Pharmacological and biological activities of areca nut (Areca catechu L.): A systematic review

The areca nut ( Areca catechu L.) is a widely consumed masticatory product in Southeast Asian countries such as India, Indonesia, Taiwan, Thailand, and China owing to its cultural importance and potential medicinal value. The areca nut, which is the seed of the Areca catechu palm, is classified as a drupe and is traditionally consumed in both its unripe and ripe forms. In addition to the seeds, the leaves, roots, and inflorescences of the plant also present medicinal properties. Chemically, areca nut comprises approximately 0.5% alkaloids, 20% starch, 20% polyphenols, and 15% fats, among other constituents. To comprehensively assess its medicinal potential, we conducted a systematic literature search using four major databases, the Cochrane Library, EMBASE, PubMed, and Web of Science, supplemented by references from other relevant studies and reviews. This process yielded 262 reports, 137 of which met the inclusion criteria and were retained for further analysis. Notably, the period from 2010 to 2019 had the greatest number of publications, with antioxidant, antimicrobial, and neuropharmacological research each accounting for 16% of the total studies analysed. The results of the present study revealed a broad spectrum of pharmacological activities associated with areca nuts, including anticancer-related, antimicrobial and antiparasitic, anthelmintic, antioxidant, antihypertensive, antidiabetic, cardiometabolic and cardioprotective-related, antiaging, wound healing and gastroprotective effects, neuropharmacological, anti-inflammatory, analgesic, and other therapeutic effects. The known mechanisms underlying different medicinal properties were also explored and discussed.