Nicotinamide adenine dinucleotide (NAD+) is a critical coenzyme found in all living cells, essential for energy metabolism, DNA repair, and cell signaling. NAD+ levels decline with age, and research has increasingly focused on its supplementation as a means to promote healthy aging, improve mitochondrial function, and support metabolic health (Imai & Guarente, 2014 [1]).
NAD+ serves as a key electron carrier in redox reactions during cellular respiration, enabling ATP production in mitochondria. Beyond metabolism, NAD+ acts as a substrate for enzymes like sirtuins and poly(ADP-ribose) polymerases (PARPs), which regulate DNA repair, gene expression, and stress resistance (Verdin, 2015 [2]). The decline of NAD+ with age is linked to decreased cellular energy and impaired repair mechanisms, contributing to aging and disease progression.
Anti-Aging and Longevity: NAD+ precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) have been studied for their ability to restore NAD+ levels, improving mitochondrial function, and activating sirtuins to extend healthspan in animal models (Zhang et al., 2016 [3]; Mills et al., 2016 [4]).
Neuroprotection: Enhanced NAD+ availability supports neuronal health by reducing oxidative stress and inflammation, with implications for neurodegenerative diseases like Alzheimer’s and Parkinson’s (Gong et al., 2013 [5]).
Metabolic Health: NAD+ augmentation improves insulin sensitivity, reduces obesity-related metabolic dysfunction, and supports glucose homeostasis (Cantó et al., 2012 [6]).
DNA Repair and Genomic Stability: NAD+ fuels PARP enzymes critical for DNA repair, potentially reducing cellular senescence and age-related genomic instability (Berger et al., 2004 [7]).
Clinical trials using NAD+ precursors have demonstrated safety and improvements in biomarkers related to mitochondrial function, insulin sensitivity, and muscle performance in aging populations (Trammell et al., 2016 [8]; Martens et al., 2018 [9]). Experimental studies continue to explore NAD+ modulation’s potential to delay onset of age-related diseases and improve overall vitality.
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Imai S, Guarente L. NAD+ and sirtuins in aging and disease. Trends Cell Biol. 2014;24(8):464-471. https://pubmed.ncbi.nlm.nih.gov/24990950/
Verdin E. NAD+ in aging, metabolism, and neurodegeneration. Science. 2015;350(6265):1208-1213. https://pubmed.ncbi.nlm.nih.gov/26542540/
Zhang H, Ryu D, Wu Y, et al. NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science. 2016;352(6292):1436-1443. https://pubmed.ncbi.nlm.nih.gov/27284156/
Mills KF, Yoshida S, Stein LR, et al. Long-term administration of nicotinamide mononucleotide mitigates age-associated physiological decline in mice. Cell Metab. 2016;24(6):795-806. https://pubmed.ncbi.nlm.nih.gov/27826130/
Gong B, Pan Y, Vempati P, et al. Nicotinamide riboside restores cognition through an upregulation of proliferator-activated receptor-γ coactivator 1α regulated β-secretase 1 degradation and mitochondrial gene expression in Alzheimer’s mouse models. Neurobiol Aging. 2013;34(6):1581-1588. https://pubmed.ncbi.nlm.nih.gov/23465335/
Cantó C, Houtkooper RH, Pirinen E, et al. The NAD+ precursor nicotinamide riboside enhances oxidative metabolism and protects against high-fat diet-induced obesity. Cell Metab. 2012;15(6):838-847. https://pubmed.ncbi.nlm.nih.gov/22682224/
Berger F, Lau C, Ziegler M. Regulation of poly(ADP-ribose) polymerase activity in response to DNA damage. Chem Biol Interact. 2004;147(2):143-150. https://pubmed.ncbi.nlm.nih.gov/15358014/
Trammell SAJ, Schmidt MS, Weidemann BJ, et al. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nat Commun. 2016;7:12948. https://pubmed.ncbi.nlm.nih.gov/27698464/
Martens CR, Denman BA, Mazzo MR, et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018;9(1):1286. https://pubmed.ncbi.nlm.nih.gov/29500430/