That is according to a preliminary, randomized, double-blind clinical trial led by Northwestern University and University of Florida (UF) scientists. They found that patients who took nicotinamide riboside daily for 6 months increased their timed walking distance by more than 57 feet compared with participants who took a placebo.
“This is a signal that nicotinamide riboside could help these patients,” said Christiaan Leeuwenburgh, PhD, a UF professor of physiology and aging and senior author of the clinical trial report. “We are hoping to conduct a larger follow-up trial to verify our findings.”
The report in Nature Communications notes that patients with lower extremity PAD have increased oxidative stress, impaired mitochondrial activity, and poor walking performance. Nicotinamide adenine dinucleotide (NAD+), for which nicotinamide riboside is a precursor, reduces oxidative stress and is an essential cofactor for mitochondrial respiration, according to the researchers, who added that oral NR increases bioavailability of NAD+ in humans.
Focusing on 90 patients with PAD and an average age of 71 years, their randomized double-blind clinical trial assessed whether 6 months of NR, with and without resveratrol, improved 6-minute walk distance compared with placebo at a 6-month follow-up. At the 6-month follow-up compared to placebo, NR significantly improved 6-minute walk (+7.0 vs. –10.6 meters, between group difference: +17.6 (90% CI: +1.8, +∞).
“Among participants who took at least 75% of study pills, compared to placebo, NR improved 6-min walk by 31.0 meters and NR + resveratrol improved 6-min walk by 26.9 meters,” the authors pointed out. “In this work, NR meaningfully improved 6-min walk, and resveratrol did not add benefit to NR alone in PAD. A larger clinical trial to confirm these findings is needed.”
NR is available as an OTC supplement. In 2022, sales of NR in the U.S. exceeded $60 million. While resveratrol, a naturally occurring polyphenol, might increase sirtuin1 (SIRT1) affinity for NAD+, it was not shown to do so with NR alone in PAD.
PAD affects more than 8.5 million Americans aged older than 40 years and is associated with diabetes and smoking.
In addition to a larger trial focused on patients suffering from PAD, Dr. Leeuwenburgh said he hopes to test the effects of nicotinamide riboside on walking performance in healthy older adults.
“We need to test it on a healthy older population before we recommend healthy people take it,” Dr. Leeuwenburgh said.
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