The Effect of Exercise and Nicotinamide Riboside Muscle Health and Insulin Resistance in Survivors of Childhood Cancer

This trial studies the effect of exercise and nicotinamide riboside on muscle health and insulin resistance in adult survivors of childhood cancer with prediabetes (elevated blood sugar level that is not high enough to be considered diabetes). Nicotinamide riboside is a dietary supplement which is similar to vitamin B3. Information collected in this study may help the future development of regimens to improve metabolic outcomes such as muscle health and insulin resistance (when the body is not normally responding to insulin) in childhood cancer survivors.

Inclusion Criteria: * History of childhood cancer * History of prediabetes (HbA1c 5.7-6.4%) * In remission at time of enrollment * Time between completion of cancer-directed therapy and study entry: \>= 6 months * At least 18 years of age at time of enrollment * Able to access online exercise program at home * Ability to tolerate the prescribed resistance exercise program * English-speaking * Able to understand and sign the study specific informed consent form (ICF) Exclusion Criteria: * Taking a nicotinamide adenine dinucleotide (NAD)+ precursor in the two weeks prior to enrollment * Currently taking medication for hyperglycemia or diabetes * Females who are pregnant or planning to become pregnant * Currently recovering from an injury * Contraindication to magnetic resonance imaging (MRI) * Pacemaker