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People are living longer than ever before. But research shows that, for many of us, our health is often not sustained long enough to live those extra years to the fullest.

Here, we explore the concept of healthspan, and how optimizing your body’s natural resources can help you live in better health for longer.

What is healthspan?

Healthspan is the period of life spent in good health free from the chronic diseases and disabilities of aging.

Until the late 20th century, lifespan was the gold-standard indication of a life well lived. We have all read media articles celebrating people living to 100. But what of the many centenarians whose independence and freedom have been hampered by decades of health issues? Optimal longevity (living long, but well) can only be achieved if you remain active, productive and physically and cognitively fit as you grow older.

As scientific understanding of the aging process has advanced, so has the concept of healthspan and its role in sustaining our wellbeing and vitality.

We now have a more complete understanding of the diseases and disabilities that affect us as we grow older. Diabetes, joint pain, cognitive decline, heart problems; in addition to treating these and other age-related conditions, we now also seek to prevent their onset or ease their severity by addressing factors that drive aging itself.

This holistic perspective has shifted the focus of all those who are concerned with us aging well. Scientists, health professionals, communities, as well as you and me, all now accept that the quality of our years is just as important as the quantity.

Why is healthy aging important?

The fact that much of the developed world has an aging population has implications for us all. Between the beginning of the twentieth century and 1980 global life expectancy more than doubled. Although this rapid acceleration has slowed a little in developed countries, global life expectancy still increased by more than six years between 2000 and 20191. The World Health Organization estimates that the number of people above 60 years of age will be 1.2 billion by 2025 and two billion by 20502.

Unfortunately, healthspan has not kept pace with increases in longevity. If you experience your later years in good health, your ability to do the things you value will benefit communities and economies. But if these years of additional lifespan are marked by declines in physical and mental capacities, the implications for yourself and society may be much more negative.

Rapidly aging societies across the world are being hit hard by increasing human and economic costs of age-related diseases3. Long-term medical treatment also places a significant emotional burden on older adults4 as chronic conditions often force people to adjust their aspirations, lifestyle and employment.

Clearly, remaining in good health for as long as possible is desirable not just for your own wellbeing, but from multiple personal, social and financial perspectives, too. It’s never too early to start on the journey to better health now, and for the years ahead.

NAD+ and healthy aging

Healthy habits can take many forms. But it’s not just about diet and exercise. Your cellular health has perhaps the most powerful influence on how you look and feel.

Your cells control how you move, how your body functions, how you think and how you age. The more you can do to ensure your cells are in good working order, the better your short and long-term health is.

One of the most promising paths for promoting healthy aging is to support cellular health with NAD+.

NAD+ (nicotinamide adenine dinucleotide) is a naturally occurring molecule found in all living cells. It is responsible for key cellular and metabolic functions, and has been shown to play a vital role in more than 300 biological processes5 that keep your body running well.

Despite its critical importance to your health and aging, levels of NAD+ decline as you get older. By age 45, you have about half the NAD+ you had at 20. Research has shown that maintaining levels of NAD+ throughout your life can have profound effects on your wellbeing – particularly when it comes to some of the most common and costly age-related diseases and conditions that compromise health in adults.

Heart health

Cardiovascular disease is the leading cause of mortality worldwide, and getting older is a direct risk factor for the disease6.

NAD+ has been shown to improve cardiovascular functions in humans. Studies have shown that disturbances in NAD+ in heart muscle are linked to dysfunction in the failing heart. Research indicates that stabilizing NAD+ levels is likely a promising strategy to improving cardiac function7, and may be linked to beneficial impacts on heart conditions8.

Muscle repair

After age 30, you begin to lose around 3% to 8% of your muscle mass per decade. The rate of decline is even higher after the age of 609. Less muscle means greater weakness and less mobility, reduced strength and exercise capacity, and increased risk of falls and fractures later in life.

NAD+ (and the healthy mitochondria to which NAD+ is essential) is required by your muscles to generate the energy they need to contract and relax. Multiple studies have shown that restoring reduced NAD+ levels can help maintain muscle function10,11.

Energy creation

One of the main roles of NAD+ is energy production. It carries electrons from one place to another, which makes it essential to creating not just the energy that helps you move throughout the day, but also the energy that powers the entire network of systems and organs which keep you alive and well.

The cellular ‘respiration’ process of turning nutrients into energy using NAD+ is the foundation of a healthy metabolism. In other words, NAD+ is the beginning of every energy-driven process that maintains health in your body.

Inflammation and immunity

As you age your immune system declines. You can get sick more easily, and it becomes harder to bounce back from illnesses. Because NAD+ declines with age, your body’s ability to manage the chronic and low-grade inflammation (called inflammaging; a key driver of many age-related diseases like hypertension, diabetes, atherosclerosis, and cancer12) is lessened.

Multiple studies have demonstrated that regulating NAD+ levels could be an effective strategy to control inflammaging. It has also been shown to help regulate diseases driven by chronic inflammation, such as neurodegenerative diseases and some cancers13,14,15.

Brain health

As you get older, particularly from middle age onwards, changes can start to occur within the brain that may trigger a gradual decline in mental capabilities. This is known as age-related cognitive decline, and it typically results in people becoming more forgetful and less mentally sharp. In severe instances, it can lead to dementia.

NAD+ has been shown to play important roles in metabolic processes in your brain. It has positive effects on brain function such as transmitting messages between cells, learning, and memory16 – all vital aspects of robust cognitive health.

Insulin sensitivity

Insulin is an important hormone that controls many bodily processes. However, insulin problems are at the heart of many modern health conditions. When your cells stop responding properly to insulin it can disrupt the balance of blood sugar levels. This can lead to the onset of type 2 diabetes, which in turn can result in other complications like heart and blood vessel disease, eye damage, kidney conditions, and more.

Treatment with NMN, a molecule your body uses to create NAD+, has been shown to substantially improve insulin sensitivity in pre-diabetic humans17. It has also been shown to reduce insulin sensitivity in subjects with age-related diabetes18,19. These results highlight NMN as an effective path for correcting declines in the way your body responds to insulin as you get older.

DNA repair

We aren’t superheroes. But when your body operates like it should, its innate ability to repair itself sometimes borders on a superpower.

Encoded within your DNA are numerous processes that detect and repair damage inflicted by environmental and internal forces throughout your life. Yet, as good as your body is at repairs, the fix is not always perfect, and damage accumulates. Over time, repair systems fail to correct all the DNA damage and the result is aging and disease.

NAD+ is essential to DNA repair. The proteins in charge of the process use NAD+ as fuel to perform their vital functions20. When NAD+ is plentiful, it can also prevent the action of some proteins that meddle with your body’s ability to mend damaged DNA21. If NAD+ is not present in cells to stop this harmful interaction or to fuel repair, DNA breaks are not fixed. This can lead to cellular damage which drives the aging process itself.

How to boost NAD+ for healthy aging

Whether you’re old, young, or somewhere in between, your body is constantly using NAD+. Given that it is so important for our wellbeing, a logical question is why can’t we just increase NAD+ intake?

Unfortunately, NAD+ can’t be used as a direct supplement because it is not easily absorbed. It is too large to freely enter cells and is therefore unavailable to be used by your body in all the processes that benefit your health and aging.

The next best thing is NMN (nicotinamide mononucleotide). Like NAD+, NMN is a natural molecule that occurs in all life forms. Nicotinamide mononucleotide is the final step in the biological pathway your body uses to make NAD+.

Supplementing with NMN increases the amount of NMN available for your body to create more NAD+. Replenishing NAD+ with NMN has been shown in a growing number of clinical and preclinical studies to be a promising therapeutic strategy to counter age-associated diseases22 and support the foundations of your health.

Better health, for longer

Of course, boosting NAD+ with NMN is not the only approach to improving your healthspan. Tried and true lifestyle factors like exercise, diet, and a positive outlook continue to be prescribed by health professionals because they’re simple, accessible to all – and they work.

Dr. Eric Verdin – the Chair of Elevant’s Scientific Advisory Board and President of the Buck Institute for Research on Aging in California – says exercise is ‘the best and safest anti-aging medicine that we have today’. Wellbeing starts with making healthy choices, and an overwhelming body of scientific evidence shows that it’s never too soon to forge healthy habits that will deliver benefits decades from now.

Long healthspan means you have the health and energy to live life to the fullest. To be able to chase grandkids, experience new places, ride a bike, enjoy interacting with friends and family, even continue working if you want to. Health that lasts as long you do – this the true healthy aging we all hope to experience.

Health that lasts a lifetime

Get the support you need for optimal health and energy now, and for the years ahead.

Elevant NMN supplements work to replenish NAD+ levels which decline rapidly from age 30, helping to promote cellular health, restore vitality and defend against the hallmarks of aging.

• Support bodywide health
• Maintain energy
• Promote healthy aging
• Fuel an active, healthy lifestyle

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References

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2.  World Population Ageing report 2015 - United Nations. the United Nations. Published 2015. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pd

3.  Campisi J, Kapahi P, Lithgow GJ, Melov S, Newman JC, Verdin E. From discoveries in ageing research to therapeutics for healthy ageing. Nature. 2019;571(7764):183-192. doi:10.1038/s41586-019-1365-2

4.  Turner J, Kelly B. Emotional dimensions of chronic disease. West J Med. 2000;172(2):124-128. doi:10.1136/ewjm.172.2.124

5.  Sahar S, Nin V, Barbosa MT, Chini EN, Sassone-Corsi P. Altered behavioral and metabolic circadian rhythms in mice with disrupted NAD+ oscillation. Aging (Albany NY). 2011;3(8):794-802. doi:10.18632/aging.100368

6.  Hong W, Mo F, Zhang Z, Huang M, Wei X. Nicotinamide Mononucleotide: A Promising Molecule for Therapy of Diverse Diseases by Targeting NAD+ Metabolism. Front Cell Dev Biol. 2020;8:246. doi:10.3389/fcell.2020.0024

7.  Walker MA, Tian R. Raising NAD in Heart Failure: Time to Translate?. Circulation. 2018;137(21):2274-2277. https://dx.doi.org/10.1161%2FCIRCULATIONAHA.117.032626

8. Vignier N, Chatzifrangkeskou M, Morales Rodriguez B, et al. Rescue of biosynthesis of nicotinamide adenine dinucleotide protects the heart in cardiomyopathy caused by lamin A/C gene mutation. Hum Mol Genet. 2018 Nov 15;27(22):3870-3880. https://doi.org/10.1093/hmg/ddy278

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10. Romani M, Sorrentino V, Oh CM, et al. NAD+ boosting reduces age-associated amyloidosis and restores mitochondrial homeostasis in muscle. Cell Rep. 2021;34(3):108660. https://doi.org/10.1016/j.celrep.2020.108660

11. Ryu D, Zhang H, Ropelle ER, et al. NAD+ repletion improves muscle function in muscular dystrophy and counters global PARylation. Sci Transl Med. 2016;8(361):361ra139. https://doi.org/10.1126/scitranslmed.aaf5504

12. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22(2):119-141. doi:10.1038/s41580-020-00313-x

13. Covarrubias AJ, Kale A, Perrone R, et al. Senescent cells promote tissue NAD+ decline during ageing via the activation of CD38+ macrophages. Nat Metab. 2020;2(11):1265-1283. doi:10.1038/s42

14. Minhas PS, Liu L, Moon PK, et al. Macrophage de novo NAD+ synthesis specifies immune function in aging and inflammation. Nat Immunol. 2019;20(1):50-63. doi:10.1038/s41590-018-0255-3

15. Elhassan YS, Kluckova K, Fletcher RS, et al. Nicotinamide Riboside Augments the Aged Human Skeletal Muscle NAD+ Metabolome and Induces Transcriptomic and Anti-inflammatory Signatures. Cell Reports. 2019;28(7):1717-1728.e6. doi:10.1016/j.celrep.2019.07.043

16. Qin W, Yang T, Ho L, Zhao Z, Wang J, Chen L, Zhao W, Thiyagarajan M, MacGrogan D, Rodgers JT, Puigserver P, Sadoshima J, Deng H, Pedrini S, Gandy S, Sauve AA, Pasinetti GM. Neuronal SIRT1 activation as a novel mechanism underlying the prevention of Alzheimer disease amyloid neuropathology by calorie restriction. J Biol Chem. 2006 Aug 4;281(31):21745-21754. doi: 10.1074/jbc.M602909200. Epub 2006 Jun 2. PMID: 16751189.

17. Yoshino M, Yoshino J, Kayser BD, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. Published online April 22, 2021. doi:10.1126/science.abe9985

18. Basu R, Breda E, Oberg AL, et al. Mechanisms of the age-associated deterioration in glucose tolerance: contribution of alterations in insulin secretion, action, and clearance. Diabetes. 2003;52(7):1738-1748. doi:10.2337/diabetes.52.7.1738

19. Yoshino J, Mills KF, Yoon MJ, Imai S. Nicotinamide mononucleotide, a key NAD(+) intermediate, treats the pathophysiology of diet- and age-induced diabetes in mice. Cell Metab. 2011;14(4):528-536. doi:10.1016/j.cmet.2011.08.014

20. Wilk, A., Hayat, F., Cunningham, R. et al. Extracellular NAD+ enhances PARP-dependent DNA repair capacity independently of CD73 activity. Sci Rep 10, 651 (2020). https://doi.org/10.1038/s41598-020-57506-9

21. Jun Li, Michael S. Bonkowski, Sébastien Moniot, Dapeng Zhang, Basil P. Hubbard, Alvin J. Y. Ling, Luis A. Rajman, Bo Qin, Zhenkun Lou, Vera Gorbunova, L. Aravind, Clemens Steegborn, David A. Sinclair. A conserved NAD+ binding pocket that regulates protein-protein interactions during aging. SCIENCE24 MAR 2017 : 1312-1317. https://doi.org/10.1126/science.aad8242

22. Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol. 2021;22(2):119-141. doi:10.1038/s41580-020-00313-x