Does urolithin A from pomegranate do anything for your muscles and energy?
UA supplements (1000 mg/day) improve muscular endurance in older adults, but do not demonstrably increase total energy production in the muscles. If you are curious whether it makes a difference for you, there is sufficient evidence to consider it, but do not expect a miracle cure.
Urolithin A (UA) is a compound produced by your gut bacteria from polyphenols found in pomegranate, berries and nuts. Not everyone has the right gut bacteria for this, so how much UA you obtain through diet varies considerably from person to person. A supplement bypasses that problem.
The results are most convincing when it comes to muscular endurance. In a double-blind study in adults aged 65-90 (1000 mg/day, 4 months), participants could perform significantly more muscle contractions before fatigue, in both hand and leg muscles, compared with placebo. In middle-aged adults, another randomised study found an improvement in muscle strength of approximately 12%, although the primary endpoint in that study was not met.
On the topic of energy levels, the results are more nuanced. UA produces measurable changes in muscle cells: genes responsible for clearing away damaged energy factories become more active, and certain blood markers pointing to more efficient energy metabolism decrease. Yet the muscles themselves do not demonstrably produce more energy: both randomised studies and a systematic review of five studies found no effect on maximum ATP production in the muscles.
What UA does not do: body weight, body composition and overall physical function did not improve in that same systematic review. Aerobic fitness (oxygen uptake during exercise) did improve to a clinically modest degree in one study, but the difference was not statistically significant.
From a safety perspective, the picture looks good: across multiple clinical studies at doses up to 1000 mg/day, side effects were mild and occurred no more frequently than with placebo. Long-term data in humans are still lacking, so how things play out over years remains unknown.
Based on multiple randomised placebo-controlled studies and a systematic review of five studies (approximately 250 participants in total). Study populations: middle-aged and older adults (65-90 years). Long-term studies are lacking. Animal and laboratory research in Duchenne muscular dystrophy has not yet been translated into human trials.