Dietary nitrate intake is associated with muscle function in older women

Abstract

Background In younger individuals, dietary nitrate supplementation has been shown to improve short‐term vascular and muscle function. The role of higher habitual nitrate intake as part of a typical diet on muscle function in ageing has not been investigated. A cross‐sectional study of relationships between dietary nitrate and measures of muscle function in older community‐dwelling Australian women ( n = 1420, ≥70 years) was undertaken. Methods Participants completed a semi‐quantitative food frequency questionnaire assessing dietary intake over the previous year. Total nitrate from vegetables and non‐vegetable sources was calculated from a validated instrument that quantified the nitrate content of food recorded within the food frequency questionnaire. Handgrip strength and timed‐up‐and‐go (TUG) were assessed, representing muscle strength and physical function, respectively. Cut‐points for weak grip strength (<22 kg) and slow TUG (>10.2 s) were selected due to their association with adverse outcomes. Linear and logistic regressions were used to examine the relationship between total nitrate intake and muscle function measures. Results Mean ± standard deviation (SD) total nitrate intake was 79.5 ± 31.2 mg/day, of which 84.5% came from vegetables. Across the unadjusted tertiles of nitrate intake (<64.2 mg/day; 64.2 to <89.0 mg/day; ≥89.0 mg/day), women in the highest tertile had a 4% stronger grip strength and a 5% faster TUG performance compared with the lowest tertile. In multivariable‐adjusted models, each SD higher nitrate intake (31.2 mg/day) was associated with stronger grip strength (per kilogram, β 0.31, P = 0.027) and faster TUG (per second, β −0.27, P = 0.001). The proportion of women with weak grip strength (<22 kg) or slow TUG (>10.2 s) was 61.0% and 36.9%, respectively. Each SD higher nitrate intake (31.2 mg/day) was associated with lower odds for weak grip strength (OR 0.84, 95% CI 0.74–0.95, P = 0.005) and slow TUG (OR 0.86, 95% CI 0.76–0.98, P = 0.021). Compared with women in the lowest tertile of nitrate intake, women in the highest nitrate intake tertile had lower odds for weak grip strength (OR 0.65, 95% CI 0.49–0.87, P trend= 0.004) and slow TUG (OR 0.72, 95% CI 0.53–0.97, P trend = 0.044). Conclusions This investigation highlights potential benefits of nitrate‐rich diets on muscle strength and physical function in a large cohort of older women. Considering poor muscle strength and physical function is associated with a range of adverse health outcomes such as falling, fractures, cardiovascular disease, and mortality, increasing dietary nitrate, especially though vegetable consumption may be an effective way to limit age‐related declines in muscle function. ...

Sarcopenia and adverse health‐related outcomes: An umbrella review of meta‐analyses of observational studies

“…For healthy older populations, studies found that fish oil‐derived omega‐3 PUFA intake, high protein intake, resistance exercise training, and vitamin D3 supplements can be helpful for improving muscle mass and functions as well as preventing sarcopenia 61‐65 . Nitrate‐rich diets and oral nutritional support combined with exercise were also associated with better muscle functions 66,67 . Moreover, beta‐Hydroxy‐beta‐methylbutyrate supplements, high‐intensity resistance training, and dairy protein intake could be useful therapies for improving sarcopenia, and fat and fish dietary pattern might be associated with lower risk of sarcopenia in patients with GI cancer 68‐71 .…”

“…[61][62][63][64][65] Nitrate-rich diets and oral nutritional support combined with exercise were also associated with better muscle functions. 66,67 Moreover, beta-Hydroxy-beta-methylbutyrate supplements, high-intensity resistance training, and dairy protein intake could be useful therapies for improving sarcopenia, and fat and fish dietary pattern might be associated with lower risk of sarcopenia in patients with GI cancer. [68][69][70][71] Although drug therapies such as testosterone, myostatin antibodies, and activin receptor antibodies might have potential effects on sarcopenia treatment, 72 and recently a randomized controlled study reported that treatment with bimagrumab over 16 weeks increased muscle mass and strength in older adults with sarcopenia.…”

Nutrition in the spotlight in cachexia, sarcopenia and muscle: avoiding the wildfire

“…We selected articles investigating nutrition interventions, macronutrient intake below recommended, and micronutrient deficiency. We found 26 articles: 10 clinical trials, 3,25–33 five cross‐sectional studies, 34–38 three experimental animal studies 39–41 (one of which also included a human cross‐sectional analysis 38 ), three narrative reviews, 6,42,43 two retrospective studies, 44,45 two systematic reviews or meta‐analyses, 46,47 and one questionnaire survey 48 . Within the 320 original and review articles published in 2018, 2019, and 2020 in JCSM , the 26 articles on nutrition that we found comprise approximately 8%.…”

“…Seven studies 25,27–30,32,33 investigated the effects of multimodal interventions (defined as two or more approaches) on muscle mass. Articles also explored the associations of protein intake, 46,47 iron deficiency, 37,42 micronutrients, 35 calorie restriction, 43 nitrate dietary intake, 36 retrospective evaluation of early dietary supplementation, 44 and overall dietary intake and patterns 34 with several clinical outcomes and/or biomarkers of sarcopenia or cachexia. Two studies evaluated the perceptions of oncology patients regarding disease‐related nutritional issues and barriers to effective nutritional interventions 45,48 .…”

Dietary nitrate and population health: a narrative review of the translational potential of existing laboratory studies

“… Liu et al [ 108 ] 2900 Prospective (Blue Mountains Eye Study) 15 FFQ CVD mortality In multivariable-adjusted analysis, participants in quartile 4 [> 137.8 mg/d; HR 0.63 (95% CI 0.41, 0.95)] of vegetable NO 3 − intake had lower hazards for CVD mortality compared to participants in quartile 1 (< 69.5 mg/d) Mendy et al [ 109 ] 17,618 Prospective (NHANES) 4.3 Urinary NO 3 − in spot urine samples Hypertension and CVD prevalence and all-cause mortality 1-unit increase in log-transformed urinary NO 3 − was associated with a > 30% decrease in the odds of hypertension (odds ratio, 0.67; 95% confidence interval [CI], 0.55–0.81), stroke (OR, 0.61, 95% CI, 0.43–0.87) and cardiovascular mortality (HR, 0.44; 95% CI, 0.26–0.73) Jackson et al [ 110 ] 5324 Prospective (Australian Longitudinal Study on Women’s Health) 15 FFQ Incidence of self-reported CVD-related complications Women reporting higher total dietary NO 3 − intakes (Q4 > 78.2 mg/d) and vegetable NO 3 − intakes (Q4 > 64.4 mg/d) were 25 and 27% reduced risk of developing CVD-related complications, respectively. Jackson et al [ 111 ] Nurses’ Health Study and Health (62,535 women) Prospective 26 FFQ Coronary heart disease Dietary NO 3 − intake was not related to risk of CHD after adjustment for other lifestyle and non-vegetable dietary factors Sim et al [ 112 ] 1420 Cross-sectional (Perth Longitudinal Study of Aging in Women) – FFQ Hand-grip strength and time up and go (TUG) Higher NO 3 − intake (31.2 mg/d) was associated with lower odds for weak grip strength (OR 0.84, 95% CI 0.74–0.95, P = 0.005) and slow TUG (OR 0.86, 95% CI 0.76–0.98, P = 0.021) Riddell et al [ 113 ] 2656 Prospective 1.5 Urinary NO 3 − to creatinine ratio (uNCR) Prediction of renal transplant rejection Overall uNCR was h...…”