (first millennium C.E.). Teeth from a burial site on the island of Bohol (Central Visayas region of the Philippines) were found to have the characteristic reddish stain associated with betel chewing. At the expansive neolithic site of Beinan on the East Coast of Taiwan numerous skeletal remains in the over fifteen hundred excavated burial sites had dentitions with stained teeth.

Evidence for the earliest use of areca nut in mainland Southeast Asia in fact points to two different cultural complexes with different linguistic affiliations in Vietnam. One of them is the Dong Son culture centered on the Red River delta in northern Vietnam. It reached its classical phase around the middle of the last millennium B.C. Dentitions ranging in age from 3000 to 1700 before present from a Dong Son site in Nui Nap] have been subjected to further analyses.Three quarters of the assessed individuals displayed some dark-reddish stains on their teeth. One maxillary incisor dated 2400 to 2000 before present was examined with scanning electron microscopy which showed changes in surface morphology consistent with deliberate etching. Mass spectrometrical analysis of the actual stain material on the same tooth showed some identical mass fragments between the stain and areca nut extract, but no alkaloids specific to A. catechu L. were detectable in the stain. This study tentatively supports that areca nut was known to the inhabitants of Nui Nap and was used in the context of teeth dyeing (after a process of etching) and hence probably was also chewed casually. Betel chewing in pre-Dong Son Metal cultures of North Vietnam (Phung Nguyen and Dong Dau cultures), with dates as early as the first half of the second millennnium B.C., has been proposed but the validity of these claims cannot be assessed for lack of documentation.

Betel Nut Chewing Spreads to South Asia and the Pacific Islands

Betel chewing appears to have originated in Southeast Asia, so how did it spread from there to South Asia and the Pacific Islands? Thomas J. Zumbroich wrote: By synthesizing evidence from the disciplines of archaeology, historical linguistics and textual analysis on the plants and the material culture of betel chewing, a picture emerges that is far more complex than had previously been suggested. Currently no single model of dispersal, such as the migration of Austronesian speakers, fully explains the transmission of A. catechu L. and P. betle L. across Asia. However, a number of biological and cultural factors can be identified that have facilitated the dynamic expansion of betel chewing across a wide geographic area up to the present.[Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

Llinguistic analysis confirms that neither areca nut nor betel leaf were native to southern India. They were probably introduced in the time period before the breakup of Proto-South Dravidian which is estimated to have occurred around 1500 B.C. Despite claims to the contrary, none of the works of the Vedic period which ended around 700 B.C. contain any convincing references to the betel habit. Such references are also absent from the later and rather encyclopedic epic Mahābhārata. Only in a single edition of a subrecension of the Rāmāyana is the term tāmbūlika ‘betel seller’ present, but this variant reading is of a relatively late date. In its archetypal form the Rāmāyana reflects the time period between 750 and 500 B.C. before the rise of Buddhism.”

As for the Pacific Islands: “For Western Micronesia, historical accounts from the time of first European contact described that on the Mariana Islands indigenous Chamorro ‘continously’ chewed a betel quid and that the women commonly stained their visible teeth black. Detailed chemical analysis of a tooth of a female from the Latte period (A.D. 1000 to 1521) presumed to have been ‘blackened’ proved that the brown residue indeed contained areca nut alkaloids, though the authors’ other conclusion that on the Marianas ‘women did not chew areca nut on a regular basis’ is clearly wrong. Further evidence from the Marianas dated to the pre-Latte (first millennium) to Latte periods, including staining as well as patterns of dental pathology, indicates that betel chewing was widely practised. On Guam, the southernmost of the Mariana Islands, archaeological findings of shell containers filled with slaked lime point in the same direction. An even earlier, well-documented date is provided by the investigation of 3000 year old burial sites at Chelechol ra Orrak on the island of Palau where reddish stains on teeth, and, so it is presumed, the use of betel, were very common amongst adults. Whether the observed concentration of stains on antemolar teeth was primarily due to deliberate staining or betel chewing cannot be resolved based on the evidence presented. The early use of areca nut appears to be supported by microfossil pollen records for Palau that indicate a presence of A. catechu L. at roughly compatible dates, though no concomitant evidence for the presence of a Piper species was found. Reflexes of Proto-Austronesian *buaq ‘areca nut’ in Chamorro and Palauan confirm the notion that the areca nut palm was introduced to the Marianas and Palau with the settlement by Austronesian speakers from the Philippines and/or eastern Indonesia. The areca nut tradition would therefore date to about 1500 B.C. in the Marianas and 1000 B.C. for Palau,

“There is a scarcity of findings from Melanesia [Papua New Guinea, Solomon Islands and parts of the South Pacific) except for untested dental staining reported from the St. Matthias (Mussau) Islands of the Bismarck archipelago [with a date of 1600 to 500 B.C.These dental remains are connected with the earliest sites of the distinctive ‘Lapita cultural complex’. After about 1500 B.C. betel chewing spread from there as part of the Lapita diaspora across the Southwest Pacific into the Solomon Islands and the Santa Cruz area.

Highlights of Betel Nut History

There is evidence that the chewing of betel and areca nut dates took place in the pre-Vedic Indus Valley Civilization. In ancient India and Sri Lanka, royalty chewed areca nut with betel leaf and kings had special attendants whose job was to carry a box with all the necessary ingredients for chewing. There was also a traditional for lovers to chew areca nut and betel leaf together, because of its breath-freshening and relaxant properties. As a result of this sexual symbolism became attached to the chewing of the nut and the leaf, with areca nut representing the male principle, and the betel leaf the female principle. The areca nut and betel leaf are used in religious ceremonies and to pay respect to people in South Asia and both are considered auspicious in Hinduism and some schools of Buddhism, [Source: Wikipedia]

On what he saw in India in the A.D. 14th century, Ibn Battuta wrote: “"Betel-trees are grown like vines on can trellises or else trained up coco-palms. They have no fruit and are only grown for their leaves. The Indians have a high opinion of betel, and if a man visits a friend and the latter gives him five leaves of it, you would think he had given him the world, especially if he is a prince or notable. A gift of betel is a far greater honour than a gift of gold and silver. It is used in the following way: First one takes areca-nuts, which are like nutmegs, crushes them into small bits and chews them. Then the betel leaves are taken, a little chalk is put on them, and they are chewed with the areca-nuts." [Source: "Ibn Battuta, Travels in Asia and Africa 1325-1354" published by Routledge and Kegan Paul, p. 114, from A.S. Chughtai, Silk Road Foundation silk-road.com ]

In 1568, the Spanish mariner Álvaro de Mendaña reported observing Solomon Islanders chewing areca nut and betel leaf with caustic lime and commented on how the habit stained their mouths red. He noted how friendly chief on Santa Isabel Island offered him some as a token of friendship every time they met. The addition of tobacco leaf to the chewing mixture is a relatively recent innovation, as tobacco was not introduced from the American continent until the colonial era. [Source: Wikipedia]

Chewing Betel Nut

Betel Nut (Areca) Palm and Seed

Betel nut turns the saliva a bright red color. Frequent usage turns the teeth, gums and the inside of the mouth red and eventually black. The lime causes the copious amounts of red saliva, which should not be swallowed. You can often even tell a betel chewer when his or her mouth is closed — the fingertips are also usually bright red. Many people who chew betel nut have terrible teeth. Ironically chewers say they chew betel nut to protect their tooth from tooth decay and recent scientific research seems to back up these claims.

Usually for chewing, a few slices of the nut are wrapped in a betel leaf along with calcium hydroxide (slaked lime) and may include cloves, cinammon, cardamom, catechu (kattha), or other spices for extra flavouring. Some people chew beetle nut without lime, for the taste, which has been compared with licorice and cheap toothpaste. Powdered betel nuts can be brewed like coffee. In India it is mixed with spices and wrapped in leaves and eaten as a snack. In Malaysia, it is mixed with acacia gun, lime and nutmeg. You can eat betel leaves. Betel leaf has a fresh, peppery taste, and is sometimes described as a pepper leaf, but it can also be bitter to varying degrees depending on what kind it is. [Source: Wikipedia]

The first time I tried betel nut was in Yap in Micronesia in the late 1990s. There, it seemed like everyone chewed it. The nuts were green and looked sort of like fresh acorns. Users cut up their own nuts and put the pieces in their mouth with a little lime and betel leaves, which they had in separate bags. I chewed much of the day and had an enjoyable time walking through mangrove swamps with fiddler crabs, along beaches with giant coconut crabs and visiting villages with giant stone money. When I needed some more nuts the owner at my guesthouse climbed a tree and got some for me. On a trip to Assam and Arunachel Pradesh in northeast India in the 2010s I consumed betel nut along Nagaland ganja. It was a nice dreamy but alert buzz that heightened the pleasure of looking at rainforest and Himalayan mountain scenery out the window of the SUV I spent much of the day traveling in. I also chewed a lot of betel nut with my driver in Bhutan.

Betel Nut High

Betel nut produces a stimulating high that is similar to the high one gets from chewing coca leaves (the source of cocaine). Both betel nut and coca are chewed with lime, which stimulates saliva flow and causes chemical reactions with the chemicals in the nut and leaves to produce the mild stimulant. The active ingredient in betel nut is a volatile oil called arecoline. Released from the nut by saliva and lime, it is a mild central nervous system stimulant which increases respiration.

It is said that betel nut causes a warming sensation in the body and slightly heightened alertness, but effects can vary from person to person. The major alkaloid in betel nut is arecoline. Other compounds in include arecaidine, guvacine, isoguvacine, guvacoline and arecolidine. Arecoline, arecaidine and guvacine all have vasoconstricting properties that cause muscles around the blood vessels to tighten and become narrower. The main tannins are proanthocyanidins along with catechins and arecatannin The areca nut also contains gallic acid; a fixed oil gum; a little terpineol; lignin and various saline substances The betel leaf chewed along with the nut contains eugenol, another vasoconstrictor. Tobacco leaf is often added to the mixture, thereby adding the effect of nicotine.

Zumbroich wrote: Betel chewing releases a complex set of biologically active components into the blood stream which result in diverse physiological and psychosomatic responses. Betel chewers experience a sense of well-being, heightened alertness, a warm body sensation, improved digestion and increased stamina. This wide range of effects has been validated by an understanding of some of the underlying mechanisms. After chewing a betelnut, the red residue is generally spat out. [Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

Betel Palm

Betel nuts are the fruit of the betel palm. They are not a true nut, but rather the seed of a fruit categorized as a berry. The “nuts” are about the size and shape of olives or hen’s eggs and are yellowish to scarlet with a fibrous covering. They grow in clusters of 200 to 300 and hang in bunches under the palm canopy at the top of betel nut palm trees. Betel nuts are harvested when the fruits are ripe. When the nut is washed free of pulp it is about the size of an acorn. Most people who collect their own nuts do so by picking them from the tree or knocking them with a stick.

The areca nut palm (Areca catechu) grows in much of the tropical Pacific (Melanesia and Micronesia), South and Southeast Asia, and parts of east Africa like in Kenya. Indigenous to Indonesia, the species arrived in India sometime in the 4th century and has been a mainstay there ever since. [Source: Wikipedia]

The betel nut palm is very tall and slender. It can grow up to 30 meters (100 feet) tall with a trunk only six inches in diameter. It is topped by a crown of three, six-foot-long leaved divided into many leaflets. An adult tree can produce 250 nuts a year. In the Pacific, the betel nut palm does not grown on the coral atolls and residents of these islands are totally dependent on large islands for their betel nut supply.

Farmers like betel nut palms because they are easy to grow and maintain and require relatively little fertilizer. The trees bear fruit after five years and nuts are quite valuable. A farmer can earn about 16 times more growing betel than rice.

Zumbroich wrote: A.catechu L. is part of a genus of forty-eight species of understory palms and thrives in humid tropical forests at low to medium elevations. Unlike some other members of its genus, A.catechu L. is quite adaptable. It readily self-seeds and is tolerant of open conditions. As is the case with other cultigens, including a number of palms such as the coconut (Cocos nucifera L.), peach palm (Bactris gasipaes Kunth) or sugar palm (Arenga pinnata (Wurmb.) Merril), the origin of A. catechu L. is unclear. Other Areca species are widespread from India along the Sunda shelf crossing Wallace’s line to Papua New Guinea. Speculations on the center of origin for A. catechu L. have ranged from the Andamans to Western Malaysia and Java to the Philippines. Amongst the various hypotheses, the one with relatively the strongest support is Beccari’s, who argued that A. catechu L. speciated in the Philippines. [Source: Thomas J.Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

Ingredients of the Betel Nut Quid

Zumbroich wrote: “The ingredient common to almost all masticatory mixtures referred to as ‘betel chew’ or “quid” is the fruit of Arecacatechu L. The fruit of the ‘areca nut palm’ turns a yellow to scarlet colour as it ripens and then consists of a thick fibrous pericarp, the so-called husk, that encloses the seed, commonly, yet incorrectly called a nut.. This seed which is primarily made up of reddish brown endosperm with dark waxy lines is masticated after dehusking and slicing. Depending on local preference, the fruit is harvested at different stages of maturity. All parts of A. catechu L., but in particular the endosperm contain as biologically active components four related pyridine alkaloids and a wide range of phenolic compounds In cases where Arecacatechu L. palm is difficult to obtain, the seeds of other wild growing palm species such as, e.g. Pinangadicksonii Blume in South India or Arecamacrocalyx Zipp. ex Blume on the Moluccas and New Guinea, can be substituted as an inferior choice.[Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

Slaked lime (calcium hydroxide, Ca(OH)2) is the second essential ingredient of the betel chew. Its increases the intraoral alkalinity which in turn reduces the astringency of the tannins of areca nut, releases its alkaloids, especially arecoline, and aids the overall freshening effect on the mouth. Hence, lime makes the betel quid both more palatable and physiologically effective. Quicklime (Calciumoxide, CaO) is traditionally prepared in coastal areas by heating the shells of marine molluscs or coral to high temperature. Freshwater shellfish or terrestrial molluscs and, rarely, pearls are alternative raw materials. If actual limestone is available, such as in Thailand or Vietnam, it is preferred by connoiseurs for its superior taste. The lime is usually smeared onto the of the leaf of Piper betle L.

Piper betle L. (‘betel pepper’) is the third essential ingredient of the betel chew. Many members of the complex genus Piper L., with over a thousand species, contain volatile aromatic oils, and their leaves are used for a variety of medicinal or culinary purposes. Piper betle L. is a climbing plant typically propagated asexually from stem cuttings rather than from seeds. The leaves of P. betle L. have a relative high content of phenolic compounds which not only taste refreshingly but also exert a range of pharmacological activities. The broad heart shape of the leaf makes itideally suited for assembling areca nut and lime paste on its surface and to be folded into a ‘betel quid’

Types of Betel Nut Preparations

Betel nut is commercially available in dried, cured, fermented, boiled and fresh forms. When the husk of the fresh fruit is green, the nut inside is soft enough that it can be be cut with a normal knife. As the fruit ripens, the husk becomes yellow or orange. 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. [Source: Wikipedia]

The way the nuts are prepared varies from region to region. Typically, they are boiled, dried and sliced first. In India, Taiwan, the Philippines and Southeast Asia, betel nut is usually dried and cut into small pieces and sold already wrapped with lime in a ready-to-chew betel- or pepper-leaf quids. In India it is dried and called paan. Paan Masala refers to an aromatic been blend of spices and condiments chewed with betel. Gutka is a betel quid preparation made of crushed areca nut, tobacco, catechu, paraffin wax, slaked lime and sweet or savory flavorings. It is popular in India, Pakistan, other South Asian countries.

On Yap and other Micronesian islands, the seed is bit open while it is still green and then wrapped in a pepper leaf along with some lime made from burnt and pulverized coral or clam shells, and then chewed. Sometimes it is chewed with tobacco or tobacco soaked in vodka. In Taiwan fresh, very unripe fruit is included in the betel quid without dehuskin. In the southern Chinese province of Hunan only the husk is chewed without betel leaf or lime. Often, colored and aromatic plant products, such as catechu (heartwood extract from Acacia catechu L.) or turmeric are added to the lime to improve the taste. Sometimes a specific color is added that is considered auspicious for a certain occasion. [Source: Thomas J. Zumbroich, “The origin and diffusion of betel chewing: a synthesis of evidence from South Asia, Southeast Asia and beyond,” Journal of Indian Medicine, 2008]

Betel Nut and Medicine

In addition to its use as a stimulant the areca nut — and other parts of the areca palm — has traditionally been used in a variety of medicinal purposes, most significantly for intestinal ailments and to get rid of worms. According to traditional Chinese medicine, betel nut aids digestion, removes plaque and expels worms. Chinese who eat just the preserved husk do so to deter the fruit’s carcinogenic effects, according to recent studies but local dentists and doctors denounce the practice, saying it can cause other mouth diseases.

In parts of India and Sri Lanka, areca nuts are used in the preparation of Ayurvedic medicines. Powdered areca nut is a component of dentifrices and drinks use to get rid of tapeworms and other intestinal parasites. The drinks often have a few teaspoons of powdered areca nut. There are also decoctions (concentrated liquors made from heating or boiling the nut or plant parts) and tablets containing the extracted alkaloids. [Source: Wikipedia]

Betel nut is used in Ayurvedic medicine to treat headaches, stomach pains, venereal diseases, fever, rheumatism and other ailments. Some chewing areca nut and betel leaf is a good remedy against bad breath. In the 1830s, the diplomat Edmund Roberts noted that Chinese people mix areca nut with Uncaria gambir (a plant used in tanning and betel nut chewing) during his visit to China.

Betel Nut Spitting and Red Lips

Betel nut makes the saliva red. Regular usage stains the mouth, teeth and gums red. Long terms users have damaged and blackened teeth and damaged soft tissues in the mouth. The red juice that users spit is quite unsightly and places with many betel nut chewers often have sign forbidding the nut. The red splotches on the ground and pavement are such an eyesore that betel use is outlawed. Watching somebody spit out the red juice is not a pleasant sight either.

When I arrived at the airport in Yap, Micronesia, one of my first sights was a group of topless elderly women with red-stained lips chewing betel nut. There the floor was painted red so the betel nut splotches didn’t stand out.

Brigette and Robert wrote on their blog “Brigette and Robert on Tour”: “Spitting – A National Phenomenon. We have to admit that it took us a while to get used to the look of people’s faces, especially men’s faces. Most Myanmari men have quite ugly looking red lips and discolored teeth. While you talk to them they always chew something and suddenly they start spitting out red saliva right next to you. You can see red spit on the streets literally everywhere. Let’s face it: it looks disgusting, but you get used to it. Different cultures, different habits!.. Bus drivers spit their red saliva in transparent plastic bags while driving… we often had a seat in the very front – just envision this delicious sight and the wonderful noise when you try to fall asleep on a 15 hours bus ride?! [Source: Brigette and Robert on Tour, Blog]

Betel Nut Health Issues

The active ingredient in betel nut — the a volatile oil arecoline — is released from the nut by saliva and lime. Studies of the drug have shown that it improves learning and memory and counteracts intestinal parasites. Mostly betel nut is considered a health hazard — linked with throat, mouth and esophageal cancers and other ailments such as chronic kidney disease in men and milk-alkali syndrome.

Ananya Bhattacharya wrote in Quartz: “Betel nut addiction is spawning a major health crisis. Not only has it been classified as a group 1 carcinogen, chewing it, with or without tobacco, is also shown to damage vital organs to cause liver cirrhosis, type II diabetes, cardiovascular disease, and other serious ailments. The US food and drug authority has listed it among poisonous plants; Australia considers it a prescription-only medicine, illegal to possess or sell without permission. The habit is also a “hidden gateway” to tobacco use among the youth. More than 45% of school-going kids in rural India have developed the habit, with the likelihood increasing among government school students.” Quartz photographed one 62-year-old manwho used to consume gutka, at a New Delhi hospital after doctors lopped off parts of his jaw, gums, and teeth to stop the spread of cancer in his mouth, in August 2012. [Source: Ananya Bhattacharya, Quartz, January 18, 2022]

According to Garg et al. (2014): Areca nut affects almost all organs of the human body, including the brain, heart, lungs, gastrointestinal tract and reproductive organs. It causes or aggravates pre-existing conditions such as neuronal injury, myocardial infarction, cardiac arrhythmias, hepatotoxicity, asthma, central obesity, type II diabetes, hyperlipidemia, metabolic syndrome, etc. Areca nut affects the endocrine system, leading to hypothyroidism, prostate hyperplasia and infertility. It affects the immune system leading to suppression of T-cell activity and decreased release of cytokines. It has harmful effects on the fetus when used during pregnancy.”

According to Medline Plus, Acute effects of betel chewing include asthma exacerbation, hypertension, and tachycardia. Other effects can include altered blood sugar levels, which may in turn increase the risk of developing type 2 diabetes." Bloomberg reported: “A 2000 study of ethnic Indian users in London found that paan masala can be as addictive as cocaine, according to the British Medical Journal. Patients describe typical dependency symptoms, with difficulty in abstaining, withdrawal symptoms including headache and sweating, and need for a morning paan to relieve these symptoms,'' the 2002 Journal report said.[Source: Yu-huay Sun, Bloomberg, January 26, 2006, Wikipedia]

Research conducted by Loma Linda University in the United States of America and WHO’s Dr Daravuth Yel shows that betel nut quid (areca nut, betel leaf and tobacco) may make users more susceptible to such infectious diseases as HIV, tuberculosis, dengue and typhoid. The study, which analysed results of Cambodia’s national tobacco survey and was published in the International Journal of Infectious Disease, raises the possibility that tobacco control could be an important component in the control of infectious diseases. Compared to people who did not use betel quid, users were 2.6 times more likely to be diagnosed with HIV/AIDS, 2.4 times more likely to have had dengue, 1.5 times more likely be diagnosed with tuberculosis and 1.48 times more likely to have had typhoid. [Source: Wikipedia]

Betel Nut and Cancer

According to Medline Plus, "Long-term use [of betel-areca preparations] has been associated with oral submucosal fibrosis (OSF), pre-cancerous oral lesions and squamous cell carcinoma. There may be a higher risk of cancers of the liver, mouth, esophagus, stomach, prostate, cervix, and lung with regular betel use.

Audrey Wang wrote in the Taiwan Review, “As early as in 1985, "WHO-affiliated International Agency for Research on Cancer (IARC) "found betel quid (the combination of betel nut and lime paste wrapped in betel leaf) to have carcinogenic properties, just like tobacco. And like tobacco, betel nut is seen to be habit-forming thanks to the presence of arecoline. Similar in structure to nicotine, arecoline is believed to be the source of betel nuts' stimulating effect. The IARC in 2004 further identified arecoline as a possible cause of oral submucous fibrosis, a precancerous condition. [Source: Audrey Wang, Taiwan Review, February 2008 ~]

The IARC lists the ingredients of the betel nut quid, with the exception of cardamom and cinnamon, as cancer-causing agents. According to to the BBC: “The slaked lime is seen as a particular problem as it causes hundreds of tiny abrasions to form in the mouth. This is thought to be a possible entry point for many of the cancer-causing chemicals. "About half of the men here still don't know that betel nuts can cause oral cancer," says Prof Hahn Liang-jiunn, an oral cancer specialist at the National Taiwan University Hospital. "[This is despite] Taiwan's incidence or mortality rates for oral cancer ranking among the top two or three in the world." [Source: Cindy Sui and Anna Lacey, BBC, March 22, 2015]

Various compounds in betel the nut, including nicotine-like arecoline, have been linked to degrading oral mucosa ( mucous membrane lining the inside of the mouth). As with chewing tobacco, its use is discouraged. Because betel nut is consumed by hundreds of millions of people worldwide, its use has been described as a "neglected global public health emergency". In 2003 the IARV found sufficient evidence to say that betel quid chewing causes cancer in humans, a conclusion confirmed at an IARC meeting in October 2009 with 30 scientists from 10 countries. [Source: Wikipedia]

World’s Top Areca Nut Producing, Exporting and Importing Countries

World’s Top Producers of Areca Nuts (2020): 1) India: 904729 tonnes; 2) Bangladesh: 328610 tonnes; 3) Myanmar: 203215 tonnes; 4) Indonesia: 132601 tonnes; 5) Taiwan: 98565 tonnes; 6) Sri Lanka: 63986 tonnes; 7) Thailand: 38204 tonnes; 8) Bhutan: 17446 tonnes; 9) Nepal: 8782 tonnes; 10) Kenya: 113 tonnes; 11) Maldives: 13 tonnes; 12) Malaysia: 2 tonnes. [Source: FAOSTAT, Food and Agriculture Organization (U.N.), fao.org. A tonne (or metric ton) is a metric unit of mass equivalent to 1,000 kilograms (kgs) or 2,204.6 pounds (lbs). A ton is an imperial unit of mass equivalent to 1,016.047 kg or 2,240 lbs.]

World’s Top Producers (in terms of value) of Areca Nuts (2019): 1) India: Int.$2478420,000 ; 2) Bangladesh: Int.$871202,000 ; 3) Indonesia: Int.$411099,000 ; 4) Myanmar: Int.$373177,000 ; 5) Taiwan: Int.$285436,000 ; 6) Sri Lanka: Int.$147564,000 ; 7) Thailand: Int.$110132,000 ; 8) Bhutan: Int.$44306,000 ; 9) Nepal: Int.$15245,000 ; 10) Malaysia: Int.$567,000 ; 11) Kenya: Int.$311,000 ; [An international dollar (Int.$) buys a comparable amount of goods in the cited country that a U.S. dollar would buy in the United States.]

World’s Top Exporters of Areca Nuts (2020): 1) Indonesia: 205200 tonnes; 2) Myanmar: 70080 tonnes; 3) Thailand: 48562 tonnes; 4) Singapore: 25499 tonnes; 5) Sri Lanka: 13711 tonnes; 6) Vietnam: 3251 tonnes; 7) India: 2519 tonnes; 8) Malaysia: 1630 tonnes; 9) United Arab Emirates: 1372 tonnes; 10) Hong Kong: 152 tonnes; 11) Taiwan: 98 tonnes; 12) Nigeria: 98 tonnes; 13) China: 82 tonnes; 14) Bangladesh: 22 tonnes; 15) Poland: 18 tonnes; 16) Pakistan: 9 tonnes; 17) South Africa: 7 tonnes; 18) United Kingdom: 7 tonnes; 19) Syria: 5 tonnes; 20) France: 4 tonnes.

World’s Top Exporters (in value terms) of Areca Nuts (2020): 1) Indonesia: US$256518,000; 2) Myanmar: US$111681,000; 3) Thailand: US$75023,000; 4) Sri Lanka: US$49530,000; 5) Singapore: US$30349,000; 6) India: US$10310,000; 7) Vietnam: US$7578,000; 8) United Arab Emirates: US$2438,000; 9) Malaysia: US$2308,000; 10) China: US$226,000; 11) Poland: US$209,000; 12) Hong Kong: US$202,000; 13) Taiwan: US$137,000; 14) Jordan: US$126,000; 15) Bangladesh: US$87,000; 16) Pakistan: US$49,000; 17) Syria: US$35,000; 18) United Kingdom: US$29,000; 19) Nigeria: US$21,000; 20) France: US$11,000

World’s Top Importers of Areca Nuts (2020): 1) Iran: 100844 tonnes; 2) Thailand: 26462 tonnes; 3) Singapore: 25848 tonnes; 4) India: 25485 tonnes; 5) Bangladesh: 18098 tonnes; 6) Afghanistan: 8936 tonnes; 7) China: 4054 tonnes; 8) Malaysia: 2221 tonnes; 9) Nepal: 2030 tonnes; 10) United Arab Emirates: 934 tonnes; 11) Maldives: 833 tonnes; 12) United States: 571 tonnes; 13) Poland: 550 tonnes; 14) Indonesia: 442 tonnes; 15) Hong Kong: 369 tonnes; 16) United Kingdom: 300 tonnes; 17) Saudi Arabia: 272 tonnes; 18) Vietnam: 215 tonnes; 19) Sri Lanka: 135 tonnes; 20) South Africa: 127 tonnes.

World’s Top Importers (in value terms) of Areca Nuts (2020): 1) Iran: US$137388,000; 2) India: US$75453,000; 3) Singapore: US$30708,000; 4) Bangladesh: US$30346,000; 5) Thailand: US$28534,000; 6) Afghanistan: US$12886,000; 7) Poland: US$6144,000; 8) China: US$4413,000; 9) Maldives: US$4217,000; 10) United States: US$3539,000; 11) Nepal: US$2758,000; 12) Malaysia: US$1970,000; 13) United Arab Emirates: US$1591,000; 14) Saudi Arabia: US$1454,000; 15) United Kingdom: US$902,000; 16) South Africa: US$751,000; 17) Vietnam: US$711,000; 18) Indonesia: US$511,000; 19) Sri Lanka: US$491,000; 20) Hong Kong: US$364,000

In the United States, areca nut is not a controlled or specially taxed substance and may be found in some Asian grocery stores. However, importation of areca nut in a form other than whole or carved kernels of nuts can be stopped at the discretion of U.S. Customs officers on the grounds of food, agricultural, or medicinal drug violations nut this rarely happens. [Source: Wikipedia]

Image Sources: Wikimedia Commons

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated April 2022