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Tan R, Baranauskas MN, Karl ST, Ortiz de Zevallos J, Shei RJ, Paris HL, Wiggins CC, Bailey SJ. Effects of dietary nitrate supplementation on peak power output: Influence of supplementation strategy and population. Nitric Oxide 2023; 138-139:105-119. [PMID: 37438201 DOI: 10.1016/j.niox.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Increasing evidence indicates that dietary nitrate supplementation has the potential to increase muscular power output during skeletal muscle contractions. However, there is still a paucity of data characterizing the impact of different nitrate dosing regimens on nitric oxide bioavailability and its potential ergogenic effects across various population groups. This review discusses the potential influence of different dietary nitrate supplementation strategies on nitric oxide bioavailability and muscular peak power output in healthy adults, athletes, older adults and some clinical populations. Effect sizes were calculated for peak power output and absolute and/or relative nitrate doses were considered where applicable. There was no relationship between the effect sizes of peak power output change following nitrate supplementation and when nitrate dosage when considered in absolute or relative terms. Areas for further research are also recommended including a focus on nitrate dosing regimens that optimize nitric oxide bioavailability for enhancing peak power at times of increased muscular work in a variety of healthy and disease populations.
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Affiliation(s)
- Rachel Tan
- Department of Sports Medicine, Pepperdine University, Malibu, CA, 90263, USA.
| | - Marissa N Baranauskas
- Department of Human Physiology & Nutrition, University of Colorado, Colorado Springs, CO, 80918, USA
| | - Sean T Karl
- Department of Sports Medicine, Pepperdine University, Malibu, CA, 90263, USA
| | | | - Ren-Jay Shei
- Indiana University Alumni Association, Indiana University, Bloomington, IN, 47408, USA
| | - Hunter L Paris
- Department of Sports Medicine, Pepperdine University, Malibu, CA, 90263, USA
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
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Alsharif NS, Clifford T, Alhebshi A, Rowland SN, Bailey SJ. Effects of Dietary Nitrate Supplementation on Performance during Single and Repeated Bouts of Short-Duration High-Intensity Exercise: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Antioxidants (Basel) 2023; 12:1194. [PMID: 37371924 DOI: 10.3390/antiox12061194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
Inorganic nitrate (NO3-) has emerged as a potential ergogenic aid over the last couple of decades. While recent systematic reviews and meta-analyses have suggested some small positive effects of NO3- supplementation on performance across a range of exercise tasks, the effect of NO3- supplementation on performance during single and repeated bouts of short-duration, high-intensity exercise is unclear. This review was conducted following PRISMA guidelines. MEDLINE and SPORTDiscus were searched from inception to January 2023. A paired analysis model for cross-over trials was incorporated to perform a random effects meta-analysis for each performance outcome and to generate standardized mean differences (SMD) between the NO3- and placebo supplementation conditions. The systematic review and meta-analysis included 27 and 23 studies, respectively. Time to reach peak power (SMD: 0.75, p = 0.02), mean power output (SMD: 0.20, p = 0.02), and total distance covered in the Yo-Yo intermittent recovery level 1 test (SMD: 0.17, p < 0.0001) were all improved after NO3- supplementation. Dietary NO3- supplementation had small positive effects on some performance outcomes during single and repeated bouts of high-intensity exercise. Therefore, athletes competing in sports requiring single or repeated bouts of high-intensity exercise may benefit from NO3- supplementation.
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Affiliation(s)
- Nehal S Alsharif
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Abrar Alhebshi
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 24382, Saudi Arabia
| | - Samantha N Rowland
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
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Tan R, Baranauskas MN, Karl ST, Ortiz de Zevallos J, Shei RJ, Paris HL, Wiggins CC, Bailey SJ. Effects of dietary nitrate supplementation on muscular power output: Influence of supplementation strategy and population. Nitric Oxide 2023:S1089-8603(23)00047-2. [PMID: 37244391 DOI: 10.1016/j.niox.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023]
Abstract
Increasing evidence indicates that dietary nitrate supplementation has the potential to increase muscular power output during skeletal muscle contractions. However, there is still a paucity of data characterizing the impact of different nitrate dosing regimens on nitric oxide bioavailability its potential ergogenic effects across various population groups. This narrative review discusses the potential influence of different dietary nitrate supplementation strategies on nitric oxide bioavailability and muscular power output in healthy adults, athletes, older adults and some clinical populations. Areas for further research are also recommended including a focus individualized nitrate dosing regimens to optimize nitric oxide bioavailability and to promote muscular power enhancements in different populations.
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Affiliation(s)
- Rachel Tan
- Department of Sports Medicine, Pepperdine University, Malibu, CA, 90263, USA.
| | - Marissa N Baranauskas
- Department of Human Physiology & Nutrition, University of Colorado, Colorado Springs, CO, 80918, USA
| | - Sean T Karl
- Department of Sports Medicine, Pepperdine University, Malibu, CA, 90263, USA
| | | | - Ren-Jay Shei
- Indiana University Alumni Association, Indiana University, Bloomington, IN, 47408, USA
| | - Hunter L Paris
- Department of Sports Medicine, Pepperdine University, Malibu, CA, 90263, USA
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
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Morito A, Inami T, Hirata A, Yamada S, Shimomasuda M, Haramoto M, Kato K, Tahara S, Oguma Y, Ishida H, Kohtake N. Ice slurry ingestion improves physical performance during high-intensity intermittent exercise in a hot environment. PLoS One 2022; 17:e0274584. [PMID: 36107972 PMCID: PMC9477354 DOI: 10.1371/journal.pone.0274584] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Ice slurry ingestion enhances exercise performance by lowering the core body temperature. However, an operational issue related to this ingestion is the requirement for a high intake of 7.5 g·kg-1 to produce the desired effects. We investigated the effects of the intake of low amounts of ice slurry at −2°C on the tympanic temperature and exercise performance during repeated high-intensity intermittent exercises in a hot environment. This study was a randomized, crossover study, with a 6-day washout period. Twelve university rugby union players performed two 30-min sessions of high-intensity intermittent exercises separated by a 15-min half-time break on a cycle ergometer in a hot environment (28.8°C ± 0.1°C, 49.5% ± 0.6% relative humidity). The participants ingested 450 g of −2°C-ice slurry (ICE), or a 30°C-beverage (CON) having the same composition as ICE, or 30°C-water (WAT) during the half-time break. The tympanic temperature and skin temperature were measured as the physiological data, and the peak power and mean power as the exercise performance data. The tympanic temperature at the half-time break and beginning of the 2nd session was significantly lower in the ICE group as compared with the CON and WAT groups. The skin temperature at the half-time break was significantly lower in the ICE group as compared with the WAT group. While the peak power and mean power during the 2nd session were significantly greater in the ICE group as compared with the CON and WAT groups. Our findings suggest that even the intake of lower amounts, as compared with those used in previous studies, of low-temperature ice slurry can reduce the body temperature and improve the peak power. These results suggest that intake of low-temperature ice slurry as a strategy for internal body cooling is useful for improving endurance exercise performance in hot environments.
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Affiliation(s)
- Akihisa Morito
- Graduate School of System Design and Management, Keio University, Kanagawa, Japan
- R&D Laboratories, Self-Medication, Taisho Pharmaceutical Co., Ltd., Saitama, Japan
- * E-mail:
| | - Takayuki Inami
- Institute of Physical Education, Keio University, Kanagawa, Japan
| | - Akihiro Hirata
- Graduate School of System Design and Management, Keio University, Kanagawa, Japan
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Satoshi Yamada
- R&D Laboratories, Self-Medication, Taisho Pharmaceutical Co., Ltd., Saitama, Japan
| | - Masatsugu Shimomasuda
- Research & Development Headquarters, Self-Medication, Taisho Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Maki Haramoto
- Research & Development Headquarters, Self-Medication, Taisho Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Keita Kato
- R&D Laboratories, Self-Medication, Taisho Pharmaceutical Co., Ltd., Saitama, Japan
| | - Shigeyuki Tahara
- Graduate School of System Design and Management, Keio University, Kanagawa, Japan
| | - Yuko Oguma
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Hiroyuki Ishida
- Sports Medicine Research Center, Keio University, Kanagawa, Japan
| | - Naohiko Kohtake
- Graduate School of System Design and Management, Keio University, Kanagawa, Japan
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Tan R, Cano L, Lago-Rodríguez Á, Domínguez R. The Effects of Dietary Nitrate Supplementation on Explosive Exercise Performance: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020762. [PMID: 35055584 PMCID: PMC8775572 DOI: 10.3390/ijerph19020762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 02/07/2023]
Abstract
Dietary nitrate supplementation is evidenced to induce physiological effects on skeletal muscle function in fast-twitch muscle fibers and may enhance high-intensity exercise performance. An important component of sport-specific skills is the ability to perform explosive movements; however, it is unclear if nitrate supplementation can impact explosive efforts. We examined the existing evidence to determine whether nitrate supplementation improves explosive efforts lasting ≤ 6 s. PubMed, Scopus and Directory of Open Access Journals (DOAJ) were searched for articles using the following search strategy: (nitrate OR nitrite OR beetroot) AND (supplement OR supplementation) AND (explosive OR power OR high intensity OR high-intensity OR sprint* OR “athletic performance”). Out of 810 studies, 18 were eligible according to inclusion criteria. Results showed that 4 of the 10 sprint-type studies observed improved sprint time, power output, and total work in cycling or running, whereas 4 of the 10 resistance-based exercise studies observed improvements to power and velocity of free-weight bench press as well as isokinetic knee extension and flexion at certain angular velocities. These results suggest that nitrate potentially improves explosive exercise performance, but further work is required to clarify the factors influencing the efficacy of nitrate in different exercise modalities.
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Affiliation(s)
- Rachel Tan
- Faculty of Sports Medicine, Natural Sciences Division, Pepperdine University, Malibu, CA 90263, USA;
| | - Leire Cano
- Independent Researcher, 48991 Getxo, Spain;
| | - Ángel Lago-Rodríguez
- Movement, Brain and Health Group, Center of Higher Education Alberta Giménez, 07013 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-680-330-105
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento, Universidad de Sevilla, 41013 Sevilla, Spain;
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, Lavras 37200-000, Brazil
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Wong TH, Sim A, Burns SF. The Effect of Beetroot Ingestion on High-Intensity Interval Training: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:3674. [PMID: 34835931 PMCID: PMC8618171 DOI: 10.3390/nu13113674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 02/07/2023] Open
Abstract
Dietary nitrate supplementation has shown promising ergogenic effects on endurance exercise. However, at present there is no systematic analysis evaluating the effects of acute or chronic nitrate supplementation on performance measures during high-intensity interval training (HIIT) and sprint interval training (SIT). The main aim of this systematic review and meta-analysis was to evaluate the evidence for supplementation of dietary beetroot-a common source of nitrate-to improve peak and mean power output during HIIT and SIT. A systematic literature search was carried out following PRISMA guidelines and the PICOS framework within the following databases: PubMed, ProQuest, ScienceDirect, and SPORTDiscus. Search terms used were: ((nitrate OR nitrite OR beetroot) AND (HIIT or high intensity or sprint interval or SIT) AND (performance)). A total of 17 studies were included and reviewed independently. Seven studies applied an acute supplementation strategy and ten studies applied chronic supplementation. The standardised mean difference for mean power output showed an overall trivial, non-significant effect in favour of placebo (Hedges' g = -0.05, 95% CI -0.32 to 0.21, Z = 0.39, p = 0.69). The standardised mean difference for peak power output showed a trivial, non-significant effect in favour of the beetroot juice intervention (Hedges' g = 0.08, 95% CI -0.14 to 0.30, Z = 0.72, p = 0.47). The present meta-analysis showed trivial statistical heterogeneity in power output, but the variation in the exercise protocols, nitrate dosage, type of beetroot products, supplementation strategy, and duration among studies restricted a firm conclusion of the effect of beetroot supplementation on HIIT performance. Our findings suggest that beetroot supplementation offers no significant improvement to peak or mean power output during HIIT or SIT. Future research could further examine the ergogenic potential by optimising the beetroot supplementation strategy in terms of dosage, timing, and type of beetroot product. The potential combined effect of other ingredients in the beetroot products should not be undermined. Finally, a chronic supplementation protocol with a higher beetroot dosage (>12.9 mmol/day for 6 days) is recommended for future HIIT and SIT study.
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Affiliation(s)
| | | | - Stephen F. Burns
- Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore; (T.H.W.); (A.S.)
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Coggan AR, Baranauskas MN, Hinrichs RJ, Liu Z, Carter SJ. Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis. J Int Soc Sports Nutr 2021; 18:66. [PMID: 34625064 PMCID: PMC8501726 DOI: 10.1186/s12970-021-00463-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/15/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Previous narrative reviews have concluded that dietary nitrate (NO3-) improves maximal neuromuscular power in humans. This conclusion, however, was based on a limited number of studies, and no attempt has been made to quantify the exact magnitude of this beneficial effect. Such information would help ensure adequate statistical power in future studies and could help place the effects of dietary NO3- on various aspects of exercise performance (i.e., endurance vs. strength vs. power) in better context. We therefore undertook a systematic review and individual participant data meta-analysis to quantify the effects of NO3- supplementation on human muscle power. METHODS The literature was searched using a strategy developed by a health sciences librarian. Data sources included Medline Ovid, Embase, SPORTDiscus, Scopus, Clinicaltrials.gov , and Google Scholar. Studies were included if they used a randomized, double-blind, placebo-controlled, crossover experimental design to measure the effects of dietary NO3- on maximal power during exercise in the non-fatigued state and the within-subject correlation could be determined from data in the published manuscript or obtained from the authors. RESULTS Nineteen studies of a total of 268 participants (218 men, 50 women) met the criteria for inclusion. The overall effect size (ES; Hedge's g) calculated using a fixed effects model was 0.42 (95% confidence interval (CI) 0.29, 0.56; p = 6.310 × 10- 11). There was limited heterogeneity between studies (i.e., I2 = 22.79%, H2 = 1.30, p = 0.3460). The ES estimated using a random effects model was therefore similar (i.e., 0.45, 95% CI 0.30, 0.61; p = 1.064 × 10- 9). Sub-group analyses revealed no significant differences due to subject age, sex, or test modality (i.e., small vs. large muscle mass exercise). However, the ES in studies using an acute dose (i.e., 0.54, 95% CI 0.37, 0.71; p = 6.774 × 10- 12) was greater (p = 0.0211) than in studies using a multiple dose regimen (i.e., 0.22, 95% CI 0.01, 0.43; p = 0.003630). CONCLUSIONS Acute or chronic dietary NO3- intake significantly increases maximal muscle power in humans. The magnitude of this effect-on average, ~ 5%-is likely to be of considerable practical and clinical importance.
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Affiliation(s)
- Andrew R Coggan
- Department of Kinesiology, Indiana University Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
- Department of Kinesiology, Indiana University Purdue University Indianapolis, IF 101C, 250 University Boulevard, Indianapolis, IN, 46112, USA.
| | | | - Rachel J Hinrichs
- University Library, Indiana University Purdue University Indianapolis, Indianapolis, IN, 46202, USA
| | - Ziyue Liu
- Department of Biostatistics, Indiana University Purdue University Indianapolis, Indianapolis, IN, 46202, USA
| | - Stephen J Carter
- Department of Kinesiology, Indiana University, Bloomington, IN, 47405, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University Purdue University Indianapolis, Indianapolis, IN, 46202, USA
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Moreira LDSG, Fanton S, Cardozo L, Borges NA, Combet E, Shiels PG, Stenvinkel P, Mafra D. Pink pressure: beetroot (Beta vulgaris rubra) as a possible novel medical therapy for chronic kidney disease. Nutr Rev 2021; 80:1041-1061. [PMID: 34613396 DOI: 10.1093/nutrit/nuab074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic kidney disease (CKD) manifests with systemic inflammation, oxidative stress, and gut dysbiosis, resulting in metabolic disorders and elevated rates of cardiovascular disease-associated death. These all correlate with a high economic cost to healthcare systems. Growing evidence indicates that diet is an indispensable ally in the prevention and management of CKD and its complications. In this context, the root vegetable beetroot (Beta vulgaris rubra) deserves special attention because it is a source of several bioactive compounds, such as nitrate, betaine, and betalain, and has shown beneficial effects in CKD, including reduction of blood pressure, anti-inflammatory effects, and antioxidant actions by scavenging radical oxidative species, as observed in preclinical studies. Beetroot consumption as a possible therapeutic strategy to improve the clinical treatment of patients with CKD and future directions for clinical studies are addressed in this narrative review.
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Affiliation(s)
- Laís de Souza Gouveia Moreira
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Susane Fanton
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ludmila Cardozo
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Natalia A Borges
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Emilie Combet
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Paul G Shiels
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Stenvinkel
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Denise Mafra
- L.d.S.G. Moreira and D. Mafra are with the Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janiero, Brazil. S. Fanton, L. Cardozo, and D. Mafra are with the Graduate Program in Cardiovascular Sciences, Federal Fluminense University, Niterói-Rio de Janeiro, RJ, Brazil. N.A. Borges is with the Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, Brazil. E. Combet is with the School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom. P.G. Shiels is with the Wolfson Wohl Translational Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom. P. Stenvinkel is with the Department of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
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Peel JS, McNarry MA, Heffernan SM, Nevola VR, Kilduff LP, Waldron M. The Effect of Dietary Supplements on Endurance Exercise Performance and Core Temperature in Hot Environments: A Meta-analysis and Meta-regression. Sports Med 2021; 51:2351-2371. [PMID: 34129223 PMCID: PMC8514372 DOI: 10.1007/s40279-021-01500-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND The ergogenic effects of dietary supplements on endurance exercise performance are well-established; however, their efficacy in hot environmental conditions has not been systematically evaluated. OBJECTIVES (1) To meta-analyse studies investigating the effects of selected dietary supplements on endurance performance and core temperature responses in the heat. Supplements were included if they were deemed to: (a) have a strong evidence base for 'directly' improving thermoneutral endurance performance, based on current position statements, or (b) have a proposed mechanism of action that related to modifiable factors associated with thermal balance. (2) To conduct meta-regressions to evaluate the moderating effect of selected variables on endurance performance and core temperature responses in the heat following dietary supplementation. METHODS A search was performed using various databases in May 2020. After screening, 25 peer-reviewed articles were identified for inclusion, across three separate meta-analyses: (1) exercise performance; (2) end core temperature; (3) submaximal core temperature. The moderating effect of several variables were assessed via sub-analysis and meta-regression. RESULTS Overall, dietary supplementation had a trivial significant positive effect on exercise performance (Hedges' g = 0.18, 95% CI 0.007-0.352, P = 0.042), a trivial non-significant positive effect on submaximal core temperature (Hedges' g = 0.18, 95% CI - 0.021 to 0.379, P = 0.080) and a small non-significant positive effect on end core temperature (Hedges' g = 0.20, 95% CI - 0.041 to 0.439, P = 0.104) in the heat. There was a non-significant effect of individual supplements on exercise performance (P = 0.973) and submaximal core temperature (P = 0.599). However, end core temperature was significantly affected by supplement type (P = 0.003), which was attributable to caffeine's large significant positive effect (n = 8; Hedges' g = 0.82, 95% CI 0.433-1.202, P < 0.001) and taurine's medium significant negative effect (n = 1; Hedges' g = - 0.96, 95% CI - 1.855 to - 0.069, P = 0.035). CONCLUSION Supplements such as caffeine and nitrates do not enhance endurance performance in the heat, with caffeine also increasing core temperature responses. Some amino acids might offer the greatest performance benefits in the heat. Exercising in the heat negatively affected the efficacy of many dietary supplements, indicating that further research is needed and current guidelines for performance in hot environments likely require revision.
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Affiliation(s)
- Jennifer S Peel
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK.
| | - Melitta A McNarry
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK
| | - Shane M Heffernan
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK
| | - Venturino R Nevola
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK
- Defence Science and Technology Laboratory (Dstl), Fareham, Hampshire, UK
| | - Liam P Kilduff
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK
- Welsh Institute of Performance Science, Swansea University, Swansea, UK
| | - Mark Waldron
- A-STEM Centre, College of Engineering, Swansea University, Swansea, UK
- Welsh Institute of Performance Science, Swansea University, Swansea, UK
- School of Science and Technology, University of New England, Armidale, NSW, Australia
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10
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Impact of Red Spinach Extract Supplementation on Bench Press Performance, Muscle Oxygenation, and Cognitive Function in Resistance-Trained Males. Sports (Basel) 2021; 9:sports9060077. [PMID: 34071862 PMCID: PMC8227312 DOI: 10.3390/sports9060077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to assess the impact of short-term dietary nitrate supplementation, in the form of red spinach extract (RSE), on bench press performance, muscle oxygenation, and cognitive function in resistance-trained males. Ten resistance-trained males participated in this randomized, cross-over, placebo-controlled, double-blind investigation. Each participant completed 7 days of either RSE (2 g; 180 mg NO3−) or a maltodextrin placebo (PL) in a counterbalanced fashion with a 14-day washout between treatments. During experimental visits, participants were provided their 8th and last dose of RSE or PL 40 min before completing 5 sets of the barbell bench press exercise to failure at 75% of a predetermined 1-repetition maximum with 2 min rest intervals. Mean and peak power were recorded via a linear transducer. Near-infrared spectroscopy (NIRS) was implemented to estimate muscle oxygenation, a Stroop Test was used to assess cognitive function, and subjective performance ratings were obtained in relation to the acute resistance exercise sessions. Data were analyzed via separate repeated measures analyses of variance. There were no time by group interactions for bench press repetitions (p = 0.549), peak power (p = 0.061), or mean power (p = 0.877) across the 5 sets of bench press. Additionally, no significant differences (p > 0.05) were observed for any measure of muscle oxygenation, Stroop performance, or subjective performance ratings. It appears that 7 days of RSE supplementation did not alter performance, muscle oxygenation, nor Stroop scores during or following the bench press exercise in resistance-trained males.
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11
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Senefeld JW, Wiggins CC, Regimbal RJ, Dominelli PB, Baker SE, Joyner MJ. Ergogenic Effect of Nitrate Supplementation: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2021; 52:2250-2261. [PMID: 32936597 PMCID: PMC7494956 DOI: 10.1249/mss.0000000000002363] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Supplemental digital content is available in the text. Although over 100 studies and reviews have examined the ergogenic effects of dietary nitrate (NO3−) supplementation in young, healthy men and women, it is unclear if participant and environmental factors modulate the well-described ergogenic effects—particularly relevant factors include biological sex, aerobic fitness, and fraction of inspired oxygen (FiO2) during exercise. To address this limitation, the literature was systematically reviewed for randomized, crossover, placebo-controlled studies reporting exercise performance outcome metrics with NO3− supplementation in young, healthy adults. Of the 2033 articles identified, 80 were eligible for inclusion in the meta-analysis. Random-effects meta-analysis demonstrated that exercise performance improved with NO3− supplementation compared with placebo (d = 0.174; 95% confidence interval (CI), 0.120–0.229; P < 0.001). Subgroup analyses conducted on biological sex, aerobic fitness, and FiO2 demonstrated that the ergogenic effect of NO3− supplementation was as follows: 1) not observed in studies with only women (n = 6; d = 0.116; 95% CI, −0.126 to 0.358; P = 0.347), 2) not observed in well-trained endurance athletes (≥65 mL·kg−1·min−1; n = 26; d = 0.021; 95% CI, −0.103 to 0.144; P = 0.745), and 3) not modulated by FiO2 (hypoxia vs normoxia). Together, the meta-analyses demonstrated a clear ergogenic effect of NO3− supplementation in recreationally active, young, healthy men across different exercise paradigms and NO3− supplementation parameters; however, the effect size of NO3− supplementation was objectively small (d = 0.174). NO3− supplementation has more limited utility as an ergogenic aid in participants with excellent aerobic fitness that have optimized other training parameters. Mechanistic research and studies incorporating a wide variety of subjects (e.g., women) are needed to advance the study of NO3− supplementation; however, additional descriptive studies of young, healthy men may have limited utility.
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Affiliation(s)
- Jonathon W Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Riley J Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | | | - Sarah E Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
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12
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Engan H, Patrician A, Lodin-Sundström A, Johansson H, Melin M, Schagatay E. Spleen contraction and Hb elevation after dietary nitrate intake. J Appl Physiol (1985) 2020; 129:1324-1329. [PMID: 33031018 DOI: 10.1152/japplphysiol.00236.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ingestion of dietary nitrate ([Formula: see text]) is associated with improved exercise tolerance and reduced oxygen (O2) cost of exercise, ascribed to enhanced mitochondrial efficiency, muscle contractile function, or other factors. Nitrate ingestion has also been found to attenuate the reduction in arterial oxygen saturation ([Formula: see text]) during apnea and to prolong apneic duration. The spleen serves as a dynamic blood pool expelling erythrocytes into the circulation during apnea, and [Formula: see text] and nitric oxide donors may induce vasoactive effects in the mesenteric and splanchnic circulation. Our aim was to investigate the effect of ingestion of concentrated organic [Formula: see text]-rich beetroot juice (BR) on spleen volume and spleen contraction during apnea, and the resulting hemoglobin (Hb) concentration. Eight volunteers performed two apneas of submaximal and maximal duration during prone rest ∼2.5 h after ingesting 70 mL of BR (∼5 mmol [Formula: see text]) or placebo (PL; ∼0.003 mmol [Formula: see text]), on separate days in weighted order. Heart rate and [Formula: see text] were monitored continuously and spleen diameters were measured every minute for triaxial volume calculation. Capillary Hb samples were collected at baseline and after the maximal apnea. Baseline spleen volume was reduced by 66 mL after BR ingestion (22.9%; P = 0.026) and Hb was elevated (+3.0%; P = 0.015). During apneas, spleen contraction and Hb increase were similar between BR and PL conditions (NS). The study shows that dietary [Formula: see text]reduces spleen volume at rest, resulting in increased Hb. This spleen-induced Hb elevation following [Formula: see text] ingestions represents a novel mechanism that could enhance performance in conditions involving exercise, apnea, and hypoxia.NEW & NOTEWORTHY This is the first study to examine changes of spleen volume and circulating Hb following dietary [Formula: see text] supplementation. After dietary [Formula: see text] ingestion, the spleen volume at rest was reduced and Hb was elevated. The spleen contains a dynamic red blood cell reservoir, which can be mobilized and facilitate oxygen transport during various types of physiological stress. This study has revealed an additional, previously unexplored mechanism possibly contributing to the ergogenic effects of dietary [Formula: see text].
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Affiliation(s)
- Harald Engan
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Unicare Rehabilitation Norway, Oslo, Norway
| | - Alexander Patrician
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Centre for Heart, Lung & Vascular Health, University of British Columbia Okanagan, Kelowna, Canada
| | - Angelica Lodin-Sundström
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Hampus Johansson
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Maja Melin
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Erika Schagatay
- Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.,Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden
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13
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dos S. Baião D, da Silva DVT, Paschoalin VMF. Beetroot, a Remarkable Vegetable: Its Nitrate and Phytochemical Contents Can be Adjusted in Novel Formulations to Benefit Health and Support Cardiovascular Disease Therapies. Antioxidants (Basel) 2020; 9:E960. [PMID: 33049969 PMCID: PMC7600128 DOI: 10.3390/antiox9100960] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 02/06/2023] Open
Abstract
The cardioprotective effects of dietary nitrate from beetroot in healthy and hypertensive individuals are undeniable and irrefutable. Nitrate and nitrate-derived nitrite are precursors for nitric oxide synthesis exhibiting an effect on cardiomyocytes and myocardial ischemia/reperfusion, improving endothelial function, reducing arterial stiffness and stimulating smooth muscle relaxation, decreasing systolic and diastolic blood pressures. Beetroot phytochemicals like betanin, saponins, polyphenols, and organic acids can resist simulated gastrointestinal digestion, raising the hypothesis that the cardioprotective effects of beetroots result from the combination of nitrate/nitrite and bioactive compounds that limit the generation of reactive oxygen species and modulate gene expression. Nitrate and phytochemical concentrations can be adjusted in beet formulations to fulfill requirements for acute or long-term supplementations, enhancing patient adherence to beet intervention. Based on in vitro, in vivo, and clinical trials, beet nitrate and its bioactive phytochemicals are promising as a novel supportive therapy to ameliorate cardiovascular diseases.
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Affiliation(s)
| | | | - Vania M. F. Paschoalin
- Instituto de Química, Universidade Federal do Rio de Janeiro, Avenida Athos da Silveira Ramos 149, Rio de Janeiro 21941-909, Brazil; (D.d.S.B.); (D.V.T.d.S.)
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14
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Rodríguez-Fernández A, Castillo D, Raya-González J, Domínguez R, Bailey SJ. Beetroot juice supplementation increases concentric and eccentric muscle power output. Original investigation. J Sci Med Sport 2020; 24:80-84. [PMID: 32507624 DOI: 10.1016/j.jsams.2020.05.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/03/2020] [Accepted: 05/18/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Beetroot juice (BJ) supplementation has been reported to enhance skeletal muscle contractile function; however, it is currently unclear whether BJ supplementation elicits comparable improvements in power output during different types of skeletal muscle contractions. The purpose of the current study was to assess the effect of BJ supplementation on power output during concentric (CON) and eccentric (ECC) muscle contractions during a half-squat. DESIGN In a randomized, double-blind placebo-controlled crossover design, eighteen adult males (age: 22.8±4.9y) completed two experimental testing sessions 2.5h following the acute ingestion of 140mL nitrate-rich BJ concentrate or a placebo. METHODS Each experimental session comprised four sets of eight all-out half-squat repetitions with each set completed with a different moment intertia (0.025, 0.050, 0.075 and 0.100kg·m-2). RESULTS Compared to placebo, BJ supplementation increased mean power output (MP) during the CON (ES: 0.61-1.01) and ECC (ES: 0.54-0.89; all p<0.05) movement phases to a similar extent. Moreover, comparable increases in peak power output (PP) during the CON (ES: 0.86-1.24) and ECC (ES: 0.6-1.08; all p<0.05) movement phases were observed following BJ supplementation. CONCLUSION Acute BJ supplementation increased mean and peak lower limb power output in the concentric and eccentric movement phases of a half-squat. These findings improve understanding of the effects of BJ supplementation on skeletal muscle contractile function and might have implications for enhancing sports performance in events where muscle power output is a key performance determinant.
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Affiliation(s)
| | | | | | | | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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15
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Zamani H, de Joode MEJR, Hossein IJ, Henckens NFT, Guggeis MA, Berends JE, de Kok TMCM, van Breda SGJ. The benefits and risks of beetroot juice consumption: a systematic review. Crit Rev Food Sci Nutr 2020; 61:788-804. [PMID: 32292042 DOI: 10.1080/10408398.2020.1746629] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Beetroot juice (BRJ) has become increasingly popular amongst athletes aiming to improve sport performances. BRJ contains high concentrations of nitrate, which can be converted into nitric oxide (NO) after consumption. NO has various functions in the human body, including a vasodilatory effect, which reduces blood pressure and increases oxygen- and nutrient delivery to various organs. These effects indicate that BRJ may have relevant applications in prevention and treatment of cardiovascular disease. Furthermore, the consumption of BRJ also has an impact on oxygen delivery to skeletal muscles, muscle efficiency, tolerance and endurance and may thus have a positive impact on sports performances. Aside from the beneficial aspects of BRJ consumption, there may also be potential health risks. Drinking BRJ may easily increase nitrate intake above the acceptable daily intake, which is known to stimulate the endogenous formation of N-nitroso compounds (NOC's), a class of compounds that is known to be carcinogenic and that may also induce several other adverse effects. Compared to studies on the beneficial effects, the amount of data and literature on the negative effects of BRJ is rather limited, and should be increased in order to perform a balanced risk assessment.
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Affiliation(s)
- H Zamani
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - M E J R de Joode
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - I J Hossein
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - N F T Henckens
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - M A Guggeis
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - J E Berends
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - T M C M de Kok
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - S G J van Breda
- Department of Toxicogenomics, GROW-school for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
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