{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:27:25Z","timestamp":1760059645984,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"U54 Minority Institution\/Cancer Center Partnership Grant from the National Cancer Institute","award":["5U54CA143727","5U54CA143728"],"award-info":[{"award-number":["5U54CA143727","5U54CA143728"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Areca nut\/betel quid (AN\/BQ), a stimulant consumed across the Asia and Pacific region, has been associated with metabolic risks including obesity. This study investigated the association between AN\/BQ use and obesity in Guam. Participants included 120 men and women 18+ years old. Recruitment and interviews were conducted at a central dental clinic in Guam between July 2013 and October 2014. Multivariate general linear models were utilized to estimate the association of AN\/BQ chewing with body mass index (BMI). Of the participants with a mean BMI of 30.4 (SD 6.9) kg\/m2, 82.5% reported ever chewing AN\/BQ. The mean adjusted BMI among AN\/BQ chewers was 4.53 kg\/m2 (95% CI 1.19, 7.87) higher than among non-chewers in the minimally adjusted model; 4.72 kg\/m2 (95% CI 1.09, 8.35) higher with additional adjustment for annual household income, tobacco smoking, and alcohol use (n = 108); and non-significantly higher by 0.55 kg\/m2 (95% CI \u22123.92, 5.02) after additional adjustment for ethnicity. Although AN\/BQ chewing was not associated with BMI after considering ethnicity, our results do not exclude the possibility that AN\/BQ chewing can be considered a risk factor for obesity.<\/jats:p>","DOI":"10.3390\/ijerph22071006","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T05:53:13Z","timestamp":1750917193000},"page":"1006","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Betel Nut Chewing and Body Mass Index: A Cross-Sectional Study in Guam"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0168-5008","authenticated-orcid":false,"given":"Michelle","family":"Nagata","sequence":"first","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey E.","family":"Merifield","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8413-3914","authenticated-orcid":false,"given":"Gabriela","family":"Cruz-Mattos","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allen","family":"Oamil","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7236-7900","authenticated-orcid":false,"given":"Xavier","family":"Heidelberg","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-958X","authenticated-orcid":false,"given":"Gertraud","family":"Maskarinec","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2946-1957","authenticated-orcid":false,"given":"Thaddeus A.","family":"Herzog","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-9618","authenticated-orcid":false,"given":"Yurii B.","family":"Shvetsov","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6214-6249","authenticated-orcid":false,"given":"Yvette C.","family":"Paulino","sequence":"additional","affiliation":[{"name":"School of Health, University of Guam, 303 University Drive, Mangilao, GU 96913, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda Y.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Population Sciences in the Pacific, University of Hawai\u2019i Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","unstructured":"CIA (2024, December 21). 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