Longevity & Aging · Supplements
NAD+ precursors (NMN, NR) improves physical capacity
In plain terms: Do NAD+ booster supplements improve fitness?
Part of: 🧪 nad+ precursors (nmn, nr)
Unclear — evidence is mixed to negative; better studies find no real strength or endurance benefit.
📅 Last reviewed: 2026-07-14 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: Human trials (RCT / n-of-1)
How the studies fall
What the evidence shows
Whether NMN/NR improve endurance/strength/clinical metabolic outcomes - the honest nulls live here. Two meta-analyses find no significant functional benefit despite NAD elevation; positive signals are low-quality, industry-linked, or rest on secondary endpoints.
The evidence (19)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Shoji 2025 · Aging Cell | RCT | tested-null | low | Werner-syndrome crossover: NR improved some progeroid/metabolic markers but evidence for physical-capacity gain limited and disease-specific |
| Prokopidis 2025 · J Cachexia Sarcopenia Muscle | meta-analysis | tested-null | moderate | [FT-verified] FT: no sig effect SMI/grip/gait (CIs cross 0) |
| NIH 2020 ClinicalTrials.gov | RCT | tested-null | low | Sole completed registered NMN organ-system trial; sparse registry base consistent with weak physical-capacity evidence |
| Lin KY 2026 · Lancet Neurol | RCT | contradicts | moderate | 12-wk RCT: NR alone gave NO significant peak-VO2 improvement vs control (0.06 vs -0.05 L/min, p=0.188); only NR+exercise improved VO2 (i.e. the exercise, not NR). Null for NR as a standalone performance aid. |
| Yoshino 2021 · Science | RCT | mixed | moderate | Imai-lab NMN RCT: improved muscle insulin sensitivity in prediabetic women but no change in body weight, lipids or other endpoints |
| Igarashi 2022 · NPJ Aging | RCT | mixed | low | NMN 250mg up to 12wk raised NAD+ in older men; only nominal gait-speed/left-grip gains, no body-composition change - weak, secondary-endpoint signal |
| Ahmadi 2023 · JCI Insight | RCT | tested-null | moderate | Crossover in CKD: NR (and CoQ10) did not improve VO2peak or work efficiency vs placebo; NR lowered submaximal VO2 - null for aerobic capacity |
| Dollerup 2020 · J Physiol | RCT | tested-null | moderate | NR did not improve muscle mitochondrial respiration, content or morphology in obese insulin-resistant men |
| Orr 2024 · GeroScience | RCT | tested-null | moderate | NR 1g/d in MCI raised NAD+ but did not improve cognition; walking speed improved only in placebo (practice effect) - null for function |
| Wen J 2024 · Cureus | RCT | tested-null | low | Systematic review/MA of 10 RCTs (437 participants, NMN 150-1200 mg/day): improvements in grip strength and physical-performance parameters were NON-SIGNIFICANT - human evidence that NMN does not meaningfully improve physical capacity. |
| Liao 2021 · J Int Soc Sports Nutr | RCT | mixed | low | [FT-verified] FT n=12/arm single team no COI decl; improved submax thresholds NOT VO2max/peak; weaker than supports |
| Christen 2026 · Nat Metab | RCT | tested-null | moderate | Head-to-head RCT of three NAD+ precursors: differential NAD+ raising but clinical/functional translation modest - precursor pharmacodynamics outpace outcomes |
| McDermott 2024 · Nat Commun | RCT | supports | moderate | NICE RCT n=90 PAD: 6mo NR improved 6-min walk vs placebo (+17.6m; +31m in >=75% adherent); resveratrol added no benefit - positive physical-capacity signal ⚠️ correction-on-file (Crossref) - kept, corrigendum not retraction |
| Zhang 2025 · Crit Rev Food Sci Nutr | meta-analysis | tested-null | moderate | [FT-verified] 12 studies/513 raises NAD but clinical outcomes NS; authors call benefit exaggerated |
| Morifuji 2024 · GeroScience | RCT | mixed | moderate | NMN 250mg/12wk: primary stepping-test endpoint NULL; only secondary 4m-walk and sleep improved |
| Hsu YJ 2025 · Nutrients | animal | mixed | moderate | Aged mice: NMN 300 mg/kg/day for 6 weeks improved maximal strength and aerobic endurance - preclinical support for a performance benefit not reproduced in the human RCT/MA evidence. |
| Berven 2023 · Nat Commun | RCT | tested-null | low | NR-SAFE: high-dose NR safe in PD, raised NAD+; UPDRS change confounded by levodopa timing - no robust functional/capacity benefit |
| Norheim 2024 · Nat Aging | RCT | tested-null | moderate | NR vs placebo in COPD: no improvement in airway inflammation; functional/capacity endpoints not benefited |
| Lin 2025 · GeroScience | RCT | tested-null | low | Pilot RCT: NR+exercise NOT superior to placebo+exercise for systolic BP/PWV in older hypertensives; exercise-capacity benefit not demonstrated |
Disagree, or know a study we missed?
We grade by evidence, not opinions. The way to weigh in is to point us to a study we haven't cited (check the evidence table above first), or to flag a problem with one we have. Every submission is reviewed; if it holds up, the grade updates and shows in Science Changes Its Mind.
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Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.