Betel Nut Chewing Decreased Calcaneus Ultrasound T-Score in a Large Taiwanese Population Follow-Up Study

Chewing betel nut is common in Taiwan. Although previous studies have shown that chewing betel nuts is associated with adverse health effects, findings about the impact on bone density have been inconsistent. Therefore, the aim of this study was to investigate the correlation between betel nut chewing and calcaneus ultrasound T-score in a longitudinal study of 118,856 participants from the Taiwan Biobank. Of these participants, 27,002 were followed up with for a median of 4 years. The T-score of the calcaneus was measured in the non-dominant foot using ultrasound. Multivariable analysis showed that a history of chewing betel nut (coefficient β = −0.232; p < 0.001) was significantly associated with low baseline T-score in all participants (n = 118,856). In addition, a long duration of betel nut chewing (per 1 year; coefficient β = −0.003; p = 0.022) was significantly associated with a low baseline T-score in the participants with a history of chewing betel nut (n = 7210). Further, a long duration of betel nut chewing (per 1 year; coefficient β = −0.004; p = 0.039) was significantly associated with a low ΔT-score in the participants with a history of chewing betel nut (n = 1778) after 4 years of follow-up. In conclusion, our results showed that betel nut chewing was associated with a decrease in calcaneus ultrasound T-score, and thus, it is important to stop chewing betel nut to help prevent an increased risk of osteoporosis in the Taiwanese population.

Effect of chewing betel nut on the gut microbiota of Hainanese

Betel nut chewing (BNC) is prevalent in South Asia and Southeast Asia. BNC can affect host health by modulating the gut microbiota. The aim of this study is to evaluate the effect of BNC on the gut microbiota of the host. Feces samples were obtained from 34 BNC individuals from Ledong and Lingshui, Hainan, China. The microbiota was analyzed by 16S rRNA gene sequencing. BNC decreased the microbial α-diversity. Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria were the predominant phyla, accounting for 99.35% of the BNC group. The Firmicutes-to-Bacteroidetes ratio was significantly increased in the BNC group compared to a control group. The abundances of the families Aerococcaceae, Neisseriaceae, Moraxellaceae, Porphyromonadaceae, and Planococcaceae were decreased in the BNC/BNC_Male/BNC_Female groups compared to the control group, whereas the abundances of Coriobacteriaceae, Streptococcaceae, Micrococcaceae, Xanthomonadaceae, Coxiellaceae, Nocardioidaceae, Rhodobacteraceae, and Succinivibrionaceae were increased. In general, the gut microbiome profiles suggest that BNC may have positive effects, such as an increase in the abundance of beneficial microbes and a reduction in the abundance of disease-related microbes. However, BNC may also produce an increase in the abundance of disease-related microbes. Therefore, extraction of prebiotic components could increase the beneficial value of betel nut.

Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

The prevalence of betel nut chewing in Taiwan is high at approximately 7%, however, few studies have evaluated the relationship between betel nut chewing and lung disease. Therefore, the aim of this study was to investigate associations between betel nut chewing and lung function in 80,877 participants in the Taiwan Biobank (TWB). We further investigated correlations between betel nut chewing characteristics such as years of use, frequency, daily amount, and accumulative dose, with obstructive lung disease. We used data from the TWB. Lung function was assessed using spirometry measurements of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). The participants were classified into normal lung function and obstructive lung function (FEV1/FVC < 70%) groups. The participants were asked questions about betel nut chewing, including years of use, frequency, and daily amount. After multivariable analysis, betel nut chewing (odds ratio [OR] = 1.159; p < 0.001) was significantly associated with FEV1/FVC < 70% in all participants (n = 80,877). Further, in the participants who chewed betel nut (n = 5135), a long duration of betel nut chewing (per 1 year; OR = 1.008; p = 0.012), betel nut use every day (vs. 1–3 days/month; OR = 1.793; p = 0.036), 10–20 quids a day (vs. <10 quids; OR = 1.404; p = 0.019), 21–30 quids a day (vs. <10 quids; OR = 1.662; p = 0.010), ≥31 quids a day (vs. <10 quids; OR = 1.717; p = 0.003), and high cumulative dose (per 1 year × frequency × daily score; OR = 1.001; p = 0.002) were significantly associated with FEV1/FVC < 70%. In this large population-based cohort study, chewing betel nut was associated with obstructive lung disease. Furthermore, a long duration of betel nut chewing, more frequent use, higher daily amount, and high cumulative dose were associated with obstructive lung disease. This suggests that preventing betel nut chewing should be considered to reduce obstructive lung disease in Taiwan.

Association of visual impairment with cognitive decline among older adults in Taiwan

This study investigated the association between visual impairment and cognitive decline among the elderly in Taiwan. The data were obtained from a government-sponsored, annual physical examination program for elderly citizens ≥ 65 years in Taipei City during 2005–2012. Distance presenting visual acuity was measured using the Snellen chart. Visual impairment was classified into low vision and blindness. The Short Portable Mental Status Questionnaire (SPMSQ) was selected to measure cognitive decline. The confounding factors including age, sex, sociodemographic factors: living status, marital status, education level, health behaviors: smoking, alcohol consumption, betel nut chewing, and physical comorbidities: BMI, hypertension, diabetes, cholesterol and triglyceride were collected for analysis. We recruited 105,208 participants and 4542 (4.3%) have abnormal SPMSQ. The abnormal SPMSQ had significantly higher prevalence of low vision (44.52% vs 18.79%) and blindness (8.89% vs 0.93%) compared with normal SPMSQ. The hazard ratios of abnormal SPMSQ in low vision and blindness were 2.34 (95% CI 2.17–2.52), and 5.13 (95% CI 4.50–5.85), after adjustment for confounders. In conclusion, visual impairment was independently and significantly associated with greater incident cognitive decline among elderly Asian people. Prevention of visual impairment may help to reduce the incidence of cognitive decline in the aged Asian population.

Perilaku Merokok pada Mahasiswa Fakultas Kedokteran dan Fakultas Pertambangan Universitas Papua, Sorong

Indonesia merupakan salah satu negara dengan prevalensi perokok tertinggi di dunia. Saat ini merokok masih menjadi gaya hidup di lingkungan mahasiswa, tetapi perilaku merokok pada populasi di wilayah TImur Indonesia terutama Papua masih jarang diteliti. Penelitian ini bertujuan untuk mengetahui perilaku merokok pada mahasiswa Fakultas Kedokteran (FK) dan fakultas non-kesehatan (Fakultas Teknik Pertambangan dan Perminyakan/FTPP). Studi ini menggunakan desain studi potong lintang. Pengambilan data dilakukan pada Maret 2019 dengan teknik total sampling dan instrument yang digunakan yaitu kuesioner tervalidasi dari Global Adult Tobacco Survey (GATS) dan Global Youth Tobacco Survey (GYTS). Didapatkan 113 responden mahasiswa FK dan 72 responden mahasiswa FTPP. Perilaku merokok 1 batang setiap hari dalam 30 hari terakhir didapatkan terbanyak pada mahasiswa FTPP (29,8%) dibandingkan FK (7,1%). Ditemukan juga kekerapan kebiasaan yang berpengaruh terhadap kesehatan seperti mengunyah sirih, mengunyah pinang, VAPE bahkan konsumsi alkohol pada populasi baik mahasiswa FK maupun mahasiswa FTPP. Prevalensi merokok, menyirih dan konsumsi alkohol pada mahasiswa fakultas teknik lebih tinggi daripada mahasiswa fakultas kedokteran dan perlu dilakukan penelitian terkait terjadinya gangguan kesehatan dimasa depan. Kata kunci: merokok, menyirih, mahasiswa kedokteran, mahasiswa teknik. Smoking Behavior among Medical and Engineering Students in Universitas Papua, Sorong Abstract Indonesia is among the highest prevalence of cigarette smoking in the world and it is a common lifestyle among undergraduate students. This study aims to measure smoking behaviour among undergraduate medical student and non medical students in West Papua. A cross sectional study with total sampling was done among undergraduate students in Faculty of Medicine and Faculty of Mining Engineering Universitas Papua, Sorong. Global Adults Tobacco Survey (GATS) and Global Youth Tobacco Survey (GYTS) questionnairre were administered with additional question regarding other habits that might be related to addiction such as betel nut chewing, consuming alcohol and vaping. There are 113 medical student and 72 non medical students were recruited. The prevalence of smoking among undergraduate medical students was 7.1% and 29.8% among undergraduate non medical students. Interestingly the prevalence of betel nut chewing is high among non medical students. The prevalence of smoking among undergraduate non medical students is higher compared with medical students in West Papua. The prevalence of betel-nut chewing and alcohol consumption were also high among non medical student and need further study regarding its health risk. Keywords: cigarette smoking, betel nut chewing, medical students, non medical students

A Positive Relationship between Betel Nut Chewing and Significant Liver Fibrosis in NAFLD Subjects, but Not in Non-NAFLD Ones

Background: Betel nut chewing is associated with oral cancer, cardiovascular disease, liver cirrhosis, and hepatocellular carcinoma (HCC). The aim of this study was to explore the association of betel nut chewing with liver fibrosis in subjects with and without nonalcoholic fatty liver disease (NAFLD). Method: A total of 5967 subjects were enrolled. NAFLD was diagnosed with ultrasonography. Betel nut chewing was classified into non-chewing, ex-chewing, and current chewing, and cumulative dosages were calculated. The aspartate aminotransferase (AST)/platelet ratio index and NAFLD fibrosis scores (NFS) were calculated for evaluation of liver fibrosis. Results: NAFLD increased the associated risk of liver fibrosis in those with (odds ratio (OR): 5.51, 95% confidence interval (CI): 3.09–9.80) and without betel nut chewing (OR: 2.33, 95% CI: 1.64–3.29). In subjects without NAFLD, betel nut chewing was not associated with liver fibrosis (OR: 1.12, 95% CI: 0.44–2.86). In subjects with NAFLD, cumulative betel nut chewing and ex- and current chewing were positively associated with NFS and significant liver fibrosis. Conclusions: In subjects with NAFLD, betel nut chewing, even ex-chewing, was associated with a higher risk of liver fibrosis, where higher cumulative levels were found to increase the risk of significant liver fibrosis. However, the associated risk of liver fibrosis due to betel nut chewing was insignificant in subjects without NAFLD.

Label-free Quantitation of the Changes in Salivary Proteome associated with the Chronic Consumption of the Betel nut (Areca Catechu)

Areca nut or betel nut chewing is most frequently used in Pakistan and is associated with a high risk for oral cancer. Until now, however, there has not been any...

The Association between Metabolic Syndrome and Related Factors among the Community-Dwelling Indigenous Population in Taiwan

The aim of this study was to conduct a community-based study with a view to construct a detailed analysis about metabolic syndrome and the related risk factors of the indigenous population. This was an observational, population-based and cross-sectional study that was conducted in remote villages of an indigenous community in northern Taiwan between 2010 and 2013. A total of 586 participants, 275 men and 311 women, were eligible for analysis. The participants underwent a questionnaire survey that included demographic and health behavior issues. An anthropometric assessment and measurements of blood pressure were carried out including serum biochemical variables. Metabolic syndrome (MetS) was defined by following the criteria provided by the modified Adult Treatment Panel III (ATP III) criteria of the National Cholesterol Education Program (NCEP). Univariate and multiple logistic regressions were used to identify the risk factors for metabolic syndrome. The standardized prevalence rates of substance use (cigarette smoking, alcohol drinking and betel nut chewing) were significantly higher than the general population regardless of whether it was northern, central or southern Taiwan and this was especially the case with betel nut chewing in women. The prevalence rate of metabolic syndrome was 42.9% in the indigenous population with 41.3% in men and 44.4% in women, which was higher than for urban Taiwanese. In the multiple logistic regression models, we found that the significant associated factors for metabolic syndrome were older age, lower education level, high levels of uric acid, alanine transaminase (ALT), gamma-glutamyl transferase (γ-GT) and creatinine. A higher prevalence rate of metabolic syndrome and substance use were observed in the indigenous population compared with urban Taiwanese, especially in women.

Oral Submucous Fibrosis: A Review on Biomarkers, Pathogenic Mechanisms, and Treatments

Oral submucous fibrosis (OSF) is a collagen deposition disorder that affects a patient’s oral function and quality of life. It may also potentially transform into malignancy. This review summarizes the risk factors, pathogenic mechanisms, and treatments of OSF based on clinical and bio-molecular evidence. Betel nut chewing is a major risk factor that causes OSF in Asia. However, no direct evidence of arecoline-induced carcinogenesis has been found in animal models. Despite identification of numerous biomarkers of OSF lesions and conducting trials with different drug combinations, clinicians still adopt conservative treatments that primarily focus on relieving the symptoms of OSF. Treatments focus on reducing inflammation and improving mouth opening to improve a patient’s quality of life. In conclusion, high-quality clinical studies are needed to aid clinicians in developing and applying molecular biomarkers as well as standard treatment guidelines.

Tobacco Smoking and Association between Betel Nut Chewing and Meta-bolic Abnormalities among Military Males: The CHIEF Study

Aim: To investigate the effect of smoking and alcohol intake on the association between betel nut chewing and each metabolic abnormality. Background: Betel nut chewing has been associated with metabolic syndrome. Objective: Whether the association is affected by tobacco or alcohol use is not clarified so far. Methods: We made a cross-sectional study using 6,657 military males, aged 18-50 years in eastern Taiwan in 2013-2014. Metabolic syn-drome was defined according to the International Diabetes Federation ethnic criteria for Asians. The population was classified as non-betel nut chewers (N =5,749), current chewers with both tobacco and alcohol use (N =615), and current chewers without tobacco and/or alcohol use (N =293). Multiple logistic regressions analyses were stepwise adjusted for the confounders including alcohol and tobacco use to de-termine the associations of betel chewing with the metabolic abnormalities. Results: As compared with the non-current chewers, the current chewers with both tobacco/alcohol use and those without had higher risk of metabolic syndrome (odds ratios (OR) and 95% confidence intervals: 2.46 (2.00-3.02), and 2.04 (1.53-2.73), respectively) after controlling for age, service specialty, total cholesterol levels ≥200 mg/dL and exercise frequency (model 1). The association did not change much in the two chewing groups after additionally adjusting for alcohol consumption (model 2) (OR: 2.49 (1.99-3.12), and 2.04 (1.52-2.73), respective-ly), whereas the relationship reduced significantly in the chewers with both tobacco/alcohol use rather than those without after further ad-justing for smoking (model 3) (OR: 2.18 (1.71-2.78) and 2.02 (1.51-2.71), respectively). This was in parallel with the pattern for the associ-ation of betel nut chewing with serum triglycerides >150 mg/dL in the chewers with both tobacco/alcohol use and those without in model 1 (OR: 2.90 (2.40-3.51) and 1.90 (1.45-2.49), respectively, p =0.011), in model 2 (OR: 2.82 (2.30-3.46) and 1.89 (1.44-2.49), respectively, p =0.040), and in model 3 (2.26 (1.81-2.81) and 1.87 (1.42-2.45), respectively, p =0.76). Conclusion: Our findings suggest that tobacco smoking but not alcohol intake could increase the relationship of betel nut chewing with metabolic syndrome, which is likely mediated by a synergic effect on increasing serum triglycerides levels.