Cross-Sectional Associations between Dietary Daily Nicotinamide Intake and Patient-Reported Outcomes in Colorectal Cancer Survivors, 2 to 10 Years Post-Diagnosis

Abstract

Supplementation with nicotinamide adenine dinucleotide (NAD+) precursors including dietary nicotinamide has been found to boost tissue NAD+ levels and ameliorate oxidative stress-induced damage that contributes to aging and aging-related diseases. The association between dietary NAD+ precursors and patient-reported health-related outcomes in cancer survivors has not been investigated. This study aimed to determine associations of dietary nicotinamide intake with different patient-reported outcomes in colorectal cancer survivors, 2 to 10 years post-diagnosis. A total of 145 eligible participants were recruited into this cross-sectional study. Dietary nicotinamide intake level was calculated based on data from 7-day food diaries. Fatigue was assessed with the Checklist Individual Strength (CIS), which is a subscale of the cancer-specific European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC), and anxiety and depression were assessed with Hospital Anxiety and Depression Scale (HADS). Oxidative stress marker serum protein carbonyl contents and serum NAD+ levels were measured. A hierarchical linear regression model with confounder adjustment was performed to analyze the association of nicotinamide intake, serum protein carbonyl contents, and NAD+ levels with patient-reported outcomes. The median values of daily nicotinamide intake for male and female participants were 19.1 and 14.4 mg, respectively. Daily dietary nicotinamide intake was associated with a lower level of fatigue (β: −14.85 (−28.14, −1.56)) and a lower level of anxiety and depression (β: −4.69 (−8.55, −0.83)). Subgroup analyses by sex showed that a beneficial association between nicotinamide intake and patient-reported outcomes was mainly found in men. To conclude, our findings suggested that higher dietary NAD+ precursor nicotinamide intake was cross-sectionally associated with less patient-reported outcomes in CRC survivors.

Effects of Lifestyle Interventions on Health and Life Quality of Colorectal Cancer Survivors

“…It is reported that CRC survivors who received a dietary intervention had significantly lower levels of depression, but no significant changes in the levels of anxiety 28 . A study finds that dietary daily nicotinamide reduced the levels of anxiety and depression in men 56 . However, the results of this study showed that there were no significant differences in the levels of depression and anxiety between the lifestyle intervention group and the control group.…”

“…28 A study finds that dietary daily nicotinamide reduced the levels of anxiety and depression in men. 56 However, the results of this study showed that there were no significant differences in the levels of depression and anxiety between the lifestyle intervention group and the control group. Small sample size and ceiling effects may have limited the ability of the included studies to detect the improvement of depression and anxiety.…”

Effect of 12-Week Intake of Nicotinamide Mononucleotide on Sleep Quality, Fatigue, and Physical Performance in Older Japanese Adults: A Randomized, Double-Blind Placebo-Controlled Study

“…The second human clinical study investigated the effects of NMN intake (250 mg/day) in obese postmenopausal women with prediabetes (NMN = 13, placebo = 12) for 10 weeks in a randomized, placebo-controlled, double-blind trial, reporting that significant improvement was found in protein kinase AKT, mTOR protein, and insulin sensitivity, whereas no significant changes were found in grip strength, fatigability, and recovery from the fatiguing exercise of the leg [23]. On the contrary, in a cross-sectional study, daily intake of dietary nicotinamide, which has a different salvage pathway from NMN, was reported to be significantly associated with not only higher grip strength but also lower subjective fatigue in colorectal cancer survivors [33]. In this study, despite the non-significant change in grip strength, NMN intake in the afternoon was effective in improving drowsiness among several factors of subjective fatigue.…”