Food as Medicine: Moringa (Moringa oleifera, Moringaceae)

Moringa oleifera is one of the 12 known Moringa species in the horseradish tree family (Moringaceae) that flourish in drier parts of the world.1 Nine species occur in eastern Ethiopia, northern Kenya, and Somalia, of which eight moringa flowersare endemic to Africa, and three species occur in India.1,2 Belonging to the Brassicales order, this plant family is distantly related to cruciferous vegetables like arugula (Eruca vesicaria ssp. sativa, Brassicaceae) and broccoli (Brassica oleracea var. italica, Brassicaceae) and contains many of the same nutrients and sulfurous phytochemicals.1,3 Moringa species grow as stout-stemmed trees or shrubs. Some species are known as bottle trees and have a large root system that enhances water storage and aids the trees’ survival during periods of drought.1 Members of the Moringa genus have corky gray bark and distinct bi- or tri-pinnately compound leaves that have conspicuous swellings, or pulvini, at the base of each leaf stalk where it connects to the leaves.

Native to northern India, M. oleifera is now widely distributed across tropical and subtropical climates worldwide.4 On average, moringa grows 15 to 20 feet tall and produces clusters of scented white bisexual flowers with five stamens held to one side surrounded by five unequal, thinly veined yellowish-white petals.4,5 Fruit pods are pendulous and three-sided with nine longitudinal ridges and a pointed tip, and grow up to 18 inches long. Moringa trees can produce hundreds or even thousands of seed pods per season.5 Moringa seeds are round or triangular in shape, enclosed individually by a thin, brownish semi-permeable seed hull, and explode from the pod when ripe.1,6

Its resilience to drought and poor soils has made moringa an important source of food and medicine in underserved populations.4 In fact, moringa is one of several plants promoted as an important food source by three non-governmental organizations: Trees for Life, Church World Service, and the Educational Concerns for Hunger Organization. Moringa leaves can be consumed fresh or dried as a powder. Dried leaf powder is shelf-stable and can be stored for several months without losing the majority of its nutritional properties, providing substantial health benefits to countries struggling with malnutrition and hunger.4,7 Having researched M. oleifera for nearly a decade, Carrie Waterman, Ph.D., a natural products chemist at the University of California, Davis, reports that moringa is among the top 10 plants that can feed the world over the next 100 years.3 Moringa is fast-growing and produces leaves during the dry season and during droughts, which provide a nutritious green vegetable when little other food is available.2

Historical and Commercial Uses

moringa illustrationThe use of M. oleifera as a medicinal herb was first described around 2000 BCE in India. Moringa has a long history of use in traditional Indian and African cuisine and medicine and was considered a panacea that was used to treat more than 300 conditions.7,8 Moringa is known by various common names including “Africa’s miracle tree,” “mother’s best friend,” “drumstick tree,” or “horseradish tree.”8 Moringa leaf is known as malunggay in the Philippines, ma-rum in Thailand, saijan in Hindi, and nebedaye (meaning “never die”) in many African languages.5,8,9 The traditional medicinal uses of this plant are numerous and include the use of flowers, leaves, and roots for treating ascites (excess fluid in the abdomen), rheumatism, and venomous bites.5 The seed oil is used externally to treat skin diseases. Small amounts of the leaf juice are commonly used to treat hiccups (though it is an emetic in high doses), and cooked leaves are used to treat influenza, often in chicken soups. The root bark is used for its analgesic, anti-inflammatory, and antiviral properties. Stem bark and flowers are used for hypoglycemia. Seed decoctions commonly are consumed for their anti-inflammatory, antispasmodic, and diuretic effects as well as to treat venereal diseases.

Young moringa leaves, consumed fresh or dried, are high in protein, vitamins, and minerals and used extensively to combat anemia and malnutrition, especially in infants, children, and those with underlying chronic conditions such as inflammation, infections, or diabetes.1,2,6,8 Fresh leaves are used in salads, sauces, and soups.8 In Africa and countries where moringa is a common accessible food, including Nicaragua, the Philippines, and Thailand, the leaves commonly are used to fortify noodles, bread, biscuits, cereal porridge, and cakes as well as yogurt and cheese. Using moringa leaves as a dietary supplement alone or in fortified foods can decrease the incidence of iron deficiencies and oxidative stress.6

Flowers are either cooked or fried and often combined with relishes. When crushed, the horseradish-flavored roots are used as a condiment.1 Moringa’s green, immature seed pods are highly nutritious and commonly consumed raw or cooked.6 Seed pods and seeds provide significant sources of calcium, potassium, sodium, and iron.6

Moringa seeds are eaten raw, boiled, roasted, fried, or powdered and are a traditional ingredient in curries.2 Moringa seeds are abundant in lipids (mainly oleic, stearic, and saturated palmitic acids) and can produce up to 45% oil after processing.6,8 On average, one kilogram of moringa seeds yields 400 mL of cooking oil.6 In developing countries, this seed oil is an ideal substitute for olive (Olea europaea, Oleaceae) oil, valued in cooking and baking, and is considered sweet, non-sticking, non-drying, and more resistant to oxidative rancidity.2, 6-8 Moringa seed oil can be used as a solidifying agent in margarine, eliminating typical hydrogenation processes.6 Moringa seed oil is also known as “ben oil” and is used as a lubricant by watchmakers and in cosmetics, where it is valued for its ability to retain scents when used in perfumes.6,7

Phytochemicals and Constituents

All parts of the moringa tree — bark, pods, leaves, nuts, seeds, tubers, roots, and flowers — are edible and have been analyzed for their nutrient and phytochemical contents. Moringa flowers contain essential oil, moringa leaves and flowersglucosinolates, flavonoids (quercetin- and kaempferol glycosides), and other phenolics, such as chlorogenic acid derivatives. Moringa’s stem bark is nontoxic and contains procyanidins (condensed tannins), essential oil (e.g., vanillin), triterpenoids, alkaloids (moringine and moringinine), and fatty acids (e.g., octacosanoic acid).4, 10 The stem bark has shown antibacterial activity against both gram-positive and gram-negative bacteria and is also antifungal.11 Roots contain procyanidins, flavonoids, amides (e.g., aurantiamide acetate, 3-dibenzylurea), and phenolics (e.g., chlorogenic acid).4

The seeds are abundant in lipids, comprising 30% of their dry weight, and includes saturated (stearic, palmitic, and oleic acids) and polyunsaturated fatty acids (PUFAs), including linoleic and α-linoleic acids.4,5 Research indicates that moringa seed oil contains approximately 76% PUFAs, making it an ideal substitute for olive oil.7 The seeds contain numerous phytochemicals including glucosinolates, phenolics (e.g., gallic acid, catechins, epicatechin, ferulic acid, vanillin, caffeic acid, protocatechuic acid, and cinnamic acid), phytosterols, and flavonoids (e.g., quercetin- and kaempferol glycosides).4,10

Moringa leaves, the most commonly consumed part of the plant, contain carotenoids, phenolic acids, glucosinolates, oxalates, phytates, tannins, saponins, alkaloids, and flavonoids.6 The leaves contain more antioxidant compounds than the pods or seeds.8 These compounds include vitamins A and C, carotenoids, terpenoids and flavonoids (including quercetin, kaempferol, catechin, and epicatechin), as well as sulfur-containing glucosinolates and isothiocyanates. Quercetin, reported to exhibit anti-inflammatory properties, is abundant in moringa leaves. Tannins and saponins also contribute to moringa leaf’s anti-inflammatory and cancer prevention potential.

Additionally, moringa leaves contain amino acids, 10 of which are considered essential.6  Leaves contain more calcium, potassium, magnesium, and iron per serving than other regionally available plant sources such as cassava (Manihot esculenta, Euphorbiaceae), amaranth (Amaranthus spinosus, Amaranthaceae), and fluted pumpkin (Telfairia occidentalis, Cucurbitaceae).6 Comparative analysis shows that fresh moringa leaf has four times the vitamin A content of carrots (Daucus carota, Apiaceae), four times the calcium of milk, three times the potassium of bananas (Musa acuminata, Musaceae), seven times the vitamin C of oranges (Citrus × aurantium var. sinensis, Rutaceae), and twice the protein of yogurt per 100 g serving.4

Moringa leaf is mineral-rich and can be used as an affordable way to supplement calcium and iron. Eight ounces of milk provides 300-400 mg calcium per 100 g serving, while fresh moringa leaves can provide 1000 mg and dried leaves can provide more than 4000 mg per 100 g serving, corresponding to 240 mg calcium per tablespoon moringa powder.7 Moringa leaf powder can be used as a non-constipating iron supplement to treat anemia. Moringa leaf powder provides 28 mg iron compared to 2 mg iron from beef per 100 g serving. However, the daily dose of moringa leaves should not exceed 70 g to avoid excess iron intake. Average daily intake is approximately 1 tablespoon, or 6 grams, of moringa powder.7 Boiling moringa leaves (as opposed to simmering or blanching) increases the bioavailability of iron and antioxidant compounds while reducing the small amounts of anti-nutrient compounds including oxalates, phytates, and cyanide.

Modern Research and Potential Health Benefits

Moringa products have been investigated for their antioxidant, anti-inflammatory, hypocholesterolemic, hypoglycemic, antispasmodic, antibiotic, and diuretic properties as well as their importance in improving nutritional status in women, infants, and children.2

Antioxidant Activity

Moringa’s antioxidant compounds are concentrated in the leaves, pods, and seeds. The high content of flavonoids and other phenolic compounds, especially in the leaves, has been shown to reduce oxidative damage in vitro by inhibiting lipid peroxidation and nitric oxide formation which prevents the generation of free radicals.4 Moringa leaf extracts have been shown to reduce oxidative stress and brain lipid peroxidation in cultured nerve cells while increasing levels of superoxide dismutase and catalase, enzymes with potent antioxidant activity.

Clinical studies using 7 g of moringa leaf powder daily as a dietary supplement for three months found a significant increase in blood levels of antioxidant compounds including ascorbic acid, superoxide dismutase, and glutathione peroxidase and a significant decrease in malondialdehyde, generated by lipid peroxidation.8 The antioxidant activity of moringa leaf preparations is directly related to anti-inflammatory and antibacterial effects and should be further investigated for potential hepatoprotective and antitumor effects.

Anti-inflammatory and Immunomodulatory Activity

Pharmacological studies reveal that extracts of moringa roots, stems, leaves, flowers, pods, and seeds demonstrate anti-inflammatory activity.4 In Ayurveda, one of the traditional medicine systems of India, moringa is used in the treatment of chronic rheumatism, allergies, and bronchial asthma.12 Research indicates that the incidence of asthma and allergic conditions may be linked to low hemoglobin (Hb) levels, which is a risk factor for lower respiratory tract infections (LRTIs). An open-label, noncomparative clinical study was conducted in India to investigate the safety and effectiveness of moringa seed kernels to treat bronchial asthma. Twenty patients with mild-to-moderate bronchial asthma were given 3 g of finely powdered moringa seed kernels daily for three weeks. In addition to the reduction in common symptoms such as shortness of breath, wheezing, tightness in the chest, and cough, participants receiving moringa seed powder had significantly higher Hb levels. There was also a statistically significant improvement in lung volumes, as measured by forced vital capacity (FVC) and forced expiratory volume (FEV), and lung flow rates as measured by peak expiratory flow rate (PEFR), maximum ventilatory volume (MVV), and forced expiratory volume in one second (FEV1).

It is thought that moringine, an alkaloid present in moringa seeds, relax bronchioles and closely resembles ephedrine in action, which makes it potentially useful in treating bronchial asthma.12 Moringa’s quercetin content may also play a role by inhibiting nuclear factor-kappa B, which impedes the chain reaction of inflammatory cytokine production.4 Additionally, animal and human studies have demonstrated that moringa seed extract modifies Th1/Th2 cytokines by interrupting acetylcholine-induced bronchospasms and airway inflammation. More clinical trials are necessary to further investigate moringa seed’s use in the treatment of asthma and other chronic inflammatory conditions.

Diabetes Mellitus and Hypoglycemia

Diabetes, a chronic metabolic disease characterized by insulin resistance and elevated blood glucose, can be treated and managed but not yet cured.13 Most often occurring in overweight individuals over the age of 40, type 2 diabetes mellitus (T2DM) is a complex disease that affects pancreatic beta cells, impairing their ability to secrete insulin. T2DM is associated with a higher incidence of hypertension, atherosclerosis, and osteoarthritis. Although few clinical studies have been conducted on moringa and T2DM, moringa leaf preparations have significant potential to safely and effectively treat hyperglycemia and dyslipidemia.8

In a small clinical trial of 10 healthy participants, 500 mg moringa leaf capsules were given orally in increasing doses (0 g, 1 g, 2 g, and 4 g) every two weeks for a total of six weeks.9 Fasting blood glucose and insulin levels were measured a baseline, and at 0.5, 1, 1.5, 2, 4, and 6 hours following each dose. There was a significant increase in insulin secretion after participants received a 4 g dose, despite no change in blood glucose levels. Thee lack response regarding the glucose concentrations was attributed to the overall health of participants, none of whom had hypoglycemia or diabetes. No adverse effects were reported.

In a clinical trial conducted in India, 55 T2DM patients between 30 and 60 years old were selected from the Acharya Nagarjuna University Hospital’s Diabetic Care Center and divided into three groups. For 40 days, group 1 was given 8 g moringa leaf powder daily, group 2 was given 6 g neem (Azadirachta indica, Meliaceae) seed powder daily in three divided doses, and group 3 did not receive any treatment.13 Participants in both active treatment groups demonstrated a significant reduction in fasting blood glucose (P < 0.01) as well as postprandial blood glucose levels (P < 0.05) compared to the control group. While both herbs used in the study exhibited significant hypoglycemic effects, moringa leaf powder was found to be more effective in reducing blood lipid values and improving glucose tolerance than neem seed powder. Moringa leaves also improved bile acid excretion and caused a significant reduction in total cholesterol and triglycerides, as well as low-density lipoprotein and very-low-density lipoprotein levels.8,13 These results suggest moringa leaf’s potential as a safe and effective treatment for T2DM patients, although a further clinical investigation is necessary.

Urinary Tract Infections

Urinary tract infections (UTIs) result in more than eight million doctor visits annually in the United States and are the second most common infection in humans.11 Antibiotics are the standard treatment of care despite the common occurrence of antibiotic resistance, reinfection, and relapse. The majority of UTIs are caused by gram-negative bacteria including Escherichia coliProteus mirabilisKlebsiella pneumonia, and Enterobacter aerogenesE. coli alone is responsible for 80 percent of UTIs. Gram-positive bacteria such as Staphylococcus saprophyticusS. aureus, and Enterococci also cause UTIs. Antibiotic resistance has become most common when treating StaphylococcusPseudomonas, and Escherichia infections.

In India, moringa stem bark decoctions have been used as a diuretic and natural antibiotic for treating UTIs. Similar to cranberry (Vaccinium macrocarpon, Ericaceae), moringa appears to inhibit the adhesion of infection-causing bacteria to the wall of the bladder and help to eliminate the pathogen via urination.11 Moringa’s flavonoids and alkaloids are thought to be involved in inhibiting biofilms of problematic microorganisms such as S. aureusPseudomonas aeruginosa, and Candida albicans.4

In a randomized controlled trial, 30 UTI patients were divided into two groups of 15. The treatment group received 40mL moringa bark decoction (15 g coarse powder in 100 mL water) for 21 days, twice daily. The control group was given the antibiotic medication levofloxacin.11 The moringa stem bark decoction demonstrated antibacterial action against urinary pathogens such as E. coli. and was as effective at alleviating UTI symptoms as the antibiotic, without adverse effects.11 Results are encouraging and suggest that moringa bark may provide a safe, affordable and accessible way to effectively treat a variety of UTIs.

Maternal Health and Malnutrition in Underserved Populations

Approximately 25% of moringa leaf’s dry weight consists of proteins and essential amino acids, making this plant an important part of combating malnutrition, especially in children and infants.

In areas where moringa is a regional food source (various African and Asian countries, Latin America, and New Zealand), fresh or dried leaf consumption is recommended for pregnant and nursing mothers as well as children, as it provides protein, B vitamins, antioxidant vitamins A, C, and E, minerals including iron, calcium, and potassium, as well as sitosterol, stigmasterol, and kampesterol.2,6,7,12 Moringa’s protein content is easy to digest; the vitamin content aids iron absorption; and the vitamin A content can help improve immunity, bone growth, vision, and skin health.12 Moringa leaf powder is often used as a supplement to provide daily requirements of dietary calcium and iron during pregnancy.7

Galactagogues are medications (such as metoclopramide) or natural substances (such as anise seed [Pimpinella anisum, Apiaceae] and fennel seed [Foeniculum vulgare, Apiaceae]) that are used to support the initiation, maintenance, or increase of maternal milk production.14 Frequent nursing is necessary to maintain high plasma prolactin levels, which correlate to breastmilk supply. Moringa leaf has a history of postpartum use to increase breastmilk production.7

A systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in the Philippines evaluated the effectiveness of moringa leaf supplementation in postpartum women to improve breastmilk production and infant growth. Of the five RCTs evaluated, 366 participants met the inclusion criteria. Evidence from the RCTs reported a statistically significant increase in breastmilk volume on days four, five, and seven following treatment with moringa leaf capsules (250 mg twice daily) compared with placebo. However, only two RCTs reported an increase in infant weight gain.14 Overall, studies indicate that moringa leaf supplementation increases maternal prolactin levels among breastfeeding mothers.

Malnutrition is one of the most serious and often neglected health problems. Every year, more than 2.7 million deaths worldwide are attributed to diets with insufficient amounts of protein, fruits, and vegetables, placing malnutrition among the top 10 mortality risk factors.12 A six-month longitudinal pilot study conducted in the rehabilitation unit of Centre Médical Paul VI in Ouagadougou, Burkina Faso, aimed to assess the impact of moringa leaf powder on the nutritional status of 110 severely malnourished children aged six months to five years old. Clinical signs of malnutrition and associated symptoms included edema, marasmus (abnormally low weight caused by undernourishment), kwashiorkor (malnutrition as a result of severe protein deficiency), diarrhea, vomiting, and rashes. Participants were divided into two treatment groups: Group 1 received the Center of Nutritional Recovery and Education’s (CREN’s) standard nutritional care diet and one 10-gram dose of moringa leaf powder daily, and group 2 received the CREN diet only. At the conclusion of the study, participants in group 1 experienced a significantly higher average weight gain (8.9 + 4.3 g/kg/day compared to 5.7 + 2.72 g/kg/day in group 2; P= 0.002) and a quicker recovery rate (an average stay of 36 + 15.54 days versus 57 + 19.2 days) compared to those not receiving moringa supplementation. There was no significant improvement in hemoglobin rate in either group. Dietary supplementation of moringa leaf powder appears to improve the nutritional recovery of severely malnourished children.

Consumer Considerations

Able to withstand both severe drought and mild frost conditions, moringa is cultivated widely in tropical and subtropical climates for its numerous nutritional, medicinal, and ecological benefits.7 The largest producer of M. oleifera is India, which meets 80% of commercial demand worldwide. Africa, Asia, and Central and South America also cultivate moringa for regional and commercial use.6

Aside from its nutritional and medicinal attributes, moringa is used as fodder and in textiles (bark) and biofuel (seed oil). In developing countries, moringa leaves are fed to livestock to increase weight gain, milk production, and overall nutritional status.8 When planted close together, these trees provide windbreaks and reduce soil erosion.2 Moringa seed oil is also used as a biofuel and as a lubricant for fine machinery.8 After seeds are processed for oil, the spent seed cake is repurposed as fertilizer for improving soils and food production. Moringa leaves contain a growth hormone called zeatin and frequently are used as a foliar feed for plants to increase crop yields by 35% to 30%.7,8 Dried leaves are antifungal and can be blended into potting soil to prevent damping off in seedlings.5 Moringa is also valued by beekeepers for its nectar-rich flowers.

Moringa seeds have been gaining recognition and use as a natural water treatment in urban and rural areas. Frequently, drinking water must be treated physically and chemically, through coagulation and flocculation processes using chemical coagulants, to make it drinkable. Water is often treated with aluminum sulfate or ferric chloride, but the use of moringa seeds shows promise in completely or partly replacing coagulating agents, reducing cost and improving human and environmental health.4 Moringa seeds have also been used to treat aquaculture wastewater, which often contains potentially zoonotic opportunistic pathogens that may cause economic losses for fish farmers as well as public health problems.

Moringa seeds have natural coagulant properties that aid in regulating pH and significantly reducing turbidity, microbial load, and helminths, which helps prevent water-borne diseases.4,8 The antibacterial action of moringa extracts are attributed to gallic acid and tannins (which inhibit Vibrio spp.), and saponins, isothiocyanates, and flavonoids.4 In a comparative study of water treatments, moringa seeds were found to be less expensive and more effective than aluminum sulfate. Contaminated water treated with moringa seeds resulted in a 95% decrease in turbidity compared to an 80% reduction in turbidity when aluminum sulfate was used.4 As the seeds degrade to pulp in water, metal ions such as lead, copper, cadmium, chromium, and arsenic are adsorbed and colloid aggregation occurs.4, 8 These properties support moringa’s potential in water treatment protocols as well as in treating wastewater resulting from aquaculture production.

Nutrient Profile15

Macronutrient Profile: (Per 1 cup (21g) fresh chopped leaves)

13.4 calories
1.97 g protein
1.74 g carbohydrate
0.29 g fat

Micronutrients: (Per 1 cup (21g) fresh chopped leaves)

Excellent source of:

Vitamin A: 1590 IU (31.8% DV)

Very good source of:

Vitamin B6: 0.25 mg (14.7% DV)
Vitamin C: 10.9 mg (12.1% DV)
Thiamin: 0.05 mg (10.8% DV)
Riboflavin: 0.14 mg (10.8% DV)

Good source of:

Manganese: 0.22 mg (9.6% DV)
Iron: 0.84 mg (4.7% DV)
Calcium: 38.8 mg (2.9% DV)
Niacin: 0.47 mg (2.9% DV)
Folate: 8.4 mcg (2.1% DV)
Magnesium: 8.8 mg (2.1% DV)
Phosphorus: 23.5 mg (1.9% DV)
Potassium: 70.8 mg (1.5% DV)
Dietary Fiber: 0.42 g (1.4% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet.

Recipe: Chicken and Moringa Leaf Soup with Coconut Milk
Adapted from Casa Veneracion16

Ingredients

  • 2 large chicken breasts, thinly sliced
  • 3 to 4 cups fresh moringa leaves, stems removed
  • 1 onion, thinly sliced
  • 6 cloves garlic, minced
  • 1 two-inch piece of ginger, peeled and finely sliced
  • 2 stalks lemongrass, finely sliced (substitute grated zest from one lemon)
  • 2 Makrut lime leaves, torn (substitute with 1-2 teaspoons grated lime zest)
  • 2 to 3 Thai chilies or bird’s eye chilies, finely chopped
  • 2 tablespoons of cooking oil
  • 4 cups chicken (bone) broth
  • 2 cups whole coconut milk
  • 1-2 tablespoons Thai fish sauce (can substitute equal parts soy sauce and rice vinegar; or soy sauce and lime juice)

Directions

  1. Heat the cooking oil in a pot. Sauté the garlic, ginger, onion, chilis, and lemongrass until fragrant.
  2. Add the chicken strips and cook until no longer pink.
  3. Add the kaffir lime leaves. Stir and cook for a couple of minutes.
  4. Pour in the broth. Season with fish sauce. Bring to the boil, lower the heat, cover and simmer for 15 minutes or until the chicken is cooked through.
  5. Pour in the coconut milk and add the moringa leaves, pressing them down into the liquid.
  6. Bring to a boil, and then simmer for two minutes before turning off the heat. Avoid overcooking moringa leaves to reduce bitter flavor.
  7. Adjust seasoning to taste and serve immediately.

Image credit (top to bottom):

Moringa flowers. Image courtesy of J.M. Garg.
Moringa illustration from Flora de Filipinas by Fr. Francisco Manuel Blanco. 1837.
Moringa branch with leaves and flowers. Image courtesy of J.M. Garg.

References

  1. Caricaceae and Moringaceae. Britannica Online Encyclopedia. Available at: www.britannica.com/plant/Brassicales/Caricaceae-and-Moringaceae#ref992315. Accessed on March 27, 2020.
  2. Moringa. Traditional Crops. Food and Agriculture Organization of the United Nations website. Available at: www.fao.org/traditional-crops/moringa/en/. Accessed on March 27, 2020.
  3. Moringa – The Next Superfood? University of California website. Available at: www.universityofcalifornia.edu/news/moringa-next-superfood. Accessed on March 27, 2020.
  4. Brilhante RS, Sales JA, Pereira VS, et al. Research advances on the multiple uses of Moringa oleifera: A sustainable alternative for the socially neglected population. Asian Pacific Journal of Tropical Medicine. 2017;10(7):621-630.
  5. Egbuna C. Moringa oleifera “The Mother’s Best Friend.” International Journal of Nutrition and Food Sciences. 2015;4(6):624-630.
  6. Falowo AB, Mukumbo FE, Idamokoro EM, et al. Multi-functional application of Moringa oleifera Lam. in nutrition and animal food products: A review. Food Research International. 2018;106:317-334.
  7. Gopalakrishnan L, Doriya K, Kumar D. Moringa oleifera: A review on nutritive importance and its medicinal application. Food Science and Human Wellness. 2016;5:49-56.
  8. Matic I, Guidi A, Kenzo M, et al. Investigation of medicinal plants traditionally used as dietary supplements: A review on Moringa oleiferaJournal of Public Health in Africa. 2018;9:841.
  9. Anthanont P, Lumlerdkij N, Akarasereenont P. MD, et al. Moringa oleifera leaf increases insulin secretion after single dose administration: A preliminary study in healthy subjects. Journal of the Medical Association of Thailand. 2016;99(3):308-313.
  10. Kalappurayil TM, Joseph BP. A review of pharmacognostical studies on Moringa oleifera Lam. flowers. Pharmacognosy Journal. 2017;9(1):1-7.
  11. Maurya SK, Singh AK. Clinical efficacy of Moringa oleifera Lam. stem bark in urinary tract infections. International Scholarly Research Notices. 2014; Article ID 906843, 7 pages.
  12. Agrawal B, Mehta A. Antiasthmatic activity of Moringa oleifera: A clinical study. Indian Journal of Pharmacology. 2008;40(1):28-31.
  13. Kumari DJ. Hypoglycemic effect of Moringa oleifera and Azadirachta indica in Type 2 Diabetes Mellitus. The Bioscan — An International Quarterly Journal of Life Sciences. 2010;5(2):211-214.
  14. Drumstick leaves, raw. (Moringa oleifera). FoodData Central. Available at: www.fdc.nal.usda.gov/fdc-app.html#/food-details/168416/nutrients. Accessed on April 7, 2020.
  15. Veneracion C. Chicken and (malunggay) moringa leaf soup with coconut milk. Available at and adapted from: www.casaveneracion.com/chicken-and-malunggay-soup/. Accessed on April 7, 2020.