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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

Published online by Cambridge University Press:  09 March 2007

N. Mannan ,
B. J. Boucher  and
S. J. W. Evans
N. Mannan
Affiliation:
Academic Medical Unit and Cellular Mechanisms Research Group
B. J. Boucher*
Affiliation:
Academic Medical Unit and Cellular Mechanisms Research Group
S. J. W. Evans
Affiliation:
Department of Epidemiology and Medical Statistics, St Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary Westfield College, London E1 1BB, UK
*
*Corresponding author: Dr Barbara J. Boucher, fax +44 (0)171 377 7636, email [email protected]
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Abstract

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Type 2 diabetes is commoner in Asians than Caucasians. Many nitrosamines are diabetogenic, causing both type 2 and type 1 diabetes. Of CD1 mice fed with betel-nut or associated nitrosamines 8·5 % develop glucose intolerance with marked obesity. Glycaemia and anthropometric risk markers for type 2 diabetes were therefore examined in relation to betel usage in 993 ‘healthy’ Bangladeshis by one bilingual research-worker (N.M.). Of these, 12 % had known diabetes. A further 145 of 187 subjects ‘at-risk’ of diabetes (spot glucose >6·5 mmol/l <2 h after food, or >4·5 mmol/l >2 h after food) had a second blood glucose sample taken; sixty-one were confirmed as ‘at-risk’, and had an oral glucose tolerance test; nine new diabetics were identified. Multiple regression analysis showed that spot blood glucose values decreased with time after eating (P = 0·0005) and increased independently with waist size (P = 0·0005) and age (P = 0·0005) without relationships to other aspects of the diet, season or smoking. Waist size was strongly related to betel usage independent of other factors such as age. Betel use interacted with sex, relating to increasing glycaemia only in females. Since waist and age were the major markers of increasing glycaemia we suggest that betel chewing, a habit common to about 10 % of the world population (more than 200 million people) may contribute to the risk of developing type 2 diabetes mellitus.

Keywords

Central obesityBetel-nutDiabetesAsians
Type
Research Article
Information
British Journal of Nutrition , Volume 83 , Issue 3 , March 2000 , pp. 267 - 275
Copyright
Copyright © The Nutrition Society 2000

References

Balarajan, R (1991) Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. British Medical Journal 302, 560–564.CrossRefGoogle ScholarPubMed
Bansal, S, Rizvi, SNA, Rao, MB and Vaishnava, H (1975) Effect of hypocalcaemia on glucose tolerance, insulin release and free fatty acid levels in human subjects. Postgraduate Medical Journal 52, 471–475.CrossRefGoogle Scholar
Bedi, R & Gilthorpe, MS (1995) Betel-quid and tobacco chewing among the Bangladeshi community in areas of multiple deprivation. In Betel-quid and Tobacco Chewing Among the Bangladeshi Community in the United Kingdom, 1st ed., pp. 37–52 [Bedi, R, and Jones, P, editors]. London: Centre for Transcultural Oral Health.Google Scholar
Boucher, BJ, Ewen, SWB and Stowers, JM (1991) Betel nut (Areca catechu) consumption as an aetiological agent for diabetes mellitus; studies in CD1 mice and their offspring. Diabetic Medicine 8 (Suppl. 1), P4.Google Scholar
Boucher, BJ, Ewen, SWB and Stowers, JM (1994) Betel nut (Areca catechu) consumption and the induction of glucose intolerance in adult CD1 mice and in their F1 and F2 offspring. Diabetologia 37, 49–55.CrossRefGoogle ScholarPubMed
Boucher, BJ, Mannan, N, Noonan, K, Hales, CN and Evans, SJW (1995) Glucose intolerance and impairment of insulin secretion in relation to Vitamin Deficiency in East London Asians. Diabetologia 38, 1239–1245.CrossRefGoogle ScholarPubMed
Dave, BJ, Trivedi, AH and Adhvaryu, SG (1992) In vitro toxic effects of areca nut extract and arecoline. Journal of Cancer Research and Clinical Oncology 118, 283–288.CrossRefGoogle ScholarPubMed
Encyclopaedia Britannica (1996) Encyclopaedia Britannica Online. Areca catechu (betel-nut). http://www-lj.eb.com.Google Scholar
Gedik, O and Akalan, S (1986) Effects of Vitamin Deficiency and repletion on insulin and glucagon secretion in man. Diabetologia 29, 142–145.CrossRefGoogle ScholarPubMed
Helgason, T, Ewen, SWB, Jaffrey, B, Stowers, JM, Outram, JR, & Pollock, JR (1984) N-nitrosamines in smoked meats and their relation to diabetes. In IARC Scientific Publications no. 57, pp. 911–920. Lyon: IARC.Google Scholar
International Agency for Research on Cancer (1992) Monographs on the Evaluation of Carcinogenic Risk of Chemicals to Humans: Tobacco Habits Other Than Smoking; Betel-quid and Areca-nut Chewing, and Some Related Nitrosamines. IARC (WHO) Monographs no. 37. Lyon: IARC.Google Scholar
Johnson, NW (1991) Orofacial neoplasms: global epidemiology, risk factors and recommendations for research. International Dental Journal 41, 365–375.Google ScholarPubMed
Karam, JH, Lewitt, PA, Young, CW, Nowlain, RE, Frankel, BJ, Fujiya, H, Freedman, ZR and Grodssky, GM (1980) Insulinopenic diabetes after rodenticide (Vacor) ingestion. Diabetes 29, 971–978.CrossRefGoogle ScholarPubMed
Kiesel, U, Oschilewski, M, Taniguchi, M and Kolb, H (1989) Modulation of low-dose streptozocin-induced diabetes in mice by administration of antibodies to IA, IE and IL determinants. Diabetologia 32, 173–176.CrossRefGoogle Scholar
McKeigue, PM, Pierpoint, T, Ferrie, JE and Marmot, MG (1992) Relationship of glucose intolerance and hyperinsulinaemia to body fat pattern in South Asians and Europeans. Diabetologia 35, 785–791.CrossRefGoogle Scholar
Mannan, N (1992) Vitamin D status and its relationship to insulin levels in the Bangladeshi community of Tower Hamlets and to the contribution of fish oil to the diet. MSc Thesis, University of London.Google Scholar
Mather, PH and Keen, H (1985) The Southall Diabetes Survey; prevalence of known diabetes in Asians and Europeans. British Medical Journal 291, 1081–1084.CrossRefGoogle Scholar
Mukherjee, A, Chakrabarti, J, Chakrabarti, A, Banerjee, T and Sarma, A (1993) Effect of 'Pan Masala' on the germ cells of male mice. Cancer Letters 58, 161–165.CrossRefGoogle Scholar
Nishikawa, A, Prokopczk, B, Rivenson, A, Zang, E and Hoffman, D (1992) A study of betel-quid carcinogenesis. VIII. Carcinogenicity of 3-(methylnitrosoamino) propionaldehyde in F344 rats. Carcinogenesis 13, 369–372.CrossRefGoogle Scholar
Office of Population Censuses and Surveys (1991) Census User Guide 3: Local Statistics and Small Area Statistics. London: H.M. Stationery Office.Google Scholar
Okamoto, H, Yamamoto, S, Takasawa, S, Inoue, C, Terazono, K, Shiga, K & Kitagawa, M (1988) Molecular mechanisms of degeneration, oncogenesis and regeneration of pancreatic B-cells of islets of Langerhans. In Frontiers in Diabetes Research: Lessons From Animal Diabetes, pp. 149–157 [Shafrir, A, and Renold, AE, editors]. London: John Libby & Co.Google Scholar
Portha, B, Blondel, O, Serradas, P, McEvoy, R, Giroix, MH, Kergoat, M and Bailbe, D (1989) The rat models of non-insulin-dependent diabetes induced by neonatal streptozotocin. Diabete et Metabolisme 15, 61–75.Google ScholarPubMed
Prokopczk, BP, Rivenson, A, Bertinato, P, Brunnemann, KD and Hoffman, D (1987) 3-(Methylnitrosamino) propionitrile: occurrence in saliva of betel-chewers, carcinogenicity and DNA methylation in F344 rats. Cancer Research 47, 467–471.Google Scholar
Sheligar, KM, Hockaday, TDR and Yajnik, CS (1991) Central rather than generalised obesity is related to hyperglycaemia. Diabetic Medicine 8, 712–717.CrossRefGoogle Scholar
Simmonds, D, Williams, DRR and Powell, MJ (1991) The Coventry Diabetes Study: prevalence of diabetes and impaired glucose tolerance in Europeans and Asians. Quarterly Journal of Medicine 296, 1021–1030.CrossRefGoogle Scholar
Stitch, HF, Mathew, B, Sankaranarayan, R and Nair, MK (1991) Remission of oral precancerous lesions of tobacco/areca nut chewers following administration of beta-carotene or vitamin A, and maintenance of the protective effect. Cancer Detection and Prevention 15, 93–98.Google Scholar
Tanaka, SI, Nakajima, AS, Inoue, S, Takamura, Y, Aoki, I and Okuda, K (1990) Genetic control by Ia subregions on H-r complex of incidence of streptozotocin induced autoimmune diabetes in mice. Diabetologia 39, 1298–1304.Google Scholar
World Health Organization (1985) WHO Study Group Report on Diabetes Mellitus. Technical Report Series no. 727. Geneva: WHO.Google Scholar