Graviola in Scientific Research
1. What the fruit actually contains
Soursop's composition is usually quoted from a single reference value, and the single value is the problem. USDA Standard Reference gives 20.6 mg of vitamin C per 100 g of edible fruit. [1] A survey of soursop from orchards around Tecomán in Colima, Mexico, measuring on an explicitly stated fresh weight basis, found 41.5 to 98 mg per 100 g. [2] The same survey put total soluble solids at 13.1%, titratable acidity at 0.9 to 1.4%, and an average fruit at about 900 g, of which 80% is pulp and 2.5% is seed, with roughly 37 seeds. [2] Vitamin C is one of the nutrients with authorised wording behind it in the EU: it contributes to normal collagen formation, to the normal function of the immune system, and to the reduction of tiredness and fatigue.
2. What soursop is not: a polyphenol fruit
It is worth stating plainly, because the functional drinks category tends to assume otherwise. Total polyphenols in soursop pulp were measured at 36.7 mg gallic acid equivalents per 100 g of fresh mass, and flavonoids at 9.2 mg quercetin equivalents per 100 g. [2] For comparison, acerola pulp runs above 1,000 mg gallic acid equivalents per 100 g. Soursop sits roughly thirty times lower. Whatever makes this fruit scientifically interesting, it is not its antioxidant content, and a description that leads with antioxidants is describing a different fruit.
3. The one randomised trial in people
The only randomised human trial of soursop fruit juice recruited 143 adults with essential prehypertension and high-normal serum uric acid, drawn from a prehypertension dataset of 4,190 people. The treatment group drank 2 × 100 g of soursop juice daily for three months, with measurements at baseline, week 6 and week 12. Mean systolic blood pressure was significantly lower in the treatment group, and the control group was more likely to show high-normal or high serum uric acid at both 6 and 12 weeks. [3] The design carries one limitation that has to travel with the result: the control group received no treatment at all, so the trial was neither placebo-controlled nor blinded, and an unblinded blood pressure measurement is the kind of outcome most susceptible to that. It remains the only randomised human evidence on the juice.
4. What the cancer literature actually contains in humans
Soursop is discussed online almost entirely through a cancer story, so it is worth reporting what the human literature holds. A 2024 systematic review located five human studies in cancer patients, 273 participants in total. Four were randomised double-blind placebo-controlled trials in colorectal cancer in Indonesia, each with 30 patients, using 300 mg a day of an ethanol-soluble leaf fraction in capsules for eight weeks. The fifth was a non-randomised observational study of 162 bladder cancer patients in Italy, using ellagic acid combined with Annona muricata, 100 mg each, for six months. [4] The review rated every included study at high or critical risk of bias, performed no meta-analysis, and concluded that the evidence is neither complete nor universally applicable. [4] Four of the five studies were about leaf extract in capsules. None was about fruit juice.
5. The compound that makes this family different
Annonaceous acetogenins are found almost nowhere outside the Annonaceae, and annonacin is the most abundant one in Annona muricata. It is a lipophilic inhibitor of complex I of the mitochondrial respiratory chain — the same target as several compounds used in laboratories to model dopaminergic cell loss. In rats given annonacin by continuous intravenous infusion, the result was nigral and striatal neurodegeneration. [5] In human mesencephalic LUHMES neurons, three of four tested Annonaceae-based dietary supplements markedly reduced cell viability and caused cell death, at a magnitude comparable to extracts of the fruit itself; annonacin in those supplements was measured at up to 337 µg per gram of dry material. [6] This is animal and cell work, and the intravenous route in the rat study is not how anyone eats fruit — which is exactly the point European assessors have made about it.
6. Annonacin in the fruit and in commercial nectar, measured
In 2005 a French group used MALDI mass spectrometry to quantify annonacin in Annona muricata fruit and leaf preparations. An average fruit contained about 15 mg of annonacin; one can of commercial nectar contained about 36 mg; one cup of leaf infusion or decoction contained about 140 µg. [7] The authors calculated that an adult eating one fruit or drinking one can of nectar daily would, over a year, ingest an amount of annonacin comparable to the dose that produced brain lesions in rats given purified annonacin intravenously. [7] These are the numbers the whole European discussion of this fruit rests on, and they are about the fruit and the nectar, not about leaf supplements.
7. A year of commercial soursop juice, in mice
The most directly relevant animal study used the product rather than an isolate. Mice expressing human wild-type tau, mutant R406W tau, or no human tau drank either plain water or commercially sold soursop juice for twelve months; chemical analysis of that juice found mainly annonacin together with dozens of isoquinoline alkaloids. Juice-drinking mice showed more neurons with phosphorylated tau in cell bodies and dendrites, most strongly in the R406W animals, alongside reduced synaptophysin and increased 3-nitrotyrosine across all groups. [8] The authors concluded that long-term juice intake can induce this tau pathology even in wild-type mice and accelerate it in genetically susceptible ones. Mice are not people, and twelve months is most of a mouse's life — but this is a commercial juice, taken by mouth, over a long period, which is closer to ordinary consumption than any other experiment in this literature.
8. How European assessors read all of this
The reading is not unanimous, and the disagreement is informative. A risk assessment published in the EFSA Journal in 2020, prepared under the EU-FORA fellowship programme at the German Federal Institute for Risk Assessment, found substantial uncertainty about the safe use of Annona muricata preparations; because adequate long-term studies were scarce and human intervention data were lacking, the authors could not establish a safe intake level and judged the usual presumption-of-safety approach not feasible. [9] The French food safety agency reached a more guarded conclusion a decade earlier: a link between Annonaceae consumption and the high rate of atypical parkinsonian syndromes in Guadeloupe had been suggested but not established, the animal and in vitro models were too narrow to reflect oral human exposure, and no dose-effect relationship or no-effect dose had been demonstrated — while still recommending particular attention to corossol preparations and continued toxicovigilance. [10] A separate 2020 systematic review of Annona muricata leaf extract judged its safety and tolerability profile favourable and called for further trials. [11] All three are reading substantially the same evidence base. None of them is reading it as settled.
References
- U.S. Department of Agriculture, Agricultural Research Service. National Nutrient Database for Standard Reference, Release 27. Soursop, raw; NDB No. 09315. 2015.
- Terán-Erazo B, Alia-Tejacal I, Marisal-García K de la P, Núñez-Colín CA, Guillén-Sánchez D, Juárez-López P, López-Martínez V, Avonce-Vergara N, Villarreal-Fuentes JM, Sainz-Aispuro M de J, Campos-Rojas E. Quality and phytochemical content in soursop fruits (Annona muricata L.) from Tecomán, Colima, Mexico. Acta Horticulturae. 2022;1340:21–26. doi:10.17660/ActaHortic.2022.1340.3
- Alatas H, Sja'bani M, Mustofa M, Mukti AG, Bawazier LA, Irijanto F, Zulaela Z, Tomino Y. 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(3):223–232. doi:10.1038/s41371-019-0235-6
- Isaali MTA, Jamil N, Ahmad K. Effect of Annona muricata (Soursop) on patients with cancer: a systematic review. Malaysian Journal of Pharmacy. 2024;10(2):3–11. doi:10.52494/maljpharmv10202
- Champy P, Höglinger GU, Féger J, Gleye C, Hocquemiller R, Laurens A, Guérineau V, Laprévote O, Medja F, Lombès A, Michel PP, Lannuzel A, Hirsch EC, Ruberg M. Annonacin, a lipophilic inhibitor of mitochondrial complex I, induces nigral and striatal neurodegeneration in rats: possible relevance for atypical parkinsonism in Guadeloupe. Journal of Neurochemistry. 2004;88(1):63–69. doi:10.1046/j.1471-4159.2003.02138.x · PMID 14675150
- Höllerhage M, Rösler TW, Berjas M, Luo R, Tran K, Richards KM, Sabaa-Srur AU, Maia JGS, de Moraes MR, Godoy HT, Höglinger GU, Smith RE. Neurotoxicity of dietary supplements from Annonaceae species. International Journal of Toxicology. 2015;34(6):543–550. doi:10.1177/1091581815602252
- Champy P, Melot A, Guérineau V, Gleye C, Fall D, Höglinger GU, Ruberg M, Lannuzel A, Laprévote O, Laurens A, Hocquemiller R. Quantification of acetogenins in Annona muricata linked to atypical parkinsonism in Guadeloupe. Movement Disorders. 2005;20(12):1629–1633. doi:10.1002/mds.20632 · PMID 16078200
- Rottscholl R, Haegele M, Jainsch B, Xu H, Respondek G, Höllerhage M, Rösler TW, Bony E, Le Ven J, Guérineau V, Schmitz-Afonso I, Champy P, Oertel WH, Yamada ES, Höglinger GU. Chronic consumption of Annona muricata juice triggers and aggravates cerebral tau phosphorylation in wild-type and MAPT transgenic mice. Journal of Neurochemistry. 2016;139(4):624–639. doi:10.1111/jnc.13835 · PMID 27569447
- Raclariu-Manolica AC, Bakhiya N, Hirsch-Ernst KI. Risk assessment regarding the use of Annona muricata in food supplements. EFSA Journal. 2020;18(Suppl 1):e181112. doi:10.2903/j.efsa.2020.e181112 · PMID 33294051
- Agence française de sécurité sanitaire des aliments (Afssa). Avis relatif aux risques liés à la consommation de corossol (Annona muricata L.) et de ses préparations. Saisine n° 2008-SA-0171. Maisons-Alfort, 28 April 2010.
- Chan WJJ, McLachlan AJ, Hanrahan JR, Harnett JE. The safety and tolerability of Annona muricata leaf extract: a systematic review. Journal of Pharmacy and Pharmacology. 2020;72(1):1–16. doi:10.1111/jphp.13182
