Ura8.5

Urolithin A Research

41 peer-reviewed studies · Evidence score: 8.5/10

1

Unveiling the Anticancer Potential of Urolithin A in Colorectal Cancer: A Systematic Review

Francisco M et al. • Oncology research (2026)

Co-treatments with conventional chemotherapeutics and microbiota-derived metabolites showed additive or synergistic effects.

  • Systematic review examining Urolithin A efficacy
  • Published in Oncology research (2026)
  • Further research warranted to confirm findings
Systematic Review
DOI
2

The anti-obesity effects of postbiotics: A systematic review of pre-clinical and clinical studies

Eslami M et al. • Clinical nutrition ESPEN (2024)

Postbiotics seem to be a safe intervention and the results were in favor of a reduction in adipogenesis as well as an increase in energy expenditure.

  • Postbiotics seem to be a safe intervention and the results were in favor of a reduction in adipogenesis as well as an increase in energy expenditure.
  • Further high-quality studies are required in this relatively new topic.
  • Further research warranted to confirm findings
Systematic Reviewn=49
DOI
3

Impact of nutraceuticals and dietary supplements on mitochondria modifications in healthy aging: a systematic review of randomized controlled trials

Lippi L et al. • Aging clinical and experimental research (2022)

Further studies are needed to better elucidate the reciprocal and multilevel interactions between nutraceuticals, mitochondria, and environmental stressors in healthy older adults.

  • Further studies are needed to better elucidate the reciprocal and multilevel interactions between nutraceuticals, mitochondria, and environmental stressors in healthy older adults.
  • Published in Aging clinical and experimental research (2022)
  • Further research warranted to confirm findings
Systematic Reviewn=201
DOI
4

Targeting aging with urolithin A in humans: A systematic review

Kuerec AH et al. • Ageing research reviews (2024)

All rights reserved.

  • Unrelated adverse events were mild or moderate.
  • Further research across more physiological systems and longer intervention periods is required.Copyright © 2024 The Authors.
  • Published by Elsevier B.V.
Systematic Review
DOI
5

Age-related sarcopenia and altered gut microbiota: A systematic review

Wang M et al. • Microbial pathogenesis (2024)

Age-related sarcopenia and gut microbiota alterations are intricately linked.

  • Age-related sarcopenia and gut microbiota alterations are intricately linked.
  • Short-chain fatty acid metabolism, urolithin A, and bile acid production may be pivotal factors in the gut-muscle axis pathway.
  • Supplementation with beneficial metabolite-associated microorganisms could enhance muscle function, mitigate muscle atrophy, and decelerate sarcopenia progression.
Systematic Review
DOI
6

Urolithin A From Gut Metabolite to Therapeutic Agent: Bioavailability, Mechanisms, and Translational Insights

Yuan H et al. • Journal of food science (2026)

These insights will provide a scientific foundation for further utilization of UroA for human health.© 2026 Institute of Food Technologists.

  • Moreover, approximately 10% of individuals are classified as urolithin nonproducers, independent of age, posing an additional challenge for clinical translation.
  • To overcome those limitations, formulation strategies such as nanoparticles and liposomes have been developed, resulting in several-fold increases in systemic bioavailability compared with unformulated UroA.
  • This review would provide a comprehensive overview of recent advances in the metabolism of UroA, current approaches to improve its bioavailability, safety evaluations, and elucidated the underlying mechanisms of its bioactivities.
ReviewAI-discovered
DOI
7

Urinary polyphenol signature of the Mediterranean diet is associated with lower cardiovascular disease risk: the PREDIMED trial

Domínguez-López I et al. • BMC medicine (2025)

We identified a urinary multi-metabolite signature of MedDiet adherence that is prospectively associated with lower CVD incidence.

  • After 1 year, MedDiet interventions significantly increased urolithin A metabolites (derived from walnuts) compared to the control group.
  • We identified a urinary multi-metabolite signature of MedDiet adherence that is prospectively associated with lower CVD incidence.
  • These findings support that polyphenols derived from the MedDiet showed inverse associations with cardiovascular outcomes.
RCTn=603
DOI
8

Assessment of Urolithin A effects on muscle endurance, strength, inflammation, oxidative stress, and protein metabolism in male athletes with resistance training: an 8-week randomized, double-blind, placebo-controlled study

Zhao H et al. • Journal of the International Society of Sports Nutrition (2024)

After 8 weeks of UA supplementation at 1 g/day, resistance-trained male athletes showed improvements in muscle strength and endurance.

  • After 8 weeks of UA supplementation, the UA group showed a significant decrease in 3-methylhistidine (3-MH) compared to baseline measurement (Δ=-2.38 ± 1.96 μmol/L, p = 0.049).
  • Additionally, the UA group exhibited a significant increase in C-reactive protein (CRP) compared to baseline (Δ = 0.71 ± 0.21 mg/L, p = 0.001).
  • Furthermore, the UA group showed a significant decrease in SOD compared to the placebo group (Δ=-4.32 ± 0.90 U/mL, p = 0.041).
RCT
DOI
9

The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS)

Kaplan A et al. • The American journal of clinical nutrition (2022)

A Green-MED (high-polyphenol) diet, rich in Mankai, green tea, and walnuts and low in red/processed meat, is potentially neuroprotective for age-related brain atrophy.This trial was registered at clinicaltrials.gov as NCT03020186.

  • Among 284 participants (88% men; mean age: 51 y; BMI: 31.2 kg/m2; APOE-ε4 genotype = 15.7%), 224 (79%) completed the trial with eligible whole-brain MRIs.
  • The pallidum (-4.2%), third ventricle (+3.9%), and LVV (+2.2%) disclosed the largest volume changes.
  • Compared with younger participants, atrophy was accelerated among those ≥50 y old (HOC change: -1.0% ± 1.4% compared with -0.06% ± 1.1%; 95% CI: 0.6%, 1.3%; P < 0.001; LVV change: 3.2% ± 4.5% compared with 1.3% ± 4.1%; 95% CI: -3.1%, -0.8%; P = 0.001).
RCTn=284
DOI
10

Effect of the mitophagy inducer urolithin A on age-related immune decline: a randomized, placebo-controlled trial

Denk D et al. • Nature aging (2025)

This rct examined the effects of Urolithin A.

  • Exploratory single-cell RNA sequencing demonstrated UA-driven transcriptional shifts across immune populations, modulating pathways linked to inflammation and metabolism.
  • These findings indicate that short-term UA supplementation modulates human immune cell composition and function, supporting its potential to counteract age-related immune decline and inflammaging.
  • ClinicalTrials.gov registration number: NCT05735886 .© 2025.
RCT
DOI
11

Multi-Species Synbiotic Supplementation Enhances Gut Microbial Diversity, Increases Urolithin A and Butyrate Production, and Reduces Inflammation in Healthy Adults: A Randomized, Placebo-Controlled Trial

Napier BA et al. • Nutrients (2025)

This is the first synbiotic to increase both UroA and butyrate.

  • Results: The synbiotic significantly increased alpha-diversity of Bifidobacterium and Lactobacillus spp. at all timepoints, including at end-of-study (Day 91, p < 0.0001) and increased native beneficial microbes.
  • UroA production was significantly increased in the synbiotic arm at short-term (Day 7, 12-fold, p < 0.02) and long-term (Day 91, 49-fold, p < 0.001) timepoints.
  • A higher proportion of synbiotic participants were capable of converting polyphenols into UroA (Day 91, 100% vs. 44.4%; p < 0.01).
RCTn=32
DOI
12

The effect of polyphenols on DNA methylation-assessed biological age attenuation: the DIRECT PLUS randomized controlled trial

Yaskolka Meir A et al. • BMC medicine (2023)

This study showed that MED and green-MED diets with increased polyphenols intake, such as green tea and Mankai, are inversely associated with biological aging.

  • This study showed that MED and green-MED diets with increased polyphenols intake, such as green tea and Mankai, are inversely associated with biological aging.
  • To the best of our knowledge, this is the first clinical trial to indicate a potential link between polyphenol intake, urine polyphenols, and biological aging.
  • Further research warranted to confirm findings
RCTn=256
DOI
13

The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial

Zelicha H et al. • BMC medicine (2022)

A green-MED diet, enriched with plant-based polyphenols and lower in red/processed meat, may be a potent intervention to promote visceral adiposity regression.

  • Participants (age = 51 years; 88% men; body mass index = 31.2 kg/m2; 29% VAT) had an 89.8% retention rate and 79.3% completed eligible MRIs.
  • A green-MED diet, enriched with plant-based polyphenols and lower in red/processed meat, may be a potent intervention to promote visceral adiposity regression.
  • Further research warranted to confirm findings
RCTn=294
DOI
14

Evaluating the Impact of Urolithin A Supplementation on Running Performance, Recovery, and Mitochondrial Biomarkers in Highly Trained Male Distance Runners

Whitfield J et al. • Sports medicine (Auckland, N.Z.) (2025)

Our results show that 4 weeks of daily UA supplementation facilitates recovery by downregulating inflammatory pathways and indirect markers of muscle damage.

  • While not statistically significant, UA led to a medium effect for increased markers of mitophagy (d = - 0.74), without changes in mitochondrial function.
  • Our results show that 4 weeks of daily UA supplementation facilitates recovery by downregulating inflammatory pathways and indirect markers of muscle damage.
  • However, despite a reduction in rating of exertion and increased aerobic capacity, UA supplementation did not further enhance performance in highly trained male endurance athletes.
RCT
DOI
15

Evaluation of Urolithin A Efficacy in Heart Failure Patients with Reduced Ejection Fraction: A Randomized, Double-blind, Crossover, Placebo-controlled Clinical Trial

Jamialahmadi T et al. • Reviews on recent clinical trials (2024)

The results of the present study do not support any positive effect of UA supplementation in improving echocardiographic and biochemical indices of HFrEF.

  • Serum HDL-C levels were increased with UA compared with placebo (+6.46 ± 2.33 mg/dL, p =0.026), whereas other lipid indices (LDL-C, triglycerides, total cholesterol, and VLDL-C) remained unchanged (p >0.05).
  • The results of the present study do not support any positive effect of UA supplementation in improving echocardiographic and biochemical indices of HFrEF.
  • Further studies with higher doses of UA and longer supplementation duration are encouraged to be conducted.
Crossovern=10
DOI
16

Direct supplementation with Urolithin A overcomes limitations of dietary exposure and gut microbiome variability in healthy adults to achieve consistent levels across the population

Singh A et al. • European journal of clinical nutrition (2022)

Differences in gut microbiome and diet that dictate natural exposure to UA can be overcome via direct dietary UA supplementation.

  • Only 12% of subjects had detectable levels of UA at baseline.
  • Following PJ intake ~40% of the subjects converted significantly the precursor compounds into UA.
  • Direct supplementation with UA significantly increased plasma levels and provided a >6-fold exposure to UA vs.
RCTn=100
DOI
17

A double-blind, randomized, neoadjuvant study of the tissue effects of POMx pills in men with prostate cancer before radical prostatectomy

Freedland SJ et al. • Cancer prevention research (Philadelphia, Pa.) (2013)

Future larger longer studies are needed to more definitively test whether POMx reduces prostate oxidative stress, as well as further animal testing to better understand the multiple mechanisms through which POMx may alter prostate cancer biology.

  • Primary endpoint was differences in 8-OHdG, and the study was powered to detect 35% reduction.
  • POMx was associated with 16% lower benign tissue 8-OHdG (P = 0.095), which was not statistically significant.
  • Urolithin A was detected in 21 of the 33 patients in the POMx group versus 12 of the 35 in the placebo group (P = 0.031).
RCTn=33
DOI
18

Effect of Urolithin A Supplementation on Muscle Endurance and Mitochondrial Health in Older Adults: A Randomized Clinical Trial

Liu S et al. • JAMA network open (2022)

This randomized clinical trial found that urolithin A supplementation was safe and well tolerated in the assessed population.

  • These participants had a mean (SD) age of 71.7 (4.94) years, were predominantly women (50 [75.8%]), and were all White individuals.
  • Urolithin A, compared with placebo, significantly improved muscle endurance (ie, increase in the number of muscle contractions until fatigue from baseline) in the FDI and TA at 2 months (urolithin A: FDI, 95.3 [115.5] and TA, 41.4 [65.5]; placebo: FDI, 11.6 [147.4] and TA, 5.7 [127.1]).
  • These results showed no significant improvement with urolithin A supplementation compared with placebo.
RCTn=66
DOI
19

Urolithin A improves muscle strength in middle-aged adults

Singh A et al. • Cell Reports Medicine (2022)

Urolithin A significantly improved muscle endurance and strength.

  • Improved leg muscle endurance
  • Increased muscle strength
  • Benefits in 4 months
RCTn=88
DOI
20

Metabolic Profiling of Dietary Polyphenols and Methylxanthines in Normal and Malignant Mammary Tissues from Breast Cancer Patients

Ávila-Gálvez MÁ et al. • Molecular nutrition & food research (2019)

This is the first study that describes the metabolic profiling of dietary phenolics and methylxanthines in MT and NT comprehensively.

  • This is the first study that describes the metabolic profiling of dietary phenolics and methylxanthines in MT and NT comprehensively.
  • Although phase-II conjugation might hamper a direct anticancer activity, long-term tumor-senescent chemoprevention cannot be discarded.
  • Further research warranted to confirm findings
RCTn=101
DOI
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