Text and Photos by Jims Vincent T. Capuno
“Diabetes is going to be the biggest epidemic in human history,” predicts Dr. Paul Zimmet, director of the International Diabetes Institute in Victoria, Australia. In the last two decades, the number of people around the world suffering from diabetes has skyrocketed from 30 million to more than 230 million.
“The number is estimated to get past 350 million in less than 20 years if we don’t take steps now. The situation is no different here in the Philippines where some 500 Filipinos are being diagnosed with diabetes every day,” warned Dr. Francisco Pasaporte, president of the Philippine Association of Diabetes Educators.
The country is home to about four million diabetics, with more than three million not knowing they have the disease. “Many people still do not know that they have diabetes,” said Dr. Tommy Ty Wiling, president of Diabetes Philippines. The Department of Health listed diabetes as the ninth leading cause of death among Filipinos today.
Diabetes is a chronic, debilitating and often deadly disease that affects how the body turns food into energy. Normally, the food we eat is converted into glucose and used or stored by the body with little problems. Circulating insulin hormone stimulates the uptake of sugar by the body’s cells. But with diabetes something goes awry. The pancreas, which is the organ responsible for producing insulin, becomes irresponsible.
Some diabetics are usually totally dependent on insulin injections for survival. In fact, there are those that require daily administration of insulin. “Insulin treatment can help manage diabetes,” writes Ellie Rose in an article which appeared in Reader’s Digest. “But in some places, annual care for one person can cost 75 percent of the average income.”
Enter a sour-tasting, warty fruit called bitter melon (scientific name: Momordica charantia). “Commonly known as ampalaya in the Philippines, researchers refer to it as a vegetable, fruit, or herb,” wrote Frank Murray in his book, Ampalaya: Nature’s Remedy for Type 1 and Type 2 Diabetes. “It is indigenous to Asia, but is cultivated around the world, where it goes by almost 90 different names.”
Ampalaya can be considered as nature’s answer to diabetes. Almost 100 studies have demonstrated the blood sugar lowering effect of this bitter fruit. Dr. A. Raman and Dr. C. Lau, who reviewed over 150 pre-clinical and clinical studies on ampalaya’s anti-diabetes properties and phytochemistry, concluded that, “Oral administration of fruit juice or seed powder (of bitter melon) causes a reduction in fasting blood glucose and improves glucose tolerance.”
In the Philippines, Dr. William Torres, former director of Bureau of Food and Drugs, came up with this conclusion after reviewing several studies done on ampalaya: “Ampalaya fruits, leaves, seeds and other parts, when used as dry powders, extracts, decoctions, fresh or cooled, have clearly demonstrated hypoglycemic activity.”
Researchers have identified the key compounds present in ampalaya, notably polypeptide-P, a plant insulin found only in the ampalaya. Similar to animal insulin, polypeptide-P lowers elevated blood sugar levels. Dr. Torres maintains that ampalaya, when taken regularly, helps to increase glucose tolerance and “potentiate insulin.”
Reader’s Digest’s Rose reports that ampalaya contains high levels of charantin, which increases insulin sensitivity and compounds that activate AMPK, a protein that regulates glucose uptake. “It also has a form of lectin (a sugar-binding protein) that lowers blood glucose and suppresses appetite,” Rose writes.
Even ampalaya leaves have some blood sugar lowering effect among diabetics, according to Dr. Eduardo G. Gonzales, of the College of Medicine at De La Salle University. “This effect is noticeable regardless of how the leaves are prepared — boiled then eaten, or in the form of extract, tea, capsule or tablet.”
Although it has been found that a serving has a similar effect to a daily dose of the anti-diabetes drug glibenclamide, Dr. Gonzales warneddiabetics not to be “overly enthusiastic in replacing their proprietary medicines with ampalaya teas, capsules or tablets.” As he wrote in his column published in a national daily: “None of the studies so far conducted on ampalaya and diabetes can be labeled conclusive. All were done using a very limited number of human subjects, and most are not controlled.”
Dr. Willie T. Ong, author of How to Live Longer, has this caution: “Diabetes experts strongly advise their patients to continue their regular medications and just use ampalaya as a supplement. In serious cases of diabetes, you really need your maintenance medicines.”
In terms of nutritional contents, the fruits and leaves of the ampalaya are reportedly rich in minerals and vitamins, notably iron, calcium, phosphorus and Vitamin B. Filipinos prepared ampalaya into various dishes: it can be stir-fried with ground beef and oyster sauce, or with eggs and diced tomato. A very popular dish from the Ilocos region is the pinakbet, which consists mainly of ampalaya, eggplant, okra, string beans, tomatoes, lima beans, and other various regional vegetables stewed with a little bagoong-based stock.
In other parts of the world, ampalaya is cooked in various ways. In Chinese cooking, it is often used for its bitter flavor, typically in stir-fries (often with pork and douchi, soups, and also as tea.
Ampalaya is also very popular throughout India. In North India, it is often prepared with potatoes and served with yogurt on the side to offset the bitterness, or used in sabji. In Southern India, it is used in the dishes thuvaran (mixed with grated coconut), theeyal (cooked with roasted coconut) and pachadi (considered a medicinal food for diabetics).
In Pakistan and Bangladesh, ampalaya is often cooked with onions, red chili powder, turmeric powder, salt, coriander powder, and a pinch of cumin seeds. In Indonesia, ampalaya is prepared in various dishes, such as gado-gado, and also stir fried, cooked in coconut milk, or steamed.
In Vietnam, raw ampalaya slices consumed with dried meat floss and stuffed to make bitter melon soup with shrimp are popular dishes. Ampalaya stuffed with ground pork are served as a popular summer soup in the South.
In Nepal, ampalaya is prepared as a fresh pickle called achar. For this, the ampalaya is cut into cubes or slices and sautéed covered in oil and a sprinkle of water. When it is softened and reduced, it is minced in a mortar with a few cloves of garlic, salt and a red or green pepper. It is also sautéed to golden-brown, stuffed, or as a curry on its own or with potatoes.
But ampalaya is more than just a vegetable or food. Philippine traditional medicine attributes many medicinal properties to ampalaya. Books and articles on Philippine medicinal plants list several diseases where ampalaya is apparently beneficial. Reportedly, the extract from the leaves or roots shrinks hemorrhoids. The leaf juice is supposedly a good antitussive (i.e., it stops cough), antipyretic (i.e., for fever), purgative and anthelmintic (i.e., against roundworms).
Ampalaya is also used to treat sterility in women and it can supposedly alleviate liver problems. Likewise, it is claimed that ampalaya has some antimicrobial activity and can help infected wounds.
But the Philippines is not the only country promoting ampalaya against diseases. China, too, is doing several studies. In the book, Zhong Yao Da Ci Dian (Great Dictionary of Chinese Medicines), ampalaya (locally known as ku gua) is described as bitter and cold and entering the heart, spleen, and stomach channels, or, alternatively, the heart, liver, and lung channels.
“Its traditional functions are that it clears summer heat and flushes heat, brightens the eyes, and resolves toxins,” the book states. “It has been traditionally indicated for heat disease vexatious thirst leading to drinking, summer heat stroke, dysentery, red, painful eyes, welling abscesses, swellings, and cinnabar toxins, and malign sores.”
In China, several studies have been that ampalaya have cholesterol-lowering effects. In one study, elevated cholesterol and triglyceride levels in diabetic rats were returned to normal after 10 weeks of treatment. In another study, results showed that bitter melon extract reduced triglyceride and low-density lipid (LDL) levels, and increased high-density lipid (HDL) levels.
In yet another Chinese study, HDLs (the so-called good cholesterols) were consistently elevated by dietary bitter melon both in the presence and absence of dietary cholesterol, indicating an ability of bitter melon to prevent or protect against atherosclerosis.
Though it has been claimed that ampalaya’s bitterness comes from quinine, no evidence could be located supporting this claim. Ampalaya is traditionally regarded by Asians, as well as Panamanians and Colombians, as useful for preventing and treating malaria. Laboratory studies have confirmed that various species of the bitter fruit have anti-malarial activity, though human studies have not yet been published.
Scientists at the World Vegetable Center in Taiwan are currently experimenting with 280 different varieties of the bitter fruit “to try to crossbreed a ‘super’ version with maximum anti-diabetic effect,” Rose reports. “The center hopes to have the variety ready for market within five to eight years.”
