Nitrate: The Dr. Jekyll and Mr. Hyde of human health?

Bondonno, Catherine P.; Liu, Zhong; Bondonno, Nicola P.; Sim, Marc; Blekkenhorst, Lauren C.; Liu, Alex H.; Rajendra, Anjana; Pokharel, Pratik; Erichsen, Dorit W.; Neubauer, Oliver; Croft, Kevin D.; Hodgson, Jonathan M.

doi:10.1016/j.tifs.2023.03.014

Cited by 14 publications

(15 citation statements)

References 152 publications

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“…Evidence suggests that consuming nitrate from drinking water can lead to endogenous N -nitrosamine formation in humans ( 38 ). Recent meta-analyses have linked drinking water nitrate with elevated risks of gastric and colorectal cancer, while some individual studies also hint at its association with other cancers ( 1 ). European Union guidelines, including those in Denmark, have set the maximum nitrate level in drinking water at 50 mg/L ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

“…Nitrate and nitrite are controversial dietary components, and the health consequences of their consumption has been a topic of continued debate and research interest. We are continually exposed to nitrate and nitrite, as they are not only formed endogenously but are ubiquitous in nature being found in plants, animal-sourced foods, and water ( 1 ). In plants, nitrate and nitrite hold pivotal functions, supporting growth and development ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Nitrate itself is innocuous and evidence points to beneficial physiological effects of plant-sourced nitrate consumption owing to its conversion to nitric oxide (NO) through the enterosalivary nitrate-nitrite-NO pathway ( 11 ). These effects include, but are not limited to, a lowering of blood pressure, improved blood vessel function, enhanced exercise performance, tissue protection during ischemia–reperfusion, advanced mitochondrial function, and potential neuroprotective roles ( 1 ). However, there is also evidence of possible carcinogenic potential.…”

Section: Introductionmentioning

confidence: 99%

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Source-specific nitrate and nitrite intakes and associations with sociodemographic factors in the Danish Diet Cancer and Health cohort

Erichsen,

Pokharel,

Kyrø

et al. 2024

Front. Nutr.

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BackgroundThe dietary source and intake levels of nitrate and nitrite may govern its deleterious versus beneficial effects on human health. Existing evidence on detailed source-specific intake is limited. The objectives of this study were to assess nitrate and nitrite intakes from different dietary sources (plant-based foods, animal-based foods, and water), characterize the background diets of participants with low and high intakes, and investigate how sociodemographic and lifestyle factors associate with intake levels.MethodsIn the Danish Diet, Cancer and Health Cohort, sociodemographic and lifestyle information was obtained from participants at enrolment (1993–1997). Source-dependent nitrate and nitrite intakes were calculated using comprehensive food composition databases, with tap water nitrate intakes estimated via the national drinking water quality monitoring database linked with participants’ residential addresses from 1978 to 2016. Underlying dietary patterns were examined using radar plots comparing high to low consumers while sociodemographic predictors of source-dependent nitrate intakes were investigated using linear regression models.ResultsIn a Danish cohort of 55,754 participants aged 50–65 at enrolment, the median [IQR] intakes of dietary nitrate and nitrite were 58.13 [44.27–74.90] mg/d and 1.79 [1.43–2.21] mg/d, respectively. Plant-based foods accounted for ~76% of nitrate intake, animal-based foods ~10%, and water ~5%. Nitrite intake was sourced roughly equally from plants and animals. Higher plant-sourced nitrate intake was associated with healthier lifestyles, better dietary patterns, more physical activity, higher education, lower age and lower BMI. Females and participants who had never smoked also had significantly higher plant-sourced nitrate intakes. Higher water-sourced nitrate intake was linked to sociodemographic risk factors (smoking, obesity, lower education). Patterns for animal-sourced nitrate were less clear.ConclusionParticipants with higher plant-sourced nitrate intakes tend to be healthier while participants with higher water-sourced nitrate intakes tended to be unhealthier than their low consuming counterparts. Future research in this cohort should account for the sociodemographic and dietary predictors of source-specific nitrate intake we have identified.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Source-specific nitrate and nitrite intakes and associations with sociodemographic factors in the Danish Diet Cancer and Health cohort

Erichsen,

Pokharel,

Kyrø

et al. 2024

Front. Nutr.

Self Cite

View full text Add to dashboard Cite

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“…Finally, risks associated with other sources of dietary nitrate and nitrite (processed meats and drinking water) are not evident with plant-based sources; instead, exposure to plant-based sources of dietary nitrate are associated with health benefits and cardiovascular protection. We, like other groups [ 126 , 159 ], understand that additional well-designed epidemiological studies will be necessary to clarify concerns about cancer risk related to dietary nitrate intake.…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned in the previous section, the 3 different dietary nitrate exposure routes–drinking water, animal-based foods (especially cured and processed meats), and vegetables and fruits–are associated with different health risks [ 126 , 127 ]. This distinction is paramount for the consideration of dietary nitrate specifically from plant-based food sources as a conditionally essential nutrient.…”

Section: Risks Associated With Dietary Nitrate: Context Mattersmentioning

confidence: 99%

Dietary Nitrate from Plant Foods: A Conditionally Essential Nutrient for Cardiovascular Health

Pinaffi-Langley,

Dajani,

Prater

et al. 2024

Advances in Nutrition

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Higher plant-derived nitrate intake is associated with lower odds of frailty in a cross-sectional study of community-dwelling older women

Hayes,

Dent,

Shannon

et al. 2024

Eur J Nutr

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Purpose Dietary nitrate intake is inversely related to numerous contributors towards frailty, including cardiovascular disease and poor physical function. Whether these findings extend to frailty remain unknown. We investigated if habitual nitrate intake, derived from plants or animal-based foods, was cross-sectionally associated with frailty in women. Methods Community-dwelling older Australian women (n = 1390, mean age 75.1 ± 2.7 years) completed a validated semi-quantitative food frequency questionnaire (FFQ). Nitrate concentrations in food were obtained from international nitrate databases. We adopted the Rockwood frailty index (FI) of cumulative deficits comprising 33 variables across multiple health domains (scored 0 to 1), which predicts increased hospitalisation and mortality risk. A FI ≥ 0.25 indicated frailty. Cross-sectional associations between nitrate intake (total plant and animal nitrate, separately) and frailty were analysed using multivariable-adjusted logistic regression models (including lifestyle factors), as part of restricted cubic splines. Results A non-linear inverse relationship was observed between total plant nitrate intake and frailty. Compared to women with the lowest plant nitrate intake (Quartile [Q]1), women with greater intakes in Q2 (OR 0.69 95%CI 0.56–0.84), Q3 (OR 0.67 95%CI 0.50–0.90) and Q4 (OR 0.66 95%CI 0.45–0.98) had lower odds for frailty. A nadir in the inverse association was observed once intakes reached ~ 64 mg/d (median Q2). No relationship was observed between total animal nitrate and frailty. Conclusion Community-dwelling older women consuming low amounts of plant-derived nitrate were more likely to present with frailty. Consuming at least one daily serving (~ 75 g) of nitrate-rich green leafy vegetables may be beneficial in preventing frailty.

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Nitrate: The Dr. Jekyll and Mr. Hyde of human health?

Cited by 14 publications

References 152 publications

Source-specific nitrate and nitrite intakes and associations with sociodemographic factors in the Danish Diet Cancer and Health cohort

Source-specific nitrate and nitrite intakes and associations with sociodemographic factors in the Danish Diet Cancer and Health cohort

Dietary Nitrate from Plant Foods: A Conditionally Essential Nutrient for Cardiovascular Health

Higher plant-derived nitrate intake is associated with lower odds of frailty in a cross-sectional study of community-dwelling older women

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