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Higher dietary spermidine intake associates with improved hepatic function in older adults with metabolic syndromeHigher spermidine intake linked to better liver health in older adults

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Key Takeaway
Note that higher dietary spermidine intake is associated with improved liver markers in patients with metabolic syndrome.

Researchers analyzed data from a large cohort of overweight and obese older adults with metabolic syndrome to evaluate the impact of dietary spermidine on hepatic and cardiometabolic health. By identifying distinct intake patterns through time series clustering, the study compared different levels of spermidine consumption over a one-year period.

The findings indicated that individuals in the highest intake group showed modest improvements across several markers. These included reductions in fatty liver indices, hepatic steatosis indices, and specific liver enzymes like ALT and AST. Additionally, participants in this group demonstrated improvements in glycated hemoglobin levels and various measurements of body composition, such as BMI and waist circumference.

The authors noted certain limitations, including the fact that human evidence regarding spermidine remains limited. Furthermore, spermidine intake was estimated using a semi-quantitative food frequency questionnaire rather than direct measurement. Because this was an observational analysis of trial data, the results indicate associations only. Clinicians should view these findings as preliminary evidence regarding dietary patterns and their potential link to metabolic health in older populations.

For many older adults, managing metabolic syndrome is a significant concern. This condition involves a group of risk factors, such as high blood pressure and excess body fat, that can increase the risk of heart disease and liver issues. Because these conditions are common in older populations, finding ways to support liver health through nutrition is an important area of research.

To explore this link, researchers analyzed data from over 2,600 overweight and obese older adults with metabolic syndrome. The study followed these participants for one year. Researchers looked at how different levels of dietary spermidine—a compound found in various foods—related to liver health markers and body measurements like waist circumference and weight. The results showed that individuals who consumed the highest amounts of spermidine (referred to as Cluster 3) saw notable improvements over the year. Specifically, these participants showed a decrease in fatty liver indexes and hepatic steatosis scores. They also showed lower levels of ALT and AST, which are enzymes used to measure liver health. Additionally, those with higher spermidine intake saw reductions in their body mass index (BMI), waist circumference, and hip circumference compared to other groups.

While these findings are encouraging, it is important to understand the limitations of this specific study. First, this was an observational study based on existing data from a larger trial. This means researchers observed patterns rather than testing a specific treatment. Second, spermidine levels were estimated through food surveys rather than direct blood tests. Because of these factors, we cannot say for certain that spermidine caused these improvements; it may simply be linked to overall healthier eating habits.

For patients today, this research suggests that dietary patterns containing spermidine might play a role in supporting liver health and managing weight. However, because the evidence is based on an observational study with some limitations in how data was collected, it does not change immediate medical advice. Patients should continue to work with their doctors to develop personalized nutrition plans for metabolic syndrome rather than making major dietary changes based on this single study alone.

What this means for you:
Higher spermidine intake is linked to better liver health and lower waist size in older adults with metabolic syndrome.

Study Details

Study typeRct
Sample sizen = 2,664
EvidenceLevel 2
Follow-up12.0 mo
PublishedJul 2026
View Original Abstract ↓
PURPOSE: Spermidine administration ameliorates hepatic steatosis and cardiometabolic dysfunction in animal models. However, evidence in humans remains limited. We aimed to explore the 1-year longitudinal associations between changes in dietary spermidine intake and changes in hepatic function indexes and cardiometabolic traits in overweight and obese older adults with metabolic syndrome. METHODS: We used baseline and 1-year follow-up data from 2664 participants from the PREDIMED-Plus trial. Dietary spermidine intake was estimated using a semi-quantitative food frequency questionnaire. Time series clustering identified temporal patterns of 1-year change in spermidine intake. Linear mixed-effects models assessed the associations between spermidine intake clusters and changes in hepatic and cardiometabolic markers. RESULTS: Three distinct spermidine intake patterns were identified across baseline, six months and 1 year follow-up. Cluster 3, characterized by the highest baseline and increased 1-year spermidine intake, was associated with mean reductions in fatty liver index (- 8.97 [- 9.96 to - 7.97], p-int < 0.001), hepatic steatosis index (- 1.88 [- 2.13 to - 1.63], p-int < 0.001), alanine aminotransferase (- 2.93 [- 3.83 to - 2.02] U/L, p-int < 0.05), aspartate aminotransferase (- 1.11 [- 1.76 to - 0.45] U/L, p-int < 0.05) and glycated hemoglobin levels (- 0.14 [- 0.18 to - 0.10]%, p-int < 0.01). Cluster 3 also showed, mean decreases in body mass index (- 1.26 [- 1.37 to - 1.15]), waist (- 3.72 [- 4.11 to - 3.32] cm) and hip circumference (- 2.33 [- 2.67 to - 1.99] cm) (all p-int < 0.001). CONCLUSION: A 1-year increase in dietary spermidine intake was associated with improvements in hepatic function indexes and cardiometabolic traits in overweight and obese older adults with metabolic syndrome.
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