As a registered dietitian, I have heard numerous claims that supplements such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) can raise levels of nicotinamide adenine dinucleotide (NAD+), improve mitochondrial function, enhance DNA repair, slow aging, and improve health or athletic performance.
To understand these claims, it helps to first understand the underlying biology. NR and NMN are naturally occurring compounds ultimately derived from vitamin B3 (niacin) metabolism that the body can use to produce NAD+, a molecule critical for energy metabolism.
NAD+ plays a critical role in converting the energy stored in carbohydrates, fats, and proteins into a form that cells can use. During metabolism, NAD+ accepts electrons and hydrogen ions released from food molecules and becomes NADH. In turn, NADH delivers those electrons to the mitochondria, where they help drive the production of adenosine triphosphate (ATP), the primary energy currency used by cells for muscle contraction, nerve signaling, and countless other physiological processes.
Because NAD+ is necessary for this process, low NAD+ availability can impair the efficient transfer of energy from food into ATP. Mitochondria do, in fact, rely on NAD+ to help convert food into usable energy. NAD+ is also required by enzymes involved in DNA repair and other cellular maintenance processes, including the regulation of inflammation. Given these important roles, it is reasonable to hypothesize that increasing NAD+ through precursor compounds such as NR and NMN could improve energy metabolism and other cellular processes. The key scientific question is whether this theoretical benefit translates into meaningful improvements in health and performance in humans.
In rodents, NR and NMN do increase NAD+ levels in tissues, and some studies show improvements in mitochondrial function, metabolism, exercise capacity, and age-related decline. The problem is the leap from rodents to humans.
Human studies show fairly well that NR and NMN can raise NAD+ or related blood markers. What remains uncertain is whether those increases lead to meaningful improvements in mitochondrial function, DNA repair, longevity, health, or athletic performance in humans. So, NR/NMN may raise blood NAD+; after that, the claims are uncertain.
Although perhaps less enticing, lifestyle approaches have stronger human evidence. Exercise reliably stimulates mitochondrial remodeling and improves the body’s ability to use oxygen and fuel, especially in skeletal muscle. Diet patterns rich in minimally processed, antioxidant-containing foods help reduce oxidative stress, which is one of the
processes that can damage mitochondria and DNA. These foods include berries, cherries, citrus fruits, leafy greens, cruciferous vegetables, peppers, beans, lentils, peas, nuts, seeds, herbs, spices, whole grains, and omega-3-rich fish. Conversely, reducing consumption of many ultraprocessed foods, which are often high in refined carbohydrates, added sugars, sodium, unhealthy fats, and overall calories while also containing industrially formulated ingredients such as emulsifiers, artificial flavorings, colorants, sweeteners, stabilizers, and other additives rarely used in home cooking, may help reduce some of the oxidative and metabolic stresses that these healthier foods are intended to mitigate.
Managing sleep and stress are also important. Sleep loss has been linked to oxidative stress and mitochondrial disruption. Similarly, chronic psychological stress can alter mitochondrial function and cellular energy regulation.
In conclusion, although NR and NMN show interesting promise, the strongest evidence for supporting mitochondrial health still comes from exercise, sleep, stress management, and a diet rich in minimally processed, antioxidant-containing foods while limiting ultraprocessed foods. A registered dietitian can help translate this science into a practical, sustainable eating pattern that supports mitochondrial health and overall well-being.
Patrick Traynor, PhD, MPH, RD, CSOWM, CPT, is a registered dietitian and founder of MNT Scientific, LLC (MNTScientific.com), an insurance-based nutrition practice serving South Lake Tahoe, CA; Minden, NV; and Ashland, OR. He holds the Interdisciplinary Specialist Certification in Obesity and Weight Management (CSOWM) from the Commission on Dietetic Registration. Virtual appointments are available via telehealth. For inquiries or appointments, visit MNTScientific.com, call (530) 429-7363, or email info@mntscientific.com.
