NAD+ stands for nicotinamide adenine dinucleotide and is a coenzyme, which means that it’s a compound that helps enzymes function properly. In the case of NAD+, it helps specifically with our mitochondria, the energy centers of our cells that are responsible for converting the nutrients we eat into fuel that our body can use to help us move, think, eat, and do the things we want to do! Beyond the mitochondria, NAD+ does a lot of things, but one important activity is helping sirtuins, a type of protein that helps regular cellular health, aging, and metabolism.
Like collagen and other important things in the body, NAD+ levels decrease as we age (1), which means sirtuin production is less supported. Researchers have long suspected that declining NAD+ levels are at least partly to blame for age-related diseases and decline, including a lag in energy levels. For example, in one 2018 study, researchers showed that when mice drank water with added NR, they had less DNA damage and an increased production of new neurons (2), which is great for cognition.
In other words, it’s pretty important to support NAD+ production as much as you can to keep your body functioning at optimal capacity, no matter what your age.
Beyond NR supplements, there are a bunch of ways to increase NAD+ naturally, starting with foods that are rich in B vitamins.
1. Eat foods with NAD+ precursors
Our bodies mainly produce NAD+ by taking specific ingredients in food that are NAD+ precursors and transforming them into NAD+. Foods that are high in NAD+ precursors include:
- Milk (I recommend full-fat, organic, grass-fed milk)
- Chicken (I recommend always opting for organic, free-range chicken)
- Crimini mushrooms
- Green vegetables
2. Exercise regularly
Exercise positively benefits the mitochondria and NAD+ levels. For example, one study showed that older adults who take up exercise can restore NAD+ levels (3) in skeletal muscle.
3. Eat an anti-inflammatory diet
Declining NAD+ levels are further exacerbated by chronic inflammation, so adopting an anti-inflammatory diet — which is low in refined sugar and grains and high in healthy fats, leafy greens, and colorful fruits — is a great place to start. (For more about fending off chronic inflammation, check out my book The Inflammation Spectrum.)
4. Try intermittent fasting
Studies have shown that fasting leads to an increase in sirtuin levels (4), which explains many of its anti-aging and energy-boosting benefits.
5. Eat fermented foods
One of the byproducts of fermentation is NAD+, so fermented foods like kimchi, kombucha, sauerkraut, and kefir contain low levels of NAD+ and have a ton of other gut health benefits.
6. Limit alcohol
Studies have shown that NAD+ declines significantly during binge drinking (5). In the long term, this can cause liver injury because the enzymes that require NAD+ as a cofactor work to prevent organ injury and protect the liver.
If you’re incorporating plenty of NAD+ boosting practices into your routine but still want to try a supplement, I highly encourage trying one out! A supplement is probably the best way to know for sure if increasing your NAD+ levels will benefit you. NR supplements don’t come cheap, so if you’re young and healthy, you might want to just focus on NAD+ boosting activities. But if you’re struggling with low energy levels or are over 50 and noticing that you’re starting to feel a little more sluggish, you’re a particularly great candidate to give NR a try.
I always recommend adding one supplement at a time and mindfully paying attention to your energy levels, mood, sleep, and any other symptoms that may change. And remember to buy from a supplement company that lab tests their products for potency and purity, which means they check that there are no contaminants like microbes or heavy metals.
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