Dietary Nitrates, Nitrites, and Cardiovascular Disease

Abstract

Dietary nitrate (NO(3)), nitrite (NO(2)), and arginine can serve as sources for production of NO(x) (a diverse group of metabolites including nitric oxide, nitrosothiols, and nitroalkenes) via ultraviolet light exposure to skin, mammalian nitrate/nitrite reductases in tissues, and nitric oxide synthase enzymes, respectively. NO(x) are responsible for the hypotensive, antiplatelet, and cytoprotective effects of dietary nitrates and nitrites. Current regulatory limits on nitrate intakes, based on concerns regarding potential risk of carcinogenicity and methemoglobinemia, are exceeded by normal daily intakes of single foods, such as soya milk and spinach, as well as by some recommended dietary patterns such as the Dietary Approaches to Stop Hypertension diet. This review includes a call for regulatory bodies to consider all available data on the beneficial physiologic roles of nitrate and nitrite in order to derive rational bases for dietary recommendations.

Long-term processed and unprocessed red meat consumption and risk of heart failure: A prospective cohort study of women

“…The results are, however, inconsistent with respect to CVD -recent review articles highlighted that total dietary nitrite and nitrate may have cardiovascular protective properties [18] by lowering blood pressure and by having antiplatelet and cytoprotective effects [19]. In contrast, some studies indicated that high concentration of nitrites in diet is related to endothelial dysfunction and impaired insulin response in adults [20].…”

Vascular effects of the Mediterranean diet Part I: Anti-hypertensive and anti-thrombotic effects

“…Even though 80% of the basal plasma nitrite levels derive from the oxidation of NO [28], reduction of nitrate also significantly contributes to increasing nitrite levels and, eventually, to the synthesis of NO [29,30] (Fig. 1).…”

Processed and Unprocessed Red Meat Consumption and Risk of Heart Failure

“…Nitrites are frequently used in the preservation of processed meat (cured meats) and have been suggested to affect the risk of HF, but results are inconsistent-recent review articles highlighted that total dietary nitrite and nitrate may have cardiovascular protective properties 16 by hypotensive, antiplatelet, and cytoprotective effects. 17 In contrast, some studies indicated that high concentration of nitrites in diet is related to endothelial dysfunction and impaired insulin response in adults.…”

“…Nitrites are frequently used in the preservation of processed meat (cured meats) and have been suggested to affect the risk of HF, but results are inconsistent-recent review articles highlighted that total dietary nitrite and nitrate may have cardiovascular protective properties 16 by hypotensive, antiplatelet, and cytoprotective effects. 17 In contrast, some studies indicated that high concentration of nitrites in diet is related to endothelial dysfunction and impaired insulin response in adults.18 Phosphate-containing food additives can promote HF by impairment of the calcium phosphate metabolism. Among coronary heart disease patients, higher levels of serum phosphate were associated with increased risk of new HF and coronary heart disease events compared with participants with lower levels.…”