SynthesisPloS one2013
Chewing betel quid and the risk of metabolic disease, cardiovascular disease, and all-cause mortality: a meta-analysis.
Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
31 citing papers in PubMed, 73 citations in OpenAlex.
- Inverse Association Between Betel Quid Use and Diabetes in Rural Bangladesh.American journal of human biology : the official journal of the Human Biology Council · 2026Article
- The Potential Association Between Betel Nut Consumption and Apical Periodontitis: A Multicenter Cross-Sectional Study.International journal of dentistry · 2026Article
- Cognitive function and associations with demographic, socioeconomic, health and behavioural factors among older adult men and women in rural Bangladesh: a population-based cross-sectional study.The Lancet regional health. Southeast Asia · 2025Article
- Association Between Routes of Tobacco Use and Hypertension Among Adult Rural People in Bangladesh: A Cross-Sectional Study.Tobacco use insights · 2025Article
- Maternal betel quid use during pregnancy and child growth: a cohort study from rural Bangladesh.Global health action · 2024Article
- Towards a replacement therapy for stimulant betel quid dependence: A proof of concept study.Addiction biology · 2024Article
- Sex differences in risk factors for metabolic syndrome in middle-aged and senior hospital employees: a population-based cohort study.BMC public health · 2023Article
- Association of Metabolic Syndrome and Other Factors with the Presence of Diabetic Nephropathy in Type 2 Diabetic Patients.International journal of environmental research and public health · 2023Article
- The impact ofAging · 2022Article
- Article
- Betel Nut Chewing Is Associated with the Risk of Kidney Stone Disease.Journal of personalized medicine · 2022Article
- Development and Validation of a Self-Administered Screening Test for Betel Quid Use Disorders in Betel Quid Chewers in Hunan, China.International journal of general medicine · 2022Article
- Cumulative Betel Quid Chewing and the Risk of Significant Liver Fibrosis in Subjects With and Without Metabolic Syndrome.Frontiers in nutrition · 2022Article
- Areca catechu-(Betel-nut)-induced whole transcriptome changes in a human monocyte cell line that may have relevance to diabetes and obesity; a pilot study.BMC endocrine disorders · 2021Article
- Enzymatic browning in relation to permeation of oxygen into the kernel of postharvest areca nut under different storage temperatures.Food science & nutrition · 2021Article
- Association between Triglyceride Glucose Index and Corrected QT Prolongation in Chinese Male Steelworkers.International journal of environmental research and public health · 2021Article
- A Positive Relationship between Betel Nut Chewing and Significant Liver Fibrosis in NAFLD Subjects, but Not in Non-NAFLD Ones.Nutrients · 2021Article
- The Association between Metabolic Syndrome and Related Factors among the Community-Dwelling Indigenous Population in Taiwan.International journal of environmental research and public health · 2020Article
- 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 · 2020Review
- Association between gallstone and cardio-cerebrovascular disease: Systematic review and meta-analysis.Experimental and therapeutic medicine · 2019Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBetel nut (Areca nut) is the fruit of the Areca catechu tree. Approximately 700 million individuals regularly chew betel nut (or betel quid) worldwide and it is a known risk factor for oral cancer and esophageal cancer. We performed a meta-analysis to assess the influence of chewing betel quid on metabolic diseases, cardiovascular disease, and all-cause mortality. METHODOLOGY/PRINCIPAL
findingsWe searched Medline, Cochrane Library, Web of Science, and Science Direct for pertinent articles (including the references) published between 1951 and 2013. The adjusted relative risk (RR) and 95% confidence interval were calculated using the random effect model. Sex was used as an independent category for comparison.
resultsOf 580 potentially relevant studies, 17 studies from Asia (5 cohort studies and 12 case-control studies) covering 388,134 subjects (range: 94 to 97,244) were selected. Seven studies (N = 121,585) showed significant dose-response relationships between betel quid consumption and the risk of events. According to pooled analysis, the adjusted RR of betel quid chewers vs. non-chewers was 1.47 (P<0.001) for obesity (N = 30,623), 1.51 (P = 0.01) for metabolic syndrome (N = 23,291), 1.47 (P<0.001) for diabetes (N = 51,412), 1.45 (P = 0.06) for hypertension (N = 89,051), 1.2 (P = 0.02) for cardiovascular disease (N = 201,488), and 1.21 (P = 0.02) for all-cause mortality (N = 179,582). CONCLUSION/SIGNIFICANCE: Betel quid chewing is associated with an increased risk of metabolic disease, cardiovascular disease, and all-cause mortality. Thus, in addition to preventing oral cancer, stopping betel quid use could be a valuable public health measure for metabolic diseases that are showing a rapid increase in South-East Asia and the Western Pacific.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.