Scientific name: Spinacia oleracea L.1

Varieties: Flat-leaf (includes baby spinach), savoy (curly leaf), semi-savoy2

Description: Spinach is a dark, leafy green vegetable that has many nutritional benefits.3–6 It can be consumed raw or cooked and is sold fresh (in bunches or prepackaged), canned, and frozen. 

Flat-leaf spinach is the most popular variety in the United States.2 It has smooth, spade-shaped leaves, a tender texture, and a slightly sweet taste.2 Baby spinach is a type of flat-leaf spinach that is harvested early so that the leaves and stems are smaller, softer, and sweeter.2 Flat-leaf spinach is commonly used in salads and other raw preparations. This is also the variety that is often canned or frozen7 because it grows faster and is easier to clean than savoy and semi-savoy.8

Savoy spinach is also known as curly leaf spinach because of its crinkly, curly leaves.2 This variety of spinach is crisper than flat-leaf spinach and has a more bitter flavor, making it more suitable for cooking.2 

Semi-savoy spinach is similar to savoy spinach in texture and taste, but its leaves are not ascrinkly.2 

Spinach is a cool-weather crop that should be grown in early spring or early fall.8  

Nutrients: Spinach is a good source of several important nutrients and antioxidants9 – molecules that help defend the body against harmful chemicals called free radicals10 – including vitamins A, C, and K, iron, folate, and calcium.11 It is also low in calories and high in fiber.11

The United States Department of Agriculture (USDA) has documented that one cup of raw spinach (30 grams) contains:12

  • 6.9 calories
  • 0.86 grams (g) of protein
  • 0.12 g of fat
  • 1.09 g of total carbohydrates
  • 0.66 g of fiber 
  • 0.13 g of sugar
  • 23.7 milligrams (mg) of sodium
  • 0 g of cholesterol

Key vitamins and minerals in one cup of raw spinach include:

  • 145 micrograms (mcg) of vitamin K (120.83% daily value)
  • 141 mcg of vitamin A (15.67% DV)
  • 58.2 mcg of folate (14.55% DV)
  • 8.43 mg of vitamin C (9.37% DV)
  • 23.7 mg of magnesium (5.64% DV)
  • 0.813 mg of iron (4.52% DV)
  • 167 mg of potassium (3.55% DV)
  • 29.7 mg of calcium (2.28% DV)

Some of the nutrient content may be altered when it is cooked. If it is boiled in water, it may lose a significant amount of vitamin C, because vitamin C is water-soluble and will leach out into the cooking water.13 On the other hand, cooked spinach contains more beta carotene, an antioxidant that converts to vitamin A in the body, than raw spinach.13 

It is important to note, too, that spinach loses a significant amount of volume when it is cooked.- Two pounds of raw spinach will reduce to about three cups cooked.2 Therefore, the amount of spinach consumed is generally much greater when it is eaten cooked, and the increase in quantity consumed may compensate for any nutrient loss that occurs during cooking.13  

Geographic origin: Spinach is thought to have originated in ancient Persia (Iran)14 more than 2,000 years ago.8 At some point, it was introduced to India, but it is unclear when and how.15 The earliest written account of spinach is in Chinese, stating that the vegetable was introduced to China around 647 AD.15 In the 11th century, Arabs introduced spinach to Spain, and it became widespread throughout Europe by the 14th century.8 In the early 19th century, American colonists introduced spinach to North America.16

Today, 98 percent of spinach sold commercially in the US is grown in California, Arizona, New Jersey, and Texas.17 

History of use as medicine: There is limited documentation regarding the uses of spinach for medicinal purposes prior to the 19th century. 

In 1870, the German chemist Erich von Wolf was researching the iron content of various green vegetables and misplaced a decimal point when recording the amount in spinach. While it actually has 3.5 milligrams of iron in a 100-gram serving, von Wolf accidentally wrote that there were 35 milligrams, leading people to believe that spinach had 10 times more iron than it actually did.18 During World War I, some sources19–21 say that soldiers were given red wine mixed with spinach juices to heal hemorrhaging wounds, likely because of the belief that its supposed high-iron content could replace the iron lost from blood. In the 1920s, cartoonist Elzie Crisler Segar was developing the character Popeye for a comic strip and decided that his  super-strength would come from spinach.18 It was not until 1937 that somebody realized von Wolf’s error, but in spite of the fact that its nutrient profile was corrected and publicized, spinach maintained its reputation as a powerful source of iron.18 

Current Uses and Scientific Literature Review: Spinach consumption has many health benefits that result from its many essential nutrients, including vitamins K, A, and C, folate, calcium, iron, magnesium, and potassium, as well as the antioxidants beta-carotene,22 lutein,23 and zeaxanthin.24 Research has shown that spinach and/or its nutritional components may have value for bone health, cancer treatment, cardiovascular health, diabetes management, digestive health, eye health, and weight management. 

Note: Before reviewing the literature, it is important to note that many peer-reviewed studies may be biased because of industry-funded research to promote product sales, and a conflict of interest is not always disclosed (see information from biologist and nutritionist Marion Nestle on sponsored research here). In this article, we have done our best not to include any industry-funded studies. As discussed in the Food as Medicine Report (on page 158, specifically), there is a need for more government funding for food as medicine initiatives. 

Bone Health

Animal studies using spinach extracts to treat and prevent bone loss and cartilage damage have shown promising results. More research is needed to determine whether humans would derive the same benefits from dietary consumption of whole spinach leaves. 

  • Prevention of Cartilage Damage (animal study): Kothari et al (2020)25 used a spinach extract on a rat model of osteoarthritis26 to determine if and how it would protect against joint damage. After four weeks, rats that received the spinach extract had better-looking joints, with thicker and shinier cartilage, compared to the rats that did not receive the extract. Osteoarthritis generally produces the loss of a substance in cartilage called proteoglycan,27 but this loss was prevented in the rats that received the spinach extract. 
  • Bone Protection in Osteoarthritis (animal study): Choudhary et al (2018)28 simulated osteoarthritis in rats’ knee joints, then fed the rats a spinach extract for 28 days. Tests showed that the spinach extract increased the rats’ bone volume, reduced inflammation, and improved mobility and balance. 
  • Osteopenia Protection (animal study): Adhikary et al (2017)29 also studied the effects of a spinach extract on rats with ovaries removed, mimicking osteopenic (low bone mineral density) conditions. The extract not only prevented bone loss but also facilitated the healing of bone fractures. 

Cancer Treatment

Certain compounds in spinach, including lutein and glycolipids, have demonstrated beneficial effects in the treatment of breast, pancreatic, and colon cancers. 

  • Dietary Spinach and Colon Cancer Treatment (animal studies): Chen et al (2021)30 investigated how dietary spinach might prevent or treat colon cancer. They worked with rats that had a condition making them prone to developing growths called polyps in the colon. The rats were fed spinach for 26 weeks, from age 4 weeks to age 30 weeks, and, as a result, the growth of tumors was significantly reduced compared to a control group.
  • Parasramka et al (2012)31 fed spinach to rats with colon tumors and observed a tumor-suppressive effect. A particular family of microRNA32 molecules that is typically disrupted in colon cancer and leads to tumor recurrence and reduced patient survival rates, was partially normalized after the rats consumed spinach. These findings suggest that spinach consumption may have beneficial effects for preventing and treating colon cancer.
  • Maeda et al (2008)33 extracted a group of substances called glycolipids from spinach and fed it to mice with cancerous colon tumors. After the mice took the glycolipids orally for two weeks, their tumor sizes were reduced by 56 percent with no negative side effects. A previous study from the same researchers as above (published as Kuriyama et al (2005)34) showed that, among eight vegetables containing glycolipids, spinach was most able to reduce the growth and spread of human cancer cells. Matsubara et al (2005)35 came to similar conclusions that glycolipids from spinach can suppress tumor growth by inhibiting angiogenesis,36 the formation of new blood vessels. 
  • Breast Cancer Treatment (lab study): Kavalappa et al (2021)37 examined the effects of lutein, an antioxidant found abundantly in spinach, on breast cancer cells. Lutein appeared to decrease the production of proteins that work against antioxidants and enhance cancer cell survival and growth. This means that lutein inhibited the survival and spread of cancer cells and promoted cancer cell death (apoptosis). 
  • Pancreatic Cancer Treatment (lab and animal study): Akasaka et al (2016)38 extracted a substance called monogalactosyl diacylglycerol (MGDG), a type of glycolipid, from dried spinach and studied its effects on pancreatic cancer cells in vitro, alone or in combination with radiation therapy. They further assessed the substance’s effects on tumor growth in a mouse model. Radiation therapy in combination with MGDG from spinach slowed the growth of cancer cells and increased cell death more than either treatment by itself, in both the lab study and the mouse model. 

Cardiovascular Health

There is limited research concerning the impact of spinach on heart health. However, components of spinach, including potassium, magnesium, calcium, nitrates, and glycolipids, have been studied for their cardiovascular benefits. The following studies provide promising evidence assessing the value of spinach consumption for heart health, but more research is needed to draw definitive conclusions. 

  • Potassium, Magnesium, and Calcium and Cardiovascular Disease (observational): A one-cup serving of raw spinach contains 167 mg of potassium, 24 mg of magnesium, and 30 mg of calcium.12 Pickering et al (2021)39 explored the relationship between intake of dietary, potassium, magnesium, and calcium and cardiovascular disease in an observational study of 2,362 adult men. Consumption of at least 3,000 mg of potassium per day (compared to less than 2,500mg) was associated with a 25 percent lower risk of cardiovascular disease. Magnesium intake of at least 320 mg per day (compared to less than 240 mg) was associated with a 34 percent lower risk, and daily calcium intake of at least 700 mg (compared to less than 500 mg) reduced cardiovascular disease risk by 19 percent. Because spinach contains potassium, magnesium, and calcium, eating it regularly may contribute to a reduced risk of cardiovascular disease. 
  • Glycolipids and Blood Vessel Inflammation (lab study): Ishii et al (2017)40 examined how glycolipids from spinach affect human endothelial cells (the cells lining blood vessels). The glycolipids boosted the production of nitric oxide, which has protective effects on blood vessels, and saw significantly reduced inflammation in these cells, suggesting a potential treatment option for diseases involving inflammation of blood vessels. 
  • Dietary Nitrate and Blood Pressure Management (interventional): Nitrates41 are compounds found naturally in the human body and in various foods as well as in medications that treat chest pain (angina). Because spinach has a high nitrate content, Jovanovski et al (2015)42 studied 27 healthy adults who consumed either high-nitrate (spinach) or low-nitrate (asparagus) soup daily for one week and observed outcomes related to blood pressure. The participants who ate the high-nitrate spinach soup had a reduction in arterial stiffness and blood pressure compared to the asparagus group, indicating that spinach consumption could have benefits for blood pressure control. 

Diabetes Management

In animal studies, extracts from spinach have been shown to positively affect the treatment of diabetes symptoms and complications. 

  • Spinach Extract and Diabetic Ulcers (animal study): Diabetic ulcers43 are open skin wounds, usually on the feet, resulting from complications of high blood sugar levels. Rahati et al (2023, 2015)44,45 used a diabetic rat model to examine the use of spinach extract for healing ulcers and improving symptoms. Compared to untreated diabetic mice, those treated with spinach extract had significantly faster and better healing of their ulcers, as well as improvements in blood vessel growth, blood glucose levels, and weight loss. The extract also had a protective effect and more pronounced improvements when given to the mice both before and after the onset of the disease and wound infliction. 
  • Phenolic Compounds and Diabetes (animal study): Mehmood et al (2023)46 explored the effects of plant components called phenolic compounds47 from spinach, mustard, and cabbage on diabetic mice. Phenolic-rich extracts from these leafy vegetables significantly improved body weight, liver and kidney function, and fasting blood sugar, cholesterol, and triglyceride levels in mice with diabetes. Therefore, these compounds show potential for managing diabetes. 
  • Spinach Flavonoids and Diabetic Complications (animal study): Gutierrez and Velazquez (2020)48 isolated ten natural and beneficial compounds called flavonoids49 from spinach and used a zebrafish model of diabetes to study their impact. The spinach flavonoids inhibited the formation of advanced glycation end products (AGEs),50 which are commonly developed in individuals with diabetes and may contribute to diabetic complications such as retinopathy (blindness), nephropathy (kidney disease), neuropathy (nerve damage), and cardiomyopathy (heart failure). 
  • Spinach Extract and Metabolic Syndrome (animal study): Panda et al (2017)51 evaluated the impact of spinach extract on metabolic syndrome52 – a group of symptoms associated with an increased risk of heart disease, stroke, and diabetes – in rats. For 45 days, a variety of treatments were tested, including the spinach extract, a standard drug treatment, aerobic exercise, and a combination of spinach extract and aerobic exercise. The combination treatment produced the greatest reduction in insulin resistance and improved glucose tolerance, indicating that spinach consumption combined with exercise may be an effective, drug-free treatment for metabolic syndrome. 

Digestive Health

As with most dark, leafy greens and other vegetables, spinach contains a lot of fiber,12 which helps promote regular bowel movements and serves as food for the good bacteria in the gut (gut microbiota). 

  • Dietary Spinach and Gut Bacteria (animal study): Chen et al (2021)’s30 study of dietary spinach and colon cancer prevention in rats (described above) also revealed that the diversity of gut bacteria, an important marker for digestive and overall health, increased when the rats ate spinach. 
  • Non-Alcoholic Fatty Liver Disease, Spinach, and Gut Microbiota (animal study): Non-alcoholic fatty liver disease (NAFLD)53 is a condition in which fat builds up in the liver and increases the risk of cardiovascular disease, type 2 diabetes, high blood pressure, high cholesterol, and metabolic syndrome. The disease is common in individuals who are overweight or obese.53 Changes in gut microbiota influence the severity of NAFLD.54 Elvira-Torales et al (2019)55 used a rat model to study how various dietary patterns, with or without spinach, affect gut bacteria and NAFLD. Rats fed a high-fat diet for five weeks developed NAFLD and unhealthy levels of fat in their blood. However, rats that were fed the same high-fat diet with the addition of spinach had increased good bacteria (Lactobacillus) counts, lower cholesterol levels, and overall improved biomarkers. These findings suggest that including spinach in the diet helps to boost the good bacteria in the gut, which, in turn, can improve other health markers as well. 
  • Thylakoids and Gut Bacteria (animal study): Thylakoids56 are parts of chloroplasts,57 which are found in the cells of green plants. Montelius et al (2013)58 looked at the effects of dietary thylakoids from spinach on gut bacteria in rats. Rats fed a thylakoid diet for 10 days had an increase in a specific type of good bacteria, Lactobacillus reuteri, in the lower part of the small intestine, but not anywhere else in the digestive tract, and a decrease in harmful bacteria. There was no difference in the amount of bifidobacteria, another type of beneficial bacteria, between the thylakoid-fed and control rats. 

Eye Health

Spinach contains the carotenoids59 (antioxidants found in plants) lutein and zeaxanthin, which can treat or prevent eye diseases and vision problems. 

  • Dietary Lutein and Risk of Age-related Macular Degeneration (observational): Jiang et al (2023)60 interviewed 260 individuals with age-related macular degeneration (AMD)61 (an eye disease that causes vision problems), and 260 controls without the condition, about their dietary intake. Higher intakes of egg and spinach, which are both significant sources of a vitamin called lutein, were associated with a much lower risk of AMD. Spinach may be beneficial for preventing vision loss from AMD due to its high content of lutein. 
  • Spinach Extract and Diabetes-related Retina Damage (animal study): Bautista-Perez et al (2021)62 studied the retinas (part of the eye) of diabetic rats that were treated with a spinach extract. The extract reduced oxidative stress,9 inflammation, and cell death in the retina, meaning that it helped to reduce retinal damage in diabetic rats. 
  • Carotenoid and Vitamin A Consumption and Cataracts (observational): Brown et al (1999)63 and Chasan-Taber et al (1999)64 investigated the food intakes of 36,644 men and 77,466 women over eight years (men) and 12 years (women). Men and women who ate more of the compounds lutein and zeaxanthin, particularly from broccoli and spinach (men) or spinach and kale (women), had lower risks of cataracts65 – a cloudy area in the lens of the eye that can cause blurred vision or other sight problems.  

Weight Management

Research has shown that compounds called thylakoids,56 which are present in leafy green vegetables like spinach, may help increase satiety and decrease appetite. 

  • Thylakoids and Obesity (interventional): Tabrizi et al (2020)66 studied 48 obese women who were on a restricted-calorie diet. For 12 weeks, the participants received either 5g thylakoids per day or a placebo. Compared to the placebo group, those who received thylakoids had significant decreases in weight, waist circumference, body fat, and insulin levels. These findings indicate that thylakoid intake, from spinach or other leafy greens, may be helpful for those trying to lose or manage their weight. 
  • Thylakoids and Weight (review): Amirinejad et al (2019)67 reviewed the human literature on thylakoids from spinach and other green leafy vegetables and their relationship to appetite and weight. The eight studies they analyzed came to similar conclusions that thylakoid-rich meals increase satiety and reduce appetite, although there were mixed results regarding weight loss. However, the fact that the thylakoids present in spinach seem to reduce appetite suggests that spinach consumption may be beneficial for individuals who are trying to manage their food intake. 
  • Thylakoids, Gut Bacteria, and Appetite (animal study): Montelius et al (2013)’s58 study of thylakoids in rats (described above) showed that the increase in the bacteria Lactobacillus reuteri in rats fed a high-thylakoid (spinach) diet generated a reduction in appetite, decreased food intake, and lowered body weight and body fat percentages compared to control mice. 

Potential Negative Effects: Spinach contains high levels of oxalate, or oxalic acid, which is a naturally-occurring plant compound that can have detrimental effects on human health.68,69 One cup of raw spinach contains 656 milligrams of oxalate and a half-cup serving of cooked spinach contains 755 milligrams.69 Oxalate is considered an antinutrient because it blocks the absorption of essential nutrients, including calcium, sodium, iron, and zinc, in the human body.70 It can also create crystals in urine that stick together and form a solid mass known as kidney stones.71 To reduce the risk of kidney stones from high oxalate intake, it is beneficial to eat calcium-rich foods like cheese or milk along with spinach (or other high-oxalate foods) in a meal.71  

Individuals who take blood-thinning medications may need to limit their spinach intake.72 Spinach contains a large amount of vitamin K, which helps with blood clotting and, therefore, may counteract the effects of blood-thinners. 

As with most fruits and vegetables, there is a potential for contamination with bacteria like E. coli when spinach is eaten raw.73,74 While leafy greens are at the greatest risk of contamination74 compared to other fruits and vegetables, the risk of getting sick from spinach remains low.74 

Because of its high fiber content, when spinach is eaten in large quantities, especially when raw, it may produce gas, bloating, and cramping.75 

Cooking tips: When buying fresh spinach, whether in bunches or pre-washed and packaged,  look for leaves that are crisp and dark green, and avoid any that are yellow, limp, wilted, or slimy.2 Always check the expiration or “best by” date on packaged spinach as well.2 

Even pre-washed spinach may contain dirt or sand, so it is recommended to rinse the leaves thoroughly before consuming.2 Fresh spinach should be wrapped in a paper towel to absorb any excess moisture and stored in a sealed container or bag in the refrigerator for up to 10 days.76 Cooked spinach will keep in an airtight container in the refrigerator for three to five days.76 

To cook spinach, avoid using pots or pans with aluminum interiors, because this will cause the spinach to become discolored.2 When spinach is boiled in water, it loses heat-sensitive, water-soluble nutrients, such as vitamin C, that leach out into the water.13 To retain the vegetable’s nutrients, steaming, microwaving, or sauteing may be the best cooking methods.13 

When cooked spinach or thawed frozen spinach is used as an ingredient in other recipes, such as quiches or casseroles, it is important to squeeze the excess moisture out of the leaves with a kitchen towel to avoid making the final product too watery.2 

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References

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34. Kuriyama I, Musumi K, Yonezawa Y, et al. Inhibitory effects of glycolipids fraction from spinach on mammalian DNA polymerase activity and human cancer cell proliferation. J Nutr Biochem. 2005;16(10):594-601. doi:10.1016/j.jnutbio.2005.02.007

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38. Akasaka H, Mizushina Y, Yoshida K, et al. MGDG extracted from spinach enhances the cytotoxicity of radiation in pancreatic cancer cells. Radiat Oncol. 2016;11(1):153. doi:10.1186/s13014-016-0729-0

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42. Jovanovski E, Bosco L, Khan K, et al. Effect of Spinach, a High Dietary Nitrate Source, on Arterial Stiffness and Related Hemodynamic Measures: A Randomized, Controlled Trial in Healthy Adults. Clin Nutr Res. 2015;4(3):160-167. doi:10.7762/cnr.2015.4.3.160

43. Diabetic ulcers affect the skin, cognition and mental health. news. Accessed October 6, 2023. https://health.ucdavis.edu/news/headlines/diabetic-ulcers-affect-the-skin-cognition-and-mental-health/2022/04

44. Rahati S, Kamalinezhad M, Ebrahimi A, Eshraghian M, Pishva H. Accelerated wound healing induced by spinach extract in experimental model diabetic rats with streptozotocin. Sci Rep. 2023;13(1):14933. doi:10.1038/s41598-023-42033-0

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