Rzeski · Nutrients 2026 · narrative review · n=?

Natural Bioactive Compounds Targeting Key Hallmarks of Aging: Functional Food Potential of Spermidine, Fisetin, Berberine, and Urolithin A.

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Level 5 - mechanism / opinion, no new human data

Narrative review of mechanisms and clinical literature without systematic search or new empirical data.

PubMed 42588134 · doi:10.3390/nu18152511 · record verified 2026-08-26

What was done

This narrative review synthesized mechanistic, preclinical, and clinical evidence for four natural bioactive compounds proposed as functional food ingredients targeting hallmarks of aging: spermidine (autophagy via EP300 inhibition), fisetin (senolysis via PI3K/AKT and Bcl-2/Bcl-xL inhibition), berberine (AMPK activation and gut microbiota modulation), and urolithin A (mitophagy via PINK1/Parkin). The authors evaluated the biological rationale for multi-target combination formulations alongside bioavailability, safety, and regulatory considerations.

What was found

The abstract provides no quantitative metrics or effect sizes. It qualitatively reports that spermidine is associated with reduced all-cause mortality in prospective observational studies, fisetin has emerging clinical evidence for senolytic activity, berberine holds the largest human clinical evidence base among the four for metabolic dysfunction, and urolithin A has completed or registered clinical trials for mitophagy. The review identified a lack of direct empirical evidence evaluating the co-administration or synergy of these four compounds together.

Why it matters

It outlines a conceptual framework for developing multi-target nutraceutical strategies that simultaneously address distinct biological drivers of aging rather than targeting single pathways in isolation.

Limits

As a narrative review, it introduces no primary clinical or experimental data and does not follow a systematic review methodology. Evidence evaluating the safety, pharmacokinetics, potential drug interactions, optimal dosing, or efficacy of combining these four compounds in humans is currently absent.

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