Is NAD (Nicotinamide adenine dinucleotide) effective for weight loss and energy enhancement?

NAD+ Supplementation for Weight Loss and Energy: Limited Evidence for Efficacy

Based on current evidence, NAD+ supplementation is not recommended as an effective intervention for weight loss or energy enhancement, as there is insufficient high-quality clinical evidence supporting its use for these purposes.

Current Evidence on NAD+ and Weight Loss

NAD+ (Nicotinamide adenine dinucleotide) is a critical coenzyme involved in numerous cellular processes, functioning as a cofactor for over 400 enzymes in the body and providing antioxidant effects 1. While preclinical studies show promising results, the clinical evidence for NAD+ supplementation for weight loss in humans remains limited:

• Animal studies have shown that NAD+ precursors like NMN (Nicotinamide mononucleotide) can alter body composition in obese mice, reducing fat mass and increasing lean mass 2
• Research in mice demonstrates that chronic NAD+ supplementation can attenuate weight gain in high-fat diet-fed obese mice 3
• Human studies have shown that weight loss itself is associated with increased NAD+/SIRT1 expression and reduced PARP activity in white adipose tissue 4

However, these findings have not translated to robust clinical evidence in humans for weight loss outcomes.

Established Weight Loss Approaches

For effective weight loss, guidelines consistently recommend the following evidence-based approaches:

Dietary Interventions

• Create an energy deficit of 500-750 kcal/day, which typically results in 1-2 pounds of weight loss per week 5
• For individuals with BMI 25.0-29.9 kg/m², aim for approximately 500 kcal/day deficit
• For individuals with BMI ≥30.0 kg/m², aim for a more aggressive 500-1000 kcal/day deficit 5
• Dietary recommendations should focus on reducing macronutrient content, limiting saturated fat, starch, and added sugar 5
• Mediterranean diet has the best evidence for improving liver and cardiometabolic health 5

Physical Activity

• Aim for 150-300 minutes per week of moderate-intensity physical activity 5
• For weight maintenance after weight loss, 200-300 minutes per week of moderate-intensity activity or 30-45 minutes per day of vigorous activity is recommended 5
• Combine both aerobic and resistance training for optimal results 5

Behavioral Strategies

• High frequency of counseling (≥16 sessions in 6 months) focused on nutrition changes, physical activity, and behavioral strategies 5
• Self-monitoring of body weight (weekly or more frequently) 5
• Long-term weight maintenance programs lasting ≥1 year with at least monthly contact and support 5

NAD+ in Clinical Practice

While NAD+ plays important roles in cellular metabolism:

• There are no FDA-approved NAD+ supplements specifically for weight loss
• Current guidelines do not include NAD+ supplementation as a recommended approach for weight management
• The available NAD+ supplement (NicAzel®) is a dietary supplement containing nicotinamide, zinc, azelaic acid, pyridoxine, copper, and folic acid, but is not indicated for weight loss 6

Potential Concerns with NAD+ Supplementation

• Nicotinic acid (a form of niacin) can cause flushing at doses as low as 30 mg 1
• Serious hepatotoxicity can occur with niacin at doses around 3 g per day 1
• Patients with diabetes may have impaired nicotinamide salvage pathway reactions, potentially making NAD+ supplementation less effective or problematic 7

Conclusion

For individuals seeking weight loss and increased energy, focus on established, evidence-based approaches:

1. Create a caloric deficit through dietary changes (500-750 kcal/day)
2. Increase physical activity (150-300 minutes/week)
3. Implement behavioral strategies for long-term adherence

While NAD+ biology is an active area of research with promising preclinical results, current clinical evidence does not support recommending NAD+ supplementation specifically for weight loss or energy enhancement in humans.