Wild Edible Fruits as a Source of Food and Medicine: A Study among Tribal Communities of Southern Khyber Pakhtunkhwa

Botanical surveys in all parts of Pakistan are mainly focused on ethnomedicinal uses of plants, and very little attention has been paid to documenting edible wild fruit species (EWFs). Multiple methodologies and tools were used for data collection. In a recent survey 74 EWF species belonging to 29 families were documented, including their medicinal uses for the treatment of various diseases. The most cited (23%) preparation method was raw, fresh parts. The UV and RFC of EWF species ranged from 0.08 to 0.4 and from 0.02 to 0.18, respectively. In terms of specific disease treatments and their consensus, the ICF ranged from 0 to 0.38. Sexual, gastrointestinal, and respiratory disorders had the highest use reports, and 11 species of plants had the highest FL of 100%. On the basis of uses reported by the inhabitants of seven districts of Southern Khyber Pakhtunkhwa Province, the CSI ranged from the lowest 1.3 to the highest 41. It is concluded that the traditional uses of EWF species depend mainly on socio-economic factors rather than climatic conditions or the number of species. However, there is a gradual loss of traditional knowledge among the younger generations. The present survey is the first baseline study about the socio-economic dimension of local communities regarding the use of EWF species for food as well as medicine.


Introduction
Ethnobotany is a multidisciplinary approach [1] and can be applied to select medicinal plants for pharmacological studies [2], as a precursor to drug development [3].Since the dawn of human civilization, food and defense against various disease-causing pathogens have been the primary concerns [4].Medicinal plants represent a large portion of the floristic richness worldwide [5].Previous ethnobotanical surveys have mainly focused on traditional medicines based solely on medicinal plants [6,7], but very little attention has been given to edible wild fruit species (EWFs) [8,9].However, over the last few years, an increasing interest in EWF species has been noticed among different communities of the world [10], and there is an incentive to rediscover the importance of traditional medicine based on EWF species [11].The EWFs are generally characterized by high medicinal and Plants 2024, 13, 39 2 of 24 nutritional values [12][13][14][15], a higher fiber content [9], and being rich in antioxidants and flavonoids [9].Apart from their nutritional perspectives, many of them have yielded important beneficial outcomes in preventing and healing several chronic diseases, such as age-related disorders, heart disorders, diabetes, and various kinds of cancers [16,17].Previous studies indicate that more than 300 million people throughout the world depend, for their livelihood, on forests abundant with EWF species [18,19].This dependence is very common in areas where there is a rich diversity of these species with easy access for local communities [20].
With rapid economic growth, many traditional uses of EWF species are decreasing.The migration of people to urbanized areas, the adoption of new lifestyles, and other factors led to the replacement of traditional medicine with allopathic medicine.Factors like environmental fluctuations, earthquakes, natural disasters and anthropogenic activities have also influenced traditional knowledge.There is a high need to revive and conserve this valuable indigenous knowledge, but only limited studies have been conducted on the traditional uses of EWF species in different parts of the world, for example, in Italy [21], some other European countries [22], and Pakistan [23].
In Pakistan, there are about 6000 species of higher plants [24,25].Of them, 400-600 are considered important because of their medicinal properties based on ethno-botanicaldirected research [26].However, little attention has been paid in the past to exploring their medicinal values as well as their nutritional perspectives.Abbasi et al. [23] stated that the traditional use of EWF species is declining.Similarly, only a few studies have been conducted on their phytochemical and biological properties in Pakistan [27].Therefore, ethno-directed research can be useful in the documentation and identification of these species and aims at developing new drugs, generating food resources, and conserving the resources themselves [2].
The EWFs distributed in rural areas are vital sources of food and a valuable source of nutrition for the local communities.The current study aims (i) to enlist EWF species distributed in the tribal communities of Southern Khyber Pakhtunkhwa, Pakistan; (ii) to document local knowledge related to these EWF species; and (iii) to compare their uses with the available literature.

Study Area
The Khyber Pakhtunkhwa (KP) province (Pakistan) is located between 31 • 15 ′′ and 32 • 32 ′′ N and 70 • 11 ′′ and 71 • 20 ′′ E. It is divided into northern and southern parts.Southern KP is composed of Kohat, Karak, Hangu, Bannu, Lakki Marwat, Dera Ismail Khan, and Tank districts (Figure 1).In the west, it is bordered by the Orakzai and Kurram Agencies of the Federally Administrated Tribal Area (FATA) and it is bordered also by North and South Waziristan.In the east, it is linked to different districts of Southern Punjab.The Southern KP, where the project took place, is arid with hot summers and relatively mild winters, and scarcer in fall.Its climate varies from extremely cold to very hot.The maximum temperature in June has been recorded at 42 • C and the minimum at 27 • C in January [28].The average rainfall varies from 70-90 mm in southern parts and 100-130 mm in northern parts.The main tribes of the Southern KP are Saraiky, Marwat, Yusufzai, Khattak, Shinwari, Bangash, Mahsud, Wazir, Syeds, Awans, Qureshis, Sardars, and Sheikhs.
Economically, Southern KP is lagging behind compared with Northern KP.The socioeconomic features of informants show that the lower socio-economic class have no permanent source of income.Topography and a shortage of water are the main restraints for agriculture.Arable areas are restricted to 18.8% of the total land area.Rain-fed agriculture is mostly practiced in this region, and only 11% of the total cultivated area is irrigated [29].Economically, Southern KP is lagging behind compared with Northern KP.The socio-economic features of informants show that the lower socio-economic class have no permanent source of income.Topography and a shortage of water are the main restraints for agriculture.Arable areas are restricted to 18.8% of the total land area.Rain-fed agriculture is mostly practiced in this region, and only 11% of the total cultivated area is irrigated [29].

Ethno-Medicinal Data Collection
The present study was conducted in 21 localities in South West Pakistan, for which the ISE code of ethics was followed by the International Society of Ethnobiology, [30].In total, 233 local informants were interviewed using semi-structured questionnaire methods as employed by [31][32][33] and the guidelines endorsed by the International Society of Ethnobiology [30].A total of 8 field surveys, each of which consisted of 7 to 8 days were established in the study area.In each field survey, participants were chosen randomly, except for key informants and Traditional Health Practitioners (THPs).Key informants are those who are experts about EWF localities and have experience using them.THPs were selected based on their experience and expertise.
During interviews, information about the local name of the plant, part(s) used, medicinal uses, disease treatment, and methods of preparation were documented by showing fresh specimens or photographs during field walks whenever possible to informants.Data about the demographic information of participants were also collected: age, gender, educational status, and experience with EWF uses.In most cases, data were cross-checked among informants of different villages, either by showing the fresh specimen, telling them about local names, or showing field photographs of wild fruit plants to verify the authenticity of the claims and select potential medicinal wild fruit plants of the study area.

Plant Identification and Comparative Studies
During fieldwork, 74 medicinally important EWF species were collected, pressed, and dried for correct taxonomic identification in the herbarium.All species were identified using the Flora of Pakistan [34,35].After complete identification, plant specimens were submitted to the Herbarium of Pakistan (ISL), Quaid-i-Azam University

Ethno-Medicinal Data Collection
The present study was conducted in 21 localities in South West Pakistan, for which the ISE code of ethics was followed by the International Society of Ethnobiology, [30].In total, 233 local informants were interviewed using semi-structured questionnaire methods as employed by [31][32][33] and the guidelines endorsed by the International Society of Ethnobiology [30].A total of 8 field surveys, each of which consisted of 7 to 8 days were established in the study area.In each field survey, participants were chosen randomly, except for key informants and Traditional Health Practitioners (THPs).Key informants are those who are experts about EWF localities and have experience using them.THPs were selected based on their experience and expertise.
During interviews, information about the local name of the plant, part(s) used, medicinal uses, disease treatment, and methods of preparation were documented by showing fresh specimens or photographs during field walks whenever possible to informants.Data about the demographic information of participants were also collected: age, gender, educational status, and experience with EWF uses.In most cases, data were cross-checked among informants of different villages, either by showing the fresh specimen, telling them about local names, or showing field photographs of wild fruit plants to verify the authenticity of the claims and select potential medicinal wild fruit plants of the study area.

Plant Identification and Comparative Studies
During fieldwork, 74 medicinally important EWF species were collected, pressed, and dried for correct taxonomic identification in the herbarium.All species were identified using the Flora of Pakistan [34,35].After complete identification, plant specimens were submitted to the Herbarium of Pakistan (ISL), Quaid-i-Azam University Islamabad, for future reference.Further, botanical names of species were verified using the International Plant Name Index [36].In addition to this, we compared the documented uses of EWFs with the previously published literature about their medicinal uses.The objective of this comparison was to underline changes that may have occurred between the literature and current medicinal data and also to assess the most important species for future phytochemical, pharmaceutical, and nutritional screening.

Informant Consensus Factor (ICF)
The Informants' Consensus Factor (ICF) [37,38] is determined using the following formula: where "Nur" is the total number of use reports for each disease category and "Nt" represents the number of species used in that category.The ICF gives information about the consensus of informants about the use of EWFs and determines the consensus in the selection of EWFs against reported diseases.The maximum value that is close to 1 indicates that relatively well-known species are used by a large proportion of local people due to their authenticity in disease management, while a low value that is close to 0 shows that the informants disagree on the specificity of species and use any species by random selection to treat reported diseases [39].

Use Value (UV)
This quantitative method demonstrates the relative importance of plant species based on traditional uses.It is calculated according to the following formula: where "UV" represents the use value of individual species; "U" represents the number of uses recorded for a species; and "N" represents the number of informants who reported species [38,40].

Relative Frequency of Citation (RFC)
RFC shows the local importance of each species in the study area based on the number of informants [41,42].This index is calculated using a formula from [43].It varies between 0 and 1.It is calculated as follows: where RFC stands for the relative frequency of citations; FC (frequency of citations) expresses the number of total informants for each species; and "N" shows the total informants interviewed in the study.

Cultural Significance Index (CSI)
This is a quantitative anthropological technique in ethnobotany introduced by Turner [44] and recently changed by Da Silva et al. [45].It describes the importance of plant species by assigning multiple ranking factors: species management (i), preference of species for a given use (e), and use frequency (c).A consensus called Correction Factor (CF) is also used to reduce the sensitivity of this method to sampling intensity.A value is given to each factor and ranks between 2 and 1.It is calculated using the following formula: CSI equates the Cultural Significance Index, "i" represents species management, "e" represents the preference of species to a given use, and "c" expresses the use frequency of each species, while CF stands for the correction factor.It is calculated by dividing the number of informants interviewed (FC) for each species by the maximum number of informants for any species.

Fidelity Level
Fidelity level (FL) expresses the preference for a species over others to treat any specific disease [46].It is meant to select the most ideal species used in the treatment of a specific ailment [47].It is calculated according to the following formula: FL = I p /I u × 100 where "Ip" represents the number of informants who mentioned the use of a species for a specific ailment, while "Iu" indicates informants who mentioned the species for any disease.

Demographic Data of Participants
The demographic information of the 233 participants interviewed (187 men and 46 women) is presented in Table 1.Male participants can be further divided into 163 indigenous lay-people and 24 Traditional Health Practitioners (THPs).In this study, male participants were greater in number than female participants due simply to the fact that women were reluctant to converse with male strangers (the interviewers).During the conversation with THPs, it was noted that they were highly interested in using EWFs for the treatment of various diseases as well as for nutritional purposes.The informants were divided into four different age groups, ranging from 18 to 80 years.The indigenous knowledge regarding the use of EWFs for the treatment of various ailments was more prevalent among the old participants, while the young ones were less knowledgeable.The reason might be the rapidly changing lifestyle and migration of the rural population to urbanized areas.Informants with knowledge about EWFs had a variety of different backgrounds and included retired army personnel, farmers, herdsmen, craftsmen, shopkeepers, teachers, and housewives.Most of the informants interviewed were educated up to secondary school education level or even less (Table 1).The local language is Saraiki or Pashto.Highly educated people were found to have less knowledge about the medicinal uses of EWFs as compared to illiterate and less educated people.

Taxonomic Diversity of EWFs
In this study, 74 EWF species belonging to 26 families were documented and assessed using ethnobotanical and quantitative techniques.Rosaceae was found to be the most cited family (27 species), followed by Moraceae (6 species) and Rhamnaceae (5 species) (Table 2 and Figure 2).Moraceae and Rhamnaceae were also rich in edible plant species (Figure 3).A total of 60% of the reported EWFs were trees, followed by shrubs (30%), and most fruits were obtained from trees.The present study shows (Figure 4) that the fruits were more frequently used.The present study reported nine preparation methods (Figure 5).These indigenous formulations were mostly prepared from single species, and mixtures were rare.Water was mostly used as a medium for preparation.On the other hand, milk, ghee, oil, eggs, and butter were used for applications in the majority of cases.The most cited preparation method was raw, fresh parts (23%), followed by decoctions (21%).The frequent use of fresh parts may be an artifact due to the aim of this study, i.e., documenting the use of wild fruits.The majority of EWFs in fresh form were sweet and delicious in taste, and they were eaten in raw form for treating different diseases.Eating whole, wild edible fruits was preferred because they are rich in energy and metabolites that play a great role in indigenous treatments.Decoctions were the second-most common preparation.[48]∆, [23]∆, [49]∆, [50]∆, [51]∆, [52]∆, [53]∆, [43]∆, [54]∆, [55]∆, [56]∆, [57]∆, [58]∆, [59]∆, [60]∆, [61]∆, [62]∆, [63] ® , [64]∆, [65]∆, [66]∆ Plants 2024, 13, 39 tions (21%).The frequent use of fresh parts may be an artifact due to the aim of this study, i.e., documenting the use of wild fruits.The majority of EWFs in fresh form were sweet and delicious in taste, and t h e y w e r e eaten in raw form for treating different diseases.Eating whole, wild edible fruits was preferred because they are rich in energy and metabolites that play a great role in indigenous treatments.Decoctions were the second-most common preparation.Leaves 20% Root 6% Seed

Informant Consensus Factor (ICF)
The ICF calculated for disease categories indicates the extent of homogeneity of the consensus among local people regarding the use of EWFs.In this study, the reported ailments are separated into 11 categories for ICF calculation and interpretation.The results show that the ICF values range from 0 to 0.38 (Table 3).The highest ICF value was observed for sexual disorders (0.38), followed by GIT diseases and respiratory diseases with 0.26 and 0.24, respectively.The use categories with more than 20 use reports were GIT diseases (59 use reports, 44 species), cardiovascular disorders (25 use reports, 23 species), and glandular disorders (23 use reports, 19 species) (Figure 6).The highest values of ICF in sexual, GIT, and respiratory disorders indicate that the inhabitants of select

Informant Consensus Factor (ICF)
The ICF calculated for disease categories indicates the extent of homogeneity of the consensus among local people regarding the use of EWFs.In this study, the reported ailments are separated into 11 categories for ICF calculation and interpretation.The results show that the ICF values range from 0 to 0.38 (Table 3).The highest ICF value was observed for sexual disorders (0.38), followed by GIT diseases and respiratory diseases with 0.26 and 0.24, respectively.The use categories with more than 20 use reports were GIT diseases (59 use reports, 44 species), cardiovascular disorders (25 use reports, 23 species), and glandular disorders (23 use reports, 19 species) (Figure 6).The highest values of ICF in sexual, GIT, and respiratory disorders indicate that the inhabitants of select specific EWFs to treat those ailments.The top-ranked EWF species based on FC, reported for sexual disorders, were Phoenix dactylifera, Celtis australis, Daphne mucronata, and Punica granatum.In previous pharmacological studies, D. mucronata was not found as a remedy against sexual disorders.Phoenix dactylifera and Punica granatum are common herbal sources that may be used against these disorders.The well-known species for GIT disorders were as follows: Berberis aristata, Cydonia oblonga, Lathyrus aphaca, and Morus nigra.Cydonia oblonga was reported in the current study.Lathyrus aphaca is reported to be effective against diarrhea and dysentery, but it has not yet been studied in pharmacological assays.For respiratory Phoenix dactylifera and Punica granatum are common herbal sources that may be used against these disorders.The well-known species for GIT disorders were as follows: Berberis aristata, Cydonia oblonga, Lathyrus aphaca, and Morus nigra.Cydonia oblonga was reported in the current study.Lathyrus aphaca is reported to be effective against diarrhea and dysentery, but it has not yet been studied in pharmacological assays.For respiratory disorders, the most cited EWFs in this study were as follows: Cydonia oblonga, Diospyros kaki, Ficus palmata, Prunus persica, Pyrus sinensis, and Solanum surattense.

Fidelity Level (FL)
The relative healing potential of EWFs used against human ailments can be estimated using a fidelity level (Table 2).It determines which EWFs are used more, preferably for any specific ailment.The FL percentage varies from 46% to 100%, the highest value (Figure 7).Three categories of EWFs based on their FL percentage that inform us about their healing potential and popularity can be distinguished: well-known EWFs, moderately known EWFs, and little-known EWFs, with a range of FL percentages from 100 to 81, 80 to 61, and 60 to 46, respectively.The first category included 20 species, the second included 46 species, and the third included only 8 species (Figure 7).The well-known EWFs had 100% FL, underlining the choice made by local users to treat an ailment with a specific EWF.This pinpoints the curative properties of EWFs.A few species found in this study with 100% FL received attention in clinical trials and pharmacological assays.The present study revealed that B. aristata had the potential to treat constipation, and it should be further studied in detail.The current results also showed that Daphne mucronata, Eriobotrya japonica, Ficus racemosa, Lathyrus aphaca, Malus pumila, and Morus nigra were highly reported for the treatment of muscle pains, hypertension, diabetes, nerve problems, diabetes, and constipation.The relationship between the number of informants that mentioned use of a certain wild fruit for a particular disease; N is the total number of informants that cited the species for any disease.Numbers represent the fidelity level (FL %) as they appear in Table 3.

Use Value (UV) and Relative Frequency of Citation (RFC)
This index explains the prominence of the EWF species on the basis of their uses and the informants who reported these species (Figure 8).The UV ranges from the lowest 0.08 (Juglans regia) to the highest 0.4 (Elaeagnus umbellata).EWF species are classified into five classes based on the UV obtained: UV 0.08 to 0.10 (18 species), 0.11 to 0.12 (24 species), 0.13 to 0.17 (13 species), 0.18 to 0.25 (16 species), and UV from 0.26 to 0.4 (3 species).The species with the highest UV indicate common occurrence and utilization by the local people.Unlike UV, the RFC shows the local importance of the EWF species based on the relative informant ratios.In this study, it varies from the lowest 0.02 (Elaeagnus umbellata) to the highest 0.18 (Berberis aristata, Cydonia oblonga, and Daphne mucronata).Based on their prominence, t h e EWFs of this study were grouped into five RFC classes: 0.02 to 0.05 (12 species), 0.06 to 0.10 (25 species), 0.11 to 0.13 (18 species), 0.14 to 0.15 (12 species), and 0.16 to 0.18 (7 species).The species with the highest RFC were the most popular plants based on the majority of informants (Figure 9).The relationship between the number of informants that mentioned use of a certain wild fruit for a particular disease; N is the total number of informants that cited the species for any disease.Numbers represent the fidelity level (FL %) as they appear in Table 3.

Use Value (UV) and Relative Frequency of Citation (RFC)
This index explains the prominence of the EWF species on the basis of their uses and the informants who reported these species (Figure 8).The UV ranges from the lowest 0.08 (Juglans regia) to the highest 0.4 (Elaeagnus umbellata).EWF species are classified into five classes based on the UV obtained: UV 0.08 to 0.10 (18 species), 0.11 to 0.12 (24 species), 0.13 to 0.17 (13 species), 0.18 to 0.25 (16 species), and UV from 0.26 to 0.4 (3 species).The species with the highest UV indicate common occurrence and utilization by the local people.Unlike UV, the RFC shows the local importance of the EWF species based on the relative informant ratios.In this study, it varies from the lowest 0.02 (Elaeagnus umbellata) to the highest 0.18 (Berberis aristata, Cydonia oblonga, and Daphne mucronata).Based on their prominence, the EWFs of this study were grouped into five RFC classes: 0.02 to 0.05 (12 species), 0.06 to 0.10 (25 species), 0.11 to 0.13 (18 species), 0.14 to 0.15 (12 species), and 0.16 to 0.18 (7 species).The species with the highest RFC were the most popular plants based on the majority of informants (Figure 9).Plants 2024, 13, 39 18 of 24

Cultural Significance Index
To assess the importance of EWF species in local culture, the Cultural Significance Index (CSI) is calculated.On the basis of uses reported by inhabitants of seven districts of Southern KP, the CSI ranges from the lowest 1.3 to the highest 41.The top EWF species along with their specific uses were as follows: (jaundice), Berberis lycium (eye infections), Cotoneaster acuminatus (lung disorder), Cydonia oblonga (liver disorders), Daphne mucronata (muscle pain), Eriobotrya japonica (high blood pressure), Malus pumila (diabetes), Prunus domestica L. (constipation), Ficus racemosa (diabetes), Morus nigra (constipation), and Rosa moschata (skin diseases) (Figure 10).

Cultural Significance Index
To assess the importance of EWF species in local culture, the Cultural Significance Index (CSI) is calculated.On the basis of uses reported by inhabitants of seven districts of Southern KP, the CSI ranges from the lowest 1.3 to the highest 41.The top EWF species along with their specific uses were as follows: (jaundice), Berberis lycium (eye infections), Cotoneaster acuminatus (lung disorder), Cydonia oblonga (liver disorders), Daphne mucronata (muscle pain), Eriobotrya japonica (high blood pressure), Malus pumila (diabetes), Prunus domestica L. (constipation), Ficus racemosa (diabetes), Morus nigra (constipation), and Rosa moschata (skin diseases) (Figure 10).

Comparison with Previous Ethnomedicinal Studies
To compare to other studies, we used 21 available references (Table 2).Overall, 88.6% of the uses found in the current study represent new ethnobotanical data, while 5.6% of the uses and 5.8% of the reports were comparable to the literature.The EWFs found already in the literature were as follows: Punica granatum, Cydonia oblonga, Berberis aristata, Berberis lyceum, Juglans regia, Ficus racemosa, Zanthoxylum armatum, Syzygium cumini, and Ziziphus jujuba.This comparison shows that the majority of EWFs reported in the current study are confined to the topographical region of K. Some EWFs have, however, a wide distribution and are to be found in adjacent countries with similar medicinal uses.Nonetheless, among those species, some new medicinal uses were observed.

Threats to EWFs in Southern
The EWFs used by the tribal communities of Southern KP, Pakistan, are facing threats in their natural habitats, mainly due to anthropogenic activities.Such impacts vary, however, from place to place.According to some experienced THPs and key informants, overgrazing, overharvesting, uncontrolled fire setting, agricultural land expansion,

Comparison with Previous Ethnomedicinal Studies
To compare to other studies, we used 21 available references (Table 2).Overall, 88.6% of the uses found in the current study represent new ethnobotanical data, while 5.6% of the uses and 5.8% of the reports were comparable to the literature.The EWFs found already in the literature were as follows: Punica granatum, Cydonia oblonga, Berberis aristata, Berberis lyceum, Juglans regia, Ficus racemosa, Zanthoxylum armatum, Syzygium cumini, and Ziziphus jujuba.This comparison shows that the majority of EWFs reported in the current study are confined to the topographical region of K. Some EWFs have, however, a wide distribution and are to be found in adjacent countries with similar medicinal uses.Nonetheless, among those species, some new medicinal uses were observed.

Threats to EWFs in Southern
The EWFs used by the tribal communities of Southern KP, Pakistan, are facing threats in their natural habitats, mainly due to anthropogenic activities.Such impacts vary, however, from place to place.According to some experienced THPs and key informants, overgrazing, overharvesting, uncontrolled fire setting, agricultural land expansion, roads and home construction, fodders, and fuel wood collection are some common threats to EWF species in the area.Most of the EWFs in the study areas are not protected.However, economically important species are overharvested and sold in the local herbal markets at very cheap prices.Some species are then traded to pharmaceutical companies.

Discussion
The results of the present study diverged from previously reported ethnobotanical studies conducted in Pakistan [24,25].In most previous ethnobotanical studies, herbs were found to be the most commonly used [67][68][69][70][71][72][73].Fruits were more frequently used instead of leaves, as observed in previous studies conducted in Pakistan [24][25][26] as well as all over the world [74][75][76][77][78].The majority of EWFs were reported as sweet and delicious in taste [22].Decoctions, the second-most common preparation, were reported in the literature as the most used preparation method in previous ethnomedicinal studies in Pakistan and other regions of the world [47,79,80].
Medicinal plants that are presumed to be more effective for treating certain diseases should have higher ICF values [81,82].In this study, Cydonia oblonga was used for gastrointestinal disorders.Cydonia oblonga was also reported by Romero et al. [83] against diarrhea, dysentery, and gastric ulcers.B. aristata was studied by Joshi et al. [84] to treat stomach infections and ulcers with inconclusive results, but the potential of this plant for treating piles and constipation has never been studied.Also, Gilani and Janbaz [85] assessed the hepatoprotective effect of B. aristata.In a previous study, Tosun et al. [86] evaluated the antimicrobial activity of C. oblonga to treat tuberculosis, whereas D. kaki, F. palmata, and P. sinensis have no previous pharmacological record against respiratory disorders.
A few species found in this study with 100% FL received attention in clinical trials and pharmacological assays.Joshi et al. [84] studied the antidiarrheal activity of Berberis aristata.The same species was evaluated for hepatotoxicity by [85].The present study revealed that B. aristata had the potential to treat constipation, and it should be further studied in detail.Another top-ranked plant, Carissa spinarum, has been studied against hepatitis [87], internal infections [88], and heart problems [89], but no study has been performed in relation to asthma, a key finding in this study.D. mucronata, L. aphaca, and M. nigra have not been scientifically studied in detail, while the other species have received attention in pharmacological studies [90,91].A very high FL may give indications about which species to prioritize in pharmacological, phytochemical, and clinical studies for the reported specific uses cited in the current survey [92].The UV and RFC can be used to select potential candidates among all plant species for further pharmacological studies and, therefore, state recommendations for drug discovery and development.Species that have been studied using pharmacological assays are for stomach infections and ulcers [84], eye infections [93], jaundice [85], and wounds and skin diseases [94].
To compare to other studies, 21 available reference studies were used (Table 2).Overall, 88.6% of the uses found in this study represent new ethnobotanical data, while 5.6% of the uses and 5.8% of the reports were comparable to the literature.The EWFs found already in the literature were as follows: Punica granatum, Cydonia oblonga, Berberis aristata, Berberis lyceum, Juglans regia, Ficus racemosa, Zanthoxylum armatum, Syzygium cumini, and Ziziphus jujuba.This comparison shows that the majority of EWFs reported in the current study are confined to the topographical region of KP.Some EWFs found have, however, a wide distribution and are to be found in adjacent countries with similar medicinal uses.The possible reason behind the dominance of Rosaceae may be due to the rich diversity of EWF species within the family, a diversity known and used by local inhabitants.Nonetheless, among those species, some new medicinal uses were observed.The use of Ziziphus jujuba for the treatment of diabetes is new to the literature, as is its use as a body tonic [64].Economically important species are overharvested and sold in the local herbal markets at very cheap prices.Some species are then traded to pharmaceutical companies.
The conservation of locally important and threatened species must be promoted in the future [95,96].
Although the current study enlists EWFs and their medicinal uses with little attention to documenting the ecological aspects or conservation status of the species.Further investigation of the nutritional value of these species is needed.The current exploration deals with data collection from specific localities, and a more comprehensive study is required to enlist all EWFs and their traditional uses in Pakistan.

Conclusions
The ethnobotanical data obtained from this survey show that the inhabitants of KP have a close relationship with EWF species.The tradition of using EWFs is very much alive among the different populations of Southern KP, and a total of 74 EWF species are extensively consumed as food as well as medicine.The number of recorded EWFs and their medicinal uses indicate the depth of the local indigenous knowledge of medicinal plants and their application.This provides evidence that EWFs continue to play a vital role in the health care systems of the indigenous people in the study area.Our study also underlines that the pattern of EWF usage depends mainly on socio-economic factors rather than climatic conditions or its floristic diversity.

Figure 1 .
Figure 1.Map of study area.

Figure 1 .
Figure 1.Map of study area.

Figure 2 .
Figure 2. Families of wild edible fruits used in communities of Southern Khyber Pakhtunkhwa Province (Pakistan).

Figure 2 .
Figure 2. Families of wild edible fruits used in communities of Southern Khyber Pakhtunkhwa Province (Pakistan).

Figure 3 .
Figure 3. Life forms of wild edible fruits used in communities of Southern Khyber Pakhtunkhwa Province (Pakistan).

Figure 3 .
Figure 3. Life forms of wild edible fruits used in communities of Southern Khyber Pakhtunkhwa Province (Pakistan).

Figure 4 .
Figure 4. Plant parts used in treatment of various diseases.

Figure 4 .
Figure 4. Plant parts used in treatment of various diseases.Plants 2024, 13, x FOR PEER REVIEW 19 of 29

Figure 5 .
Figure 5. Mode of utilization of wild edible fruits of study area.

Figure 5 .
Figure 5. Mode of utilization of wild edible fruits of study area.

Figure 6 .
Figure 6.Categories of ailments treated by health practitioners arranged by number of use reports.

Figure 6 .
Figure 6.Categories of ailments treated by health practitioners arranged by number of use reports.

Figure 7 .
Figure 7.The relationship between the number of informants that mentioned use of a certain wild fruit for a particular disease; N is the total number of informants that cited the species for any disease.Numbers represent the fidelity level (FL %) as they appear in Table3.

Figure 7 .
Figure 7.The relationship between the number of informants that mentioned use of a certain wild fruit for a particular disease; N is the total number of informants that cited the species for any disease.Numbers represent the fidelity level (FL %) as they appear in Table3.

Figure 9 .
Figure 9. Quantitative analysis of wild edible medicinal fruits showing RFC and UV.

Figure 9 .
Figure 9. Quantitative analysis of wild edible medicinal fruits showing RFC and UV.

Figure 9 .
Figure 9. Quantitative analysis of wild edible medicinal fruits showing RFC and UV.

Table 1 .
Demographic data of participants.

Table 2 .
Medicinal uses of EWFs in Southern KPK province, Pakistan.

Table 3 .
ICF values and diseases categories in study are.