Dietary nitrate supplementation improves sprint and high-intensity intermittent running performance

Investigation of the effect of nitrate and L-arginine intake on aerobic, anaerobic performance, balance, agility, and recovery in elite taekwondo athletes

BACKGROUND

Taekwondo is a complex martial art that requires speed, balance, agility, and endurance. This study aims to examine the effects of nitrate and L-arginine supplementation on acute aerobic and anaerobic performance, balance, agility, and recovery in elite taekwondo athletes.

METHOD

This study was conducted as a double-blind, randomized, crossover study with the participation of 15 experienced taekwondo athletes aged 19.06 ± 0.96 years and 8.93 ± 1.27 years of training experience. Participants visited the laboratory a total of nine times, including a practice session and anthropometric measurements. These visits consisted of eight experimental sessions conducted at 72-hour intervals. The experimental sessions were conducted with nitrate, L-arginine, and a combination of both supplements (NIT*L-ARG) and placebo. Nitrate supplementation was provided by homogenizing fresh spinach (837.40 mg/kg), while L-ARG was given as a single dose of 6 g in powder form three hours before exercise.

RESULTS

NIT*L-ARG supplementation significantly improved the anaerobic performance of athletes in Wingate peak power and peak power (w/kg) compared to placebo and in mean power compared to NIT, L-ARG, and PLA. In addition, NIT*L-ARG supplementation significantly improved blood lactate levels and agility performance immediately after Wingate and Shuttle run tests.

CONCLUSION

The combined intake of NIT*L-ARG was found to be effective in improving aerobic, anaerobic, and agility performances as well as fatigue levels of athletes. It was determined that taking NIT and L-ARG supplements alone contributed to the improvement of improving athletes' performance in Wingate mean power values and subsequent fatigue level compared to PLA.

The Effect of Dark Chocolate Consumption on Arterial Function in Endurance Male Runners: Prospective Cohort Study

Foods rich in polyphenols have beneficial effects on health. This study aimed to examine the impact of dark chocolate on endurance runners' arterial function. Forty-six male amateur runners, aged 25-55, participated. The initial assessments included clinical testing, arterial stiffness measurements, and a cardiopulmonary exercise test. The participants then consumed 50 g of dark chocolate (70% cocoa) daily for two weeks, maintaining their usual training routine. After this period, the baseline assessment was repeated. The results showed significant improvements. Pulse wave velocity decreased by 11.82% (p < 0.001), and augmentation index by 19.47% (p < 0.001). Systolic brachial blood pressure reduced by 2.12% (p < 0.05), diastolic by 2.79% (p < 0.05), and mean pressure by 2.41% (p < 0.05). Central arterial pressure also decreased, with systolic by 1.24% (p < 0.05), diastolic by 2.80% (p < 0.05), and mean pressure by 2.43% (p < 0.05). Resting heart rate increased by 4.57% (p < 0.05) and left ventricular ejection time decreased by 4.89% (p < 0.05), particularly in athletes over 40. Exercise time increased by 2.16% (p < 0.05), heart rate (max) by 1.15% (p < 0.05), VO2max by 2.31% (p < 0.05), and anaerobic threshold shifted by 6.91% (p < 0.001) in exercise time and 6.93% (p < 0.001) in VO2max. In conclusion, dark chocolate improves arterial function in endurance runners, enhancing vascular health.

Acute inorganic nitrate ingestion does not impact oral microbial composition, cognitive function, or high-intensity exercise performance in female team-sport athletes

The purpose of this study was to investigate the effects of acute nitrate (NO3-)-rich beetroot juice ingestion on explosive and high-intensity exercise performance, oral microbiota composition, and cognitive flexibility (i.e., function), before and after maximal intermittent running exercise. Fifteen women team-sport athletes were assigned in a randomized, double-blind, crossover design to consume concentrated NO3--depleted beetroot juice (PL; 0.1 mmol NO3-) and NO3--rich beetroot juice (BR; 12.0 mmol NO3-) 2.5 h prior to performing a battery of exercise performance tasks and cognitive testing before and after the Yo-Yo intermittent recovery level 1 (YYIR1) running test. Resting plasma [NO3-] and plasma nitrite ([NO2-]) were elevated following BR (P < 0.001). BR did not impact global composition or relative abundance of taxa in the oral microbiome (P > 0.05) or cognitive flexibility before or after exercise (P > 0.05). There was no significant difference in performance during 20-m (PRE, PL: 4.38 ± 0.27 vs. BR: 4.38 ± 0.32 s; POST, PL: 4.45 ± 0.29 vs. BR: 4.43 ± 0.35 s) and 10-m sprints (PRE, PL 2.78 ± 0.15 vs. BR 2.79 ± 0.18 s; POST, PL: 2.82 ± 0.16 vs. BR: 2.81 ± 0.19 s), isokinetic handgrip dynamometry, medicine ball throw, horizontal countermovement jump, or YYIR1 (PL: 355 ± 163 m vs. BR: 368 ± 184 m) between BR and PL (P > 0.05). These findings indicate that acute dietary NO3- may not influence the oral microbiome, explosive and high-intensity exercise performance, or cognitive function in women team-sport athletes.

Multiday Beetroot Juice Ingestion Improves Some Aspects of Neuromuscular Performance in Semi-Professional, Male Handball Players: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study

The aim of this study was to examine the effects of multiday beetroot juice ingestion on neuromuscular performance in semi-professional, male handball players. Twelve handball players competing in the second Spanish national division received 70 ml of beetroot juice (6.4 mmol of nitrate [NO3-]) or 70 ml of a placebo beetroot juice (0.04 mmol NO3-) for three consecutive days in a randomized, double-blind, crossover manner with a 1-week washout between conditions. Following supplementation in each condition, players completed a neuromuscular test battery involving handball throwing, isometric handgrip strength, countermovement jump, change-of-direction speed, and repeated-sprint assessments, with side effects also measured. Countermovement jump (4.7%; p = .038; Hedge's gav = 0.29) and isometric handgrip strength (7.8%; p = .021; gav = 0.59) were significantly superior with beetroot juice ingestion compared to the placebo. In contrast, nonsignificant differences were evident between conditions for all other neuromuscular performance variables (p > .05; gav = 0.00-0.27). Red urine production was the only side effect, demonstrating a significantly higher prevalence (p = .046) with beetroot juice ingestion. Three days of beetroot juice supplementation may be a useful nutritional strategy in semi-professional, male handball players given its ergogenic benefit to some aspects of neuromuscular performance.

Effects of Acute Ingestion of Guarana (Paullinia Cupana) on Soccer Player Performance: A Randomized, Cross-over, Placebo-Controlled Study

OBJECTIVE

To investigate the acute effects of ingesting a beverage containing guarana (Paullinia cupana) seed powder on performance during field tests related to physical capacities that are determinants of soccer performance, such as lower limb power, sprint, agility, and the capacity to carry out intermittent exercise.

METHODS

The study was conducted using a randomized, crossover, and counterbalanced design, with a beverage containing guarana or placebo administered in a double-blind manner. Twenty-seven under-17 soccer players of a professional soccer club performed a battery of tests 60 min after the ingestion of guarana (3 g of the fruit seed powder) or placebo. Trials were performed with a 7-day washout period. The battery of tests included a countermovement jump test, sprints of 10 and 20 m, an Illinois agility test, and a Yo-Yo Intermittent Recovery Test level 1 (YYIR1).

RESULTS

Guarana ingestion did not improve countermovement jump, sprints, or agility (p > 0.05). However, guarana ingestion increased the distance covered in the YYIR1, compared with placebo ingestion (p = 0.01).

CONCLUSION

Acute ingestion of guarana improves the capacity to perform intermittent exercise in soccer players but seems to be ineffective to improve lower limb power, sprint, and agility.

Effects of an Isotonic Beetroot Drink on Power Output During Sprint Exercise and Jump Performance in Physically Active Individuals: A Randomized Crossover Trial

Exogenous nitrate ingestion can improve exercise performance. This study investigated whether an isotonic beetroot drink could improve jump and sprint performance in active individuals. Twenty-three physically active participants (17 males, 6 females) (mean ± SD; age: 26 ± 4 years; body mass index: 22.4 ± 1.9 kg/m2) completed a double-blind, randomized, cross-over study where they consumed 570mL of either beetroot juice drink (BR) or isotonic beetroot juice drink (ISO-BR) three hours before performing countermovement (CMJ) and standing broad jump (SBJ) tests and a 30-second all-out sprint on a cycle ergometer. Both drinks contained equal nitrate (12.9 mmol) and carbohydrate (6.1g per 100mL) content but differed in osmolality (BR: 420 mOsm/kg vs. ISO-BR: 315 mOsm/kg). Salivary total nitrate and nitrite concentrations (NOx) 3 hours post-ingestion were significantly higher after consuming ISO-BR than BR. ISO-BR significantly improved peak power output compared to BR by 3.9% (ISO-BR: 11.4 ± 2.5 W/kg vs. BR: 11.0 ± 2.3 W/kg, p = .04) but not time to peak power (ISO-BR: 2.8 ± 1.7 s vs. BR: 2.9 ± 1.6 s, p = .62) or mean power output (ISO-BR: 7.3 ± 1.5 W/kg vs. BR: 7.3 ± 1.5 W/kg, p = .37). There were no significant differences in CMJ or SBJ between trials (p > .05). Sensory evaluation indicated that ISO-BR was preferred by 91% (n = 21) of participants compared with BR (average score; ISO-BR: 5.52 vs. BR: 3.52, p < .05). An ISO-BR drink improved peak power output during sprint cycling but not jump performance compared with BR alone, potentially via increased NOx.

A randomised crossover trial of nitrate and breakfast on prefrontal cognitive and haemodynamic response functions

It remains unknown whether dietary nitrate and breakfast may enhance working memory (WM) performance by augmenting physiological mechanisms and subjective psychological well-being. We performed a 3-arm randomised within-subject crossover study, with pretest-posttest comparisons, to test whether nitrate consumption via breakfast with a beetroot juice shot or regular breakfast compared to no breakfast improved WM (measured with n-back tests) and cognitive task-related changes in prefrontal cortical haemodynamic response (oxygenated- and deoxygenated-haemoglobin derived from functional near-infrared spectroscopy). In addition, effects on peripheral vascular function and self-reported psychological factors were assessed. In 60 adolescents (13-15 years old; 66% girls), WM improved in all conditions, with no intervention effects. Intervention effects were seen for oxygenated-haemoglobin changes, such that it increased after the breakfast with a nitrate shot during the WM tests and decreased after the regular breakfast. Thus, different neurophysiological mechanisms may be at play to preserve WM in adolescents depending on their breakfast composition. The trial was registered in the ISRCTN registry (ISRCTN16596056) on 21/02/2022.

Sodium Nitrate Improves Oxidative Energy Contribution and Reduces Phosphocreatine Contribution During High-Intensity Intermittent Exercise

The present study aimed to verify the effect of acute nitrate supplementation on oxidative, phosphocreatine, and glycolytic energy contribution (COXI, CPCr, and CLAC, respectively) during a high-intensity intermittent exercise (HIIE). Fifteen physically active subjects were submitted to incremental running test on a treadmill and two random HIIE (10 × 1 min at maximal aerobic speed with 1 min of passive recovery) in the following conditions: sodium nitrate (SN) or Placebo (PL). Repeated measure ANOVA was used to compare COXI, and CPCr within the 10 efforts. Student t test was used to compare total COXI, CPCr, CLAC, as well oxidative and non-oxidative contribution. Considering the 10 efforts, COXI presented the main effect for condition (F = 16.7; p = .001; SN: 1.9 ± 0.1 L; PL: 1.6 ± 0.1 L), and no interaction effect (F = 0.9; p = .415), while CPCr presented effect for condition (F = 13.4; p = .003; SN: 1.2 ± 0.1; PL: 1.4 ± 0.8 L), and no interaction (F = 1.2; p = .317). Total oxidative contribution were higher (p < .001) after SN (19.1 ± 3.4 L) than Placebo (16.7 ± 3.1 L), while total CPCr were lower (p = .002) after SN (12.4 ± 2.5 L) than PL (14.1 ± 2.6 L). Total energy contribution were not different between trials. Acute dose of SN supplementation improved oxidative contribution during HIIE, and reduced CPCr. Higher COXI is likely related to increased oxygen kinetics, while the lower CPCr might be related to the improved energetic efficiency.

Dietary nitrate supplementation and cognitive health: the nitric oxide-dependent neurovascular coupling hypothesis

Diet is currently recognized as a major modifiable agent of human health. In particular, dietary nitrate has been increasingly explored as a strategy to modulate different physiological mechanisms with demonstrated benefits in multiple organs, including gastrointestinal, cardiovascular, metabolic, and endocrine systems. An intriguing exception in this scenario has been the brain, for which the evidence of the nitrate benefits remains controversial. Upon consumption, nitrate can undergo sequential reduction reactions in vivo to produce nitric oxide (•NO), a ubiquitous paracrine messenger that supports multiple physiological events such as vasodilation and neuromodulation. In the brain, •NO plays a key role in neurovascular coupling, a fine process associated with the dynamic regulation of cerebral blood flow matching the metabolic needs of neurons and crucial for sustaining brain function. Neurovascular coupling dysregulation has been associated with neurodegeneration and cognitive dysfunction during different pathological conditions and aging. We discuss the potential biological action of nitrate on brain health, concerning the molecular mechanisms underpinning this association, particularly via modulation of •NO-dependent neurovascular coupling. The impact of nitrate supplementation on cognitive performance was scrutinized through preclinical and clinical data, suggesting that intervention length and the health condition of the participants are determinants of the outcome. Also, it stresses the need for multimodal quantitative studies relating cellular and mechanistic approaches to function coupled with behavior clinical outputs to understand whether a mechanistic relationship between dietary nitrate and cognitive health is operative in the brain. If proven, it supports the exciting hypothesis of cognitive enhancement via diet.

A review on nitrates' health benefits and disease prevention

Dietary nitrates (NO3-) are naturally occurring compounds in various vegetables, especially beetroot, which is mainly supplemented in the form of BRJ. Dietary nitrates (NO3-) play a crucial function in human physiology. On consumption, nitrates (NO3-) undergo a conversion process, producing nitric oxide (NO) via a complex metabolic pathway. Nitric oxide (NO) is associated with many physiological processes, entailing immune modulation, neurotransmission, and vasodilation, enabling blood vessel dilation and relaxation, which boosts blood flow and oxygen delivery to tissues, positively influencing cardiovascular health, exercise performance, and cognitive function. There are various analytical processes to determine the level of nitrate (NO3-) present in dietary sources. The impact of dietary nitrates (NO3-) can differ among individuals. Thus, the review revisits the dietary source of nitrates (NO3-), its metabolism, absorption, excretion, analytical techniques to assess nitrates (NO3-) content in various dietary sources, and discusses health effects.

Chronic beetroot juice supplementation attenuates neuromuscular fatigue etiology during simulated soccer match play

The aim of the present study was to assess the effect of beetroot juice supplementation (BEET) on neuromuscular fatigue etiology during simulated soccer match play. In a randomized, double-blind, crossover design, 13 soccer players completed the Loughborough Intermittent Shuttle Test (LIST). Players received either BEET (2×150 mL; ∼8 mmol/L nitrate) or placebo (PLA) for 7 days (6 days prior to the experimental session and on the day of trial, 2 h before LIST). Neuromuscular assessments were performed at baseline, 45 min (half time: HT), and 90 min (full time: FT) following LIST. Maximal voluntary contraction (MVC) and twitch responses, delivered through electrical femoral nerve stimulation, were used to assess peripheral (quadriceps resting twitch force Qtw,pot) and central fatigue (voluntary activation, VA). Compared with baseline, MVC Qtw,pot and VA values decreased in PLA and BEET conditions at HT and FT (P < 0.05). Compared with PLA, the decrease in MVC and Qtw,pot was significantly attenuated with BEET at HT and FT (P < 0.001). Likewise, BEET attenuated the decrease in VA at HT (P < 0.001, d = 1.3) and FT (P < 0.001, d = 1.5) compared with the PLA condition. Chronic beetroot juice supplementation attenuates neuromuscular fatigue development during simulated soccer matches, and this is due to both central and peripheral factors. Consequently, chronic beetroot may optimize physical performance.

Acute beetroot juice supplementation did not enhance intermittent running performance in trained rugby players

ABSTRACTPurpose: Since the effect of dietary nitrate (NO3-) supplementation on rugby performance is unclear, the aim of the present study was to determine the effect of acute NO3- supplementation, on the modified Yo-Yo intermittent recovery level 1 (IR1) performance test in trained male rugby players.Methods: In a randomised, counterbalanced, double-blind, placebo-controlled crossover design, 12 trained rugby union players performed two experimental trials three hours after supplementation of either 140 mL NO3--rich (BRJ; ∼12.8 mmol NO3-) or NO3--depleted (PLA) BRJ. After blood sampling, players performed the modified Yo-Yo IR1 test. Countermovement jumps (CMJ) were also measured before (pre-CMJ) and after (post-CMJ) the prone Yo-Yo IR1 test.Results: Plasma NO3- (BRJ: 570 ± 146 µM vs. PLA: 72 ± 23 µM) and nitrite (NO2-) concentrations (BRJ: 320 ± 123 nM vs. PLA: 103 ± 57 nM) were increased after BRJ compared to PLA supplementation (both P < 0.001). Performance in the modified Yo-Yo IR1 test did not differ between BRJ (542 ± 209 m) and PLA (498 ± 185 m, P = 0.3). The jump height in pre-CMJ and in post-CMJ were similar between trials (both P > 0.05).Conclusions: Acute BRJ supplementation increased plasma NO3- and NO2- concentrations but had no benefit on an intermittent running test that reflects the demands of rugby performance, and CMJ performances. The findings do not support acute high-dose NO3- supplementation as an ergogenic aid to enhance physical performance in trained male rugby players.

Effects of dietary nitrate supplementation on peak power output: Influence of supplementation strategy and population

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.

Dietary nitrate intake in relation to the risk of dementia and imaging markers of vascular brain health: a population-based study

BACKGROUND

Nitric oxide is a free radical that can be produced from dietary nitrate and positively affects cardiovascular health. With cardiovascular health playing an important role in the etiology of dementia, we hypothesized a link between dietary nitrate intake and the risk of dementia.

OBJECTIVES

This study aimed to find the association of total, vegetable, and nonvegetable dietary nitrate intake with the risk of dementia and imaging markers of vascular brain health, such as total brain volume, global cerebral perfusion, white matter hyperintensity volume, microbleeds, and lacunar infarcts.

METHODS

Between 1990 and 2009, dietary intake was assessed using food-frequency questionnaires in 9543 dementia-free participants (mean age, 64 y; 58% female) from the prospective population-based Rotterdam Study. Participants were followed up for incidence dementia until January 2020. We used Cox models to determine the association between dietary nitrate intake and incident dementia. Using linear mixed models and logistic regression models, we assessed the association of dietary nitrate intake with changes in imaging markers across 3 consecutive examination rounds (mean interval between images 4.6 y).

RESULTS

Participants median dietary nitrate consumption was 85 mg/d (interquartile range, 55 mg/d), derived on average for 81% from vegetable sources. During a mean follow-up of 14.5 y, 1472 participants developed dementia. A higher intake of total and vegetable dietary nitrate was associated with a lower risk of dementia per 50-mg/d increase [hazard ratio (HR): 0.92; 95% confidence interval (CI): 0.87, 0.98; and HR: 0.92; 95% CI: 0.86, 0.97, respectively] but not with changes in neuroimaging markers. No association between nonvegetable dietary nitrate intake and the risk of dementia (HR: 1.15; 95% CI: 0.64, 2.07) or changes in neuroimaging markers were observed.

CONCLUSIONS

A higher dietary nitrate intake from vegetable sources was associated with a lower risk of dementia. We found no evidence that this association was driven by vascular brain health.

Habitual dietary nitrate intake and cognition in the Australian Imaging, Biomarkers and Lifestyle Study of ageing: A prospective cohort study

BACKGROUND & AIMS

Dietary nitrate improves cardiovascular health via a nitric oxide (NO) pathway. NO is key to both cardiovascular and brain health. There is also a strong association between vascular risk factors and brain health. Dietary nitrate intake could therefore be associated with better cognitive function and reduced risk of cognitive decline. This is yet to be investigated. The aim of this study was to investigate the association between habitual intake of dietary nitrate from sources where nitrate is naturally present, and cognitive function, and cognitive decline, in the presence or absence of the apolipoprotein E (APOE) ε4 allele.

METHODS

The study included 1254 older adult participants of the Australian Imaging, Biomarkers and Lifestyle Study of Ageing who were cognitively normal at baseline. Plant-derived, vegetable-derived, animal derived nitrate (not including meat where nitrate is an allowed additive), and total nitrate intakes were calculated from baseline food frequency questionnaires using comprehensive nitrate databases. Cognition was assessed at baseline and every 18 months over a follow-up period of 126 months using a comprehensive neuropsychological test battery. Multivariable-adjusted linear mixed effect models were used to examine the association between baseline nitrate intake and cognition over the 126 months (median [IQR] follow-up time of 36 [18-72] months), stratified by APOE ε4 carrier status.

RESULTS

In non APOE ε4 carriers, for every 60 mg/day higher intake of plant-derived nitrate at baseline there was an associated higher language score [β (95% CI): 0.10 (0.01, 0.19)] over 126 months, after multivariable adjustments. In APOE ε4 carriers, there was an associated better episodic recall memory [0.24 (0.08, 0.41)] and recognition memory [0.15 (0.01, 0.30)] scores. Similar associations were seen for the intakes of vegetable-derived and total nitrate. Additionally, in APOE ε4 carriers, for every 6 mg/day higher intake of animal-derived nitrate (excluding meat with nitrate as an allowed additive) at baseline there was an associated higher executive function score [β (95% CI): 1.41 (0.42, 2.39)]. We did not find any evidence of an association between dietary nitrate intake and rate of cognitive decline.

CONCLUSION

Our results suggest that habitual intake of dietary nitrate from sources where nitrate is naturally present impacts cognitive performance in an APOE genotype contingent manner. Further work is needed to validate our findings and understand potential mechanisms underlying the observed effects.

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

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.

Effects of dietary nitrate supplementation on muscular power output: Influence of supplementation strategy and population

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.

Beetroot juice ingestion does not improve neuromuscular performance and match-play demands in elite female hockey players: a randomized, double-blind, placebo-controlled study

PURPOSE

Beetroot juice is a dietary supplement that contains high levels of inorganic nitrate (NO_3-) and that its intake has proven effective at increasing blood nitric oxide (NO) concentrations improving endurance performance. However, the effect of this supplement in team sport performance, especially in female athletes, has been barely studied. This study aimed to compare the acute effects of beetroot juice supplementation on neuromuscular performance and match-play demands in elite female field hockey players.

METHODS

Eleven elite female hockey players (22.8 ± 5.1 years) belonging to a bronze team medal in Eurohockey Club Champions Cup participated in this study. Participants were randomly divided into two groups undergoing a test battery with beetroot juice (70 mL, 6.4 mmol NO₃^-) or placebo (70 mL, 0.04 mmol NO₃^-) in two different days with one week between protocols. The neuromuscular test battery consisted of a countermovement jump, isometric handgrip strength (i.e., dominant hand), 20 m-sprint and repeated sprint ability test (RSA). Afterward, a simulated hockey match play (2 × 12.5 min) was performed and recorded by Global Positioning System (GPS).

RESULTS

No statistically significant improvements were observed in any physical parameters analysed comparing beetroot juice compared to placebo ingestion, countermovement jump (p = 0.776, ES = 0.16), isometric handgrip strength (p = 0.829; ES = - 0.08), 20 m sprint test (p = 0.227; ES = - 0.23), mean repeated sprint ability (p = 0.955, ES = 0.03) and in any physical match demands measured by GPS (p = 0.243-1.000; ES = 0.02-0.47).

CONCLUSION

Acute beetroot juice supplementation did not produce any statistically significant improvement in neuromuscular performance or match-play demands in elite female field hockey players.

TRIAL REGISTRATION

The study was registered in ClinicalTrials.gov with the following ID: NCT05209139. The study was retrospectively registered by 26 January 2022.

15 N-labeled dietary nitrate supplementation increases human skeletal muscle nitrate concentration and improves muscle torque production

AIM

Dietary nitrate (NO₃ ^- ) supplementation increases nitric oxide bioavailability and can enhance exercise performance. We investigated the distribution and metabolic fate of ingested NO₃ ^- at rest and during exercise with a focus on skeletal muscle.

METHODS

In a randomized, crossover study, 10 healthy volunteers consumed 12.8 mmol ¹⁵ N-labeled potassium nitrate (K¹⁵ NO₃ ; NIT) or potassium chloride placebo (PLA). Muscle biopsies were taken at baseline, at 1- and 3-h post-supplement ingestion, and immediately following the completion of 60 maximal intermittent contractions of the knee extensors. Muscle, plasma, saliva, and urine samples were analyzed using chemiluminescence to determine absolute [NO₃ ^- ] and [NO₂ ^- ], and by mass spectrometry to determine the proportion of NO₃ ^- and NO₂ ^- that was ¹⁵ N-labeled.

RESULTS

Neither muscle [NO₃ ^- ] nor [NO₂ ^- ] were altered by PLA. Following NIT, muscle [NO₃ ^- ] (but not [NO₂ ^- ]) was elevated at 1-h (from ~35 to 147 nmol/g, p < 0.001) and 3-h, with almost all of the increase being ¹⁵ N-labeled. There was a significant reduction in ¹⁵ N-labeled muscle [NO₃ ^- ] from pre- to post-exercise. Relative to PLA, mean muscle torque production was ~7% greater during the first 18 contractions following NIT. This improvement in torque was correlated with the pre-exercise ¹⁵ N-labeled muscle [NO₃ ^- ] and the magnitude of decline in ¹⁵ N-labeled muscle [NO₃ ^- ] during exercise (r = 0.66 and r = 0.62, respectively; p < 0.01).

CONCLUSION

This study shows, for the first time, that skeletal muscle rapidly takes up dietary NO₃ ^- , the elevated muscle [NO₃ ^- ] following NO₃ ^- ingestion declines during exercise, and muscle NO₃ ^- dynamics are associated with enhanced torque production during maximal intermittent muscle contractions.

Influence of Chronic Nitrate-Rich Beetroot Juice Supplementation on the Endurance Performance of Active Winter Triathletes: A Randomized Controlled Trial

OBJECTIVE

The impact of high-nitrate beetroot juice (BRJ) supplementation has seen a recent explosion of interest in sports science. This study examined the potential influence of 7-day BRJ supplementation on the endurance performance of winter triathletes.

METHODS

Eighty young active winter triathletes (44 males, age = 21.50 ± 1.15 yrs; 36 females, age = 20.66 ± 1.45 yrs) participated in this study and were provided with either BRJ (6.5 mmol NO₃^-/70 mL) or a placebo (PL, 0.065 mmol NO₃^-/70 mL) for 7 days (a dose of ×3 per day) in a randomized, double-blind design. The athletes then completed a submaximal treadmill run, intraday cycling exhaustion testing, and a 10-km cross country (XC) skiing competition on the second day.

RESULTS

There was a significant decrease in the oxygen uptake, respiratory exchange ratio, and blood lactic acid level (p < 0.05) between the BRJ and PL treatment groups during V₃ speed running (males: 13.3 km·h^-1, females: 11.6 km·h^-1). BRJ treatment also remarkably increased the time to exhaustion (TTE) during cycling exhaustion testing (males: p = 0.02, females: p = 0.04). No significant differences were observed in medium- or low-speed submaximal treadmill runs and 10-km XC skiing performance.

CONCLUSIONS

One week of daily nitrate-rich BRJ supplementation improved running economy at high speed during the submaximal treadmill running test and extended the TTE of athletes during cycling exhaustion testing. However, BRJ supplementation did not improve the performance in 10-km on-snow time trials in XC skiing. Regarding nutritional strategies to improve endurance performance in exercise training and competition, these results should be carefully considered owing to the different motor skill levels and competitive abilities of participants.

Dietary nitrate supplementation enhances heavy load carriage performance in military cadets

PURPOSE

To determine the effects of dietary nitrate (NO₃^-) supplementation on physiological responses, cognitive function, and performance during heavy load carriage in military cadets.

METHODS

Ten healthy males (81.0 ± 6.5 kg; 180.0 ± 4.5 cm; 56.2 ± 3.7 ml·kg·min^-1 VO_2max) consumed 140 mL·d^-1 of beetroot juice (BRJ; 12.8 mmol NO₃^-) or placebo (PL) for six d preceding an exercise trial, which consisted of 45 min of load carriage (55% body mass) at 4.83 km·h^-1 and 1.5% grade, followed by a 1.6-km time-trial (TT) at 4% grade. Gas exchange, heart rate, and perceptual responses were assessed during constant-load exercise and the TT. Cognitive function was assessed immediately prior to, during, and post-exercise via the psychomotor vigilance test (PVT).

RESULTS

Post-TT HR (188 ± 7.1 vs. 185 ± 7.4; d = 0.40; p = 0.03), mean tidal volume (2.15 ± 0.27 vs. 2.04 ± 0.23; p = 0.02; d = 0.47), and performance (770.9 ± 78.2 s vs. 809.8 ± 61.4 s; p = 0.03; d = 0.63) were increased during the TT with BRJ versus PL. There were no effects of BRJ on constant-load gas exchange or perceptual responses, and cognitive function was unchanged at all time points.

CONCLUSION

BRJ supplementation improves heavy load carriage performance in military cadets possibly as a result of attenuated respiratory muscle fatigue, rather than enhanced exercise economy.

Potential role of dietary nitrate in relation to cardiovascular and cerebrovascular health, cognition, cognitive decline and dementia: a review

There is currently no effective treatment for dementia, of which Alzheimer's disease (AD) is the most common form. It is, therefore, imperative to focus on evidence-based preventive strategies to combat this extremely debilitating chronic disease. Nitric oxide (NO) is a key signalling molecule in the cardiovascular, cerebrovascular, and central nervous systems. Vegetables rich in nitrate, such as spinach and beetroot, are an important source of NO, with beneficial effects on validated markers of cardiovascular health and an association with a lower risk of cardiovascular disease. Given the link between cardiovascular disease risk factors and dementia, together with the important role of NO in vascular health and cognition, it is important to determine whether dietary nitrate could also improve cognitive function, markers of brain health, and lower risk of dementia. This review presents an overview of NO's role in the cardiovascular, cerebrovascular, and central nervous systems; an overview of the available evidence that nitrate, through effects on NO, improves cardiovascular health; and evaluates the current evidence regarding dietary nitrate's potential role in cerebrovascular health, cognitive function, and brain health assessed via biomarkers.

The effects of nitrate ingestion on high-intensity endurance time-trial performance: A systematic review and meta-analysis

Background/Objective

Dietary nitrate ingestion extends endurance capacity, but data supporting endurance time-trial performance are unclear. This systematic review and meta-analysis evaluated the evidence for dietary nitrate supplementation to improve high-intensity endurance time-trial performance over 5-30 min on the premise that nitrate may alleviate peripheral fatigue over shorter durations.

Methods

A systematic literature search and data extraction was carried out following PRISMA guidelines and the PICOS framework within five databases: PubMed, ProQuest, ScienceDirect, Scopus and SPORTDiscus. Search terms used were: (nitrate OR nitrite OR beetroot) AND (high intensity OR all out) AND (time trial or total work done) AND performance.

Results

Twenty-four studies were included. Fifteen studies applied an acute supplementation strategy (4.1 mmol-15.2 mmol serving on one day), eight chronic supplementation (4.0 mmol-13.0 mmol per day over 3-15 days), and one applied both acute and chronic supplementation (8.0 mmol on one day and over 15 days). Standardised mean difference for time-trial ranging from 5 to 30 min showed an overall trivial effect in favour of nitrate (Hedges'g = 0.15, 95% CI -0.00 to 0.31, Z = 1.95, p = 0.05). Subgroup analysis revealed a small, borderline effect in favour of chronic nitrate intervention (Hedges'g = 0.30, 95% CI -0.00 to 0.59, Z = 1.94, p = 0.05), and a non-significant effect for acute nitrate intervention (Hedges'g = 0.10, 95% CI -0.08 to 0.28, Z = 1.11, p = 0.27).

Conclusion

Chronic nitrate supplementation improves time-trial performance ranging from 5 to 30 min.

Acute Beetroot Juice Supplementation Enhances Intermittent Running Performance but Does Not Reduce Oxygen Cost of Exercise among Recreational Adults

Nitrate (NO3−) supplementation has been reported to enhance intermittent exercise performance; however, its impact on oxygen (O2) cost during intermittent running exercise is unclear. The aim of this study was to assess if acute NO3− supplementation would elicit performance benefits in recreationally active individuals during the Yo−Yo intermittent recovery level 1 (Yo-Yo IR1) test, with its potential benefit on O2 consumption (VO2), in a double-blind, randomized, crossover study, 12 recreational males consumed NO3−-rich (NIT; ~12.8 mmol), and NO3−-depleted (PLA; 0.04 mmol) concentrated beetroot juice 3 h before completing the Yo-Yo IR1 test. VO2 was measured at 160, 280 and 440 m (sub-maximal) and when the test was terminated (peak). Performance in the Yo−Yo IR1 was greater with NIT (990 ± 442.25 m) compared to PLA (870 ± 357.4 m, p = 0.007). The VO2 was not significantly different at 160 m (1.92 ± 0.99 vs. 2.1 ± 0.88 L·min−1), 280 m (2.62 ± 0.94 vs. 2.83 ± 0.94 L·min−1), 440 m (3.26 ± 1.04 vs. 3.46 ± 0.98 L·min−1) and peak (4.71 ± 1.01 vs. 4.92 ± 1.17 L·min−1) between NIT and PLA trials (all p > 0.05). The present study has indicated that acute supplementation of NO3− enhanced intermittent running performance but had no effect on VO2 during the Yo−Yo IR1 test in recreational young adults.

Acute effects of beetroot juice and caffeine co-ingestion during a team-sport-specific intermittent exercise test in semi-professional soccer players: a randomized, double-blind, placebo-controlled study

BACKGROUND

Beetroot juice (BJ) and caffeine (CAF) are considered as ergogenic aids among athletes to enhance performance, however, the ergogenic effects of BJ and CAF co-ingestion are unclear during team-sport-specific performance. This study aimed to investigate the acute effects of BJ and CAF co-ingestion on team-sport-specific performance, compared with placebo (PL), BJ, and CAF alone.

METHOD

Sixteen semi-professional male soccer players (age: 19.8 ± 2.2 years, body mass: 69.2 ± 6.1 kg, height: 177.3 ± 6.0 cm) completed four experimental trials using a randomized, double-blind study design: BJ + CAF, CAF + PL, BJ + PL, and PL + PL. Countermovement jump with arm swing (CMJAS) performance and cognitive function by Stroop Word-Color test were evaluated before and after the Yo-Yo Intermittent Recovery Test level 1 (YYIR1). Also, rate of perceived exertion (RPE), heart rate, and gastrointestinal (GI) discomfort were measured during each session.

RESULTS

No significant differences were shown between test conditions for total distance covered in YYIR1 (BJ + CAF: 1858 ± 455 m, CAF + PL: 1798 ± 422 m, BJ + PL: 1845 ± 408 m, PL + PL 1740 ± 362 m; p = 0.55). Moreover, CMJAS performance, cognitive function, and RPE during the YYIR1 were not significantly different among conditions (p > 0.05). However, the average heart rate during the YYIR1 was higher in CAF + PL compared to PL + PL (by 6 ± 9 beats/min; p < 0.05), and GI distress was greater in BJ + CAF compared to PL + PL (by 2.4 ± 3.6 a.u.; p < 0.05).

CONCLUSION

These results suggest, neither acute co-ingestion of BJ + CAF nor BJ or CAF supplementation alone significantly affected team-sport-specific performance compared to the PL treatment.

The Effects of Dietary Nitrate Supplementation on Explosive Exercise Performance: A Systematic Review

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.

Effect of food sources of nitrate, polyphenols, L-arginine and L-citrulline on endurance exercise performance: a systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Increasing nitric oxide bioavailability may induce physiological effects that enhance endurance exercise performance. This review sought to evaluate the performance effects of consuming foods containing compounds that may promote nitric oxide bioavailability.

METHODS

Scopus, Web of Science, Ovid Medline, EMBASE and SportDiscus were searched, with included studies assessing endurance performance following consumption of foods containing nitrate, L-arginine, L-citrulline or polyphenols. Random effects meta-analysis was conducted, with subgroup analyses performed based on food sources, sex, fitness, performance test type and supplementation protocol (e.g. duration).

RESULTS

One hundred and eighteen studies were included in the meta-analysis, which encompassed 59 polyphenol studies, 56 nitrate studies and three L-citrulline studies. No effect on exercise performance following consumption of foods rich in L-citrulline was identified (SMD=-0.03, p=0.24). Trivial but significant benefits were demonstrated for consumption of nitrate and polyphenol-rich foods (SMD=0.15 and 0.17, respectively, p<0.001), including performance in time-trial, time-to-exhaustion and intermittent-type tests, and following both acute and multiple-day supplementation, but no effect of nitrate or polyphenol consumption was found in females. Among nitrate-rich foods, beneficial effects were seen for beetroot, but not red spinach or Swiss chard and rhubarb. For polyphenol-rich foods, benefits were found for grape, (nitrate-depleted) beetroot, French maritime pine, Montmorency cherry and pomegranate, while no significant effects were evident for New Zealand blackcurrant, cocoa, ginseng, green tea or raisins. Considerable heterogeneity between polyphenol studies may reflect food-specific effects or differences in study designs and subject characteristics. Well-trained males (V̇O2max ≥65 ml.kg.min-1) exhibited small, significant benefits following polyphenol, but not nitrate consumption.

CONCLUSION

Foods rich in polyphenols and nitrate provide trivial benefits for endurance exercise performance, although these effects may be food dependent. Highly trained endurance athletes do not appear to benefit from consuming nitrate-rich foods but may benefit from polyphenol consumption. Further research into food sources, dosage and supplementation duration to optimise the ergogenic response to polyphenol consumption is warranted. Further studies should evaluate whether differential sex-based responses to nitrate and polyphenol consumption are attributable to physiological differences or sample size limitations.

OTHER

The review protocol was registered on the Open Science Framework ( https://osf.io/u7nsj ) and no funding was provided.

Nutritional optimization for female elite football players-topical review

Women's football is an intermittent sport characterized by frequent intense actions throughout the match. The high number of matches with limited recovery time played across a long competitive season underlines the importance of nutritional strategies to meet these large physical demands. In order to maximize sport performance and maintain good health, energy intake must be optimal. However, a considerable proportion of female elite football players does not have sufficient energy intake to match the energy expenditure, resulting in low energy availability that might have detrimental physiologic consequences and impair performance. Carbohydrates appear to be the primary fuel covering the total energy supply during match-play, and female elite football players should aim to consume sufficient carbohydrates to meet the requirements of their training program and to optimize the replenishment of muscle glycogen stores between training bouts and matches. However, several macro- and micronutrients are important for ensuring sufficient energy and nutrients for performance optimization and for overall health status in female elite football players. The inadequacy of macro-and micronutrients in the diet of these athletes may impair performance and training adaptations, and increase the risk of health disorders, compromising the player's professional career. In this topical review, we present knowledge and relevant nutritional recommendations for elite female football players for the benefit of sports nutritionists, dietitians, sports scientists, healthcare specialists, and applied researchers. We focus on dietary intake and cover the most pertinent topics in sports nutrition for the relevant physical demands in female elite football players as follows: energy intake, macronutrient and micronutrient requirements and optimal composition of the everyday diet, nutritional and hydration strategies to optimize performance and recovery, potential ergogenic effects of authorized relevant supplements, and future research considerations.

The Effect of Beetroot Ingestion on High-Intensity Interval Training: A Systematic Review and Meta-Analysis

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.

DIETARY SUPPLEMENTS FOR CONSIDERATION IN ELITE FEMALE FOOTBALLERS

The physical demands of professional female football have intensified in recent years. Supplements are only advised in addition to a healthy, balanced diet, but may warrant a greater prevalence in the professional game to support well-being, recovery, and performance. Supplements used by players should be safe, legal, and scientifically proven to be effective. An individual approach should be taken to using supplements dependant on the needs and goals of the player. Female players should aim to improve the frequency of protein intake throughout the day, whilst tailoring doses to individual body mass. Vitamin D supplementation is vital throughout the winter months in countries with limited sun exposure, however doses should be administered based on individual blood test results. Iron is likely to be important to the well-being of female athletes throughout the season, in particular during the menses. Omega-3 and collagen may be of greater benefit to female than male athletes during recovery from soft tissue injury, whilst probiotics and creatine are beneficial throughout the season for reducing risk of illness and optimising recovery, respectively. Ergogenic supplements for football include beta-alanine, nitrate and caffeine. Caution should be taken with caffeine use due to the varying tolerance of difference athletes and sleep impairments that can follow.

Effects of Nitrate Supplementation on Exercise Performance in Humans: A Narrative Review

Nitrates have become increasingly popular for their potential role as an ergogenic aid. The purpose of this article was to review the current scientific evidence of nitrate supplementation on human performance. The current recommendation of nitrate supplementation is discussed, as well as possible health complications associated with nitrate intake for athletes, and dietary strategies of covering nitrate needs through sufficient intake of nitrate-rich foods alone are presented. Pubmed, Scopus, and Web of Science were searched for articles on the effects of nitrate supplementation in humans. Nitrates are an effective ergogenic aid when taken acutely or chronically in the range of ~5-16.8 mmol (~300-1041 mg) 2-3 h before exercise and primarily in the case of exercise duration of ~10-17 min in less trained individuals (VO2max < 65 mL/kg/min). Nitrate needs are most likely meet by ingesting approximately 250-500 g of leafy and root vegetables per day; however, dietary supplements might represent a more convenient and accurate way of covering an athlete's nitrate needs. Athletes should refrain from mouthwash usage when nitrate supplementation benefits are desired. Future research should focus on the potential beneficial effects of nitrate supplementation on brain function, possible negative impacts of chronic nitrate supplementation through different nitrate sources, and the effectiveness of nitrate supplementation on strength and high-intensity intermittent exercise.

The Mediterranean dietary pattern for optimising health and performance in competitive athletes: a narrative review

Nutrition plays a key role in training for, and competing in, competitive sport, and is essential for reducing risk of injury and illness, recovering and adapting between bouts of activity, and enhancing performance. Consumption of a Mediterranean diet (MedDiet) has been demonstrated to reduce risk of various non-communicable diseases and increase longevity. Following the key principles of a MedDiet could also represent a useful framework for good nutrition in competitive athletes under most circumstances, with potential benefits for health and performance parameters. In this review, we discuss the potential effects of a MedDiet, or individual foods and compounds readily available in this dietary pattern, on oxidative stress and inflammation, injury and illness risk, vascular and cognitive function, and exercise performance in competitive athletes. We also highlight potential modifications which could be made to the MedDiet (whilst otherwise adhering to the key principles of this dietary pattern) in accordance with contemporary sports nutrition practices, to maximise health and performance effects. In addition, we discuss potential directions for future research.

Repeated administration of inorganic nitrate on blood pressure and arterial stiffness: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

We aim to synthesize effects of repeated administration (≥3 days) of inorganic nitrate on blood pressure and arterial stiffness measures.

METHODS

We conducted a systematic review and meta-analysis of randomized controlled trials with at least 3 days treatment of inorganic nitrate on blood pressure and arterial stiffness in individuals with or without elevated cardiovascular disease risk. MEDLINE, EMBASE and the Cochrane Library were searched through 2 July 2019. Two independent reviewers extracted relevant study data. Data were pooled using the generic inverse variance method with random-effects model, and expressed as mean differences with 95% confidence intervals. Certainty in the evidence was assessed using GRADE.

RESULTS

Forty-seven trials were included (n = 1101). Administration of inorganic nitrate significantly lowered SBP [mean difference: -2.91 mmHg, 95% confidence interval (95% CI): -3.92 to -1.89, I = 76%], DBP (mean difference: -1.45 mmHg, 95% CI: -2.22 to -0.68, I = 78%], central SBP (mean difference: -1.56 mmHg, 95% CI: -2.62 to -0.50, I = 30%) and central DBP (mean difference: -1.99 mmHg, 95% CI: -2.37 to -1.60, I = 0%). There was no effect on 24-h blood pressure, augmentation index or pulse wave velocity. Certainty in the evidence was graded moderate for central blood pressure, pulse wave velocity and low for peripheral blood pressure, 24-h blood pressure and augmentation index.

CONCLUSION

Repeated administration (≥3 days) of inorganic nitrate lower peripheral and central blood pressure. Results appear to be driven by beneficial effects in healthy and hypertensive individuals. More studies are required to increase certainty in the evidence.

Dietary and Ergogenic Supplementation to Improve Elite Soccer Players' Performance

BACKGROUND

Soccer is an extremely competitive sport, where the most match important moments can be defined in detail. Use of ergogenic supplements can be crucial to improve the performance of a high-performance athlete. Therefore, knowing which ergogenic supplements are important for soccer players can be an interesting strategy to maintain high level in this sport until final and decisive moments of the match. In addition, other supplements, such as dietary supplements, have been studied and increasingly referenced in the scientific literature. But, what if ergogenic supplements were combined with dietary supplements? This review brings some recommendations to improve performance of soccer athletes on the field through dietary and/or ergogenic supplements that can be used simultaneously.

SUMMARY

Soccer is a competitive sport, where the match important moments can be defined in detail. Thus, use of ergogenic supplements covered in this review can improve performance of elite soccer players maintaining high level in the match until final moments, such as creatine 3-5 g day-1, caffeine 3-6 mg kg-1 BW around 60 min before the match, sodium bicarbonate 0.1-0.4 g kg-1 BW starting from 30 to 180 min before the match, β-alanine 3.2 and 6.4 g day-1 provided in the sustained-release tablets divided into 4 times a day, and nitrate-rich beetroot juice 60 g in 200 mL of water (6 mmol of NO3- L) around 120 min before match or training, including a combination possible with taurine 50 mg kg-1 BW day-1, citrulline 1.2-3.4 g day-1, and arginine 1.2-6 g day-1. Key Messages: Soccer athletes can combine ergogenic and dietary supplements to improve their performance on the field. The ergogenic and dietary supplements used in a scientifically recommended dose did not demonstrate relevant side effects. The use of various evidence-based supplements can add up to further improvement in the performance of the elite soccer players.

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

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.

Impact of Red Spinach Extract Supplementation on Bench Press Performance, Muscle Oxygenation, and Cognitive Function in Resistance-Trained Males

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.

Marching to the Beet: The effect of dietary nitrate supplementation on high altitude exercise performance and adaptation during a military trekking expedition

PURPOSE

The aim was to investigate the effect of dietary nitrate supplementation (in the form of beetroot juice, BRJ) for 20 days on salivary nitrite (a potential precursor of bioactive nitric oxide), exercise performance and high altitude (HA) acclimatisation in field conditions (hypobaric hypoxia).

METHODS

This was a single-blinded randomised control study of 22 healthy adult participants (12 men, 10 women, mean age 28 ± 12 years) across a HA military expedition. Participants were randomised pre-ascent to receive two 70 ml dose per day of either BRJ (~12.5 mmol nitrate per day; n = 11) or non-nitrate calorie matched control (n = 11). Participants ingested supplement doses daily, beginning 3 days prior to departure and continued until the highest sleeping altitude (4800 m) reached on day 17 of the expedition. Data were collected at baseline (44 m altitude), at 2350 m (day 9), 3400 m (day 12) and 4800 m (day 17).

RESULTS

BRJ enhanced the salivary levels of nitrite (p = 0.007). There was a significant decrease in peripheral oxygen saturation and there were increases in heart rate, diastolic blood pressure, and rating of perceived exertion with increasing altitude (p=<0.001). Harvard Step Test fitness scores significantly declined at 4800 m in the control group (p = 0.003) compared with baseline. In contrast, there was no decline in fitness scores at 4800 m compared with baseline (p = 0.26) in the BRJ group. Heart rate recovery speed following exercise at 4800 m was significantly prolonged in the control group (p=<0.01) but was unchanged in the BRJ group (p = 0.61). BRJ did not affect the burden of HA illness (p = 1.00).

CONCLUSIONS

BRJ increases salivary nitrite levels and ameliorates the decline in fitness at altitude but does not affect the occurrence of HA illness.

Ergogenic Effect of Nitrate Supplementation: A Systematic Review and Meta-analysis

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 (F_iO₂) 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 F_iO₂ 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 F_iO₂ (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.

Effects of Chewing Gum on Nitric Oxide Metabolism, Markers of Cardiovascular Health and Neurocognitive Performance after a Nitrate-Rich Meal

OBJECTIVES

Cardiovascular and neurocognitive responses to chewing gum have been reported, but the mechanisms are not well understood. Chewing gum after a nitrate-rich meal may upregulate the reduction of oral nitrate to nitrite and increase nitric oxide (NO), a molecule important to cardiovascular and neurocognitive health. We aimed to explore effects of chewing gum after a nitrate-rich meal on nitrate metabolism (through the enterosalivary nitrate-nitrite-NO pathway), endothelial function, blood pressure (BP), neurocognitive performance, mood and anxiety.

METHODS

Twenty healthy men (n = 6) and women (n = 14) with a mean age of 48 years (range: 23-69) were recruited to a randomized controlled cross-over trial. After consumption of a nitrate-rich meal (180 mg of nitrate), we assessed the acute effects of chewing gum, compared to no gum chewing, on (i) salivary nitrate, nitrite and the nitrate reductase ratio (100 x [nitrite]/([nitrate] + [nitrite]); (ii) plasma nitrite, S-nitrosothiols and other nitroso species (RXNO); (iii) endothelial function (measured by flow mediated dilatation); (iv) BP; (v) neurocognitive performance; (vi) mood; and (vii) anxiety.

RESULTS

Consumption of the nitrate-rich meal resulted in a significant increase in markers of nitrate metabolism. A significantly higher peak flow mediated dilatation was observed with chewing compared to no chewing (baseline adjusted mean difference: 1.10%, 95% CI: 0.06, 2.14; p = 0.038) after the nitrate-rich meal. A significant small increase in systolic BP, diastolic BP and heart rate were observed with chewing compared to no chewing after the nitrate-rich meal. The study did not observe increased oral reduction of nitrate to nitrite and NO, or improvements in neurocognitive performance, mood or anxiety with chewing compared to no chewing.

CONCLUSION

Chewing gum after a nitrate-rich meal resulted in an acute improvement in endothelial function and a small increase in BP but did not result in acute effects on neurocognitive function, mood or anxiety.

Dietary Nitrate and Nitric Oxide Metabolism: Mouth, Circulation, Skeletal Muscle, and Exercise Performance

Nitric oxide (NO) is a gaseous signaling molecule that plays an important role in myriad physiological processes, including the regulation of vascular tone, neurotransmission, mitochondrial respiration, and skeletal muscle contractile function. NO may be produced via the canonical NO synthase-catalyzed oxidation of l-arginine and also by the sequential reduction of nitrate to nitrite and then NO. The body's nitrate stores can be augmented by the ingestion of nitrate-rich foods (primarily green leafy vegetables). NO bioavailability is greatly enhanced by the activity of bacteria residing in the mouth, which reduce nitrate to nitrite, thereby increasing the concentration of circulating nitrite, which can be reduced further to NO in regions of low oxygen availability. Recent investigations have focused on promoting this nitrate-nitrite-NO pathway to positively affect indices of cardiovascular health and exercise tolerance. It has been reported that dietary nitrate supplementation with beetroot juice lowers blood pressure in hypertensive patients, and sodium nitrite supplementation improves vascular endothelial function and reduces the stiffening of large elastic arteries in older humans. Nitrate supplementation has also been shown to enhance skeletal muscle function and to improve exercise performance in some circumstances. Recently, it has been established that nitrate concentration in skeletal muscle is much higher than that in blood and that muscle nitrate stores are exquisitely sensitive to dietary nitrate supplementation and deprivation. In this review, we consider the possibility that nitrate represents an essential storage form of NO and discuss the integrated function of the oral microbiome, circulation, and skeletal muscle in nitrate-nitrite-NO metabolism, as well as the practical relevance for health and performance.

Nitrate and nitrite exposure leads to mild anxiogenic-like behavior and alters brain metabolomic profile in zebrafish

Dietary nitrate lowers blood pressure and improves athletic performance in humans, yet data supporting observations that it may increase cerebral blood flow and improve cognitive performance are mixed. We tested the hypothesis that nitrate and nitrite treatment would improve indicators of learning and cognitive performance in a zebrafish (Danio rerio) model. We utilized targeted and untargeted liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis to examine the extent to which treatment resulted in changes in nitrate or nitrite concentrations in the brain and altered the brain metabolome. Fish were exposed to sodium nitrate (606.9 mg/L), sodium nitrite (19.5 mg/L), or control water for 2–4 weeks and free swim, startle response, and shuttle box assays were performed. Nitrate and nitrite treatment did not change fish weight, length, predator avoidance, or distance and velocity traveled in an unstressed environment. Nitrate- and nitrite-treated fish initially experienced more negative reinforcement and increased time to decision in the shuttle box assay, which is consistent with a decrease in associative learning or executive function however, over multiple trials, all treatment groups demonstrated behaviors associated with learning. Nitrate and nitrite treatment was associated with mild anxiogenic-like behavior but did not alter epinephrine, norepinephrine or dopamine levels. Targeted metabolomics analysis revealed no significant increase in brain nitrate or nitrite concentrations with treatment. Untargeted metabolomics analysis found 47 metabolites whose abundance was significantly altered in the brain with nitrate and nitrite treatment. Overall, the depletion in brain metabolites is plausibly associated with the regulation of neuronal activity including statistically significant reductions in the inhibitory neurotransmitter γ-aminobutyric acid (GABA; 18–19%), and its precursor, glutamine (17–22%). Nitrate treatment caused significant depletion in the brain concentration of fatty acids including linoleic acid (LA) by 50% and arachidonic acid (ARA) by 80%; nitrite treatment caused depletion of LA by ~90% and ARA by 60%, change which could alter the function of dopaminergic neurons and affect behavior. Nitrate and nitrite treatment did not adversely affect multiple parameters of zebrafish health. It is plausible that indirect NO-mediated mechanisms may be responsible for the nitrate and nitrite-mediated effects on the brain metabolome and behavior in zebrafish.

Influence of Dietary Nitrate Supplementation on High-Intensity Intermittent Running Performance at Different Doses of Normobaric Hypoxia in Endurance-Trained Males

This study investigated whether supplementation with nitrate-rich beetroot juice (BR) can improve high-intensity intermittent running performance in trained males in normoxia and different doses of normobaric hypoxia. Eight endurance-trained males (V˙O2peak, 62 ± 6 ml·kg-1·min-1) completed repeated 90 s intervals at 110% of peak treadmill velocity, from an initial step incremental test, interspersed by 60 s of passive recovery until exhaustion (Tlim). Participants completed the first three experimental trials during days 3, 5, and 7 of BR or nitrate-depleted beetroot juice (PLA) supplementation and completed the remaining experimental visits on the alternative supplement following at least 7 days of washout. The fraction of inspired oxygen during visits 1-3 was either 0.209, 0.182, or 0.157, equivalent to an altitude of 0, 1,200, and 2,400 m, respectively, and this order was replicated on visits 4-6. Arterial oxygen saturation declined dose dependently as fraction of inspired oxygen was lowered (p < .05). Plasma nitrite concentration was higher pre- and postexercise after BR compared with PLA supplementation (p < .05). There was no difference in Tlim between PLA and BR at 0 m (445 [324, 508] and 410 [368, 548] s); 1,200 m (341 [270, 390] and 332 [314, 356] s); or 2,400 m (233 [177, 373] and 251 [221, 323] s) (median and [interquartile range]; p > .05). The findings from this study suggest that short-term BR supplementation does not improve high-intensity intermittent running performance in endurance-trained males in normoxia or at doses of normobaric hypoxia that correspond to altitudes at which athletes typically train while on altitude training camps.

Acute Beetroot Juice Supplementation Does Not Improve Match-Play Activity in Professional Tennis Players

OBJECTIVE

Beetroot juice is a source of dietary nitrate (NO₃-) recognized as a potential ergogenic aid to enhance tolerance during endurance exercise of submaximal-to-maximal intensity. However, little is known about the effects of beetroot juice on exercise performance in intermittent sports such as tennis. The present study aimed to determine the effect of acute beetroot juice supplementation on movement patterns during a competitive tennis match in professional players.

METHODS

In a double-blind and randomized experiment, nine professional tennis players performed two experimental trials 3 h after ingesting either 70 mL of a commercially-available concentrated beetroot juice (6.4 mmol NO₃-) or placebo (0.005 mmol NO₃-). In each experimental trial, players completed a 3-set tennis match and two performance tests (i.e., serve speed and isometric handgrip strength) before and after the match. Match-play running performance was recorded using wearable GPS and accelerometer units.

RESULTS

In comparison to the placebo trial, the acute beetroot juice supplementation did not modify any match-play running performance (p = 0.178 to 0.997, d = 0.01 to 0.42). Furthermore, beetroot juice supplementation did not alter the pre-to-post match change in serve speed (p = 0.663, ηp² = 0.03) or isometric handgrip strength (p = 0.219, ηp² = 0.18).

CONCLUSIONS

The current results indicated that acute ingestion of a commercialized shot of nitrate-rich beetroot juice (70 mL containing 6.4 mmol of NO₃-) did not produce any performance benefit on tennis matchplay. Thus, acute beetroot juice supplementation seems an ergogenic aid with little value to enhance physical performance in professional tennis players.

Spleen contraction and Hb elevation after dietary nitrate intake

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].

Dietary Nitrate Supplementation and Exercise-Related Performance

Over the last decade, there has been a growing interest in the utility of nitrate (NO3^-) supplementation to improve exercise-related performance. After consumption, dietary NO3^- can be reduced to nitric oxide, a free radical gas involved in numerous physiological actions including blood vessel vasodilation, mitochondrial respiration, and skeletal muscle contractile function. Emerging evidence indicates that dietary NO3^- supplementation has a small but nevertheless significant beneficial effect on endurance performance through the combined effects of enhanced tissue oxygenation and metabolic efficiency in active skeletal muscle. There is further evidence to suggest that dietary NO3^- exerts a direct influence on contractile mechanisms within the skeletal muscle through alterations in calcium availability and sensitivity. Response heterogeneity and sizeable variability in the nitrate content of beetroot juice products influence the effectiveness of dietary NO3^- for exercise performance, and so dosing and product quality, as well as training history, sex, and individual-specific characteristics, should be considered.

Effects of Dietary Nitrate Supplementation on Weightlifting Exercise Performance in Healthy Adults: A Systematic Review

Dietary nitrate (NO3-) supplementation has been evidenced to induce an ergogenic effect in endurance and sprint-type exercise, which may be underpinned by enhanced muscle contractility and perfusion, particularly in type II muscle fibers. However, limited data are available to evaluate the ergogenic potential of NO3- supplementation during other exercise modalities that mandate type II fiber recruitment, such as weightlifting exercise (i.e., resistance exercise). In this systematic review, we examine the existing evidence basis for NO3- supplementation to improve muscular power, velocity of contraction, and muscular endurance during weightlifting exercise in healthy adults. We also discuss the potential mechanistic bases for any positive effects of NO3- supplementation on resistance exercise performance. Dialnet, Directory of Open Access Journals, Medline, Pubmed, Scielo, Scopus and SPORT Discus databases were searched for articles using the keywords: nitrate or beetroot and supplement or nut*r or diet and strength or "resistance exercise" or "resistance training" or "muscular power". Four articles fulfilling the inclusion criteria were identified. Two of the four studies indicated that NO3- supplementation could increase aspects of upper body weightlifting exercise (i.e., bench press) performance (increases in mean power/velocity of contraction/number of repetitions to failure), whereas another study observed an increase in the number of repetitions to failure during lower limb weightlifting exercise (i.e., back squat). Although these preliminary observations are encouraging, further research is required for the ergogenic potential of NO3- supplementation on weightlifting exercise performance to be determined.

Effectiveness of beetroot juice derived nitrates supplementation on fatigue resistance during repeated-sprints: a systematic review

In recent decades, the search for non-doping substances that enhance sports performance has increased. Ergogenic aids such as beetroot juice (BRJ) and BRJ rich in nitrates (NO₃^-) are widely used to cause physiological benefits that may lead to physical improvements. Therefore, the purpose of this systematic review was to explore the knowledge reported to date on the NO₃^- derived from BRJ intake effect on fatigue resistance during repeated sprints. A digital search was conducted following systematic review guidelines, and 18 studies met inclusion criteria from a total of 209 articles. In a third of the selected studies, the consumption of beet juice rich in NO₃^- contributes to an increase in nitrites in plasma that led to the rise in peak power, mean power, number of sprint repetitions, total work and time to task failure, and causes a decrease in fatigue index and sprints times. Some different dose has been proposed for both chronic and acute protocols. It seems that a chronic intake of ∼5-6 mmol of NO₃^- in 70 ml of BRJ, twice a day, for a minimum of 3-6 days could lead to a fatigue resistance improvement during repeated sprints. Besides, acute intake of NO₃^- 2.5-3 h before physical exertion or a dose of 250 ml/d to 500 ml/d of BRJ could lead to similar effective results. This systematic review presents some improvements (1.2-5.38%) in fatigue resistance during repeated sprints when consuming BRJ derived NO₃^-. The in-field practical meaning of these results should be explored.