Longevity & Aging · Supplements
NAD+ precursors (NMN, NR) improves physical capacity
In plain terms: Do NAD+ booster supplements improve fitness?
Contested Longevity & Aging 💰 Industry COI noted🔬 Includes disconfirming
Part of: 🧪 nad+ precursors (nmn, nr)
RefutedContestedStrong support
consensus score -0.06
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)
MechanismIn-vitroAnimalObservationalRCTMeta-analysis
How the studies fall
1 support 2 contradict 11 tested null 4 mixed · 18 sources, 3 independent groups
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 M, Kato H, Koshizaka M, Kaneko H, Baba Y, Ishikawa T, Teramoto N, Kinoshita D, Yamaguchi A, Maeda Y, Inaba Y, Shiko Y, Ozawa Y, Bohr VA, Maezawa Y, Yokote K 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 K, Moriarty F, Bahat G, McLean J, Church DD, Patel HP 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, Bucha A, McSweeney K, Wade KL, Karaj A, Tamaroff J, O'Malley S, Chung NM, Cilenti NA, Wanner J, Adzika GK, Mesaros C, Blair IA, Rojsajjakul T, Serai S, Farmer J, Bryant K, Lu Y, Harhay MO, Weber DR, Paridon SM, Seifert EL, Putt ME, Zamani P, Baur JA, Lynch DR, McCormack SE 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 M, Yoshino J, Kayser BD, Patti GJ, Franczyk MP, Mills KF, Sindelar M, Pietka T, Patterson BW, Imai SI, Klein S 2021 · Science | RCT | contradicts | moderate | Double-blind placebo-controlled RCT (NCT03151239), 25 postmenopausal overweight/obese women with prediabetes, NMN 250 mg/d (n=13) vs placebo (n=12), 10 wk. Physical capacity: 'handgrip strength and torque, fatigability and recovery from fatiguing exercise of knee extensors and flexors ... were not affected by 10 weeks of placebo or NMN treatment' (Fig. S6, no estimates in text); muscle mitochondrial oxidative capacity unchanged. Null on 'improves physical capacity' = contradicts; small n. Off-object: muscle insulin sensitivity +25 +/- 7% within the NMN arm. |
| Igarashi M, Nakagawa-Nagahama Y, Miura M, Kashiwabara K, Yaku K, Sawada M, Sekine R, Fukamizu Y, Sato T, Sakurai T, Sato J, Ino K, Kubota N, Nakagawa T, Kadowaki T, Yamauchi T 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 A, Begue G, Valencia AP, Norman JE, Lidgard B, Bennett BJ, Van Doren MP, Marcinek DJ, Fan S, Prince DK, Gamboa J, Himmelfarb J, de Boer IH, Kestenbaum BR, Roshanravan B 2023 · JCI Insight | RCT | tested-null | moderate | Double-blind placebo-controlled crossover, 25 adults with CKD (eGFR <60, mean 36.9), NR 1,000 mg/d vs CoQ10 1,200 mg/d vs placebo, 6 weeks each. Primary: VO2peak NR 21.38 vs placebo 20.64 mL/kg/min (+0.74, ~3.6%; P=0.36) - underpowered trend toward the claim (study powered for a 2.1 mL/kg/min difference); total work P=0.47 and work efficiency P=0.46 for NR, direction not given in text. Exploratory: NR lowered submaximal VO2 at 30 W (0.67 vs 0.70 L/min, P=0.03) and 60 W (P=0.07). Authors: NR 'did not improve VO2 peak or total work efficiency'. CKD population; NR supplied by ChromaDex; NIH-funded. |
| Dollerup OL, Chubanava S, Agerholm M, Søndergård SD, Altıntaş A, Møller AB, Høyer KF, Ringgaard S, Stødkilde-Jørgensen H, Lavery GG, Barrès R, Larsen S, Prats C, Jessen N, Treebak JT 2020 · J Physiol | RCT | tested-null | moderate | NR did not improve muscle mitochondrial respiration, content or morphology in obese insulin-resistant men |
| Orr ME, Kotkowski E, Ramirez P, Bair-Kelps D, Liu Q, Brenner C, Schmidt MS, Fox PT, Larbi A, Tan C, Wong G, Gelfond J, Frost B, Espinoza S, Musi N, Powers B 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, Syed B, Kim S, Shehabat M, Ansari U, Razick DI, Akhtar M, Pai D 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 B, Zhao Y, Wang D, Zhang X, Hao X, Hu M 2021 · J Int Soc Sports Nutr | RCT | mixed | low | FT n=12/arm single team no COI decl; improved submax thresholds NOT VO2max/peak; weaker than supports |
| Christen S, Redeuil K, Goulet L, Giner MP, Breton I, Rota R, Frézal A, Nazari A, Van den Abbeele P, Godin JP, Nutten S, Cuenoud B 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 MM, Martens CR, Domanchuk KJ, Zhang D, Peek CB, Criqui MH, Ferrucci L, Greenland P, Guralnik JM, Ho KJ, Kibbe MR, Kosmac K, Lloyd-Jones D, Peterson CA, Sufit R, Tian L, Wohlgemuth S, Zhao L, Zhu P, Leeuwenburgh C 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 J, Poon ET, Wong SH 2025 · Crit Rev Food Sci Nutr | meta-analysis | tested-null | moderate | 12 studies/513 raises NAD but clinical outcomes NS; authors call benefit exaggerated |
| Morifuji M, Higashi S, Ebihara S, Nagata M 2024 · GeroScience | RCT | mixed | moderate | NMN 250mg/12wk: primary stepping-test endpoint NULL; only secondary 4m-walk and sleep improved |
| Hsu YJ, Lee MC, Fan HY, Lo YC 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 H, Kverneng S, Sheard E, Søgnen M, Af Geijerstam SA, Haugarvoll K, Skeie GO, Dölle C, Tzoulis C 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 KL, Ben Ezra M, Heckenbach I, Andreasson LM, Eriksen LL, Dyhre-Petersen N, Damgaard MV, Berglind M, Pricolo L, Sampson D, Dellinger RW, Sverrild A, Treebak JT, Ditlev SB, Porsbjerg C, Scheibye-Knudsen M 2024 · Nat Aging | RCT | tested-null | moderate | NR vs placebo in COPD: no improvement in airway inflammation; functional/capacity endpoints not benefited |
| Lin Y, Zeidan RS, Lapierre-Nguyen S, Costello HM, Anton SD, Buford TW, Christou DD, Gumz ML, Leeuwenburgh C, Martens CR, McDermott MM, Migaud ME, Sandesara B, Seals DR, Qiu P, Wang Y, Mankowski RT 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 |
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