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Speaker 1: Hey, everybody, welcome to another edition of Wisdom Wednesdays. Today

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Speaker 1: we are going to have a look at a couple

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Speaker 1: of supplements that are touted to increase longevity. And if

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Speaker 1: you are interested in longevity space and you're on social media,

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Speaker 1: your social media feed has probably been bombarded with adverts

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Speaker 1: about these supplements. They are NMN and NR. Now, let's

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Speaker 1: get the tricky stuff out of the way. First. NMN

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Speaker 1: stands for nicotinamide monionucleotide and NAR stands for nicotinamide riboside. Now,

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Speaker 1: they are both precursors to what's called NAD plus nicotinamide

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Speaker 1: adenanine dye nucleotide, which is a bit of a mouthful,

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Speaker 1: but NAD plus is basically a molecule that is critical

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Speaker 1: for cellular energy and lots of different bodily function. Now,

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Speaker 1: research suggests that some that these two supplements can be

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Speaker 1: very beneficial in animal models for a range of age

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Speaker 1: related diseases. And the reason that's purported is that our

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Speaker 1: NAD levels kind of fall off a cliff in midlife,

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Speaker 1: and some researchers and particularly social media influencers and think

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Speaker 1: that taking na D and n R or sorry, NMN

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Speaker 1: and NR are ways to offset that decline and to

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Speaker 1: improve our quality of life. Now, NM and supplementation has

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Speaker 1: been shown to improve metabolic function, increase endurance, and protect

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Speaker 1: against cognitive decline in animal models and potentially could and

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Speaker 1: contribute to increase lifespan and health span. And some studies

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Speaker 1: again animal studies suggest that NMN can improve muscle strength

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Speaker 1: and exercise capacity. NR has also shown some promise in

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Speaker 1: animal models, with studies demonstrated and its ability to improve

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Speaker 1: mitochondrial function, reduce inflammation, and protect against age related diseases.

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Speaker 1: And it's also been shown NR and again in animal

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Speaker 1: models to improve blood pressure and benefit skeletal muscle. And

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Speaker 1: there's been a couple of small studies in humans sing

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Speaker 1: that NR may improve blood pressure. But I wanted to

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Speaker 1: focus in today on the idea of muscle strength and

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Speaker 1: function because a lot of these influencers are saying that

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Speaker 1: NMN and NR can actually preserve your muscle strength and

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Speaker 1: your function and can offset syclopenia, which I've talked about

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Speaker 1: numerous times. That's that loss of bone and muscle that

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Speaker 1: happens when we age. But what does the research say

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Speaker 1: in humans? This is critical. Now, there is established research

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Speaker 1: in animal models, but there has recently been released a

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Speaker 1: systematic review and meta analysis of ten randomized control trials. Right,

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Speaker 1: so picking the well designed studies and they look at

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Speaker 1: supplementation with NMN and NR and looking at muscle strength

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Speaker 1: and physical function in older adults. Right, So, little bit

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Speaker 1: of background, and we talked about cyclopedia that loss of

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Speaker 1: muscle as you age has a multitude of negative consequences

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Speaker 1: both for lifespan, how long you live, and particularly for

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Speaker 1: your health span your quality of life. And we know

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Speaker 1: that low muscle mass and strength, known as scyclopenia, worsens mobility,

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Speaker 1: worsens quality of life, and increases the risk of our

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Speaker 1: whole host of chronic diseases. And we know that that

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Speaker 1: low muscle mass and strength as well as increasing a

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Speaker 1: risk of falls, which are the fifth and sixth biggest

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Speaker 1: killer of people in their sixties and seventies, and they

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Speaker 1: also contribute to things like cardiovascular disease, type two diabetes,

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Speaker 1: and Alzheimer's disease. So there obviously is a lot of

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Speaker 1: interest in identifying any factors that can mitigate or offset

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Speaker 1: aging associated muscle loss. And as I said, some researchers

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Speaker 1: have proposed that muscle loss during aging can is partly

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Speaker 1: due to a result of decline in the levels of

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Speaker 1: NMN or sorry, NAD plus, and that replenishing NAD plus

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Speaker 1: through NMN and n R because you can't take and

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Speaker 1: if you take NAD plus, it's just a dried by

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Speaker 1: your gut. So the theory is NMN and NR are precursors,

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Speaker 1: they're converted into NAD plus and they do survive your gut,

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Speaker 1: and so taking these things might help to mitigate and

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Speaker 1: the muscle loss. So what did the study find. What

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Speaker 1: they did is they looked, as I said, at a

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Speaker 1: number of randomized control trials. Three of these trials looked

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Speaker 1: at skeletal muscle mass index. Three of them looked at

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Speaker 1: hand grip strength, which is a proxy for your overall

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Speaker 1: strength and there's actually a very strong predictor of how

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Speaker 1: long you're going to live. Four of them looked at

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Speaker 1: gate speed walking speed. That again is a strong predictor

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Speaker 1: in older adults of how long they're going to live.

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Speaker 1: They also two of the studies looked at and they

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Speaker 1: sit to stand at five times performance tests that's a

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Speaker 1: test of leg strength and older adults. They also one

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Speaker 1: of the studies looked at thirty seconds sit the stand

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Speaker 1: performance how often you can do that in thirty seconds?

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Speaker 1: Another study measured knee extension strength. Another study and did

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Speaker 1: a short physical performance battery. Another study looks at chess

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Speaker 1: press one r M, and another one looked at leg press,

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Speaker 1: and then another study looked at thigh muscle mass. Right,

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Speaker 1: So this is between the ten studies that obviously quite

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Speaker 1: a few of them did a number of these different

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Speaker 1: things and what they found in this systematic review in

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Speaker 1: NETA analysis, no effect zero had no impact on any

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Speaker 1: of those different variables that we talked about. And then

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Speaker 1: there were looking at side that was the studies looking

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Speaker 1: at NMN and then for n R supplementation looking at

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Speaker 1: the randomized control studies. Of those, two of them looked

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Speaker 1: at six minute walking distance. That's a measure of euer

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Speaker 1: aerobic capacity. Again when you're an older adult, a significant

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Speaker 1: predictor of how long you're going to live. Two of

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Speaker 1: the studies had a short physical performance battery, two of

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Speaker 1: them looked at hand grip strength, and two of them

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Speaker 1: looked at the five times sit to stand test, and

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Speaker 1: basically there were very little effects. One of them showed

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Speaker 1: improved performance in the six minute walking distance. But I've

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Speaker 1: actually looked at that study that was in an industry

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Speaker 1: sponsored study, so you always have to be worry of

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Speaker 1: these things. The other study showed no effect. And this

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Speaker 1: is what we have to see is consistency across studies

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Speaker 1: and particularly of positive effects. If you're thinking that things

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Speaker 1: are going to be beneficial. In the short physical performance battery,

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Speaker 1: there was no effect in one study and performance actually

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Speaker 1: worsened in another study. The hand grip strength no impact.

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Speaker 1: And then the five time sit to stand tests for

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Speaker 1: NR less improvement than the placebo in one study and

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Speaker 1: no effect in another study. So basically what this systematic

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Speaker 1: review and meta analysis of randomized control trials. And that's

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Speaker 1: critical because there are other bits of research out there

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Speaker 1: that are typically sponsored by industry that are showing beneficial

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Speaker 1: effects of NMN and NAR on physical function in adults,

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Speaker 1: but they're very small studies and they're industry sponsored, and

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Speaker 1: they're not randomized control trials, so not quality evidence. So

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Speaker 1: what does this tell us? Well, look for me, I

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Speaker 1: think it's pretty clear right here that the current evidence

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Speaker 1: does not support a positive effect of either NMN or

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Speaker 1: NR supplementation on muscle health or physical function in older adults.

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Speaker 1: And now having said that, and there is a possibility

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Speaker 1: that the doses may not have been enough in these studies,

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Speaker 1: So it can't rule list off out completely, especially because

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Speaker 1: they've been seen in animal studies, but and not all

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Speaker 1: animal studies translate over to humans, and there could be

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Speaker 1: that there are other effects of NMN and NR on

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Speaker 1: metabolic function and things like that. And however, and for me,

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Speaker 1: the evidence just is not there at the minute, and

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Speaker 1: it's certainly not there at the level that you will

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Speaker 1: see all of these influencers tighting about how brilliant NMN

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Speaker 1: is in NR is and how it's transformed their lives,

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Speaker 1: and we just do not have the evidence of that yet.

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Speaker 1: My take on this, I am keeping an eye on

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Speaker 1: it because I think this is an interesting space. There's

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Speaker 1: good theoretical stuff behind both of these supplements. I know

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Speaker 1: that na D plus when that drops off, does have

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Speaker 1: significant effects, and we do see benefits in animal studies.

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Speaker 1: But for me, the research is just not there. And

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Speaker 1: if you're going to spend your dollars on supplementation, I

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Speaker 1: would definitely be prioritizing vitamin D supplementation and AMIGA three

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Speaker 1: fatty acids. And if you want more detail on that,

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Speaker 1: just listen to the podcast that I did last Saturday.

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Speaker 1: So the podcast before this with Amelia Phillips were we

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Speaker 1: dive into the research around those two supplements of randomized

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Speaker 1: control trials and it is pretty astounding. So for me,

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Speaker 1: let's get the basics right. Let's get the fundamentals right

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Speaker 1: of doing your exercise, eating well, sleeping well, then adding

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Speaker 1: in things that could evidence be of stuff such as

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Speaker 1: vitamin D and Amiga three fatty acids, and then just

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Speaker 1: hold the rest of your money in your pocket, particularly

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Speaker 1: when it comes to NMN and n R until you

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Speaker 1: see better advice, because it just might be that you're

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Speaker 1: spending your money on expensive piss one