Panax ginseng Meyer supplementation and potential associations with telomere length and NAD+/NADH ratio in middle-aged adults: An exploratory study

ETHNOPHARMACOLOGICAL RELEVANCE: In terms of anti-aging, ginseng has the effect of "lightning the body and prolonging the life" since ancient times. Although Panax ginseng Meyer (ginseng) has demonstrated anti-aging associations in experimental studies, clinical validation of its impact on telomere length and nicotinamide adenine dinucleotide (NAD+)/Nicotinamide adenine dinucleotide (NADH) ratio in healthy middle-aged individuals remains lacking. AIM OF THE STUDY: Exploratory hypothesis-generating study on the association of ginseng on the telomere lengths and NAD+/NADH ratio of middle-aged adults. METHODS: This study enrolled overweight middle-aged adults aged 45-50 years (Body mass index, BMI >24 kg/m²), involving two cohorts: high-dose short-term (6 g/day, 7 days; n = 20) and low-dose long-term (3 g/day, 28 days; n = 30), then they were followed up at 21 or 28 days after the completion of medication, respectively. Blood samples were collected before and after supplementation, and follow-up period. The primary outcomes: leukocyte telomere length and the NAD⁺/NADH ratio. The secondary outcomes: protection of telomeres 1 (POT1) expression, nicotinamide phosphoribosyltransferase (NAMPT) activities of peripheral blood mononuclear cells (PBMCs), reactive oxygen species (ROS), malondialdehyde (MDA), advanced glycation end-products (AGEs) and lactic acid (LA) levels. and scores on clinical scales [e.g., Pittsburgh sleep quality index (PSQI), Ascertain dementia 8 (AD8), Fatigue scale-14 (FS-14), International index of erectile function-5 (IIEF-5), and Kupperman index)]. RESULTS: The high-dose and low-dose groups showed a significant association with increased telomere length, POT1 expression, NAD+/NADH ratio, and NAMPT activity. The two cohorts also showed a significant association with reduced levels of ROS, MDA, AGEs, and LA, as well as improved scores on all clinical scales. Furthermore, the beneficial effects of the above indicators persisted during the follow-up period. CONCLUSIONS: Ginseng supplementation is associated with telomere elongation and an increased NAD+/NADH ratio in middle-aged adults, and exerts beneficial effects on human overall health by improving potential biomarkers of aging.