Living Well I know better than to believe stories I hear at dinner parties.
I'm only human, and I still get excited when I hear that I can "triple my money by Christmas" or about a new pill that "gives you all the benefit of drinking wine without the calories"... But I've heard enough of these stories to know how they end. The promises never pan out.
This time, the president of a major Minneapolis construction business was asking me and a couple other doctors if we were taking "NAD+" to increase our healthy lifespans.
The interesting thing is, I had also heard this compound mentioned by an expert in blood cancer from the Cleveland Clinic.
He knew his stuff. One of his slides showed a biochemical pathway that included NAD+. He cited some studies on mice and alluded to forthcoming human findings as well. The work made it seem like the old mice became young mice... The markers of aging went away – things like dry skin and gray hair.
This intrigued me enough to check out the science... and after some quick reading, even buy some NAD+ to try.
Since I'm older, I'm paying more and more attention to pain, performance, and secrets-to-aging snake oil stories. In just the past few years, we've seen plenty of pills promising to make us look young and feel livelier. "Anti-aging" pills are big business. The anti-aging market brings in about $250 billion a year. And the most recent fad is something called nicotinamide adenine dinucleotide, or NAD+ (a unique form of one of the B vitamins).
To understand why NAD+ is so intriguing, we need to dive into a bit of our biology...
Most human cells contain structures called mitochondria. You might even remember them from school as "the powerhouse of the cell." Mitochondria create energy units called adenosine triphosphate (ATP). Think of this like an energy currency. Your cells need ATP to perform every task they do, from breaking up debris to making proteins.
Without getting too technical, making ATP requires a lot of movement of electrons... And our mitochondria use NAD+ to move those electrons.
We also know that over time, mitochondria don't run as quickly or as efficiently. That slows down cellular repair and action. It leads to markers of aging, including things like chronic inflammation and a decline in stem-cell activity.
We still don't understand the mechanism of action for why mitochondria break down and how exactly this ages us...
But that hasn't stopped researchers from trying to find a way to "jump start" our mitochondria to "reverse" aging.
It started with some mouse models. In a 2016 study in Cell Metabolism, researchers added a compound called nicotinamide mononucleotide (NMN) to water given to mice. The compound increased levels of NAD+ in the mice, which in turn made them act younger... and live longer than their untreated peers.
One of the theories for why this happens isn't just the role NAD+ plays in our mitochondria. NAD+ also protects our DNA, which degrades over time from things like mutations and chronic inflammation.
But as regular readers know, we're skeptical until we see human studies.
In fact, a human study was published in late 2017 in a journal partner of Nature (one of the best science journals there is) called Aging and Mechanisms of Disease. I was initially excited to learn about it. The results sounded promising. Human subjects took a supplement called NRPT. NR stands for "nicotinamide riboside," which is a precursor of NAD+... and PT, or pterostilbene, is a polyphenol (like the kind we write about often when discussing blueberries).
The subjects who took this NRPT pill saw much higher levels of NAD+ in their bloodwork over the course of the study. In fact, the NAD+ was dose-dependent... The more NRPT they took, the higher the NAD+ in their blood.
Normally, we'd like this study. It was a randomized, double-blind placebo study done in humans. That's the gold standard.
But the study only followed a small sample of 120 adults (so only 80 took the NRPT). It lasted eight weeks, which means long-term effects are still unknown.
Worse, the funding came from the supplement company itself. Now, many early drug trials do receive funding this way, but we prefer a few more degrees of separation to make sure there's absolutely no bias. In this case, the study authors state outright that they each hold shares of the company's stock, too.
Now, this isn't necessarily a reason to give up on the novel approach of increasing NAD+ to boost our feelings of "youthful" energy. In fact, we can naturally increase our levels of NAD+ with no pills and no risky potential long-term effects. Here are four things you can do today to start feeling younger...
Boost NAD+ Naturally and Feel Younger
1. Follow some of the basics of ketogenic diets. Normally, our bodies break down carbs to make glucose. We use glucose for energy. When we don't eat carbs, our bodies will break down fat. When fat breaks down, it creates an acid called a ketone (in a process called ketosis).
The ketones act as energy units that feed your body. They travel through your bloodstream to muscles. This is actually how you maintain energy when you fast.
Some folks try to jump-start this process by following so-called "ketogenic" diets... Typically, these are high-fat, low-carbohydrate diets.
The thing is... ketogenic diets work, and they do help people lose weight. But they're extremely difficult to maintain over a long period of time. They could also pose some problems for folks with diabetes.
But you can apply some of the same principles, which I recommend for everyone: Cut back on processed carbohydrates (particularly white bread) and add healthy fats to your diet (like olive oil and avocados).
2. Get some NRPT naturally. Both components of the supplement used in the trial occur naturally. NR comes from milk, and PT comes from blueberries.
In fact, NAD+ is a type of activated B vitamin – B3. You can increase your levels of B3 by eating more lean meats like chicken and turkey, mushrooms, peanuts, lentils, and green peas.
3. Work out. As I always say, if you're moving, you're alive. Research on how exercise improves levels of NAD+ suggests moving may be the key to keeping you alive.
According to a study in Cell Metabolism, exercise stimulates our skeletal muscles to produce more ATP. That means we create more NAD+ to do the job.
4. Don't neglect your built-in "Fountain of Youth." I'm talking about your telomeres –the protective caps on the ends of your chromosomes. The longer they are, the "younger" our cells.
A study published last month out of Baylor College of Medicine found that feeding mice NMN (the same NAD+ precursor used in the 2016 study) stabilized their telomere lengths... so following a lifestyle that naturally increases NAD+ production could have even more benefits than we think.
The top three things that prematurely shorten our telomeres (and lead us to aging and cell death) are inflammation, stress, and a lack of sleep. And the top three protectors for these telomeres are antioxidants, exercise, and vitamin D.
So if you're really looking to feel young, don't waste your money on some new "Fountain of Youth" pill. Just follow the advice I've given before: Eat well, exercise, and get plenty of sunshine. It's really that simple.
What We're Reading...
- Something different: Delta tops Airline Quality Rating's latest ranking.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health and Wealth Bulletin Research Team
April 9, 2019