Spinach intake and fatty liver odds in Iranian adults
What it found
In a case-control study in people, higher total and raw spinach intake was linked to lower odds of nonalcoholic fatty liver disease, while boiled spinach showed no link.
What they found
Studies in people
Total spinach intake
People in the highest tertile of daily total spinach intake had lower odds of fatty liver disease compared with those in the lowest tertile, after adjusting for other factors.
Raw spinach intake
Higher daily raw spinach intake was linked to lower odds of fatty liver disease. Those who ate the most raw spinach had lower odds than those who ate none.
Boiled spinach intake
There was no significant link between higher boiled spinach intake and odds of fatty liver disease.
Animal and lab studies
Animal and lab evidence
Animal studies have found that spinach reduces some harmful effects of a high-fat diet on blood sugar, blood fats, and liver cholesterol. Lab studies suggest polyphenols and nitrate in spinach may help, but these are not studies in people.
What the authors conclude
“The present study found an inverse association between total and raw spinach intake with the odds of NAFLD.”
Also in their conclusions
- They conclude that total and raw spinach intake was linked to lower odds of nonalcoholic fatty liver disease, but boiled spinach was not.
- They suggest that if spinach's beneficial effects on chronic disease are confirmed in future studies, it could be used as a powder to enrich foods.
- They call for more research with stronger designs, such as large cohort studies and clinical trials, to test their hypothesis.
How it was done
Spinach is rich in antioxidants and polyphenols, and lab and animal studies suggest it may protect against liver disease. The authors wanted to see if spinach intake is linked to fatty liver disease in people.
They compared 225 adults newly diagnosed with nonalcoholic fatty liver disease and 450 healthy controls, aged 20 to 60, in Iran. Participants reported their usual diet over the past year using a 168-item food frequency questionnaire.
What it can’t tell you
- This was a case-control study, so it can show a link but cannot prove that spinach causes lower odds of fatty liver disease.
- The study relied on people's memory of what they ate over the past year, which may not be exact.
- The results are from Iranian adults and may not apply to other groups.
Who paid
- Funding
- Funded by Shahid Beheshti University of Medical Sciences (from the PubMed record).
- Conflicts
- The authors declare that they have no competing interests.
- Authors work at
- Shahid Beheshti University of Medical Sciences, Iran; Iran University of Medical Sciences, Iran
The paper
- Title
- Spinach consumption and nonalcoholic fatty liver disease among adults: a case-control study
- Type
- Study
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Mokhtari E, Farhadnejad H, Salehi-Sahlabadi A, et al (2021). Spinach consumption and nonalcoholic fatty liver disease among adults: a case-control study. BMC gastroenterology. doi:10.1186/s12876-021-01784-8Free full textPubMed 33933019DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error