What are the three specific therapeutic actions that—when used together—will help you improve your health and turn back the hands of time? Intermittent fasting, prophylactic, low-dose metformin, and supplementation with nicotinamide adenine dinucleotide (NAD+) are a powerful. Let’s take a look at each of these now.

Intermittent Fasting

Fasting has been practiced for centuries to heal a sick body, promote longevity, and rest, balance, and conserve energy at critical times. Today, the practice of fasting—intermittent fasting (IF), in particular—is being used for the same purposes. Specific to anti-aging, fasting lowers blood pressure and cholesterol and stabilizes blood sugar. It also improves overall cellular and metabolic health while reducing the risk of cancer and lifestyle diseases such as diabetes, heart disease, Alzheimer’s, and obesity. Additionally, fasting increases the activation of stem cells—the body’s master cells from which all other cells are generated. Improving stem cell function slows aging! Click here to read my full blog on Intermittent Fasting.

Metformin

Managing blood sugar is a critical factor in reducing the effects of aging and the risk of chronic disease; this is where the popular oral diabetes medicine, metformin, comes in. Metformin not only improves insulin sensitivity, but it reduces the accumulation of advanced glycation endproducts (AGEs), Advanced glycation endproducts are damaged fats and proteins that age body tissues (including the skin) and worsen degenerative diseases. Metformin’s protective benefits extend to safeguarding critical molecules such as proteins and DNA; it also produces glutathione—a powerful and important antioxidant that reduces cell damage in tissues, including the skin. In this way, metformin has anti-cancer, anti-inflammatory properties and can guard against a host of degenerative and genetic disorders. As it relates to the skin, metformin can block the effects of progerin—a type of protein responsible, in part, for the unsightly signs of aging, such as sagging skin, fine lines, and wrinkles. Click here to read my full blog on Metformin.

NAD+ (nicotinamide adenine dinucleotide)

Found in virtually all living cells, NAD+ (the charged form of NAD) is a coenzyme (a helper molecule for a biochemical reaction) critical to metabolism. NAD+ is essential to life, and scientists continue to discover new ways that it contributes to longevity. So far, research has demonstrated that NAD+ can reduce chemical stress and inflammation, repair DNA, regulate immune pathways, and decrease mitochondria dysfunction. Therefore, NAD+ protects our energy-producing capacity while shielding us from chronic disease. Click here to read my full blog on NAD.

For several reasons, many of us do not eat as well as we could, get enough exercise and sleep, or engage in other healthy activities that predict a longer life. These lifestyle changes can be challenging to incorporate. That’s why it’s crucial to bring in reinforcements. Not only can the powerful trio of intermittent fasting, metformin, and NAD slow aging, it can improve your health now and well into the future.

References:

Campi, C. (2018, February). Anti-Aging Mechanisms of NAD+. Life Extension. https://www.lifeextension.com/magazine/2018/2/anti-aging-effects-of-nad

Danby F. W. (2010). Nutrition and aging skin: sugar and glycation. Clinics in dermatology, 28(4), 409–411. https://doi.org/10.1016/j.clindermatol.2010.03.018

Golbidi, S., Daiber, A., Korac, B., Li, H., Essop, M. F., & Laher, I. (2017). Health Benefits of Fasting and Caloric Restriction. Current diabetes reports, 17(12), 123. https://doi.org/10.1007/s11892-017-0951-7

Gómez, R., Mokhashi, M. H., Rao, J., Vargas, A., Compton, T., McCarter, R., & Chalew, S. A. (2002). Metformin adjunctive therapy with insulin improves glycemic control in patients with type 1 diabetes mellitus: a pilot study. Journal of pediatric endocrinology & metabolism : JPEM, 15(8), 1147–1151. https://doi.org/10.1515/jpem.2002.15.8.1147

Hu, D., Xie, F., Xiao, Y., Lu, C., Zhong, J., Huang, D., Chen, J., Wei, J., Jiang, Y., & Zhong, T. (2021). Metformin: A Potential Candidate for Targeting Aging Mechanisms. Aging and disease, 12(2), 480–493. https://doi.org/10.14336/AD.2020.0702

Lv, Z., & Guo, Y. (2020). Metformin and Its Benefits for Various Diseases. Frontiers in endocrinology, 11, 191. https://doi.org/10.3389/fendo.2020.00191

Whitten, A. (n.d.). What is Mitochondrial Dysfunction? Causes, Symptoms, and Treatment. The Energy Blueprint. https://theenergyblueprint.com/what-is-mitochondrial-dysfunction-causes-symptoms-and-treatment/

Zhao, M., Wang, Y., Li, L., Liu, S., Wang, C., Yuan, Y., Yang, G., Chen, Y., Cheng, J., Lu, Y., & Liu, J. (2021). Mitochondrial ROS promote mitochondrial dysfunction and inflammation in ischemic acute kidney injury by disrupting TFAM-mediated mtDNA maintenance. Theranostics, 11(4), 1845–1863. https://doi.org/10.7150/thno.50905

Researchers have identified two general sets of reactions for NAD+ in the human body. NAD+ helps turn nutrients into energy and transport that energy into cells (metabolism), and it assists proteins in regulating other critical biological activities. What kind of activities? NAD+ appears to reduce chemical stress and inflammation, repair DNA, regulate immune pathways, and decrease mitochondria dysfunction—all of which are imperative for maintaining health and youthfulness. For example, when mitochondria aren’t functioning well, people can experience a seizure, stroke, developmental delay, heart and kidney issues, and problems with speech, sight, digestion, and other functions. DNA damage is equally problematic to aging; it can lead to mutations and genomic instability that result in various cancers and other diseases. In these ways, NAD+ protects our energy-producing capacity while shielding us from chronic diseases.

Multiple studies demonstrate NAD+’s potential through nutritional supplementation. A key benefit is that NAD+ increases protein interactions, making old (damaged) tissue appear young again! These benefits could apply to the skin and internal tissues; however, the findings related to skin are incredibly encouraging. NAD+ mitigates skin damage due to UV sensitivity, skin cell death, DNA damage (leading to moles, freckles, blemishes, etc.), and even skin cancer.

Unsurprisingly, NAD+ is known to activate sirtuins, which are proteins that play a significant role in controlling aging and longevity. This association may help explain NAD+’s impact on age-related disease. Studies show that lower levels of NAD+ not only accelerate aging but promote metabolic disorders (diabetes, etc.), heart disease, muscle wasting, and cognitive decline. Keeping NAD+ levels high, therefore, has protective benefits, which the studies are demonstrating. Because aging and high-fat diets, for example, reduce the level of NAD+ in the body, studies in mice showed that NAD+ boosters could alleviate their diet-associated and age-related weight gain while improving exercise capacity, even in older subjects! Also, a 2019 study showed that NAD+ supplementation decreased systolic blood pressure and arterial stiffness.

What great news, since levels of NAD+ decrease substantially with age. By the age of 50, we may have only half of the NAD+ that we had at age 20; by the age of 80, the amount is only 10%. The good news is that we can restore NAD+ levels through a healthy diet, exercise, and proper supplementation. Since NAD+ is unstable, we cannot use it as a supplement. Thus, most NAD+ supplements are made from nicotinamide riboside—a precursor that the body can utilize to make NAD+. Research shows that supplementing with nicotinamide riboside boosts NAD+ levels, providing all the benefits noted above. For more impact, try an NAD+ infusion. Intravenous infusions, which we provide at Aesthetics Medical Spa, take longer to administer but offer better support and protection.

Exercise is another way to increase NAD+ naturally; daily workouts require more NAD+ for energy, and your body responds by producing it. From a dietary standpoint, focus on plant-based foods high in vitamin B, especially B3 (niacin)—another precursor to NAD+. These include avocado, asparagus, nutritional yeast, peanuts, mushrooms, whole grains (barley and buckwheat), millet and quinoa, potatoes, tomatoes, green peas, and sunflower seeds. All of these foods provide nicotinamide, the precursor to NAD+. Intermittent fasting can also stimulate the body’s production of NAD+, thereby slowing aging and promoting longevity. Read more about the benefits of fasting, and learn why fasting is a successful component of every anti-aging program.

In summary, keeping NAD+ levels high through supplementation and lifestyle modifications will benefit you in numerous ways. NAD+ not only shows tremendous potential for improving health but for increasing life span and slowing the aging process—something I think we all want to experience!  

References:

Faloon, W. (2017, September). New Resveratrol and NAD+ Suggestions. https://www.lifeextension.com/magazine/2017/9/new-resveratrol-and-nad-dosing-protocol

Imai, S., & Guarente, L. (2014). NAD+ and sirtuins in aging and disease. Trends in cell biology, 24(8), 464–471. https://doi.org/10.1016/j.tcb.2014.04.002

Kiss, T., Nyúl-Tóth, Á., Balasubramanian, P., Tarantini, S., Ahire, C., Yabluchanskiy, A., Csipo, T., Farkas, E., Wren, J. D., Garman, L., Csiszar, A., & Ungvari, Z. (2020). Nicotinamide mononucleotide (NMN) supplementation promotes neurovascular rejuvenation in aged mice: transcriptional footprint of SIRT1 activation, mitochondrial protection, anti-inflammatory, and anti-apoptotic effects. GeroScience, 42(2), 527–546. https://doi.org/10.1007/s11357-020-00165-5

Klarity Clinic. (n.d.). How to Increase your Body’s NAD+ Levels Naturally. https://www.klarityclinic.com/blog/how-to-increase-your-bodys-nad-levels-naturally

Levy, J. (2019, September 30). NAD Supplement Benefits & Ways to Increase Levels Naturally. https://draxe.com/nutrition/nad-supplement/

NMN.com. (n.d.). What Is NAD+, And Why Is It Important for Living Healthier and Longer? https://www.nmn.com/precursors/what-is-nad

Ruggeri, C. (2019, November 29). Nicotinamide Riboside: Effective Anti-Aging Supplement or Hype? https://draxe.com/nutrition/nicotinamide-riboside/

Surjana, D., Halliday, G. M., & Damian, D. L. (2010). Role of nicotinamide in DNA damage, mutagenesis, and DNA repair. Journal of nucleic acids, 2010, 157591. https://doi.org/10.4061/2010/157591

Blood sugar, or glucose, is the primary sugar found in the blood and the body’s main energy source. Glucose is created during the process of digesting food and is transported, through the blood, to all of the body’s cells to use for energy. Insulin—a hormone secreted by the pancreas—helps the glucose enter the cells. There are two possible diagnoses with glucose imbalances—hypoglycemia or hyperglycemia.

When blood sugar is too low, the diagnosis is hypoglycemia. Symptoms include fatigue, heart palpitations, paleness, irritability, sweating, shakiness, and anxiety. If untreated, hypoglycemia can lead to seizures and loss of consciousness.

If blood sugar is too high, on the other hand, the diagnosis is hyperglycemia, which is associated with diabetes. Symptoms include increased thirst, frequent urination, blurred vision, headache, fatigue, dry mouth, weakness, confusion, nausea, and vomiting. Persistent hyperglycemia also damages organs and tissues, which increases the risk of heart diseases and stroke, kidney disease, vision problems, and nerve problems. If untreated, hyperglycemia can lead to death.

In addition to increasing the risk of disease, hyperglycemia accelerates the creation of advanced glycation endproducts (AGEs). Advanced glycation endproducts are damaged fats and proteins that age body tissues (including the skin) and worsen degenerative diseases.

In addition to regulating blood sugar, how can metformin help? There are three specific ways:

• It increases the body’s sensitivity and response to insulin.
• It helps reduce the amount of glucose extracted from foods and absorbed into the bloodstream, so there is less glucose overall for the body to process.
• It reduces the total amount of glucose released by the liver, which leads to an overall reduction of glucose in the bloodstream.

Because metformin promotes better glucose utilization in the tissues, it reduces the accumulation of advanced glycation endproducts (AGEs). Metformin also protects critical molecules such as proteins and DNA while stimulating the production of glutathione—a powerful and crucial antioxidant—which inhibits the breakdown of tissues and aids in reducing cell damage. In this way, metformin demonstrates protective effects against osteoarthritis and cardiovascular concerns and has anti-cancer, anti-inflammatory effects. Additionally, metformin can assist in promoting gene repair, which is crucial for avoiding genetic disorders and diseases with a genetic component, like cancer, heart disease, and obesity. As an added benefit, people with diabetes who take metformin regularly experience a decrease in their total level of cholesterol and triglycerides.

And its benefits do not stop there. As it relates to the skin, metformin blocks the effects of progerin—a type of protein responsible, in part, for the unsightly signs of aging, such as sagging skin, fine lines, and wrinkles!

The idea for metformin dates back to medieval times. People ate the plant Galega officinalis, also known as Goat’s rue, or French lilac, to relieve frequent urination. However, the plant could be toxic, especially to livestock; so scientists began their search for a safer version. Eventually, in 1922, researchers in Dublin synthesized metformin or dimethyl biguanide. The new form was safe and easier on the digestive tract than earlier compounds but lost out to insulin in terms of the first-choice treatment of diabetes. This trend changed in the 1990s when research continued to show that metformin, used correctly, was safe and effective.

Who can benefit best from metformin today? The automatic answer is people with diabetes and anyone diagnosed with polycystic ovary syndrome and gestational diabetes. In 2008, a panel for the American Diabetes Association concluded that doctors should also consider metformin for patients who are severely obese or those with prediabetes—blood sugar above normal but not yet in range for diabetes. And because people who are taking metformin seem to have lower rates of pancreas, colon, and liver cancers, researchers are eagerly investigating metformin for cancer prevention. 

The main recommendation for preventing diabetes and other chronic health conditions is eating a high-quality plant-based diet, losing weight, getting plenty of sleep and exercise, and cultivating fulfilling relationships. Now, we have another tool that can help those who need even more support to lead a healthier life—metformin.  

References

Ehrenfeld, T. (2015, November 25). The History of the Diabetes Drug Metformin. Medhost. https://www.yourcareeverywhere.com/health-research/health-insights/diabetes-care-insights/the-history-of-the-diabetes-drug-metformin.html

Fletcher, M. (2020, February 10). How Your Body Handles Excess Glucose. https://www.livestrong.com/article/264767-how-is-excess-glucose-stored/

Gómez, R., Mokhashi, M. H., Rao, J., Vargas, A., Compton, T., McCarter, R., & Chalew, S. A. (2002). Metformin adjunctive therapy with insulin improves glycemic control in patients with type 1 diabetes mellitus: a pilot study. Journal of pediatric endocrinology & metabolism : JPEM, 15(8), 1147–1151. https://doi.org/10.1515/jpem.2002.15.8.1147

Hu, D., Xie, F., Xiao, Y., Lu, C., Zhong, J., Huang, D., Chen, J., Wei, J., Jiang, Y., & Zhong, T. (2021). Metformin: A Potential Candidate for Targeting Aging Mechanisms. Aging and disease, 12(2), 480–493. https://doi.org/10.14336/AD.2020.0702

Lv, Z., & Guo, Y. (2020). Metformin and Its Benefits for Various Diseases. Frontiers in endocrinology, 11, 191. https://doi.org/10.3389/fendo.2020.00191