Show Notes
🧬 NAD: The Molecule of Life — and the Hype How a lab coenzyme became the latest anti-aging obsession
What We Mean by Longevity and Healthspan When people talk about longevity, they usually mean how long we live. But healthspan — the years we live well — matters far more. That’s the time before disease steals our energy, mobility, and independence. Modern medicine has already doubled our lifespan in the last century. Now the goal is to extend the healthy part — without falling for pseudoscience along the way.
When Marketing Meets Medicine Longevity has become a booming business. Some gurus, like Dr. Eric Topol, do real science. Others, like Peter Attia, sell access: $150 000 per patient for lab tests, a VO₂ max treadmill run, and a few “optimized” workouts. He’s also an investor in AG1 — the influencer’s green drink of choice. Andrew Huberman promotes similar ideas under studio lights bright enough to sterilize a petri dish. Both are clever, credentialed, and caught between data and drama. Then there’s Dr. David Sinclair, who helped discover how cells age — and then helped turn that discovery into a supplement empire. His company tried to patent NMN, an NAD precursor, as a drug. The FDA briefly removed NMN from the supplement market, sending Reddit into meltdown. It’s back now, but the episode showed how quickly science slides into sales. And finally, we have the shirtless salesmen: Paul Saladino, who went from carnivore crusader to “fruit influencer.” Liver King, whose real secret wasn’t liver — it was injectable. And Gary Brecka, who claims to predict your death date (for a fee). These are subscription services disguised as sages.
What NAD Actually Is Nicotinamide adenine dinucleotide (NAD⁺) is a molecule found in every living cell. It helps convert food into energy and repair DNA. As we age, NAD levels fall — metabolism slows and damage builds up. So scientists asked: If we raise NAD again, can we slow aging? In mice, the answer looks promising. NAD precursors like nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) increase average lifespan by 5–15 percent and improve energy, insulin sensitivity, and activity. That’s great for mice — but we don’t live in cages or eat lab chow.
Can You Get NAD from Food? Not directly — but your body makes NAD from dietary precursors: tryptophan and niacin (vitamin B₃). You’ll find them in fish, poultry, beans, milk, and whole grains — basically, a Mediterranean-style diet. So before spending $90 on capsules, you can spend $9 at the farmers' market.
What the Human Studies Show Human trials of NR or NMN (usually 500–2000 mg per day for 6–12 weeks) show they are safe and well-tolerated. They modestly raise NAD levels and sometimes improve lipid profiles and blood pressure. But the effects are small and inconsistent, especially in healthy adults. NAD precursors do not reverse aging. They don’t prevent heart attacks or extend lifespan in people — at least, not yet.
NAD vs Statins: A Reality Check Meta-analyses show NAD precursors, especially niacin, can lower LDL (“bad”) cholesterol by about 8–12 percent. That’s fine, but compare it to rosuvastatin (Crestor): DoseAverage LDL Reduction5 mg≈ 45 %10 mg≈ 52 %20 mg≈ 55 %40 mg≈ 63 % That’s the difference between “interesting biochemistry” and “fewer funerals.” So NAD may nudge your cholesterol; statins save lives.
Who Might Benefit Older adults with metabolic syndrome, prediabetes, or early neurodegenerative disease could see modest improvements in inflammation or blood lipids. Younger, healthier people mostly see lighter wallets. No serious drug interactions have been documented, though theoretical ones exist with some chemotherapy or DNA-repair drugs. As always, talk to your doctor before combining anything with prescription therapy.
Food Before Pharma The best way to support NAD and longevity is still food, sleep, and movement. A Mediterranean diet rich in legumes, vegetables, olive oil, and fish fuels NAD pathways naturally — a
More from Fork U with Dr. Terry Simpson
With all the spices we have access to, it is amazing how bland recipes have become. I have many cookbooks, some from great chefs, television personalities, and friends. What I am always surprised by is how bland the food has become. People seem to think a bit of salt, pepper, maybe onions, and garlic provide the spices one needs. Perhaps it is because some associate spice with heat. Mostly because many have never experimented with some of those great warm spices available. A pinch of coriander, some freshly ground cumin, a little cardamom, or a touch of cinnamon can turn an ordinary dish into something remarkable. And the most astonishing part is that these spices financed voyages around the world, built cities, created fortunes, and caused people to kill one another. Without the spice trade, it is safe to say that the United States, as we know it, would be vastly different from what it is now. The money loaned to the United States, when we were a fledgling country, came from the wealthy spice merchants from what was considered one of the great hyperempires of the world, based in Amsterdam. But before we go to the birth of the United States, let me take you to the meatball.
Tea: The Drink That Built an Empire—and Helped Break One China had the tea. Britain had the appetite. John Hancock had a business to protect.
MesoAmerica and Chocolate In our series looking at foods that built civilizations, today we are going to stay in the Americas with chocolate. Chocolate has been used as currency, consumed by kings, incorporated into religious ceremonies, and prescribed as medicine. Today, it is a multibillion-dollar industry that wants you to believe that eating chocolate is an act of preventive cardiology. I mean, why not? They convinced us to give chocolate to people we love, eat it when we are happy, when we are sad, when only the dog understands us. Don’t feed chocolate to your dog. And we have done all this with a bitter seed that most of us would probably spit out if we tasted it straight from the tree.
I’ve been doing a series about foods that built civilizations. In this episode, we are talking about the potato. It is difficult to imagine that thousands of years ago, people constructed large buildings, managed rivers, built monuments, and created art. We have glimpses of these civilizations through stories, archaeology, and the structures they left behind, but much of their history has been lost. Imagine, we don’t even know where Cleopatra or Alexander the Great are buried, yet we know their stories. As European powers conquered Indigenous peoples, their languages, cultures, and oral traditions were suppressed. When a language disappears, so are the stories preserved within it. Our clues come from archaeology when we uncover a monument, a building, or an ancient settlement. In the Andes, the potatoes they cultivated were not the Russets, Yukon Golds, or fingerlings you find in the store today. Different colors, shapes, and textures. Adapted to survive the elevations, temperatures, and growing conditions. Biodiversity protected their food supply against frost, disease, and changing environmental conditions. If one variety failed, another might survive. The ancient wisdom of diversity that Andean farmers developed over thousands of years was lost when the potato eventually reached Ireland.
In our series about foods that built civilization, we talked a lot about grains, from wheat to corn to rice. Today, we are taking you to the ocean, with the civilizations that salmon built. From California to the interior of Alaska, salmon, a staple, allowed people to settle into villages, develop complex social networks, art, and trade routes. Those trade routes are as large as the ones in the Mediterranean. Some tribes built communal homes and developed complex art and language. Some were Seafaring tribes with canoes up to 60 feet long that traveled across oceans. All because there was a fish that would return in large numbers to streams and rivers, reliably, predictably. So predictable, the people could build their lives around salmon runs. So much so that some built a calendar not only with lunar cycles, but also with the return of the salmon. Civilizations have always gathered around food and water. The Mediterranean connected people who grew wheat and olives, giving people time to make wine, mine copper, build ships, trade with their neighbors, and occasionally go to war with them. Asia had rice and grain near the great river systems. The reliable calories from rice and grains allowed villages to become cities and to travel by water to trade. Today we are going to my home, from the Ventura River in California to my home state of Alaska.