Sitaphal (Custard Apple)

Annona squamosa
Sitaphal (Custard Apple), or Annona squamosa, is a sweet fruit revered in Ayurveda. Traditionally, it's considered to balance Vata and Pitta doshas while increasing Kapha. This widely prevalent fruit is claimed to support digestive health and provide nourishment, with its creamy texture often integrated into traditional remedies and dietary recommendations.
PLANT FAMILY
Annonaceae (Custard Apple)
PARTS USED
Fruit, leaves, seeds
AYURVEDIC ACTION
Vata ↓, Pitta ↓, Kapha ↑
ACTIVE COMPOUNDS
Annonaceous acetogenins (0.01-0.1%)

What is Sitaphal (Custard Apple)?

Sitaphal, commonly known as Custard Apple, is the edible fruit of Annona squamosa, a species of flowering plant in the Annonaceae family. Native to tropical America and the West Indies, it is widely cultivated for its sweet, creamy fruit, which is characterized by a bumpy, segmented skin and fragrant, white flesh containing numerous black seeds.

This deciduous tree thrives in warm climates and is often grown in home gardens and commercially. The fruit's unique texture and flavor, reminiscent of custard, make it a popular ingredient in desserts and fresh consumption.

Other Names of Custard Apple

  • Sugar Apple
  • Sweetsop
  • Sharifa
  • Ata

Benefits of Sitaphal (Custard Apple)

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<h3> Absolute Contraindications of Sitaphal (Custard Apple) </h3> <h4> People with Parkinsonism or known neurodegenerative parkinsonian syndromes [In simple terms: people who have Parkinson's disease or similar conditions]</h4> <ul> <li>🧠</li> <li>Recommendation: Avoid regular or concentrated consumption of Annonaceae fruits, teas or extracts; discuss any past habitual use with your neurologist.</li> <li>Reasoning: Epidemiological and experimental studies link Annonaceae consumption (fruits, juices, herbal teas) and acetogenins (e.g., annonacin) to worsened parkinsonian syndromes and dopaminergic neuron toxicity; even low cumulative intake was associated with more severe disease and cognitive decline in affected populations.</li> <li>Scientific_Study_Title: Annonaceae Consumption Worsens Disease Severity and Cognitive Deficits in Degenerative Parkinsonism.</li> <li>Scientific_Study_Authors: Elbaz et al. (authors as listed in PubMed: see original).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/36210778/</li> <li>Scientific_Study_Excerpt: <p>In a clinical analysis of Caribbean patients with degenerative parkinsonism, the authors found that lifetime consumption of Annonaceae fruit/tea correlated with worse motor and cognitive outcomes. Even low cumulative consumption (>0.2 fruit-years) or any use of Annonaceae herbal tea significantly increased the odds of having a more severe phenotype and cognitive impairment. The work supports the view that Annonaceae exposure can negatively influence the course and severity of degenerative parkinsonian disorders.</p> </li> </ul> <h4> People with cognitive impairment or dementia [In simple terms: people already showing memory loss or dementia]</h4> <ul> <li>🧩</li> <li>Recommendation: Avoid or strictly limit intake of Sitaphal fruits, juices or teas; consult the treating physician before using any Annona product.</li> <li>Reasoning: Population and clinic studies from Annonaceae-consuming regions report higher prevalence and severity of atypical parkinsonism with cognitive decline; experimental acetogenins can cross into brain tissue and produce neurodegenerative changes.</li> <li>Scientific_Study_Title: Atypical parkinsonism in the Caribbean island of Guadeloupe: etiological role of the mitochondrial complex I inhibitor annonacin.</li> <li>Scientific_Study_Authors: B. et al. (see PubMed record for full author list).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/18816693/</li> <li>Scientific_Study_Excerpt: <p>Clinical observations in Guadeloupe showed an unusually high frequency of atypical parkinsonism associated with marked cognitive impairment. Experimental work identified annonacin (an Annonaceae acetogenin) as a mitochondrial complex I inhibitor present in fruit and leaves; chronic administration in animals produced brain lesions resembling the human disease, supporting a mechanistic link between exposure and neurodegeneration.</p> </li> </ul> <h4> Use of concentrated seed or root extracts for self-treatment (high-dose preparations) [In simple terms: using strong/DIY seed or leaf extracts as medicines]</h4> <ul> <li>⚠️</li> <li>Recommendation: Do not prepare or ingest concentrated seed/acetogenin extracts at home; such concentrated preparations have demonstrable cellular toxicity and genotoxic potential - avoid unless under formal clinical trial or regulated supervision.</li> <li>Reasoning: Seeds contain high levels of annonaceous acetogenins and other bioactive substances that show potent cytotoxic activity in vitro and DNA damage in animal studies; concentrated exposure (oral or occupational) carries risks not present from moderate ripe-fruit eating.</li> <li>Scientific_Study_Title: In vivo assessment of genotoxic effects of Annona squamosa seed extract in rats.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/19457440/</li> <li>Scientific_Study_Excerpt: <p>Rats treated with increasing doses of Annona squamosa seed extract showed a dose-related rise in DNA migration (comet assay) and chromosomal changes in bone marrow tests, indicative of genotoxicity. Biochemical markers of oxidative stress were altered in multiple organs, signifying that concentrated seed extracts can damage DNA and cellular systems in vivo at the tested doses.</p> </li> </ul> <h3> Relative Contraindications of Sitaphal (Custard Apple) </h3> <h4> Pregnancy / Breastfeeding [In simple terms: pregnant or nursing women]</h4> <ul> <li>🤰</li> <li>Recommendation: Avoid concentrated extracts and seeds; eat ripe pulp only in moderation and discuss with your obstetrician-there is no convincing safety record for therapeutic doses during pregnancy and some related Annona reports raise concern.</li> <li>Reasoning: Animal and related-species studies give mixed results (some species/extracts show reproductive effects in lab studies, while isolated experiments on A. squamosa early-pregnancy rats did not show implantation changes at tested doses); because evidence is inconsistent and human safety data are limited, caution is advised.</li> <li>Scientific_Study_Title: Effects of Annona squamosa extract on early pregnancy in rats.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/12487333/</li> <li>Scientific_Study_Excerpt: <p>In a rat study testing seed aqueous extract during the pre-implantation period (days 1-5), animals treated at the tested doses showed no alteration in corpora lutea, implantation counts, or embryonic development measures by day 10. However, the authors note that doses and treatment windows matter, and that traditional uses and data from other Annona species warrant prudence.</p> </li> </ul> <h4> People taking prescribed antidiabetic medications [In simple terms: people on insulin or diabetes pills]</h4> <ul> <li>📉</li> <li>Recommendation: Consult your prescribing clinician before adding Sitaphal leaf/seed extracts or high amounts of pulp to the diet; blood glucose should be monitored because Additive glucose-lowering is possible.</li> <li>Reasoning: Multiple experimental studies show significant glucose-lowering effects of Annona squamosa extracts in diabetic animal models; combining with pharmaceutical hypoglycemics could increase risk of symptomatic hypoglycaemia without dose adjustments.</li> <li>Scientific_Study_Title: Hypoglycemic and antidiabetic effect of ethanolic extract of leaves of Annona squamosa L. in experimental animals.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/15848023/</li> <li>Scientific_Study_Excerpt: <p>Leaf ethanolic extract at the tested dose produced significant reductions in fasting blood glucose and improved glucose tolerance across several diabetic animal models, with pronounced declines after repeated dosing. These results indicate that Annona extracts can exert substantial antihyperglycemic effects experimentally, a mechanism that could interact with prescribed antidiabetic therapy.</p> </li> </ul> <h4> People with haemolytic disorders or vulnerable red-blood-cell conditions [In simple terms: those with fragile/low red blood cells]</h4> <ul> <li>🩸</li> <li>Recommendation: Avoid ingestion of concentrated seed extracts and be cautious with seed consumption; if you have anaemia or a hemolytic disorder, consult a physician before use.</li> <li>Reasoning: Recent laboratory work shows seed methanolic extracts can damage human erythrocytes in vitro at modest concentrations, causing osmotic fragility and morphological changes not seen with pulp extracts.</li> <li>Scientific_Study_Title: Influence of methanolic extracts from seeds and pulp of Annona squamosa L. on osmotic and morphological fragility in human erythrocytes.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/36970244/</li> <li>Scientific_Study_Excerpt: <p>In vitro exposure of human erythrocytes to seed methanolic extract produced over 50% toxicity at certain concentrations and induced echinocyte formation on microscopy, while pulp extracts did not show red-cell toxicity at the concentrations tested. The data indicate seed constituents can compromise erythrocyte integrity under experimental conditions.</p> </li> </ul>

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<h4> Neurodegenerative risk / worsening motor or cognitive symptoms [in plain language]</h4> <ul> <li>🧠</li> <li>Side effect summary: Regular or heavy consumption of Annonaceae fruits, juices or teas (including some Annona species) has been associated with higher rates and greater severity of atypical parkinsonism and cognitive decline in exposed communities.</li> <li>Recommendation: If you have Parkinson's disease, cognitive impairment, or a family history of such disorders, avoid regular consumption of Annonaceae fruits or preparations and discuss with your neurologist.</li> <li>Reasoning: Acetogenins such as annonacin inhibit mitochondrial complex I and produce dopaminergic neuron damage in experimental systems; population studies from Caribbean islands document associations between consumption and disease frequency/severity.</li> <li>Severity Level: Severe</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Title: The mitochondrial complex I inhibitor annonacin is toxic to mesencephalic dopaminergic neurons by impairment of energy metabolism.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/14521988/</li> <li>Scientific_Study_Excerpt: <p>In cell culture, annonacin produced potent, concentration-dependent death of dopaminergic neurons at nanomolar concentrations, impairing mitochondrial energy production and reducing dopamine uptake; the toxin was more potent than several established neurotoxins in the same model. These mechanistic findings align with population observations linking chronic Annonaceae exposure to parkinsonism-like syndromes.</p> </li> </ul> <h4> Red-blood-cell damage from seeds [in plain language]</h4> <ul> <li>🩺</li> <li>Side effect summary: Seed extracts (not the ripe pulp) can damage red blood cells in lab tests, causing fragility and abnormal shapes - this could worsen anaemia or cause hemolytic problems if consumed in concentrated form.</li> <li>Recommendation: Do not crush or ingest seeds; avoid seed extracts. If you have anaemia or a hemolytic condition, seek medical advice before using any seed-derived product.</li> <li>Reasoning: In vitro assays show seed methanolic extract produced >50% erythrocyte toxicity at certain concentrations with morphological changes; pulp did not show the same effect at tested concentrations.</li> <li>Severity Level: Moderate</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Title: Influence of methanolic extracts from seeds and pulp of Annona squamosa L. on osmotic and morphological fragility in human erythrocytes.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/36970244/</li> <li>Scientific_Study_Excerpt: <p>The study treated human erythrocytes with varying concentrations of seed and pulp methanolic extracts. Seed extract produced significant toxicity above certain concentrations and caused echinocyte formation on microscopy; pulp extract showed no toxicity at the same concentrations. The findings indicate seed constituents may be harmful to red blood cells under experimental conditions.</p> </li> </ul> <h4> Hypoglycaemia (low blood sugar) when combined with diabetes drugs [in plain language]</h4> <ul> <li>⚖️</li> <li>Side effect summary: Annona extracts can reduce blood sugar in animal studies; combined use with insulin or sulfonylureas could increase the risk of low blood sugar.</li> <li>Recommendation: People on medication for diabetes should not start Sitaphal extracts or large amounts of leaves/pulp without medical supervision and should monitor blood glucose closely.</li> <li>Reasoning: Multiple experimental models demonstrate significant reductions in fasting glucose and improvements in glucose tolerance following treatment with A. squamosa extracts, indicating an active glucose-lowering potential that can be additive with drugs.</li> <li>Severity Level: Moderate</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Title: Hypoglycemic and antidiabetic effect of ethanolic extract of leaves of Annona squamosa L. in experimental animals.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/15848023/</li> <li>Scientific_Study_Excerpt: <p>The ethanolic leaf extract lowered fasting blood glucose and improved glucose tolerance in several diabetic animal models, with substantial reductions after repeated dosing. These preclinical glucose-lowering effects suggest the potential for additive hypoglycaemic interaction with prescribed antidiabetic therapies if used concurrently.</p> </li> </ul> <h4> Genotoxic / cytotoxic effects with concentrated seed extracts [in plain language]</h4> <ul> <li>🧪</li> <li>Side effect summary: High-concentration seed extracts show DNA damage and cytotoxic effects in animal and cell models - a reason to avoid concentrated or prolonged ingestion of seed preparations.</li> <li>Recommendation: Avoid self-medication with seed extracts; seeds should not be crushed/consumed and concentrated acetogenin preparations should only be used in controlled research settings.</li> <li>Reasoning: In vivo genotoxicity assays and in vitro cytotoxicity against tumour and some normal cells demonstrate that acetogenin-rich seed fractions can damage DNA and kill cells at experimentally relevant doses.</li> <li>Severity Level: Moderate</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Title: In vivo assessment of genotoxic effects of Annona squamosa seed extract in rats.</li> <li>Scientific_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/19457440/</li> <li>Scientific_Study_Excerpt: <p>Rats given graded doses of seed extract exhibited a dose-related increase in DNA migration (comet assay) and chromosomal aberrations in bone marrow tests. Oxidative stress markers were altered in multiple organs, supporting an in vivo genotoxic profile for concentrated seed preparations at the studied doses.</p> </li> </ul>

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<h4> Antidiabetic medications (insulin, sulfonylureas, metformin - clinically relevant classes)</h4> <ul> <li>Interaction_Details: Annona squamosa extracts lower blood glucose in animal studies; adding them to prescribed glucose-lowering drugs may produce additive hypoglycaemia or require dose adjustments.</li> <li>Severity: Moderate</li> <li>Recommendation: Consult your clinician before using Sitaphal extracts or large amounts of leaf/pulp; monitor blood glucose closely and adjust medication only under medical supervision.</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/15848023/</li> <li>Scientific_Study_Title: Hypoglycemic and antidiabetic effect of ethanolic extract of leaves of Annona squamosa L. in experimental animals.</li> <li>Scientfic_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Excerpt: <p>Administration of Annona squamosa leaf ethanolic extract to diabetic animal models produced significant reductions in fasting blood glucose and improved glucose tolerance over repeated dosing. The magnitude of glucose lowering suggests that concurrent use with pharmaceutical hypoglycaemic agents could lead to clinically significant additive effects and hypoglycaemia if not monitored.</p> </li> </ul> <h4> Parkinson's disease / dopaminergic medications (clinical populations with parkinsonism)</h4> <ul> <li>Interaction_Details: Regular intake of Annonaceae fruits/teas is associated with worsening motor and cognitive symptoms in patients with degenerative parkinsonism; this is not a classical drug-drug pharmacokinetic interaction but a hazardous exposure that can aggravate disease and reduce response to therapy.</li> <li>Severity: Severe</li> <li>Recommendation: Patients with Parkinson’s disease or atypical parkinsonism should avoid Sitaphal fruits, juices and teas and should discuss any prior consumption with their neurologist; do not replace prescribed therapy with plant preparations.</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/36210778/</li> <li>Scientific_Study_Title: Annonaceae Consumption Worsens Disease Severity and Cognitive Deficits in Degenerative Parkinsonism.</li> <li>Scientfic_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Excerpt: <p>Analysis of Caribbean patients with degenerative parkinsonism showed that cumulative Annonaceae consumption (fruits, juices, herbal tea) correlated with a more severe phenotype and cognitive deficits, even at low cumulative intake levels. This supports a recommendation to avoid Annonaceae exposure in parkinsonian patients due to worsening clinical course.</p> </li> </ul> <h4> Acetylcholinesterase-active drugs (cholinesterase inhibitors used for dementia - e.g., donepezil) - potential pharmacodynamic interaction</h4> <ul> <li>Interaction_Details: Annona extracts show in vitro acetylcholinesterase inhibition; theoretically this could add to or modify effects of prescribed cholinesterase inhibitors, altering efficacy or side-effect profiles (e.g., increased cholinergic effects).</li> <li>Severity: Mild</li> <li>Recommendation: If you are on cholinesterase inhibitors for dementia, mention any Sitaphal supplement/tea to your prescriber and avoid self-medication with extracts; monitoring for side effects is reasonable.</li> <li>Scientific_Study_Available: Yes</li> <li>Scientific_Study_Link: https://pubmed.ncbi.nlm.nih.gov/34681391/</li> <li>Scientific_Study_Title: Chemical Profile and Evaluation of the Antioxidant and Anti-Acetylcholinesterase Activities of Annona squamosa L. (Annonaceae) Extracts.</li> <li>Scientfic_Study_Authors: (authors as listed on PubMed record).</li> <li>Scientific_Study_Excerpt: <p>Analysis of pulp and seed extracts revealed phenols, flavonoids and measurable acetylcholinesterase inhibition in vitro using standard assays. While these laboratory findings do not prove a clinical interaction, they indicate a plausible pharmacodynamic effect that could theoretically interact with cholinesterase-modulating drugs.</p> </li> </ul>