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de la Monte SM, Moriel N, Lin A, Abdullah Tanoukhy N, Homans C, Gallucci G, Tong M, Saito A. Betel Quid Health Risks of Insulin Resistance Diseases in Poor Young South Asian Native and Immigrant Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186690. [PMID: 32937888 PMCID: PMC7558723 DOI: 10.3390/ijerph17186690] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 01/30/2023]
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.
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Affiliation(s)
- Suzanne M. de la Monte
- Department of Pathology and Laboratory Medicine, Providence VA Medical Center, Providence, RI 02808, USA
- Women & Infants Hospital of Rhode Island, Providence, RI 02808, USA
- Alpert Medical School, Brown University, Providence, RI 02808, USA
- Departments of Medicine, Rhode Island Hospital, Providence, RI 02808, USA; (G.G.); (M.T.)
- Neurology, Neurosurgery and Neuropathology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI 02903, USA
- Correspondence:
| | - Natalia Moriel
- Department of Molecular Pharmacology and Physiology at Brown University, Providence, RI 02912, USA; (N.M.); (A.L.); (N.A.T.)
| | - Amy Lin
- Department of Molecular Pharmacology and Physiology at Brown University, Providence, RI 02912, USA; (N.M.); (A.L.); (N.A.T.)
| | - Nada Abdullah Tanoukhy
- Department of Molecular Pharmacology and Physiology at Brown University, Providence, RI 02912, USA; (N.M.); (A.L.); (N.A.T.)
| | - Camille Homans
- Department of Neuroscience, Brown University, Providence, RI 02912, USA;
| | - Gina Gallucci
- Departments of Medicine, Rhode Island Hospital, Providence, RI 02808, USA; (G.G.); (M.T.)
| | - Ming Tong
- Departments of Medicine, Rhode Island Hospital, Providence, RI 02808, USA; (G.G.); (M.T.)
| | - Ayumi Saito
- Department of Epidemiology in the School of Public Health, Brown University, Providence, RI 02912, USA;
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Heck JE, Sapkota A, Vendhan G, Roychowdhury S, Dikshit RP, Jetly DH, Brennan P, Boffetta P, Hashibe M. Dietary risk factors for hypopharyngeal cancer in India. Cancer Causes Control 2008; 19:1329-37. [PMID: 18704720 DOI: 10.1007/s10552-008-9204-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 06/27/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The Indian subcontinent has among the highest rates of hypopharyngeal cancer worldwide. The purpose of this study was to examine the associations between the Indian diet and hypopharyngeal cancer. METHODS We used data from a hospital-based case-control study of 513 incident hypopharyngeal cancers and 718 controls from four centers in India. Dietary information was assessed using a 67-item semi-quantitative food frequency questionnaire. Intakes of related foods were combined across food groups and were categorized by quartile. We used unconditional logistic regression modeling, stratified by ever tobacco use, to analyze the association between food intakes and hypopharyngeal cancer. RESULTS Among persons who had ever smoked or chewed tobacco, protective associations were seen at the highest quartiles of total fruit intake (OR = 0.37, 0.20-0.69), curds (OR = 0.35, 0.17-0.69), and leafy green (OR = 0.25, 95% CI 0.13-0.51), root (OR = 0.22, 95% CI 0.11-0.43), and cruciferous vegetable intakes (OR = 0.41, 0.20-0.84). Results were similar, although not as robust, among persons who had never smoked or chewed tobacco. An increased risk of disease was seen among tobacco users who drank milk daily (OR = 1.84, 1.14-2.98). CONCLUSIONS Dietary factors might contribute to the high risk of hypopharyngeal cancer observed in India.
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Affiliation(s)
- Julia E Heck
- International Agency for Research on Cancer, Lyon, France
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Stolberg VB. A cross-cultural and historical survey of tobacco use among various ethnic groups. J Ethn Subst Abuse 2007; 6:9-80. [PMID: 19842306 DOI: 10.1300/j233v06n03_02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
This review of tobacco use in diverse historical and cultural contexts reveals a range of behaviors engaged in and perspectives held by members of respective ethnic groups, such as whether to consider tobacco as a medicine or as a problem. After its introduction to Western societies, many attributed tobacco with an array of medicinal uses, while condemning recreational use and identifying it as immoral. Tobacco has been used variously by respective ethnic groups at different times and places and these customs have flavored understandings of the relationships between tobacco and the body. Considerable ethnic variation exists not only in terms of tobacco use and abuse, but also with respect to pharmacogenetic factors that influences the consequences of tobacco exposure. There have also been different societal responses to the use of tobacco, including those related to the media, as well as to issues of treatment and prevention.
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Affiliation(s)
- Victor B Stolberg
- Essex County College, Health Services, 303 University Avenue, Newark, NJ 07102, USA.
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Maserejian NN, Giovannucci E, Rosner B, Zavras A, Joshipura K. Prospective study of fruits and vegetables and risk of oral premalignant lesions in men. Am J Epidemiol 2006; 164:556-66. [PMID: 16847039 DOI: 10.1093/aje/kwj233] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The authors prospectively evaluated fruit and vegetable consumption and the incidence of oral premalignant lesions among 42,311 US men in the Health Professionals Follow-up Study. Diet was assessed every 4 years by food frequency questionnaires. The authors confirmed 207 cases of clinically or histopathologically diagnosed oral premalignant lesions occurring between 1986 and 2002. Multivariate-adjusted relative risks were calculated from proportional hazards models. Significant inverse associations were observed with citrus fruits, citrus fruit juice, and vitamin-C-rich fruits and vegetables, indicating 30-40% lower risks with greater intakes (e.g., citrus fruit juice quintile 5 vs. quintile 1 relative risk = 0.65, 95% confidence interval: 0.42, 0.99). Inverse associations with fruits did not vary by smoking status and were stronger in analyses of baseline consumption, with a 10-year lag time to disease follow-up (quintile 5 vs. quintile 1 relative risk = 0.41, 95% confidence interval: 0.20, 0.82; p = 0.01). No associations were observed with total vegetables or with beta-carotene-rich or lycopene-rich fruits and vegetables. For current smokers, green leafy vegetables (ptrend = 0.05) and beta-carotene-rich fruits and vegetables (ptrend = 0.02) showed significant linear trends of increased risk (one additional serving/day relative risk = 1.7). The risk of oral premalignant lesions was significantly reduced with higher consumption of fruits, particularly citrus fruits and juices, while no consistent associations were apparent for vegetables.
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Piyathilake CJ, Bell WC, Jones J, Henao OL, Heimburger DC, Niveleau A, Grizzle WE. Pattern of nonspecific (or global) DNA methylation in oral carcinogenesis. Head Neck 2006; 27:1061-7. [PMID: 16155917 PMCID: PMC1853326 DOI: 10.1002/hed.20288] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although alterations in nonspecific (or global) DNA methylation (GDM) in specific cells are known to be involved in the process of lung carcinogenesis, similar associations have not been evaluated in other smoking-related cancers of the head and neck. METHODS We evaluated the status of GDM by using monoclonal antibodies specific for 5-methylcytosine (5-mc) in oral squamous cell carcinoma (SCC) specimens of 48 cigarette smokers who had SCC develop and in 93 age-, race-, and sex-matched smokers who did not. RESULTS Percentages of cells positive for 5-mc immunostaining of DNA of SCC and dysplastic lesions were significantly higher than those of normal oral epithelial cells from cancer subjects and from noncancer subjects. The degree of DNA methylation was unrelated to DNA content. CONCLUSIONS The pattern of GDM in oral SCCs is different from that of lung SCCs. The differences in nutrient risk factor profiles that are related to GDM and differential activity of DNA methyltranferases between oral and lung SCCs may explain these observations.
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Affiliation(s)
- Chandrika J. Piyathilake
- Department of Nutrition Sciences, Division of Nutritional Biochemistry and Molecular Biology, University of Alabama at Birmingham, University Station, Birmingham, AL 35294. E-mail:
| | - Walter C. Bell
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Jennifer Jones
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Olga L. Henao
- School of Public Health of The University of Alabama at Birmingham, Birmingham, Alabama
| | - Douglas C. Heimburger
- Department of Nutrition Sciences, Division of Nutritional Biochemistry and Molecular Biology, University of Alabama at Birmingham, University Station, Birmingham, AL 35294. E-mail:
| | - Alain Niveleau
- Laboratory of Virology, Faculty of Medicine, University Joseph Fourier of Grenoble, Avenue Gresivaudan, 38706 La Tronche France
| | - William E. Grizzle
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
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