NR may improve functional mobility for Individuals with PAD

Data published in Nature Communications ​indicated that 1,000 mg per day of NR (ChromaDex’s Niagen) was associated with improved treadmill walking time and the six-minute walking distance.

Adding resveratrol to the mix did not significantly improve the six-minute walk distance compared to placebo, reported researchers led by Dr. Mary McDermott from Northwestern University Feinberg School of Medicine in Chicago.

“In this double-blind randomized clinical trial of 90 participants with PAD, compared to placebo, NR improved 6-min walk distance by 17.6 meters at 6-month follow-up, consistent with a clinically meaningful effect,” they wrote.

Commenting on the study’s findings, Dr. Andrew Shao, VP of scientific affairs at ChromaDex, said: “Elevating NAD+ levels using NR could have profound effects on muscle mitochondrial function. This study reinforces the potential of NR to support vascular health and improve functional mobility in patients with PAD.”

NAD & PAD ​

In 2004, Dr. Charles Brenner discovered that nicotinamide riboside (NR) is a potent precursor to nicotinamide adenine dinucleotide (NAD). NAD is an important cellular co-factor for improvement of mitochondrial performance and energy metabolism.

As organisms age, NAD levels drop, which leads to a decrease in mitochondrial health; this in turn leads to age-related health issues. By boosting NAD, NR may increase mitochondrial health and induce the creation of new mitochondria.

In addition to the reported benefits for skeletal muscle health and mitochondrial performance, data also shows that boosting NAD+ levels with NR can enhance vascular health.

Given that NAD+ levels decline with age and given the high incidence of PAD among older individuals, Dr. McDermott and her co-workers investigated if six months of supplementation with NR could lead to improvements in people with PAD.

Peripheral Artery Disease is characterized by a narrowing or blockage of arteries that reduces blood flow to the arms and/or legs, causing severe pain and walking disabilities due to insufficient blood flow and reduced oxygen supply. The condition affects over 200 million people worldwide, and existing options for people with PAD are often limited.

Study details​

This phase II randomized, double-blind clinical study included 90 PAD patients over the age of 50 who were randomly assigned to one of three groups: NR (1,000 mg), NR (1,000 mg) plus resveratrol (125 mg) or placebo.

After six months of supplementation, the results showed that NR was associated with significant improvements in treadmill walking time and the six-minute walking distance (by 17.6 meters), while resveratrol did not enhance the benefits of NR.

“To our knowledge, no prior randomized clinical trials have demonstrated beneficial effects of NR on walking performance in any human population,” the researchers wrote, noting that one study failed to find an impact on six-minute walking tests in people with heart failure.

“NR meaningfully improved 6-min walk at 6-month follow-up, and resveratrol did not add benefit to NR alone. Among participants with at least 75% adherence, the magnitude of the effect of NR on 6-min walk was comparable to the effects of supervised exercise for PAD. Further study is needed to confirm these findings in a larger cohort of participants with PAD,” they concluded.

Source: Nature Communications​
2024; 15​: 5046, doi: 10.1038/s41467-024-49092-5​
“Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial”
Authors: M.M. McDermott, et al.