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The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis

Konstantinos Prokopidis, Frank Moriarty, Gülistan Bahat, Joseph McLean, David D Church, Harnish P Patel
Journal of Cachexia, Sarcopenia and Muscle 2025 16(3):e13799

Bibliography

PubMed
PMID 40275690
PubMed Central
PMC12022230
DOI
10.1002/jcsm.13799
Funding
The authors reported no specific funding for this work.
Competing interests
Use the journal's full disclosure for author-specific relationships; no specific study funding was reported. The synthesis includes both NMN and NR trials and should not be read as an NMN-only meta-analysis.

Study snapshot

DesignSystematic review and random-effects meta-analysis of randomized controlled trials comparing NMN or NR with placebo; NMN outcomes analyzed separately where data permitted.
ModelAdults with mean study ages 60.9–83 years; NMN and NR randomized placebo-controlled trials.
SampleNMN pooled analyses included 3 studies for skeletal muscle index, 5 for left/right handgrip, 4 for gait speed and 2 for five-chair-stand, with narrative synthesis of additional functional outcomes.
InterventionNMN or NR supplementation versus placebo in older adults; dose and duration varied across included RCTs.
DurationVaried across included trials.
EndpointsSkeletal muscle index; Handgrip strength; Gait speed; Five-chair-stand test; Knee extension strength; Short Physical Performance Battery; Timed Up and Go; Six-minute walking distance; Thigh muscle mass

What the study showed, in plain terms

This 2025 meta-analysis asked whether NAD+ precursors preserve muscle mass or physical function in older adults. For NMN specifically, pooled analyses found no significant improvement in skeletal muscle index, handgrip strength, gait speed or five-chair-stand performance.

Narrative analyses also did not support improvements in knee-extension strength, Short Physical Performance Battery scores or thigh muscle mass with NMN.

The paper is especially useful because it counters a common marketing mistake: individual positive gait or walking findings do not add up to established sarcopenia treatment when trials are pooled.

Key findings

  • NMN did not significantly improve skeletal muscle index: MD -0.42, 95% CI -0.99 to 0.14, p=0.14.
  • NMN did not significantly improve left or right handgrip strength.
  • NMN did not significantly improve gait speed: MD -0.01, 95% CI -0.08 to 0.06, p=0.79.
  • NMN did not significantly improve five-chair-stand performance.
  • Narrative synthesis found no consistent NMN benefit for knee-extension strength, SPPB or thigh muscle mass.
  • The authors concluded that current evidence does not support NMN or NR for preserving muscle mass and function in older adults.

What this study can and cannot tell us

The review pools two different NAD+ precursors, NMN and NR, although key NMN outcomes were reported separately. It should therefore not be described as an NMN-only meta-analysis.

The NMN evidence base remains small, and endpoint-specific meta-analyses include only two to five studies. Differences in dose, participant health and outcome measurement limit precision.

Results apply to older-adult muscle mass/function outcomes and do not rule out effects in younger athletic populations or other functional endpoints.

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Dr. Khaled Mahmoud, MBBChCritical Care Medicine, Longevity Science & Editorial Direction Dr. Amr Yasser, PhDCardiometabolic, Musculoskeletal, Gut & Bioavailability Dr. Abdulla Mostafa, PhDCellular Senescence, Neurological, Mitochondrial & Brain-Ageing Biology