Effect of "Nicotinamide Mononucleotide" (NMN) on Cardiometabolic Function

This study is is looking at the effect of the dietary supplement "Nicotinamide
mononucleotide" (NMN) on key cardiovascular and metabolic functions, specifically those that
are important risk factors for diabetes and cardiovascular disease. Accordingly, the
investigators will evaluate the effect of NMN on how well (a) the hormone insulin works to
control blood sugar, (b) the body produces insulin, and (c) blood vessels dilate (get wider).
The investigators will also look at the effects of NMN on blood lipids; body fat and liver
fat; and other blood, fat tissue and muscle tissue markers of cardiovascular (heart) and
metabolic health. Data from studies conducted in rodents have shown that NMN supplementation
has beneficial effects on cardiovascular and metabolic health, but this has not yet been
studied in people.

Inclusion Criteria:

- Postmenopausal women 55-75 years old

- BMI 25.0-44.9 kg/m2

- Fasting plasma glucose concentration ≥100 mg/dl, OGTT 2 hour glucose ≥ 140 mg/dl or
HbA1C ≥5.7%

Exclusion Criteria:

- Diabetes

- Premenopausal or menopause <1 year

- Persons who have received hormone replacement therapy within the past 6 months

- Persons who take vitamin B supplementation and are not willing to discontinue
supplementation for 3 weeks before and during the entire study period.

- Structured exercise: ≥75 min/wk of vigorous exercise (e.g., jogging, activity that
causes heavy breathing and sweating) or ≥150 min/wk of low intensity physical activity
(e.g., brisk walking).

- Unstable weight (>3% change during the last 2 months before entering the study)

- Significant organ system dysfunction or disease

- Present cancer or history of cancer that has been in remission for <5 years

- Polycystic ovary syndrome

- Major psychiatric illness

- Use of medications known to affect study outcome measures (e.g., steroid) or increase
the risk of study procedures (e.g., anticoagulants) that cannot be temporarily
discontinued for the study

- Metal implants

- Smokes cigarettes

- Persons who consume >14 units of alcohol per week

- Unable or unwilling to follow the study protocol or who, for any reason, is considered
an inappropriate candidate for the study by the research team.