Nicotinamide riboside supplement relieves walking discomfort in patients with artery disease, study finds

25 Jun 2024 --- A new randomized, double-blind clinical trial by Northwestern University and University of Florida scientists discovered that patients who take nicotinamide riboside, a form of vitamin B3, daily for six months increased their walking distance by approximately 17 meters compared to those who took the placebo.

The over-the-counter (OTC) supplement increased the walking endurance of patients with peripheral artery disease, a chronic leg condition with few effective treatments.

“This is a signal that nicotinamide riboside could help these patients. We are hoping to conduct a larger follow-up trial to verify our findings,” says Dr. Christiaan Leeuwenburgh, senior author of the clinical trial report and professor of physiology and aging at the University of Florida, US.

Lower extremity PAD sufferers have increased oxidative stress, impaired mitochondrial activity and poor walking performance. NAD+ reduces oxidative stress and is an essential cofactor for mitochondrial respiration. Oral nicotinamide riboside increases the bioavailability of NAD+ in humans.

Energy generating compound
The researchers recruited 90 people with an average age of 71 with peripheral artery disease (PAD) for the study, which was published in Nature Communications. The researchers tested for the effects of nicotinamide riboside specifically.

Lower extremity ischemia from PAD results in insufficient oxygen and nutrient delivery to the skeletal muscle, exacerbating oxidative stress, damaging skeletal muscle fibers and impairing mitochondrial function.

Leeuwenburgh specializes in anti-aging treatment research and collaborated with Dr. Mary McDermott, a physician and professor of medicine at Northwestern University and an expert in PAD. They hypothesized that nicotinamide riboside could help improve walking in people with the disease because it is associated with problems generating energy within muscle cells.

In the current study, participants who took the supplement walked at least seven meters more in a six-minute walking test after six months. Participants who took the placebo walked about 10 meters less. Those who took at least 75% of the supplements increased their walking distance by 30 meters compared to the placebo group.

The researchers also tested whether resveratrol could boost the effects of nicotinamide riboside but found no additional benefits. Resveratrol, a naturally occurring polyphenol, can increase the affinity of sirtuin 1 — a hepatic glucose and lipid metabolism regulator — to NAD. Therefore, the researchers tested whether nicotinamide riboside with resveratrol improves the walking distance.

Nicotinamide riboside has become very popular as an anti-aging solution, with sales exceeding US$60 million. The compound is a precursor for the essential compound nicotinamide adenine dinucleotide (NAD), a coenzyme central to metabolism, energy generation, improved blood flow and DNA repair.

Strongly linked to smoking
Leeuwenburgh plans to test the effects of nicotinamide riboside on walking performance in healthy older adults and conduct a larger trial on patients suffering from PAD. “We need to test it on a healthy older population before we recommend healthy people take it,” he says.

PAD affects more than 8.5 million US citizens over the age of 40 and is caused by the buildup of fatty deposits in arteries. The condition which reduces blood flow in the limbs — especially the legs — is associated with diabetes and smoking.

Walking often becomes painful, declining over time. Supervised walking exercise is the first line of therapy for PAD. However, most people with the condition do not have access to supervised exercise.

Meanwhile, a women-only study investigated the effects of 40 mg/day of Bioiberica’s Collavant n2 native type II collagen on the joint functionality of participants with knee osteoarthritis. The findings reveal that the supplement improves functionality and joint comfort in six weeks.

By Inga de Jong

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