soursop.health
Part four

Research & Science

Soursop has been studied seriously for fifty years. Understanding why — and why almost none of it has reached a clinical trial — comes down to one unusual family of molecules.

Chemistry

What is in the plant

Annonaceous acetogenins

The reason anyone studies this plant. Long-chain fatty-acid derivatives found almost exclusively in the Annonaceae; more than 100 have been isolated from A. muricata alone, from leaves, bark, seeds, roots and fruit. Annonacin is the most abundant.

Their mechanism is specific and well characterized: they inhibit complex I of the mitochondrial electron transport chain, starving cells of ATP. Cells with high energy demand are hit hardest — which is simultaneously why they are studied as cytotoxic agents and why they raise neurotoxicity concerns. One molecule, both stories.

Alkaloids

Including isoquinoline alkaloids such as reticuline and coreximine, concentrated in leaves and bark. Studied mainly for effects on the nervous system.

Phenolics and flavonoids

Quercetin, luteolin and related polyphenols, plus tannins and phytosterols. The source of the antioxidant and anti-inflammatory activity seen in laboratory work.

Vitamin C and fiber

The fruit’s nutritional contribution proper, and the part that actually reaches you when you eat it. See the nutrition panel.

The state of play

Where the evidence actually stands

Research areas by highest level of evidence reached
AreaHighest evidenceWhat that means
Nutrient contentEstablishedDirectly measured and published in food composition databases.
Blood pressure & uric acidHuman trialOne randomized controlled trial, 143 adults, 12 weeks. Unreplicated.
Safety & tolerability of leaf extractSystematic reviewReview of available studies found a generally favorable tolerability profile.
Anti-inflammatoryAnimalReproduced in rodents at doses above dietary intake. No human data.
AntidiabeticAnimalConsistent in diabetic rodent models using extracts, not fruit.
AntimicrobialIn vitroDemonstrated against bacteria and yeasts in culture only.
Cytotoxicity / anticancerIn vitroExtensive cell-line work. No human clinical efficacy trial.
Neurotoxicity of annonacinAnimal + epidemiologyMechanism shown in the lab; association found in population studies.
Ethnomedicinal useDocumentedRecorded across four continents in the review literature.
Method

How to read a soursop study

Four questions that resolve most of the confusion in this literature before you read a single result.

  1. Which part of the plant? Leaf, seed, bark, root and fruit have materially different chemistry. The overwhelming majority of dramatic findings come from leaf or seed extract. Almost none come from the fruit pulp you would eat.
  2. What was it given to? Cells in a dish, a rat, or a person. In vitro results establish that a molecule can do something under ideal conditions. They do not survive contact with digestion, metabolism and dose.
  3. At what dose, and by what route? Extracts are concentrated many times over the plant material. A dose that works in a rodent, scaled by body weight, is frequently unreachable by eating fruit — and sometimes unreachable safely at all.
  4. Has anyone repeated it? A single unreplicated trial is a promising lead, not a fact. Much of what circulates about soursop rests on exactly one study, quoted for a decade.
Sources

Key literature

The papers the rest of this site rests on. Every one is findable and checkable — which is the point.

R1
Annona muricata (Annonaceae): A Review of Its Traditional Uses, Isolated Acetogenins and Biological Activities Moghadamtousi SZ, Fadaeinasab M, Nikzad S, Mohan G, Ali HM, Kadir HA — International Journal of Molecular Sciences, 2015;16(7):15625–15658 The standard reference on the plant’s acetogenins. Catalogs more than 100 isolated compounds and reviews the ethnomedicinal and pharmacological literature. Full text (PMC)doi:10.3390/ijms160715625
R2
Annona muricata: A comprehensive review on its traditional medicinal uses, phytochemicals, pharmacological activities, mechanisms of action and toxicity Coria-Téllez AV, Montalvo-González E, Yahia EM, Obledo-Vázquez EN — Arabian Journal of Chemistry, 2018;11(5):662–691 The broadest single review available: over 200 identified compounds, the documented traditional uses across tropical regions, and an explicit treatment of toxicity. Full textdoi:10.1016/j.arabjc.2016.01.004
R3
The effects of soursop supplementation on blood pressure, serum uric acid, and kidney function in a prehypertensive population in accordance with the 2017 ACC/AHA guideline Journal of Human Hypertension, 2020;34:223–232 The randomized controlled trial behind the blood-pressure claim. 143 prehypertensive adults; 2 × 100 g soursop juice daily for 12 weeks against an untreated control group. PubMed 31462727
R4
The safety and tolerability of Annona muricata leaf extract: a systematic review Chan WJJ, McLachlan AJ, Hanrahan JR, Harnett JE — Journal of Pharmacy and Pharmacology, 2020;72(1):1–16 Systematically reviews the safety data on leaf extract and concludes the profile is generally favorable, while noting how thin the human evidence base remains. PubMed 31659754doi:10.1111/jphp.13182
R5
Possible relation of atypical parkinsonism in the French West Indies with consumption of tropical plants: a case-control study Caparros-Lefebvre D, Elbaz A, Caribbean Parkinsonism Study Group — The Lancet, 1999 The epidemiological study that first linked heavy consumption of Annonaceae fruit and leaf infusions in Guadeloupe with atypical parkinsonian syndromes. PubMed 10440304
R6
Atypical parkinsonism in the Caribbean island of Guadeloupe: Etiological role of the mitochondrial complex I inhibitor annonacin Lannuzel A, et al. — Movement Disorders, 2008 The mechanistic follow-up proposing annonacin as the agent behind the Guadeloupe findings. Read alongside R9: the hypothesis is unconfirmed, unreplicated outside Guadeloupe, and was judged insufficient to establish causation by France’s food safety agency. doi:10.1002/mds.22300
R9
Opinion on the risks associated with consumption of Annonaceae (soursop) and atypical parkinsonism AFSSA / ANSES — French Agency for Food, Environmental and Occupational Health Safety The regulator’s own assessment of the Guadeloupe hypothesis: confirmed neurotoxicity of annonacin in cells and animals, but not possible to affirm that the human cases are caused by eating Annonaceae. The counterweight to R5 and R6. Read the opinion (PDF)
R7
FoodData Central — Soursop, raw US Department of Agriculture, Agricultural Research Service The source of every number in the nutrition panel on this site. fdc.nal.usda.gov
R8
187 Fake Cancer ‘Cures’ Consumers Should Avoid US Food and Drug Administration The FDA’s published list of products marketed with unproven cancer claims, on which graviola appears. Context for the “not supported” verdict on the benefits page. fda.gov