Can betel nuts that have been expelled from the food circle still be eaten?

Zhejiang, Sichuan and other places have recently issued notices prohibiting the sale of betel nuts, and some places in Zhejiang will even ban the sale of betel nuts
for a long time.
Why has a snack with regional characteristics become a "prohibited product"? The main reason is that betel nut is not included in the latest revision of the Classification Catalogue of Food Production Licenses by the State Administration for Market Regulation, which means that betel nut can no longer be managed and sold
as food.
Previous studies have pointed out that betel nut has a carcinogenic risk, there are "10 oral cancers, 9 chewing betel nut"
.
So, what are the damage of betel nut to human health? Can it still be medicated? Let's take a closer look
.

1 Carcinogenic potency is the same grade as arsenic

The history of human consumption of betel nut is 1800 years, involving Thailand, Malaysia, Indonesia, Cambodia, Vietnam and many other countries and regions, and the way to eat it is generally directly chewed or eaten
with the leaves.
According to the Encyclopedia Britannica, about one in ten people worldwide has the habit
of chewing betel nuts.

However, there has been controversy over the consumption of betel nuts
.
The earliest conclusions to clarify that this dietary habit is related to cancer came from a 1992 research article
published in The Lancet in the United Kingdom.
After studying 169 oral cancer patients in Papua New Guinea, the researchers found that 77% of patients regularly ate betel nut with lime powder-coated leaves, and the chewing site in the mouth was the primary site
of cancer.
The researchers believe this may be because the pH of the chewing site rises to around 10 and promotes the production of reactive oxygen species, which can promote lime powder to induce cancer cell proliferation
.
Later, a large number of studies corroborated oral cancer with betel nut chewing
.

In 2004, the International Agency for Research on Cancer (IARC) under the World Health Organization listed betel nut as a first-class carcinogen, including betel nut fruit, tobacco-containing betel nut chewables, and tobacco-free betel nut chews
.
In terms of carcinogenic efficacy, betel nut is the same grade
as tobacco, alcohol, aflatoxin, and arsenic.
China's "Healthy Oral Action Plan (2019-2025)" also mentioned that when China published the list of carcinogens in 2017, betel nut had been listed as a first-class carcinogen
.

The causes of betel nut cancer are mainly in the following two aspects
.

The first is related
to nitroamines.
The researchers detected 3 nitrosamines from the saliva of people who chewed betel nuts, which may be produced by
the interaction of nitrites in betel nuts with microbes and enzymes in the mouth.

The second is related
to a variety of alkaloids and active ingredients in betel nut.
These active ingredients are not only exciting and pleasant, but also have the effect of promoting cancer, such as betel nut alkaloids, betel nut tannins, betel nut-specific nitrosamines and reactive oxygen species, etc.
, which have cytotoxicity, genotoxicity, and even direct carcinogenicity
.
Betel nut alkaloids can promote apoptosis of epithelial cells and interfere with the precipitation and degradation of extracellular matrix macromolecules (collagen, elastin, etc.
); The addition of citrogenic polyphenols and active oxidants during betel nut processing can also produce certain genotoxicities
.

2 Smokers are more harmful to eat

Although betel nut has been shown to be carcinogenic, it is not a cancer that can be obtained by taking a bite, and it is unscientific to talk about toxicity without taking off the
dose.
The safety of betel nut intake depends on how it is used and dosed
.

Betel nut is hard, when people chew betel nut, the friction of betel nut fiber will cause local trauma and mucosal damage to the oral mucosa, especially the betel nut wrapped with leaves and lime is more severe
to the wear of the mouth.
Therefore, if you chew betel nut frequently, it will make the oral mucosa in a long-term damaged state, resulting in the inability of the wound to prolong, causing chronic inflammation, enhanced oxidation and cell proliferation
.
When the frequency of oral mucosal cell shedding in betel nut chewers increases significantly, the chance
of carcinogenesis increases.

In addition, smokers make up a large proportion
of the population that chews betel nuts.
Some betel nuts have added tobacco components, both eat betel nut and smoke so that the alkaloids and tobacco in betel nut act on the mouth at the same time, the concentration of toxic substances in saliva is significantly increased, it is easier to destroy the synthesis and repair of cell DNA, and jointly induce cancer
.

This conclusion is supported
by data.
Epidemiological investigations abroad have shown that chewing betel nut and smoking are very likely to cause oral cancer
.
The countries and regions with more betel nut consumption in the world are South Asia and Southeast Asia, India, Indonesia, Sri Lanka, Vietnam, Malaysia, the Philippines and other countries have the custom of chewing betel nut for the whole people, and the smoking of the people is also more common
.
The combination of these two triggers has resulted in the highest incidence of oral cancer in South and Southeast Asia, and the largest number of cancer patients, accounting for about 58%
of the global oral cancer population.

In addition to the induction of oral cancer, there are studies that show that the longer you chew betel nut, the higher
the risk of cirrhosis and hepatocellular carcinoma.
In summary, there is a dose-dependent
relationship between betel nut and cancer.
People who chew betel nuts for a long time, and who eat more betel nuts, are bound to have a higher
chance of developing related cancers.

3 Reproductive toxicity can affect fetal development

Betel nut has another hidden danger that has attracted much attention, that is, reproductive toxicity
.

As early as 1985, researchers at the State University of New York at Buffalo found that betel nut base had the ability to
induce abnormal sperm head shape and unplanned DNA synthesis for early sperm cells in mice.
They treated the mice with betel nut at the dose levels of 20 mg/kg, 40 mg/kg, and 80 mg/kg, respectively, and found that the abnormal sperm count in the head was closely related to the increase in the dose of betel nut base, which showed that betel nut base was damaging toxic to mouse germ cells
.

In addition, betel nut fruit extract can significantly reduce the sperm number, activity rate and deformity rate of
male mice.
Researchers from Peking University School of Pharmacy identified 3 main alkaloids (betel nut base, betel nut and demethyl betel nut nut basis) in betel nut in China, and evaluated 12 kinds of betel nut samples in the main betel nut producing areas in China, and found that the alkaloid content in betel nut in different regions was significantly different, the content in the grain was higher than the fruit shell, and the content in dried betel nut was higher than that of fresh betel nut
.

Subsequently, the researchers treated the samples provided by the volunteers with 3 alkaloids with different concentrations, and the results showed that betel nut base had a significant effect on sperm motility and had a strong dose dependence
.
Among them, the main thing that affects sperm activity is betel nut alkali, and the greater the concentration, the stronger
the reduction effect.
The reasons for this have not yet been clarified, but some studies suggest that this may be due to the oxidative stress and inflammatory response of
betel nut base.

In addition, the reproductive toxicity of betel nut is also reflected in the gestation and growth of embryos and fetuses, which is manifested in the fact that betel nut can reduce the number of embryonic implants, lead to miscarriage, and have toxic side effects
on subsequent fetal growth.
Pregnant women eating betel nut made of dried fruits are also related to pediatric cerebral palsy, and it is easy to have premature fetal birth
.

4 Stay away from betel nuts like away from drugs

Although betel nut is carcinogenic and reproductive toxic has been confirmed by existing research, it is also a drug
.
The 2015 edition of the Chinese Pharmacopoeia contains betel nut, coke betel nut and other medicinal materials or drinking tablets, and points out that betel nut has been concocted with the functions of killing insects, decreasing, walking gas, relieving water, and intercepting malaria, and can be used for wet stagnation, abdominal distension, unpleasant stool, swollen water, edema and unfavorable
urination.

Therefore, betel nut has a place in the "drug circle", but the medicinal use needs to follow the doctor's advice, do not buy and use it without authorization, so as not to be symptomatic and injurious
.

It should be reminded that if someone has not eaten betel nut and just wants to taste it, it is not necessary
.
It has been listed above that it can cause cancer, reproductive toxicity and other harms, especially can not coexist with the behavior of smoking, otherwise the harm is even greater
.
If you are already addicted to chewing betel nut, you should treat it as a drug and quit it as soon as possible
.
This is not alarmist, in fact, Turkey, Singapore, the United Arab Emirates, Canada, Australia and other countries have classified betel nut as a drug and banned
it.

Clinical data show that more than half of oral cancer patients will die from cancer recurrence, the 5-year survival rate is only 50%, and even patients who succeed in surgery will suffer from permanent facial trauma and severe oral dysfunction
.
So, "stay away from betel nut like away from drugs and tobacco", the benefits of this initiative are enormous
.