The promise of slowing—even reversing—the effects of aging has long been a pursuit of scientists and a hope for individuals facing age-related decline. Now, a comprehensive review published in Nature Aging suggests that a molecule called nicotinamide adenine dinucleotide, or NAD+, may hold significant potential in that quest. Researchers from the University of Oslo (UiO), Akershus University Hospital (Ahus), and collaborators worldwide have synthesized years of research, pointing to NAD+ as a key player in cellular health and a potential therapeutic target for conditions like Alzheimer’s and Parkinson’s disease.
NAD+ isn’t a new discovery; it’s a vital coenzyme present in all living cells. Often described as a cell’s “fuel regulator,” NAD+ is essential for hundreds of metabolic processes, including energy production, DNA repair, and maintaining cellular function. However, levels of this crucial molecule naturally decline with age, a decrease linked to a range of age-related health problems, from cognitive decline and muscle weakness to increased susceptibility to chronic diseases. Understanding how to restore or maintain healthy NAD+ levels is becoming a central focus in aging research.
The review, which brought together the expertise of over 25 scientists, underscores the growing momentum behind NAD+ research. “Fine-tuning NAD+ metabolism holds promise for delaying age-related health decline as well as disease such as premature ageing diseases,” explains Dr. Jianying Zhang, one of the lead authors of the study. “But to truly unlock its potential, we need to better understand the right doses, long-term safety, and interindividual variability in response to NAD+ augmentation strategies.” Which means recognizing that a one-size-fits-all approach is unlikely to be effective, and personalized strategies may be necessary.
Early Clinical Trials Show Promise with NAD+ Precursors
Researchers are exploring several avenues to boost NAD+ levels. Many approaches center around precursors – compounds the body can convert into NAD+ – such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). Early clinical trials have yielded encouraging results. Studies have reported potential improvements in memory, physical performance, and metabolic health in participants receiving NR or NMN supplements. For example, a 2022 study published in Science Translational Medicine showed that NR supplementation improved walking speed and muscle strength in older adults.
However, the authors of the Nature Aging review emphasize the need for caution and further investigation. “Even so, the researchers stress that larger and longer studies in patients are needed to confirm how effective these approaches are across different diseases,” the review states. Current trials are often small, short-term, and lack diverse participant groups, making it difficult to draw definitive conclusions about the long-term benefits and safety of NAD+ boosting strategies.
A Growing Market and Ongoing Debate
The increasing scientific interest in NAD+ has fueled a rapidly expanding market for NR and NMN supplements. Consumers are increasingly seeking ways to proactively address aging and improve their healthspan – the period of life spent in good health. However, this surge in popularity has also led to debate about the quality, efficacy, and regulation of these supplements. The supplement industry is not as tightly regulated as pharmaceuticals, raising concerns about product purity and accurate labeling. The Food and Drug Administration (FDA) provides information on dietary supplement regulation.
“Here’s why we believe the timing is right to share an expert opinion,” says Dr. Evandro Fei Fang-Stavem, senior author of the review and head of the Fang Lab at UiO and Ahus. “NAD+ is fundamental to life, yet there is still confusion and noise in the field about which supplements work best and how they should be used. Our article consolidates the evidence and provides a scientific roadmap to guide both ongoing research and future clinical use.”
The Need for Rigorous Research and Collaboration
The review highlights the importance of standardized research methodologies and international collaboration to advance the field. Prof. Torbjørn Omland, MD, PhD, MPH, Deputy Head of the Institute of Clinical Medicine and a co-author of the paper, notes a significant knowledge gap. “There is a knowledge gap on NAD+ and its clinical effects to basic researchers and clinicians, and this review paper provides the latest expert opinion to those who are interested in and are working in the field NAD+ research,” he says. “This review will also provide relevant information to many NAD+-based clinical trials across a wide spectrum of clinical conditions, including neurological and cardiovascular disease.”
Researchers are currently conducting clinical trials worldwide, including in Norway, to investigate the potential of NR and NMN in various conditions. These trials aim to determine optimal dosages, assess long-term safety, and identify individuals who are most likely to benefit from NAD+ augmentation. The authors emphasize that a deeper understanding of the complex interplay between NAD+ metabolism and individual genetic and lifestyle factors is crucial for developing effective and personalized interventions.
Looking Ahead: Continued Research and Clinical Trials
While the findings are promising, the authors caution against premature conclusions. More rigorous clinical testing and stronger collaboration between researchers are essential to translate early findings into safe and effective treatments for aging and age-related diseases. The next steps involve larger, longer-duration clinical trials with diverse populations, as well as studies to investigate the mechanisms by which NAD+ impacts specific diseases. Researchers are also exploring alternative strategies for boosting NAD+ levels, including lifestyle interventions such as exercise and dietary modifications.
Disclaimer: The information provided in this article is for general knowledge and informational purposes only, and does not constitute medical advice. It’s essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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