Moringa oleifera: Phytochemistry, Pharmacological Activities, Therapeutic Potential in Diabetes, Cardiovascular Diseases, Obesity, and Neurodegenerative Disorders, and Toxicological Perspectives

Abstract

Moringa oleifera Lam., a fast-growing tree native to the sub-Himalayan tracts of South Asia and now cultivated throughout the tropics and subtropics, has attracted sustained scientific interest owing to the breadth of bioactive constituents distributed across its leaves, seeds, pods, flowers, bark and roots. Polyphenols, flavonoids, glucosinolates, isothiocyanates, alkaloids, carotenoids and a distinctive group of thiocarbamate glycosides confer antioxidant, anti-inflammatory and multi-organ protective properties that have been explored across a wide range of non-communicable diseases. This narrative review synthesises contemporary evidence on the phytochemistry and pharmacology of M. oleifera, with particular emphasis on its therapeutic potential in diabetes mellitus, cardiovascular disease, obesity and neurodegenerative disorders, while critically appraising the toxicological literature underpinning its safety profile. Preclinical studies consistently demonstrate glucose-lowering, lipid-modulating, antihypertensive, anti-adipogenic and neuroprotective actions mediated chiefly through modulation of the nuclear factor kappa B and nuclear factor erythroid 2-related factor 2 pathways, attenuation of oxidative stress, and improvement of insulin signalling. Clinical evidence, although expanding, remains limited in scale, duration and methodological rigour, and meta-analytic findings have not yet established consistent cardiometabolic benefit in humans. Toxicological data derived from acute and subchronic rodent studies indicate a wide margin of safety for aqueous and ethanolic leaf preparations at commonly used doses, although hepatic and renal effects have been reported with higher doses and with extracts derived from other plant parts, underscoring the importance of standardisation. The review concludes that M. oleifera represents a biologically plausible adjunct in the management of metabolic and neurodegenerative disease, but that translation into clinical practice is presently constrained by heterogeneity in extract preparation, dosing and trial design.