Healthy Aging: Being Mindful of Brain Health

Regan Jones, RD

As a registered dietitian nutritionist, I’m confronted regularly with a wide variety of people with health-related inquiries. But for all the ways we differ in our individual health needs, there is one commonality we share. Every person on this planet is aging day-by-day.

It’s true that some of us are farther along on the timeline than others, but there’s no denying that we’re all putting days behind us as we move towards the days ahead of us. The question is — what are we doing each day to support that aging process as healthfully as possible? September is Healthy Aging Month and it’s the perfect time to answer this question, especially as it relates to brain health.

Why begin with the brain?

While physical signs of aging like muscle mass decline or weight gain can be seen outwardly, prompting people to lose weight or work out, the changes happening in the brain are often simply dismissed as a natural consequence of growing older — “Oh, I’m so forgetful these days!” The truth is, maintaining cognitive function is critical to healthy aging. The decline in focus and problem solving are common age-related affects among normal aging individuals.

It’s well known that as we age brain metabolism decreases which is associated with cognitive decline.1,2,3,4 There are many factors associated with age-related cognitive decline:

• Oxidative stress and free radical damage5
• Changes in hormone levels6-8
• Poor diet quality9,10
• Stress and social isolation11,12

Is cognitive decline inevitable?

Not necessarily. There are several things you can do to support brain health and cognitive function with age.

The good news is that you can support brain health through commonly recommended practices, such as increasing physical activity, decreasing stress, improving sleep quality and ensuring adequate nutrient intake through healthy eating and supplementation.13-18 With about 90 billion neurons, the brain is a sponge waiting to soak up high-quality nutrients to help it perform optimally.19 Most of that nutrition comes from the diet we eat, but supplements can help by providing additional targeted nutrients.

Healthy Eating for a Healthy Brain

To understand how healthy eating plays a role in brain health, it’s important to look at the research and, most notably, the recent revelation in the scientific community that an eating plan known as the MIND Diet substantially slows cognitive decline with age.20

The MIND Diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) emphasizes plant-based foods, specifically an increase in berries and green leafy vegetables and a decrease in saturated fats and animal-based foods. The following recommendations align with the MIND Diet21:

• At least three servings of whole grains a day
• A salad and one other vegetable a day
• One glass of wine a day
• A serving of nuts a day
• Beans every other day
• Poultry at least twice a week
• Berries at least twice a week
• Fish at least once a week
• Limiting butter (less than one tablespoon a day), cheese and fast or fried foods

Supplemental Support: Nutrients that Support Brain Health

In addition to eating a healthy diet, targeted nutritional supplementation may also support brain health.

Sage extract

Sage extract has been shown to promote healthy levels of the neurotransmitter acetylcholine and the signaling of neurotransmitters like GABA, dopamine, serotonin, and more. Also of note, in pre-clinical studies, sage extract shows promise in promoting healthy gene expression related to lipid metabolism and insulin.22


Derived from the periwinkle plant, vinpocetine has been shown to promote cognitive function, support a healthy inflammatory response and help maintain healthy blood flow, oxygen and nutrient delivery to brain cells.23

Blueberry extract

Blueberry consumption and supplementation has been shown in many studies to support brain health and cognitive function.24 AuroraBlue® is a complex of blueberry and bilberry species from across the Alaskan tundra that are known to contain powerful antioxidants.


Phosphatidylserine (PS) is an essential part of healthy cell membranes, critical to both brain metabolism and intra-brain connections. Furthermore, PS helps with brain-related glucose metabolism and stimulation of acetylcholine production.25-27


By promoting the healthy growth of nerve cell components that support brain and nervous system function, Ashwagandha has neuroprotective effects on the brain. It has been shown to support healthy stress adaptation and cognitive function in aging individuals.28-32


In pre-clinical studies, Uridine-5’-Monophosphate (UMP) has been shown to promote healthy brain function by supporting healthy levels of both acetylcholine and dopamine.33-35

Life Extension created Cognitex® Elite, which contains the nutrients listed above, specifically to provide brain-friendly nutrient support for a healthy brain and cognitive function at any age.

Every day offers a new chance to preserve and protect our bodies and brains from the decline associated with aging. Science has shown that while the risk for decline is real, so are the benefits of lifestyle and dietary interventions. Through the right combination of stress reduction, physical activity and a nutrient dense diet through foods and supplement support, maintaining a sharp mind for many years to come is a reality we can all enjoy.

About the Author: Regan Jones is an award winning registered dietitian and host of, an iTunes Top 30 personal journal podcast that offers women a roadmap through midlife. Jones, who began her career as an assistant editor at Cooking Light and Weight Watchers Magazines, is now frequently featured in the national media and is the 2017 winner of the Academy of Nutrition and Dietetic’s prestigious Media Excellence Award. She is also co-author of the Academy of Nutrition and Dietetic’s 2016 Practice Paper, Social Media and the Dietetics Practitioner: Opportunities, Challenges, and Best Practices. Jones enjoys manning the microphone from her home in Georgia, where she lives with her husband and two sons.

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  7. Yaffe K, Barnes D, Lindquist K, et al. Endogenous sex hormone levels and risk of cognitive decline in an older biracial cohort. Neurobiol Aging. 2007;28(2):171-178.
  8. Olivier B. Testosterone and cognitive function: current clinical evidence of a relationship. European Journal of Endocrinology eur j endocrinol. 2006;155(6):773-781.
  9. Valls-Pedret C, Sala-Vila A, Serra-Mir M, et al. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial Mediterranean Diet and Cognitive Decline Mediterranean Diet and Cognitive Decline. JAMA Intern Med. 2015;175(7):1094-1103.
  10. Shakersain B, Santoni G, Larsson SC, et al. Prudent diet may attenuate the adverse effects of Western diet on cognitive decline. Alzheimer's & Dementia. 2016;12(2):100-109.
  11. Marin M-F, Lord C, Andrews J, et al. Chronic stress, cognitive functioning and mental health. Neurobiol Learn Mem. 2011;96(4):583-595.
  12. Shankar A, Hamer M, McMunn A, Steptoe A. Social Isolation and Loneliness: Relationships With Cognitive Function During 4 Years of Follow-up in the English Longitudinal Study of Ageing. Psychosom Med. 2013;75(2):161-170.
  13. Erickson KI, Voss MW, Prakash RS, et al. Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences. 2011;108(7):3017-3022.
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  17. Krikorian R, Shidler MD, Nash TA, et al. Blueberry supplementation improves memory in older adults. J Agric Food Chem. 2010;58(7):3996-4000.
  18. Walker JG, Batterham PJ, Mackinnon AJ, et al. Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms—the Beyond Ageing Project: a randomized controlled trial. Am J Clin Nutr. 2011;95(1):194-203.
  19. Azevedo FA, Carvalho LR, Grinberg LT, et al. Equal numbers of neuronal and nonneuronal cells make the human brain an isometrically scaled-up primate brain. J Comp Neurol. 2009;513(5):532-541.
  20. Morris MC, Tangney CC, Wang Y, et al. MIND diet slows cognitive decline with aging. Alzheimer's & dementia. 2015;11(9):1015-1022.
  21. Marcason W. What Are the Components to the MIND Diet? J Acad Nutr Diet. 2015;115(10):1744.
  22. Lopresti AL. Salvia (Sage): A Review of its Potential Cognitive-Enhancing and Protective Effects. Drugs R D. 2017;17(1):53-64.
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  32. Shah N, Singh R, Sarangi U, et al. Combinations of Ashwagandha leaf extracts protect brain-derived cells against oxidative stress and induce differentiation. PLoS One. 2015;10(3):e0120554.
  33. Cansev M, Watkins CJ, van der Beek EM, Wurtman RJ. Oral uridine-5'-monophosphate (UMP) increases brain CDP-choline levels in gerbils. Brain Res. 2005;1058(1-2):101-108.
  34. Sakamoto T, Cansev M, Wurtman RJ. Oral supplementation with docosahexaenoic acid and uridine-5'-monophosphate increases dendritic spine density in adult gerbil hippocampus. Brain Res. 2007;1182:50-59.
  35. Wang L, Albrecht MA, Wurtman RJ. Dietary supplementation with uridine-5'-monophosphate (UMP), a membrane phosphatide precursor, increases acetylcholine level and release in striatum of aged rat. Brain Res. 2007;1133(1):42-48.

Live Foreverish Podcast: Powering Up Your Health With Astaxanthin

Did you know that astaxanthin has an antioxidant capacity that is up to 6,000 times greater than Vitamin C by some measures? 1 Astaxanthin is a potent antioxidant loaded with health benefits, largely due to its role as an antioxidant and an anti-inflammatory. Astaxanthin has been shown to provide distinct health benefits that have been clinically validated by research.

Learn what this ocean or freshwater-derived nutrient can do for your health with Dr. Michael Smith and his guest, author Bob Capelli. The podcast episode is available for download or you can listen now on

In this episode, you’ll find out:
- What form to take
- What dose to take
- The top 3 reasons to take astaxanthin

Bob Capelli has been involved in natural healing and herbology for over thirty years. He is the lead author of five books, including a book on astaxanthin called “Natural Astaxanthin: The Supplement You Can Feel,” as well as dozens of articles for trade and consumer publications and scientific papers for peer-reviewed technical journals.

About Live Foreverish: Join Dr. Mike and Dr. Crystal as they sit down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and helpful advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

1. Carotenoid Science. 2007;11(6):16-20.

Age Gracefully with PQQ (Pyrroloquinoline Quinone): An Undervalued Anti-Aging Nutrient

Juanita O. Enogieru - Life Extension Wellness Specialist

The human body functions through a multitude of pathways. It is a highly complex organism with an abundance of spinning wheels, each requiring fuel for healthy function. Thus, there are a variety of nutrients that you can include in your dietary supplement regimen that will help support your body’s ability to heal and repair damage and modulate dysfunctional pathways. Considering this fact, it is easy to understand why people have so many questions about which nutrients are critical for promoting graceful aging. This means giving your body nutrients that can enhance quality of life. But you may be asking yourself, where do I begin?

Let’s start with supporting the powerhouse of each cell, the mitochondria. Mitochondria are organelles that reside in our cells and where ATP (adenosine triphosphate) is manufactured. ATP is a source of energy that fuels the majority of metabolic reactions in our bodies. Energy-intensive organs such as the brain, heart, kidneys and skeletal muscles are rich in mitochondria. In fact, human cells may house anywhere from one to thousands of mitochondria, depending on the type of tissue and other factors.1 With age, the number and function of mitochondria decline significantly, which may result in accelerated aging and noticeable declines in cognitive, metabolic, skin, immune, neurological, reproductive and cardiovascular health.2-4

To target key characteristics of aging, it is imperative to supply the body with nutrients that support the mitochondria and energy-producing pathways.

What can cause a cell to become dysfunctional?

Most cellular functions require a continual supply of energy from mitochondria for essential activities such as growth, repair and reproduction. An important feature of mitochondrial dysfunction is a decrease in the number of mitochondria, as well as inefficient energy production due to decreased functionality.5 Mitochondria are vulnerable to damage from oxidative stress. Most people are aware that toxins in the environment can enter the body and generate free radicals that can attack cells. However, during the energy making process, free radicals are also produced.

The mitochondrial free radical theory of aging suggests that during energy production, oxidative stress occurs due to the natural production of free radicals, or reactive oxygen species (ROS), which can damage proteins and lipids and cause mutations in mitochondrial DNA. It is theorized that these alterations cause dysfunction and aging.6 Because mitochondria have their own DNA, they can grow and reproduce independently within the cell; however, mitochondrial DNA does not have many defenses against free radical damage and is highly susceptible to attack.7

Aging is accompanied by declining levels of cellular mitochondria, which leads to less ATP production. When mitochondrial numbers and functionality decline and less energy is produced, cells become dysfunctional, increasing their chance of death. The more functional mitochondria you have in your cells, the greater your overall health and sturdiness.

How can PQQ support healthy aging?

Pyrroloquinoline quinone (PQQ) is a potent antioxidant found in plant matter. We consume minute amounts of it in foods like green soybeans, oranges, tomatoes, celery and apples. Higher amounts are provided in parsley, green and oolong tea, natto (fermented soybeans), green peppers, papaya, kiwi and tofu. PQQ is even present in breast and cow’s milk. Americans tend to consume these foods sporadically or seasonally, and in moderate to minimal quantities. However, research is showing that PQQ plays a vital role in the growth and development of humans and animals.8

One of the most exciting things about PQQ is that it may support the growth of new mitochondria, as seen in animal studies.9 It can activate genes that induce the growth of new mitochondria.10 Previously, we were only aware that strenuous exercise and caloric restriction could induce this effect.11

In addition to boosting mitochondrial numbers, PQQ is a unique substance that is efficient in sustaining antioxidant capacity. PQQ can protect the mitochondria through its antioxidant-scavenging properties, and its ability to activate genes that regulate mitochondrial repair for fixing damaged DNA.12 PQQ has also been shown to improve oxygen utilization in the mitochondria, counteracting another underlying factor of mitochondrial dysfunction.13

What are the benefits of supplementing with PQQ?

Research has shown that PQQ supports healthy cognition in older adults by preventing decline in brain function, attention and working memory.14 It can also lower inflammation by modifying the activation of pro-inflammatory enzymes and lowering CRP (C-reactive protein), a marker of systemic inflammation.15 PQQ was also shown to slow the progression of rheumatoid arthritis in a preclinical study.16 In other preclinical studies, it has supported cardiovascular, immune and neurological health.17

Who should supplement with PQQ?

It’s simple, ALL aging adults could benefit from PQQ. And yes, PQQ is a supplement that you can safely use regularly. However, due to variances in biochemistry, the most suitable dosage may vary from person to person.

Can I get enough PQQ from my diet?

Cells deprived of PQQ show signs of mitochondrial dysfunction. However, as little as 200 to 300 mcg of PQQ/kg in the diet was able to reverse dysfunction in a mouse model.9 Consider the fact that one of the richest sources of PQQ, natto (fermented soybeans), contains approximately 61 ng/g wet weight (0.061 mcg/g). This is much less than what is needed to stimulate the growth of new mitochondria. Since concentrations are mostly low in food sources, if you want to modulate brain aging and reduce inflammation, taking a supplement could be ideal.

What dose of PQQ should I take daily?

Higher dosages are supportive for individuals at an increased risk for mitochondrial dysfunction, such as older adults and individuals with health concerns. A study using 20 mg of PQQ showed improvements in cognitive function with no adverse effects.14 Conversely, a younger individual who wants to support healthy aging may benefit from 10 mg of PQQ. PQQ has been shown to have low oral toxicity in rats, meaning that no adverse effects were noted for doses much higher than 20 mg of PQQ.18

By simply giving your body nutrients it needs at optimal doses, you can supply your energy-creating pathways with the tools needed to promote overall health and well-being.

Synergistic nutrients: What compliments PQQ?

Since the body thrives when you provide it with various nutrients, it may be advisable to pair PQQ with ubiquinol CoQ10 and the vitamin B3 metabolite, nicotinamide riboside (NR).

Coenzyme Q10 (CoQ10) is an antioxidant that is produced in the liver via the cholesterol pathway and is an essential cofactor in many biochemical pathways in the body, including the production of ATP in the mitochondria. In fact, CoQ10 is a critical player in the synthesis of ATP and in promoting mitochondrial function.19 The natural production of CoQ10 is known to decline during the aging process and/or with statin medication use.20 When cells lack sufficient CoQ10, mitochondrial dysfunction sets in and can lead to impaired organ function (heart, liver, kidneys, etc.), damaged blood vessels and poor circulation.21

Based on the totality of published research about CoQ10, it may be desirable for adults over the age of 30 to seek a minimum sustained blood level of more than 3 mcg/mL of blood. Maintaining blood levels up to 7 mcg/mL may support healthy aging and heart health.22 A blood test will help you figure out the dose most suitable for your biochemistry. To maximize absorption, we highly suggest the ubiquinol form of CoQ10. Ubiquinol CoQ10 has a much higher bioavailability and provides potent support at lower dosages than the ubiquinone form of CoQ10.22 Optimal blood ranges may be reached by supplementing with 100-400 mg of ubiquinol daily.

The non-flushing vitamin B3 metabolite, nicotinamide riboside (NR), converts to an essential factor in energy production in cells, nicotinamide adenine dinucleotide (NAD+). NR supplementation can raise circulating NAD+ levels in humans.23 NAD+ may help promote healthy aging by mitigating mitochondrial dysfunction by enhancing cellular energy production and boosting the function ofmitochondria. Preclinical studies show that restoring mitochondrial function with NR slows aging and extends longevity.24 Furthermore, NR has been shown to improve markers of inflammation and mitochondrial function in preclinical cell studies.25,26

Pairing PQQ with mitochondrial supporters such as CoQ10 and NR will provide the body with vital tools needed to fuel functions in the body that require energy. Considering the wide-ranging benefits of PQQ, it seems that any person seeking to stimulate the production of new mitochondria, reduce inflammation, support mitochondrial DNA repair and other vital metabolic functions that promote healthy aging should include the undervalued nutrient PQQ in their dietary supplement regimen today.

About the author: Juanita Enogieru is a nutritionist and Life Extension Wellness Specialist working with the community to build healthy and balanced nutritional habits. While pursuing an education in medicine and attempting to help her body heal, it became apparent that there was a gap in medical practices with regard to nutrition and an abundance of misinformation about balanced nutritional practices. After obtaining a bachelor’s degree in health education from the University of Florida, she worked with non-profit organizations to deliver nutrition education to community members. Wanting to learn more about nutrition and how herbs could be used to help the body heal, she pursued a master’s degree in dietetics and nutrition and shortly after began working with Life Extension. With the understanding that everyone has a unique biochemical individuality, it is vital to address each individual based on their specific needs and biochemical make-up. Her mission now is to offer guidance, support and education to individuals based on balanced nutritional insights that address the mind, body and spirit.

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Psoriasis: 4 Beneficial Vitamins and Supplements

Dr. Heidi Yanoti, DC – Life Extension Senior Wellness Specialist

August is Psoriasis Awareness Month. According to the National Psoriasis Foundation, 8 million Americans and 125 million people worldwide have some form of psoriasis. That’s 2-3% of the world population, and most have been diagnosed with a simple physical exam. 1-3 Yet so many still suffer with the uncomfortable and sometimes disfiguring symptoms of this chronic skin disease. Skin redness, inflammation, scaliness and itching are hallmarks of this disease.

It is well established that psoriasis affects much more than the appearance of the skin. Besides triggering the development of scaly patches of skin, psoriasis can also trigger inflammation throughout your body, including your blood vessels, which can increase the risk for cardiovascular disease.4

Although psoriasis cannot currently be cured, that doesn’t mean you can’t take measures to relieve symptoms and improve overall quality of life. There are a number of scientifically studied nutritional supplements that may complement conventional treatments to provide symptom relief and improve your overall quality of life.

Supplements for Psoriasis

1) Fish Oil

The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been shown to reduce inflammation and improve symptoms of many inflammatory disorders, including psoriasis. The skin rashes in psoriasis have been linked to elevated levels of metabolites derived from a pro-inflammatory factor called arachidonic acid. EPA and DHA have been shown to displace the inflammatory arachidonic acid in skin cells, thereby modulating inflammation in the skin.5 Studies of fish oil supplements for psoriasis have shown significant clinical improvements in redness, hardening, scaling and itching.6,7

2) Vitamin D

We cannot overstate the power of vitamin D: this amazing vitamin is metabolized in the body into an immune-modulating hormone that can modulate inflammation and reduce the rapid growth of skin cells that lead to psoriasis symptoms.8 Research has even indicated that psoriasis sufferers may have genetic variations related to the activation of vitamin D in the body that necessitate higher doses to achieve optimal Vitamin D benefits. Published medical studies show psoriasis symptoms significantly improved in patients receiving high daily doses of vitamin D3.9 Vitamin D3 is an incredibly affordable supplement, studied for a large number of health benefits. Tests to check your vitamin D blood levels are widely available.

3) Peony

The peony plant is known for its beautiful flowers. But what most of us are less familiar with is peony’s longstanding use in Traditional Chinese Medicine to restore immune balance. We know that an imbalance in the immune system is an important cause of the inflammation that leads to psoriasis symptoms.10 Studies show that extracts of the Peony plant give potent support for immune balance and thereby ease inflammation, showing impressive symptomatic improvement even in some of the more difficult-to-treat forms of psoriasis. Substantial clinical improvement, as well as a drop in inflammatory cytokines (blood markers of some aspects of inflammation), have been seen among people using peony extracts.11,12

4) Pycnogenol®

Pycnogenol® is a pine bark extract from a particular species, the French Maritime Pine, which has been studied for its amazing array of health benefits.13 While it has long been accepted that this pine bark extract has skin supportive properties, evidence now suggests Pycnogenol® can significantly improve psoriasis symptoms.14 And since psoriasis is associated with an increased risk for cardiovascular disease, Pycnogenol® may have additional benefits for psoriasis patients: Pycnogenol® is also well-studied in the context of cardiovascular health.15 Thus Pycnogenol® may be an especially supportive option for those affected by psoriasis.

For more information, please visit the Life Extension Psoriasis Health Protocol.

About the Author: Heidi Yanoti earned her doctor of chiropractic degree from Life University. She has been a Senior Wellness Specialist at Life Extension for over 10 years and a lifelong advocate for natural approaches to optimal health. She enjoys sharing this passion with Life Extension customers, helping them achieve their health goals with a focus on promoting wellness rather than treating disease. In her spare time she enjoys, reading, films and desert hikes in her Las Vegas, Nevada, home.

  1. Mayo Clinic. Psoriasis. Symptoms & causes. 3/13/2019. Accessed 8/13/2019. Published 2019. Accessed.
  2. Korman NJ. Management of psoriasis as a systemic disease: What is the evidence? Br J Dermatol. 2019.
  3. National Psoriasis Foundation. Statistics. Copyright 2019. Accessed 8/14/2019. Published 2019. Accessed.
  4. Jindal S, Jindal N. Psoriasis and Cardiovascular Diseases: A Literature Review to Determine the Causal Relationship. Cureus. 2018;10(2):e2195.
  5. Surette ME. The science behind dietary omega-3 fatty acids. Cmaj. 2008;178(2):177-180.
  6. Millsop JW, Bhatia BK, Debbaneh M, Koo J, Liao W. Diet and psoriasis, part III: role of nutritional supplements. J Am Acad Dermatol. 2014;71(3):561-569.
  7. Clark CCT, Taghizadeh M, Nahavandi M, Jafarnejad S. Efficacy of omega-3 supplementation in patients with psoriasis: a meta-analysis of randomized controlled trials. Clin Rheumatol. 2019;38(4):977-988.
  8. Barrea L, Savanelli MC, Di Somma C, et al. Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Reviews in endocrine & metabolic disorders. 2017;18(2):195-205.
  9. Finamor DC, Sinigaglia-Coimbra R, Neves LC, et al. A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis. Dermatoendocrinol. 2013;5(1):222-234.
  10. He DY, Dai SM. Anti-inflammatory and immunomodulatory effects of paeonia lactiflora pall., a traditional chinese herbal medicine. Frontiers in pharmacology. 2011;2:10.
  11. Li B, He S, Liu R, et al. Total glucosides of paeony attenuates animal psoriasis induced inflammatory response through inhibiting STAT1 and STAT3 phosphorylation. Journal of ethnopharmacology. 2019;243:112121.
  12. Wang YN, Zhang Y, Wang Y, et al. The beneficial effect of total glucosides of paeony on psoriatic arthritis links to circulating Tregs and Th1 cell function. Phytother Res. 2014;28(3):372-381.
  13. Iravani S, Zolfaghari B. Pharmaceutical and nutraceutical effects of Pinus pinaster bark extract. Res Pharm Sci. 2011;6(1):1-11.
  14. Belcaro G, Luzzi R, Hu S, et al. Improvement in signs and symptoms in psoriasis patients with Pycnogenol(R) supplementation. Panminerva medica. 2014;56(1):41-48.
  15. Gulati OP. Pycnogenol(R) in Metabolic Syndrome and Related Disorders. Phytother Res. 2015;29(7):949-968.

Healthy Aging Strategy: Optimizing NAD+ Levels for Youthful Cellular Function

Juanita O. Enogieru – Life Extension Wellness Specialist

Health Benefits of NAD+

Many individuals are seeking innovative natural methods to combat aging by supporting optimal cellular function. Improving NAD+ (nicotinamide adenine dinucleotide) levels is one strategy that may promote healthy aging and cellular function.

What is nicotinamide adenine dinucleotide (NAD+)’s role in the body?

NAD+ is a coenzyme needed for various mechanisms associated with normal cellular metabolism. As one gets older, NAD+ levels decline by up to 50%.1 NAD+ levels can also be depleted by obesity and lifestyle choices such as poor diet and excessive alcohol consumption.2-4 Maintaining healthy NAD+ levels while aging is crucial because NAD+ plays roles in critical cellular processes like DNA damage repair and the normal functioning of sirtuin proteins, which contribute to healthy aging.5

How does boosting NAD+ support healthy aging?

Boosting NAD+ levels activates sirtuin signaling and function, improves mitochondrial function, and boosts the body’s natural DNA repair process.2 Preclinical studies have shown that enhancing NAD+ levels promotes longevity through a variety of mechanisms.6

One way boosting NAD+ supports healthy aging is by promoting healthy sirtuin function. Sirtuins are NAD+ dependent enzymes that modulate some aspects of cellular aging by influencing important processes such as DNA repair and inflammatory responses. They also promote healthy cell proliferation.2

While compounds such as resveratrol have been shown to activate sirtuins, NAD+ is still needed for sirtuins to function. Suboptimal levels of NAD+ can hinder beneficial sirtuin function leading to vascular inflammation, increased fat storage, insulin resistance and neurodegeneration in the brain.2,5,7

NAD+ and DNA Repair

Another way in which NAD+ supports healthy aging is by helping facilitate that body’s natural DNA repair processes. DNA is highly vulnerable to damage, which can lead to broken DNA strands and mutations. Accumulated DNA damage contributes to the aging process and can result in immune senescence and deadly diseases like cancer.

An enzyme called PARP-1 plays a major role in repairing DNA damage.8 However, to carry out its function, PARP-1 consumes significant amounts of NAD+. As NAD+ is depleted, the ability of PARP-1 to repair DNA is significantly hindered.2 So, supporting efficient PARP-1 function by boosting NAD+ levels may assist with regaining youthful cell functionality and mediating accumulation of damaged cellular DNA.

Additionally, the tumor suppressor gene p53 protects against unhealthy cellular proliferation that can lead to cancer. Healthy NAD+ levels are required to support p53 activation, which is modulated by SIRT1.10 It interacts with PARP-1 to stimulate the response to DNA. When DNA damage persists, p53 becomes depleted during the repair process, which decreases NAD+ levels.9 The good news is that replenishing NAD+ in cells can encourage the body’s natural DNA repair processes.

What is nicotinamide riboside (NR), and why use it to boost NAD+ levels?

Nicotinamide riboside (NR) is a form of vitamin B3 that occurs naturally in yeast, bacteria and mammals in trace amounts. One cup of milk provides approximately 150 mcg of NR per cup.

NR does not cause the flushing effects often associated with niacin. Preclinical studies suggest that NR supplementation results in increased longevity as well as other health improvements, including neuroprotection, sirtuin activation, weight management, promoting the natural DNA repair process and healthy glucose metabolism.1,10 NR is an effective precursor for promoting healthy NAD+ levels.

Nicotinamide Riboside (NR) Vs. Nicotinamide Mononucleotide 

Nicotinamide riboside (NR) is an effective supplemental precursor for enhancing NAD+ levels. The rationale for using NMN is that it converts to NAD+ more readily because it is the molecule directly before NAD+ (immediate precursor to NAD+). Once inside the cell, NMN is effective at raising NAD+. However, outside of the cell, NMN derived from diet and/or supplementation must be converted to NR before entering the cell. So, before the body can use NMN, it must be converted to NR and then back into NMN!

Therefore, based on the metabolic use of NR and the clinical evidence of its benefits, 100 mg or 250 mg of NR is a reasonable dosing strategy for boosting levels of NAD+. It can also be paired with resveratrol to encourage healthy sirtuin function, maintain healthy cellular metabolism and support longevity.

Whether alone or paired with resveratrol, supplementing with nicotinamide riboside (NR) to boost NAD+ levels is an evidence-based strategy for promoting health and longevity.10

About the author: Juanita Enogieru is a nutritionist and Life Extension wellness specialist working with the community to build healthy and balanced nutritional habits. While pursuing an education in medicine and attempting to help her body heal, it became apparent that there was a gap in medical practices with regard to nutrition and an abundance of misinformation about balanced nutritional practices. After obtaining a bachelor’s degree in Health Education from the University of Florida, she worked with non-profit organizations to deliver nutrition education to community members. Wanting to learn more about nutrition and how herbs could be used to help the body heal, she pursued a master’s degree in Dietetics and Nutrition and shortly began working with Life Extension. With the understanding that everyone has a unique biochemical individuality, it is vital to address each individual based on their specific needs and biochemical make-up. Her mission now is to offer guidance, support and education to individuals based on balanced nutritional insights that address the mind, body and spirit.


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  2. J Biomed Sci. 2019;26(1):34.
  3. Critical reviews in biochemistry and molecular biology. 2013;48(4):397-408.
  4. Experimental and molecular pathology. 2016;100(2):303-306.
  5. Trends in Cell Biology. 2014;24(8):464-471.
  6. Ageing Res Rev. 2018;47:1-17.
  7. Pharmacol Res. 2018;128:345-358.
  8. Nature Reviews Molecular Cell Biology. 2017;18:610.
  9. Cell Cycle. 2014;13(11):1661-1662.
  10. Translational Medicine of Aging. 2018;2:30-37.

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