Effects of Dietary Nitrate on Blood Pressure in Healthy Volunteers

Larsen, Filip J.; Ekblom, Björn; Sahlin, Kent; Lundberg, Jon O.; Weitzberg, Eddie

doi:10.1056/nejmc062800

Cited by 505 publications

(416 citation statements)

References 5 publications

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“…Consistent with previous investigations, plasma nitrate and nitrite, and exhaled NO concentrations were significantly elevated following dietary nitrate supplementation [1,2,5,8,55,22,39,38], signifying an increase in the 'substrates' available for NO generation via the nitrate-nitrite-NO pathway [11]. Peak plasma nitrite concentration was 602 % higher in BRJ versus PLA, similar to Arnold et al [38] (775 %) (~ 7 mmol nitrate), but considerably greater than reported by Muggeridge et al [22] (134 %) (~ 5 mmol nitrate) and Vanhatalo et al [8] (150 %) (~ 9.3 mmol).…”

Section: Plasma Nitrate Nitrite and Exhaled Nosupporting

confidence: 92%

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Dietary nitrate supplementation enhances high-intensity running performance in moderate normobaric hypoxia, independent of aerobic fitness

et al. 2016

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Nitrate-rich beetroot juice (BRJ) increases plasma nitrite concentration, lowers the oxygen cost (V O2) of steady-state exercise and improves exercise performance in sedentary and moderately-trained, but rarely in well-trained individuals exercising at sea-level. BRJ supplementation may be more effective in a hypoxic environment, where the reduction of nitrite into nitric oxide (NO) is potentiated, such that well-trained and less well-trained individuals may derive a similar ergogenic effect.We conducted a randomised, counterbalanced, double-blind placebo controlled trial to determine the effects of BRJ on treadmill running performance in moderate normobaric hypoxia (equivalent to 2500 m altitude) in participants with a range of aerobic fitness levels. Twelve healthy males (V O2max ranging from 47.1 -76.8 ml·kg -1 ·min -1 ) ingested 138 ml concentrated BRJ (~ 15.2 mmol nitrate) or a nitrate-deplete placebo (PLA) (~ 0.2 mmol nitrate). Three hours later, participants completed steady-state moderate intensity running, and a 1500 m time-trial (TT) in a normobaric hypoxic chamber (FIO2 ~15 %). Plasma nitrite concentration was significantly greater following BRJ versus PLA 1 hour post supplementation, and remained higher in BRJ throughout the testing session (p < 0.01). Average V O2 was significantly lower (BRJ: 18.4 ± 2.0, PLA: 20.4 ± 12.6 ml·kg -1 ·min -1 ; p = 0.002), whilst arterial oxygen saturation (SaO2) was significantly greater (BRJ: 88.4 ± 2.7, PLA: 86.5 ± 3.3 %; p < 0.001) following BRJ. BRJ improved TT performance in all 12 participants by an average of 3.2 % (BRJ: 331.1 ± 45.3 vs. PL: 341.9 ± 46.1 s; p < 0.001). There was no apparent relationship between aerobic fitness and the improvement in performance following BRJ (r 2 = 0.05, p > 0.05). These findings suggests that a high nitrate dose in the form of a BRJ supplement may improve running performance in individuals with a range of aerobic fitness levels conducting moderate and high-intensity exercise in a normobaric hypoxic environment.

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Section: Plasma Nitrate Nitrite and Exhaled Nosupporting

confidence: 92%

“…These include, but are not restricted to: lower blood pressure [1][2][3], reduced O2 consumption (V O2) during steady-state exercise [4][5][6], attenuated muscle metabolic perturbations [7,8], and enhanced muscle force production [9,10]. These effects are not directly attributable to the nitrate anion, which is relatively inert [11].…”

Section: Introductionmentioning

confidence: 99%

Dietary nitrate supplementation enhances high-intensity running performance in moderate normobaric hypoxia, independent of aerobic fitness

et al. 2016

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“…[22][23][24] It has previously been shown that dietary nitrate supplementation, via sequential reduction of nitrate to nitrite and nitric oxide, can lower blood pressure and improve endothelial function in healthy humans. [25][26][27][28][29] Inorganic nitrate from the diet may have numerous other beneficial effects including improving exercise tolerance, ameliorating ischaemia-reperfusion injury, inhibition of platelet aggregation, protection against gastrointestinal infection, and protection against gastric ulceration (for review see 30 ). Furthermore, Lundberg and Weitzberg's group has shown that, in endothelial nitric oxide synthase (eNOS) knockout mice, supplementation of the diet with inorganic nitrate improved glucose tolerance and ameliorated other features of the metabolic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes

Gilchrist

Winyard

Aizawa

et al. 2013

Free Radical Biology and Medicine

209

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Diets rich in green, leafy vegetables have been shown to lower BP and reduce the risk of cardiovascular disease. Green, leafy vegetables and beetroots are particularly rich in inorganic nitrate. Dietary nitrate supplementation, via sequential reduction to nitrite and NO, has previously been shown to lower BP and improve endothelial function in healthy humans.We sought to determine if supplementing dietary nitrate with beetroot juice, a rich source of nitrate, will lower BP, improve endothelial function and insulin sensitivity in individuals with type 2 diabetes (T2DM). Twenty-seven patients, age 67.2 +/-4.9 years, (18 male) were recruited for a double blind, randomised, placebo-controlled crossover trial. Participants were randomised to begin in either order a 2 week period of supplementation with 250 ml beetroot juice daily (active) or 250 ml nitratedepleted beetroot juice (placebo). At the conclusion of each intervention period 24 hour ambulatory blood pressure monitoring, tests of macro and microvascular endothelial function and a hyperinsulinaemic isoglycaemic clamp were performed. After two weeks administration of beetroot juice mean ambulatory systolic BP was unchanged: 134.6 ± 8.4 mmHg versus 135.1 ± 7.8 mmHg (mean ± SD) placebo vs. active -mean difference of -0.5 mmHg (placebo-active), p=0.737 (95% CI -3.9 to 2.8). There were no changes in macrovascular or microvascular endothelial function or insulin sensitivity. Supplementation of the diet with 7.5 mmoles of nitrate per day for 2 weeks caused an increase in plasma nitrite and nitrate concentration, but did not lower BP, improve endothelial function or insulin sensitivity in individuals with T2DM.3

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“…Its application to modulate physiology and alleviate cardiovascular dysfunction shows particular promise in certain clinical conditions and patient cohorts, including reduction of mean arterial pressure in hypertension [1,2], effective quiescencing of platelet activation/aggregation [3], and reduce risk in conditions where tissue ischemia prevails [4]. However, it is the potential of oral NO 3 -to modify exercise/performance via elevation of plasma nitrite concentration ([NO 2 -]) that has been applied across a range of human test systems, from the effects of walking distance in a sedentary population [5] to enhancing performance in elite athletes [6].…”

Section: Introductionmentioning

confidence: 99%

Nitrate pharmacokinetics: Taking note of the difference

et al. 2015

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Effects of Dietary Nitrate on Blood Pressure in Healthy Volunteers

Cited by 505 publications

References 5 publications

Dietary nitrate supplementation enhances high-intensity running performance in moderate normobaric hypoxia, independent of aerobic fitness

Dietary nitrate supplementation enhances high-intensity running performance in moderate normobaric hypoxia, independent of aerobic fitness

Effect of dietary nitrate on blood pressure, endothelial function, and insulin sensitivity in type 2 diabetes

Nitrate pharmacokinetics: Taking note of the difference

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