Paan – A Mouthful of Betel Leaf Packaged Ambrosia for Good Health
Dr. Sharadendu Bali*
MBBS, MS, PhD, Professor General Surgery, TMMC, TMU, Moradabad, U.P., India.
DOI: 10.36347/sajb.2025.v13i01.012 | Published: 16.01.2025
Abstract
Review ArticleThe chewing of sachet-like betel leaf quids, packing various spicy and flavoured ingredients in a folded betel leaf, is a customary practise in a number of nations of South Asia. The betel leaf munchie (paan), most popularly chewed after meals, has been much berated and unfairly scorned, as it is thought to produce detrimental effects on the body. This dogma about the harmful effects of paan has been upended by recent studies demonstrating the beneficial impact of betel phytochemicals on several body functions, as well as on the gut microbiota. Moreover, the advantageous effects of the health-promoting phytochemicals contained in catechu heartwood extract (kattha), slaked lime, betel nut (supari), and the other condiments added to the quid according to individual preferences, have also been documented in a large number of studies conducted over the past decade. In the reconsidered position, the betel leaf quid can be regarded as a delectable munchie loaded with phytoactives possessing multifarious health benefits.
1. Introduction & Historical Evidence
Evidence from archaeological excavations suggests that both the areca nut and the betel leaves have been chewed since ancient times. The earliest archaeological affirmation for Betel nut use in humans comes from Spirit Cave in Thailand, dating to around 10,000 years ago. Evidence of betel leaf use in prehistoric times has been found in caves in eastern Timor, dating between 13,000 to 4,000 years ago. In the Indian subcontinent, the betel leaf (BL) and nut have played an essential part in religious pooja rituals, wherein the pongi phalam (intact oval betel nut) is placed on the tamboolam (betel leaf).
The first recorded usage in India dates to about 400 BC, with mention of chewing betel leaves in the ancient Ayurvedic text Charak Samhita. The custom of chewing betel leaf after meals became widespread between 75 AD and 300 AD, and Marco Polo noted in the 13th century that monarchs and nobles in India chewed betel after meals.
Dispelling the Oral Cancer Myth: Betel leaf chewing has often been linked with oral cancer due to tobacco and gutkha additions. However, studies evaluating pure betel leaf extract (Bhide et al., Shirname et al., Rao et al.) demonstrate that betel leaf alone is non-carcinogenic and actually exhibits potent anti-tumor, chemopreventive, and antimutagenic activities.
2. Method of Preparing the Betel Leaf Quid (Paan)
The preliminary step in crafting the packaged betel leaf quid is the application of a thin layer of slaked lime (chuuna) over one surface of the betel leaf, followed by a thin layer of Kattha (paste of Acacia catechu heartwood in water).
Applying thin layers of slaked lime (chuuna) and catechu paste (kattha) on the betel leaf.
Adding diced areca nut, coconut, gulkand, fennel, cardamom, peppermint, folding into an envelope, and piercing a clove as a rivet.
Figures 1, 2 & 3: Demonstration of betel leaf quid preparation showing lime and kattha layers, ingredients, and the clove utilized as a rivet to hold the folded quid.
3. Bioactive Compounds in Piper Betel Leaf & Pharmacological Effects
A broad range of bioactive compounds have been identified in betel leaf extract and essential oil, including Eugenol, Allylpyrocatechol (APC), Hydroxychavicol (HC), Chavibetol (CHV), Chlorogenic acid, and Flavonoids. Key pharmacological benefits include:
1. Antimicrobial & Anti-Halitosis
APC and Eugenol inhibit oral biofilm formation (S. mutans, C. albicans) and reduce volatile sulphur compounds (VSCs), preventing halitosis and periodontal disease.
2. Neuroprotective & Anti-AChE
Hydroxychavicol (HC) inhibits acetylcholinesterase (AChE), a primary therapeutic target for Alzheimer's disease treatment.
3. Anti-Ulcer Healing (93.4%)
Ethanol extract and APC accelerate stomach ulcer healing by 93.4%, boosting SOD and catalase antioxidant enzymes and mucin secretion.
4. Lipid Lowering & Hepatoprotection
Decreases Total Cholesterol, Triglycerides, LDL, VLDL, AST, ALT, and MDA levels in liver tissue.
4. Pharmacological Properties & Health Benefits of Areca Nut (Supari)
Areca nut contains active alkaloid Arecoline along with catechins, isorhamnetin, luteolin, and procyanidins offering multifaceted health actions:
- Anti-Parasitic Action: Arecoline paralyzes tapeworms and vector snails carrying blood flukes.
- Mood & Memory Enhancement: Binds GABA receptors, improving mood, alertness, memory, and cognition in Alzheimer's and depression.
- Digestive Motility & Salivation: Increases gastric and intestinal smooth muscle motility, enhances salivation, and prevents salivary duct stones.
5. Pharmacological Properties of Acacia Catechu (Kattha)
Kattha (Acacia catechu heartwood extract) is exceptionally rich in catechins, gallic acid, epicatechin, EGCG, and flavonol dimers:
- Neuroprotection & ROS Reduction: Protects neuroblastoma cells against H2O2 oxidative injury, inhibits caspase-3 activation, and protects synaptic vesicle proteome in Alzheimer's.
- Immunomodulatory & Anti-Inflammatory: Enhances neutrophil phagocytosis, increases serum immunoglobulins, and upregulates IL-10 anti-inflammatory cytokine.
- Anticancer & Hepatoprotective: Induces apoptosis in breast (MCF-7) and colon (HT-29) cancer cells. Cyanidanol protects liver architecture.
6. Pharmacological Properties of Cloves, Rose (Gulkand) & Spices
Cloves (Syzygium aromaticum)
Rich in Eugenol (71-87%). Antibacterial against MRSA, antiviral against HSV & Norovirus, anti-diabetic (inhibits alpha-glucosidase), and anticonvulsant in epilepsy models.
Rose Petals & Gulkand
Rich in phenylethyl alcohol and citronellol. Protects cortical neurons against Aβ amyloid-beta plaques, inhibits HMG-CoA reductase and ACE for blood pressure regulation.
7. Peppermint, Cardamom & Olfactory Brain Activation
Aromatic volatile molecules from cardamom (1,8-cineole, alpha-terpinyl acetate) and peppermint (menthol) penetrate directly through the cribriform plate into the frontal cortex and limbic system. Clinical studies prove they reduce cortisol, relieve nausea, enhance alertness, and soothe stress.
8. Chlorophyll, Betel Roughage & Gut Microbiome
Betel leaf chlorophyll acts as a potent antioxidant and antimutagen, binding dietary carcinogens (Aflatoxin B1). Coupled with rose petal and areca polyphenols, it selectively suppresses gut pathogens while nourishing beneficial Bifidobacteria, Lactobacilli, and Akkermansia.
Figure 4: A summary of the health benefits accruing from the different spices and condiments used to make the delicious Betel quid known as Paan.
9. Discussion & Conclusion
The south-east Asian tradition of chewing paan quid after meals is deeply rooted in Ayurvedic texts (Charaka, Sushruta, Ashtang Samgrah). When enjoyed without tobacco and harmful additives, the betel leaf quid provides several beneficial effects on body metabolism, brain health, gut microbiome, and emotional relaxation.
References
- Gorman, C. F. (1970). Excavations at Spirit Cave, north Thailand. Asian Perspectives, 13, 79-107.
- Vidyadhar, S. (2011). editor. Charak Samhita, Part 1, Sutra Sthan, chapter 5, verse 76, 77. Chaukhamba Sanskrit Pratishthan.
- Bhide, S. V., et al. (1991). Chemopreventive efficacy of a betel leaf extract against benzo[a]pyrene-induced forestomach tumors in mice. Journal of ethnopharmacology, 34(2-3), 207-213.
- Rao, A. R., et al. (1985). Inhibitory action of Piper betle on 7,12-dimethylbenz[a]anthracene-induced mammary carcinogenesis in rats. Cancer letters, 26(2), 207-214.
- Biswas, P., et al. (2022). Betelvine (Piper betle L.): A comprehensive insight into its ethnopharmacology, phytochemistry, and therapeutic attributes. Journal of Cellular and Molecular Medicine, 26(11), 3083-3119.
- Phumat, P., et al. (2020). Comparative inhibitory effects of 4-allylpyrocatechol isolated from Piper betle on Streptococcus mutans and Candida albicans. Archives of oral biology, 113, 104690.
- Dalai, M. K., et al. (2014). Evaluation of anticholinesterase activity of the standardized extract of Piper betel L. leaf. Oriental Pharmacy and Experimental Medicine, 14, 31-35.
- Sunil, M. A., et al. (2018). Immunomodulatory activities of Acacia catechu, a traditional thirst quencher of South India. Journal of Ayurveda and integrative medicine, 10(3), 185–191.
- Moss, M., et al. (2008). Modulation of cognitive performance and mood by aromas of peppermint and ylang-ylang. The International journal of neuroscience, 118(1), 59–77.
- Kamijo, M., et al. (2008). Effects of Rosa rugosa petals on intestinal bacteria. Bioscience, biotechnology, and biochemistry, 72(3), 773-777.
- Simonich, M. T., et al. (2007). Natural chlorophyll inhibits aflatoxin B1-induced multi-organ carcinogenesis in the rat. Carcinogenesis, 28(6), 1294-1302.