Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire

Shannon, Oliver M.; Grisotto, Giorgia; Babateen, Abrar; McGrattan, Andrea; Brandt, Kirsten; Mathers, John C.; Siervo, Mario

doi:10.1136/bmjopen-2019-030719

Cited by 9 publications

(22 citation statements)

References 41 publications

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“…We chose the subjects based on this criterion due to the fact that our survey could only be answered online. In sum, this study is an ICT-based structure, similar to a few other studies [31,63].…”

Section: Discussionsupporting

confidence: 52%

mHealth Apps Assessment among Postpartum Women with Obesity and Depression

2020

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Background: Pregnancy has become the main constituent for women to become overweight or obese during the postpartum phase. This could lead women to suffer from postpartum depression as well. Information technology (IT) has become more prevalent in the healthcare industry. It offers patients the opportunity to manage their health conditions via the use of several applications, one being the mHealth applications. Objective: The main purpose of this study is to experiment and understand the effects the mHealth applications (i.e., fitness and nutrition applications) have on the body mass index (BMI) and depression levels amongst postpartum women. Methods: Online questionnaires were sent to postpartum women within one year after their pregnancy, of which 819 completed questionnaires were returned. The frequency of the mHealth applications usage was categorized into daily, weekly, rarely and never streams. Therefore, the frequency of use of the mHealth applications for BMI and depression levels was analyzed based on the available statistical data. Descriptive statistics, ANOVA, and Dunnet tests were applied to analyze the experimental data. Results: Out of 819 respondents, 37.9% and 42.1% of them were overweight and obese, respectively. Almost 32.9% of the respondents were likely depressed, and 45.6% were at an increased risk. This study reports that only 23.4% and 28.6% of respondents never used the fitness and nutrition applications. The impact of the frequency of using the fitness applications on BMI and depression levels was obvious. This means that with the increased use of the fitness applications, there was also a significant effect in maintaining and decreasing the BMI and depression levels amongst Malaysians postpartum women. However, from the data of weekly and daily use of fitness applications, we found that the contribution toward the BMI and depression levels was high (p = 0.000). However, nutrition applications amongst the users were not significant within the main variables (p > 0.05). From the Dunnet test, the significance of using the fitness applications within the depression levels started from daily usage, whereas for BMI, it started from weekly usage. Conclusion: The efficiency of the fitness applications toward the BMI and depression levels has been proven in this research work. While nutrition applications did not affect the BMI and depression levels, some of the respondents were still categorized as weekly and daily users. Thus, the improvements in BMI and depression levels are associated with the types of mHealth app that had been used.

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Section: Discussionsupporting

confidence: 52%

mHealth Apps Assessment among Postpartum Women with Obesity and Depression

2020

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“…The initial results suggesting a harmful role of dietary NO 3 − intake (from food) were mostly derived from animal models and weakly designed epidemiological studies which have had a prominent, almost demonizing, influence on defining the role of dietary NO 3 − for human health [ 87 ]. These initial studies informed the still contentious WHO nutritional recommendations for dietary NO 3 − intake in humans which was set at 3.7 mg/ kg body weight [ 88 ]. The perception of dietary NO 3 − as a risk factor started to change with the discovery of the role of NO 3 − as key substrate for the NO 3 − -NO 2 − -NO pathway and the evidence of a beneficial effect of NO 3 − on health parameters such as BP.…”

Section: Main Textmentioning

confidence: 99%

“…NO 3 − is increasingly recognised as a beneficial ion that protects against chronic disease, yet, as noted in Section 3 of this review, historically, it was considered a food contaminant with adverse health effects, particularly increased risk of certain cancers and methaemoglobinaemia [ 1 , 88 ]. While the aforementioned WHO ADI for NO 3 − of 3.7 mg/kg of body mass remain in place today, the discovery of multiple positive health effects of NO 3 − have prompted a re-examination of these claims.…”

Section: Main Textmentioning

confidence: 99%

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

Shannon

Easton

Shepherd

et al. 2021

BMC Sports Sci Med Rehabil

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Background Dietary inorganic nitrate (NO3−) is a polyatomic ion, which is present in large quantities in green leafy vegetables and beetroot, and has attracted considerable attention in recent years as a potential health-promoting dietary compound. Numerous small, well-controlled laboratory studies have reported beneficial health effects of inorganic NO3− consumption on blood pressure, endothelial function, cerebrovascular blood flow, cognitive function, and exercise performance. Translating the findings from small laboratory studies into ‘real-world’ applications requires careful consideration. Main body This article provides a brief overview of the existing empirical evidence basis for the purported health-promoting effects of dietary NO3− consumption. Key areas for future research are then proposed to evaluate whether promising findings observed in small animal and human laboratory studies can effectively translate into clinically relevant improvements in population health. These proposals include: 1) conducting large-scale, longer duration trials with hard clinical endpoints (e.g. cardiovascular disease incidence); 2) exploring the feasibility and acceptability of different strategies to facilitate a prolonged increase in dietary NO3− intake; 3) exploitation of existing cohort studies to explore associations between NO3− intake and health outcomes, a research approach allowing larger samples sizes and longer duration follow up than is feasible in randomised controlled trials; 4) identifying factors which might account for individual differences in the response to inorganic NO3− (e.g. sex, genetics, habitual diet) and could assist with targeted/personalised nutritional interventions; 5) exploring the influence of oral health and medication on the therapeutic potential of NO3− supplementation; and 6) examining potential risk of adverse events with long term high- NO3− diets. Conclusion The salutary effects of dietary NO3− are well established in small, well-controlled laboratory studies. Much less is known about the feasibility and efficacy of long-term dietary NO3− enrichment for promoting health, and the factors which might explain the variable responsiveness to dietary NO3− supplementation between individuals. Future research focussing on the translation of laboratory data will provide valuable insight into the potential applications of dietary NO3− supplementation to improve population health.

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“…For example, two beetroot juice shots containing a total of 800 mg of inorganic nitrate would provide over three times the ADI of 259 mg/day for a 70-kg individual. The ADI restricting dietary nitrate intake was originally based on observational and animal model data, which suggested that acute or chronic consumption of nitrate could increase the risk of methaemoglobinaemia, whilst chronic nitrate intake could increase risk of cancer [ 27 , 28 ]. Methaemoglobinaemia is a rare condition in which the ferrous iron (Fe 2+ ) in haemoglobin is oxidized into the ferric (Fe 3+ ) state, forming methaemoglobin [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary Inorganic Nitrate as an Ergogenic Aid: An Expert Consensus Derived via the Modified Delphi Technique

et al. 2022

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Introduction Dietary inorganic nitrate is a popular nutritional supplement, which increases nitric oxide bioavailability and may improve exercise performance. Despite over a decade of research into the effects of dietary nitrate supplementation during exercise there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Moreover, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. This study aimed to address these research gaps. Methods The modified Delphi technique was used to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via videoconferencing), the expert panel members voted on 222 statements relating to dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e. yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research. Results The 12 panel members contributed to voting in all three rounds. A total of 39 statements (17.6%) reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60.4%) of the statements, and were unable to agree on the outcome of the remaining statements. Conclusions This study provides information on the current expert consensus on dietary nitrate, which may be of value to athletes, coaches, practitioners and researchers. The effects of dietary nitrate appear to be diminished in individuals with a higher aerobic fitness (peak oxygen consumption [V̇O2peak] > 60 ml/kg/min), and therefore, aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes looking to benefit from dietary nitrate supplementation should consume 8–16 mmol nitrate acutely or 4–16 mmol/day nitrate chronically (with the final dose ingested 2–4 h pre-exercise) to maximise ergogenic effects, taking into consideration that, from a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe, although the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, highlighting the need for future research in this area. Graphical Abstract

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Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire

Cited by 9 publications

References 41 publications

mHealth Apps Assessment among Postpartum Women with Obesity and Depression

mHealth Apps Assessment among Postpartum Women with Obesity and Depression

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

Dietary Inorganic Nitrate as an Ergogenic Aid: An Expert Consensus Derived via the Modified Delphi Technique

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