Both of my grandparents, and several of their friends that lived in Guam for a period of time on the base developed Parkinsonism/PSP. None of them were genetically related. My relatives never knowingly consumed pawpaw or annona fruits. We did a fair bit of research regarding cause when my second grandparent was diagnosed and it seems like it would be very difficult to unwind all of the potential causes. I'd be curious too, and I haven't looked, but about the overall increase in instances of Parkinsonism across the world and its territories and how much could be assigned to better testing, more awareness, or just overall greater case load. (before demonizing pawpaw)
Parkinsons in Guam is suspected to be linked to consumption of cycad-eating bats. But on-base it could be so many other things, as you say.
https://en.wikipedia.org/wiki/Lytico-bodig_diseaseAre there any other tropical crops that are unhealthy to eat a lot of?
Taro and Monstera deliciousa come to mind ( oxalic acid ). Not a problem if prepared properly.
Both Cashew and Mango fruit have irritating sap, many for fruit pickers.
Durian and Jackfruit directly kill a bunch of people ever year, heavy fruit falling on their heads.
Apples have cyanide in the seed, can cause problems if not removed before brewing Scrumpy Cider.
Potatoes are also toxic:
https://en.wikipedia.org/wiki/Solanine https://en.wikipedia.org/wiki/Chaconine https://en.wikipedia.org/wiki/Lenape_potato"After the Lenape variety was released for commercial production, a potato breeder in Ontario ate some to see if they might be suitable as new potatoes but soon felt nauseated. When the same occurred next time he ate them, he sent a sample to be analysed by a vegetable biochemist, Dr. Ambrose Zitnak of the University of Guelph, who found they contained exceptionally high levels of glycoalkaloids (mainly solanine and chaconine), the natural toxins found in potatoes that help protect them from pests and disease.[5] Lenape potatoes collected from around Canada were found to contain over 16–35 mg of glycoalkaloids per 100 g of fresh potato compared to 3–18 mg in other varieties.[4] Samples grown at 39 locations around the US had an average of 29 mg per 100 g of potato but ranged from 16–65 mg compared to an average of 8 mg for five other varieties."
If 29 mg/100g of glycoalkaloids causes nausea, how safe is the average 8 mg/100g? "potato farmers aim to keep solanine levels below 0.2 mg/g" So the recommended safe limit is 20 mg/100g, but 29 mg/100g causes acute nausea? It's unclear if there are long-term deleterious effects, but why risk it when there are safer alternatives?
Oxalic acid is also a lot more common than you might think:
https://en.wikipedia.org/wiki/Oxalic_acid#Content_in_food_items"Although spinach is touted as being high in iron and calcium content, and is often served and consumed in its raw form, raw spinach contains high levels of oxalates, which block absorption of calcium and iron in the stomach and small intestine. Spinach cooked in several changes of water has much lower levels of oxalates and is better digested and its nutrients absorbed more completely.[7][8] In addition to preventing absorption and use, high levels of oxalates remove iron from the body.[8][9]"
https://en.wikipedia.org/wiki/Spinach