The INTERACD+ consortium will study the preventive potential of nicotinamide adenine dinucleotide (NAD+) replenishment combined with exercise on obesity-related cardiometabolic syndrome. We aim to (1) uncover NAD+ and exercise-driven metabolic outcomes and mechanisms in a preclinical rat model of cardiometabolic syndrome, (2) analyze an existing prospective human cohort at cardiometabolic risk, and (3) perform a first-in-human pilot feasibility trial by combining an NAD precursor supplementation with exercise in patients at cardiometabolic risk.