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du Toit L, Sundqvist ML, Redondo-Rio A, Brookes Z, Casas-Agustench P, Hickson M, Benavente A, Montagut G, Weitzberg E, Gabaldón T, Lundberg JO, Bescos R. The Effect of Dietary Nitrate on the Oral Microbiome and Salivary Biomarkers in Individuals with High Blood Pressure. J Nutr 2024; 154:2696-2706. [PMID: 39019159 PMCID: PMC11393165 DOI: 10.1016/j.tjnut.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/03/2024] [Accepted: 07/02/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Green leafy vegetables (GLV) contain inorganic nitrate, an anion with potential prebiotic effects on the oral microbiome. However, it remains unclear whether GLV and pharmacological supplementation [potassium nitrate (PN)] with a nitrate salt induce similar effects on the oral microbiome. OBJECTIVES This study aimed to compare the effect of GLV with PN supplementation on the oral microbiome composition and salivary biomarkers in individuals with high blood pressure. METHODS Seventy individuals were randomly allocated to 3 different groups to follow a 5-wk dietary intervention. Group 1 consumed 300 mg/d of nitrate in form of GLV. Group 2 consumed pills with 300 mg/d of PN and low-nitrate vegetables. Group 3 consumed pills with potassium chloride (placebo: PLAC) and low-nitrate vegetables. The oral microbiome composition and salivary biomarkers of oral health were analyzed before and after the dietary intervention. RESULTS The GLV and PN groups showed similar microbial changes, probably nitrate-dependent, including an increase in the abundance of Neisseria, Capnocytophaga, Campylobacter species, and a decrease in Veillonella, Megasphaera, Actinomyces, and Eubacterium species after the treatment. Increased abundance of Rothia species, and reduced abundance of Streptococcus, Prevotella, Actinomyces, and Mogibacterium species were observed in the GLV group, which could be nitrate-independent. GLV and PN treatments increased salivary pH, but only GLV treatment showed an increase in the salivary buffering capacity and a reduction of lactate. CONCLUSION The combination of nitrate-dependent and nitrate-independent microbial changes in the GLV group has a stronger effect to potentially improve oral health biomarkers compared with PN.
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Affiliation(s)
- Lisa du Toit
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Michaela L Sundqvist
- Swedish School of Sport and Health Sciences, Department of Physiology, Nutrition and Biomechanics, Stockholm, Sweden
| | - Alvaro Redondo-Rio
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS), Barcelona, Spain
| | - Zöe Brookes
- Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Patricia Casas-Agustench
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Mary Hickson
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Alicia Benavente
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS), Barcelona, Spain
| | - Gemma Montagut
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS), Barcelona, Spain
| | - Eddie Weitzberg
- Pharmacology and Physiology Department, Karolinska Institute, Stockholm, Sweden
| | - Toni Gabaldón
- Institute for Research in Biomedicine (IRB Barcelona), Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS), Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Barcelona, Spain
| | - Jon O Lundberg
- Pharmacology and Physiology Department, Karolinska Institute, Stockholm, Sweden
| | - Raul Bescos
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
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Tyler AP, Linder BA, Ricart K, Behrens CE, Ovalle F, Patel RP, Fisher G. The Effects of Acute Beetroot Juice Intake on Glycemic and Blood Pressure Responses When Controlling for Medication in Individuals with Type 2 Diabetes: A Pilot Study. Nutrients 2024; 16:2636. [PMID: 39203773 PMCID: PMC11357045 DOI: 10.3390/nu16162636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 08/01/2024] [Accepted: 08/07/2024] [Indexed: 09/03/2024] Open
Abstract
Physical inactivity and poor dietary choices contribute to the rise in cardiometabolic diseases in the United States. It remains critical to identify strategies that may mitigate the negative impact of these behaviors. Several studies have shown that the consumption of dietary inorganic nitrate may improve vascular health and glucose regulation in animal models and some human studies. However, the improvements in glucose regulation have yet to be corroborated in humans with type 2 diabetes (T2D). Therefore, the purpose of this study was to assess the acute effects of beetroot juice (BRJ) on glycemic and hemodynamic responses in individuals with T2D while controlling for medication. Seven participants with a clinical diagnosis of T2D were recruited into this study and were temporarily removed from blood pressure- and glucose-lowering medications. Hemodynamic measurements (pulsewave velocity) and an oral glucose tolerance test (glycemic response) were measured following consumption of either BRJ or a denitrolized placebo. Saliva and blood samples were collected at baseline and two and four hours post supplementation to measure changes in nitrate and nitrite concentrations. We detected significant improvements in total plasma glucose exposure (p = 0.022) and the SVR change score (p = 0.009) in the BRJ condition. This study demonstrated that BRJ consumption can improve oral glucose tolerance in individuals with T2D while controlling for medication; however, future larger-cohort randomized controlled trials are needed to confirm if BRJ is a viable treatment for glucose control in individuals with T2D.
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Affiliation(s)
- Andrew P. Tyler
- Department of Human Studies, School of Education and Human Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Braxton A. Linder
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN 47405, USA;
| | - Karina Ricart
- Center for Free Radical Biology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (K.R.); (R.P.P.)
| | | | - Fernando Ovalle
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Rakesh P. Patel
- Center for Free Radical Biology, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (K.R.); (R.P.P.)
| | - Gordon Fisher
- Department of Human Studies, School of Education and Human Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
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Oue A, Iimura Y, Miyakoshi Y, Ota M. Effect of Acute Dietary Nitrate Supplementation on the Changes in Calf Venous Volume during Postural Change and Skeletal Muscle Pump Activity in Healthy Young Adults. Nutrients 2024; 16:1621. [PMID: 38892555 PMCID: PMC11174609 DOI: 10.3390/nu16111621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Dietary nitrate (NO3-) supplementation is known to enhance nitric oxide (NO) activity and acts as a vasodilator. In this randomized crossover study, we investigated the effect of inorganic NO3- supplementation on the changes in calf venous volume during postural change and subsequent skeletal muscle pump activity. Fifteen healthy young adults were assigned to receive beetroot juice (BRJ) or a NO3--depleted control beverage (prune juice: CON). Two hours after beverage consumption, the changes in the right calf volume during postural change from supine to upright and a subsequent right tiptoe maneuver were measured using venous occlusion plethysmography. The increase in calf volume from the supine to upright position (total venous volume [VV]) and the decrease in calf volume during the right tiptoe maneuver (venous ejection volume [Ve]) were calculated. Plasma NO3- concentration was higher in the BRJ group than in the CON group 2 h after beverage intake (p < 0.05). However, VV and Ve did not differ between CON and BRJ. These results suggest that acute intake of BRJ may enhance NO activity via the NO3- → nitrite → NO pathway but does not change calf venous pooling due to a postural change or the calf venous return due to skeletal muscle pump activity in healthy young adults.
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Affiliation(s)
- Anna Oue
- Faculty of Health and Sports Sciences, Toyo University, 1-7-11, Akabanedai, Kita-ku, Tokyo 115-8650, Japan; (Y.I.); (Y.M.); (M.O.)
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Cao G, Zuo J, Wu B, Wu Y. Polyphenol supplementation boosts aerobic endurance in athletes: systematic review. Front Physiol 2024; 15:1369174. [PMID: 38651044 PMCID: PMC11033476 DOI: 10.3389/fphys.2024.1369174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
In recent years, an increasing trend has been observed in the consumption of specific polyphenols, such as flavonoids and phenolic acids, derived from green tea, berries, and other similar sources. These compounds are believed to alleviate oxidative stress and inflammation resulting from exercise, potentially enhancing athletic performance. This systematic review critically examines the role of polyphenol supplementation in improving aerobic endurance among athletes and individuals with regular exercise habits. The review involved a thorough search of major literature databases, including PubMed, Web of Science, SCOPUS, SPORTDiscus, and Embase, covering re-search up to the year 2023. Out of 491 initially identified articles, 11 met the strict inclusion criteria for this review. These studies specifically focused on the incorporation of polyphenols or polyphenol-containing complexes in their experimental design, assessing their impact on aerobic endurance. The methodology adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the risk of bias was evaluated using the Cochrane bias risk assessment tool. While this review suggests that polyphenol supplementation might enhance certain aspects of aerobic endurance and promote fat oxidation, it is important to interpret these findings with caution, considering the limited number of studies available. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023453321.
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Affiliation(s)
- Gexin Cao
- Department of Exercise Physiology, School of Sports Science, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sports University, Beijing, China
| | - Jing Zuo
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sports University, Beijing, China
- Department of Anatomy Laboratory, School of Sports Science, Beijing Sports University, Beijing, China
| | - Baile Wu
- Department of Exercise Physiology, School of Sports Science, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sports University, Beijing, China
| | - Ying Wu
- Department of Exercise Physiology, School of Sports Science, Beijing Sports University, Beijing, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing Sports University, Beijing, China
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Benjamim CJR, Lopes da Silva LS, Valenti VE, Gonçalves LS, Porto AA, Tasinafo Júnior MF, Walhin JP, Garner DM, Gualano B, Bueno Júnior CR. Effects of dietary inorganic nitrate on blood pressure during and post-exercise recovery: A systematic review and meta-analysis of randomized placebo-controlled trials. Free Radic Biol Med 2024; 215:25-36. [PMID: 38403254 DOI: 10.1016/j.freeradbiomed.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/15/2024] [Accepted: 02/10/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES A systematic review with meta-analysis was completed to study the effects of dietary inorganic nitrate (NO3-) oral ingestion from vegetables and salts on blood pressure responses during and following exercise. BACKGROUND NO3- is a hypotensive agent with the potential to reduce blood pressure peaks during exercise and amplify exercise-induced hypotensive effects. Several randomized and controlled trials have investigated the effects of NO3- on hemodynamic responses to physical exercise, however this still has yet to be studied systematically. METHODS The searches were conducted on EMBASE, Medline, and SPORTSDiscus databases. The study included masked randomized controlled trials (RCTs) with participants ≥18 years old. The NO3-intervention group received at least 50 mg NO3-/day with similar sources amid NO3- and placebo conditions. Included studies reported systolic blood pressure (SBP) or diastolic blood pressure (DBP) values during or following exercise performance. RESULTS 1903 studies were identified, and twenty-six achieved the inclusion criteria. NO3- daily dosages ranged from 90 to 800 mg/day. Throughout exercise, SBP had smaller increases in the NO3- group (-2.81 mmHg (95%CI: -5.20 to -0.41), p=0.02. DBP demonstrated lower values in the NO3- group (-2.41 mmHg (95%CI: -4.02 to -0.79), p=0.003. In the post-exercise group, the NO3- group presented lower SBP values (-3.53 mmHg (95%CI: -5.65 to 1.41), p=0.001, while no changes were identified in DBP values between NO3- and placebo groups (p=0.31). Subgroup meta-analysis revealed that SBP baseline values, exercise type, duration of NO3- ingestion, and its dosages mediated blood pressure responses during and following exercise. CONCLUSIONS NO3- ingestion prior to exercise attenuated the increases in SBP and DBP during exercise, and increased the decline in SBP after exercise. These results are dependent on factors that moderate the blood pressure responses (e.g., health status, type of exercise, resting blood pressure values).
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Affiliation(s)
- Cicero Jonas R Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | | | | | - Leonardo S Gonçalves
- School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Jean-Philippe Walhin
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, United Kingdom
| | - David M Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, United Kingdom
| | - Bruno Gualano
- Center of Lifestyle Medicine, Applied Physiology & Nutrition Research Group, University of São Paulo, Medical School (FMUSP), São Paulo, SP, Brazil
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Wei C, Vanhatalo A, Kadach S, Stoyanov Z, Abu-Alghayth M, Black MI, Smallwood MJ, Rajaram R, Winyard PG, Jones AM. Reduction in blood pressure following acute dietary nitrate ingestion is correlated with increased red blood cell S-nitrosothiol concentrations. Nitric Oxide 2023; 138-139:1-9. [PMID: 37268184 DOI: 10.1016/j.niox.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/04/2023]
Abstract
Dietary nitrate (NO3-) supplementation can enhance nitric oxide (NO) bioavailability and lower blood pressure (BP) in humans. The nitrite concentration ([NO2-]) in the plasma is the most commonly used biomarker of increased NO availability. However, it is unknown to what extent changes in other NO congeners, such as S-nitrosothiols (RSNOs), and in other blood components, such as red blood cells (RBC), also contribute to the BP lowering effects of dietary NO3-. We investigated the correlations between changes in NO biomarkers in different blood compartments and changes in BP variables following acute NO3- ingestion. Resting BP was measured and blood samples were collected at baseline, and at 1, 2, 3, 4 and 24 h following acute beetroot juice (∼12.8 mmol NO3-, ∼11 mg NO3-/kg) ingestion in 20 healthy volunteers. Spearman rank correlation coefficients were determined between the peak individual increases in NO biomarkers (NO3-, NO2-, RSNOs) in plasma, RBC and whole blood, and corresponding decreases in resting BP variables. No significant correlation was observed between increased plasma [NO2-] and reduced BP, but increased RBC [NO2-] was correlated with decreased systolic BP (rs = -0.50, P = 0.03). Notably, increased RBC [RSNOs] was significantly correlated with decreases in systolic (rs = -0.68, P = 0.001), diastolic (rs = -0.59, P = 0.008) and mean arterial pressure (rs = -0.64, P = 0.003). Fisher's z transformation indicated no difference in the strength of the correlations between increases in RBC [NO2-] or [RSNOs] and decreased systolic blood pressure. In conclusion, increased RBC [RSNOs] may be an important mediator of the reduction in resting BP observed following dietary NO3- supplementation.
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Affiliation(s)
- Chenguang Wei
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Anni Vanhatalo
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Stefan Kadach
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Zdravko Stoyanov
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Mohammed Abu-Alghayth
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Bisha, 255, AL Nakhil, Bisha, 67714, Saudi Arabia
| | - Matthew I Black
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Miranda J Smallwood
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Raghini Rajaram
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Paul G Winyard
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK
| | - Andrew M Jones
- University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, St Luke's Campus, Exeter, UK.
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Maiuolo J, Oppedisano F, Carresi C, Gliozzi M, Musolino V, Macrì R, Scarano F, Coppoletta A, Cardamone A, Bosco F, Mollace R, Muscoli C, Palma E, Mollace V. The Generation of Nitric Oxide from Aldehyde Dehydrogenase-2: The Role of Dietary Nitrates and Their Implication in Cardiovascular Disease Management. Int J Mol Sci 2022; 23:ijms232415454. [PMID: 36555095 PMCID: PMC9779284 DOI: 10.3390/ijms232415454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/29/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Reduced bioavailability of the nitric oxide (NO) signaling molecule has been associated with the onset of cardiovascular disease. One of the better-known and effective therapies for cardiovascular disorders is the use of organic nitrates, such as glyceryl trinitrate (GTN), which increases the concentration of NO. Unfortunately, chronic use of this therapy can induce a phenomenon known as "nitrate tolerance", which is defined as the loss of hemodynamic effects and a reduction in therapeutic effects. As such, a higher dosage of GTN is required in order to achieve the same vasodilatory and antiplatelet effects. Mitochondrial aldehyde dehydrogenase 2 (ALDH2) is a cardioprotective enzyme that catalyzes the bio-activation of GTN to NO. Nitrate tolerance is accompanied by an increase in oxidative stress, endothelial dysfunction, and sympathetic activation, as well as a loss of the catalytic activity of ALDH2 itself. On the basis of current knowledge, nitrate intake in the diet would guarantee a concentration of NO such as to avoid (or at least reduce) treatment with GTN and the consequent onset of nitrate tolerance in the course of cardiovascular diseases, so as not to make necessary the increase in GTN concentrations and the possible inhibition/alteration of ALDH2, which aggravates the problem of a positive feedback mechanism. Therefore, the purpose of this review is to summarize data relating to the introduction into the diet of some natural products that could assist pharmacological therapy in order to provide the NO necessary to reduce the intake of GTN and the phenomenon of nitrate tolerance and to ensure the correct catalytic activity of ALDH2.
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Affiliation(s)
- Jessica Maiuolo
- Pharmaceutical Biology Laboratory, in Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: (J.M.); (F.O.)
| | - Francesca Oppedisano
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Correspondence: (J.M.); (F.O.)
| | - Cristina Carresi
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Micaela Gliozzi
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Musolino
- Pharmaceutical Biology Laboratory, in Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Roberta Macrì
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Federica Scarano
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Annarita Coppoletta
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Cardamone
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Francesca Bosco
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Rocco Mollace
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Carolina Muscoli
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Ernesto Palma
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Mollace
- Institute of Research for Food Safety & Health (IRC-FSH), Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Renato Dulbecco Institute, Lamezia Terme, 88046 Catanzaro, Italy
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Nho H, Kim KA. Effects of Grape Seed Extract Supplementation on Endothelial Function and Endurance Performance in Basketball Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14223. [PMID: 36361103 PMCID: PMC9658680 DOI: 10.3390/ijerph192114223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
While dietary polyphenols supplements can improve endothelial function and blood flow to exercise, the effects of chronic supplementation with grape seed extract (GSE) containing a high dose of polyphenols on endurance performance are not known. Accordingly, in 12 elite athletes, we compared the effects of both GSE and placebo (PL) on submaximal VO2, time to exhaustion performance, and endothelial function during progressive cycling exercise for 14 days. Endothelial function was evaluated from the brachial artery via flow-mediated dilation (FMD). Compared to PL, GSE decreased submaximal VO2 at 80% and 120% of VO2peak and increased the time to exhaustion (p < 0.05). GSE also resulted in FMD-induced increase in brachial artery diameter (14.4 ± 5.2% vs. 17.6 ± 4.5%, p = 0.035). We demonstrated that chronic supplementation with GSE improved endurance performance and these effects may partially be due to vasodilation in active skeletal muscle mediated by enhanced endothelial function. Thus, our results suggest that GSE appears to be an ergogenic nutraceutical that can improve exercise performance in elite athletes.
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Affiliation(s)
- Hosung Nho
- Department of Liberal Arts and Science, Suwon Women’s University, Onjeong Street 72, Gweonseon-gu, Suwon-si 16632, Korea
| | - Kyung-Ae Kim
- Human IT Solution, Gogum Building 1F, 2F, Banpo-daero, 55, Seocho-gu, Seoul 06670, Korea
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Oue A, Iimura Y, Shinagawa A, Miyakoshi Y, Ota M. Effect of Acute Dietary Nitrate Supplementation on the Venous Vascular Response to Static Exercise in Healthy Young Adults. Nutrients 2022; 14:nu14214464. [PMID: 36364727 PMCID: PMC9659063 DOI: 10.3390/nu14214464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to test the hypothesis that acute intake of inorganic nitrate (NO3−) via supplementation would attenuate the venoconstriction and pressor response to exercise. Sixteen healthy young adults were assigned in a randomized crossover design to receive beetroot juice (BRJ) or an NO3−-depleted control beverage (prune juice: CON). Two hours after consuming the allocated beverage, participants rested in the supine position. Following the baseline period of 4 min, static handgrip exercise of the left hand was performed at 30% of the maximal voluntary contraction for 2 min. Mean arterial pressure (MAP) and heart rate (HR) were measured. Changes in venous volume in the right forearm and right calf were also measured using venous occlusion plethysmography while cuffs on the upper arm and thigh were inflated constantly to 30−40 mmHg. The plasma NO3− concentration was elevated with BRJ intake (p < 0.05). Exercise increased MAP and HR and decreased venous volume in the forearm and calf, but there were no differences between CON and BRJ. Thus, these findings suggest that acute BRJ intake does not alter the sympathetic venoconstriction in the non-exercising limbs and MAP response to exercise in healthy young adults, despite the enhanced activity of nitric oxide.
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Affiliation(s)
- Anna Oue
- Faculty of Food and Nutritional Sciences, Toyo University, Gunma 374-0193, Japan
- Correspondence: ; Tel.: +81-276-82-9145; Fax: +81-276-82-9033
| | - Yasuhiro Iimura
- Graduate School of Food and Nutritional Sciences, Toyo University, Gunma 374-0193, Japan
| | - Akiho Shinagawa
- Graduate School of Food and Nutritional Sciences, Toyo University, Gunma 374-0193, Japan
| | - Yuichi Miyakoshi
- Faculty of Food and Nutritional Sciences, Toyo University, Gunma 374-0193, Japan
| | - Masako Ota
- Faculty of Food and Nutritional Sciences, Toyo University, Gunma 374-0193, Japan
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Volino-Souza M, Oliveira GVD, Pinheiro VDS, Conte-Junior CA, Alvares TDS. The effect of dietary nitrate on macro- and microvascular function: A systematic review. Crit Rev Food Sci Nutr 2022; 64:1225-1236. [PMID: 36062809 DOI: 10.1080/10408398.2022.2113989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previous studies have investigated the impact of dietary nitrate on vascular function due to the association between dietary nitrate ingestion and improvement in nitric oxide (NO) bioavailability. Considering that NO can present different effects through vascular beds (macro- vs. microvasculature) due to the specific characteristic (function and morphology) that each vessel exhibits, it is crucial to investigate the effect of dietary nitrate ingestion on the macro- and microvascular function to understand the effect of nitrate on vascular function. For this reason, this review aimed to evaluate the impact of dietary nitrate on macro- and microvascular function in humans. A total of 29 studies were included in the systematic review, of which 19 studies evaluated the effect of nitrate supplementation on macrovascular function, eight studies evaluated the effect on microvascular function, and two studies evaluated the impact on both macro- and microvascular function. The literature suggests that dietary nitrate ingestion seems to improve the vascular function in macrovasculature, whereas microvascular function appears to be modest. Future studies investigating the effect of nitrate ingestion on vascular function should focus on measuring macro- and microvascular function whenever possible so that the impact of nitrate-rich foods on vascular segments could be better understood.
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Affiliation(s)
- Mônica Volino-Souza
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center UFRJ-Macaé, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, RJ, Brazil
| | - Gustavo Vieira de Oliveira
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center UFRJ-Macaé, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil
- Nanotechnology Network, Carlos Chagas Filho Research Support Foundation of the State of Rio de Janeiro (FAPERJ), Rio de Janeiro, RJ, Brazil
| | - Vivian Dos Santos Pinheiro
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center UFRJ-Macaé, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, RJ, Brazil
| | - Carlos Adam Conte-Junior
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, RJ, Brazil
- Nanotechnology Network, Carlos Chagas Filho Research Support Foundation of the State of Rio de Janeiro (FAPERJ), Rio de Janeiro, RJ, Brazil
| | - Thiago da Silveira Alvares
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center UFRJ-Macaé, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil
- Food and Nutrition Institute, Multidisciplinary Center UFRJ-Macaé, Federal University of Rio de Janeiro, Macaé, Brazil
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11
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Esen O, Cepicka L, Gabrys T, Karayigit R. High-Dose Nitrate Supplementation Attenuates the Increased Blood Pressure Responses to Isometric Blood Flow Restriction Exercise in Healthy Males. Nutrients 2022; 14:nu14173645. [PMID: 36079902 PMCID: PMC9460709 DOI: 10.3390/nu14173645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 12/02/2022] Open
Abstract
The effect of nitrate (NO3−) supplementation on blood pressure (BP) responses during large muscle mass isometric and ischaemic exercise in healthy young adults is unclear. The aim of the present study was to assess the effect of 5-day supplementation of NO3− on BP responses during a short isometric contraction and a sustained ischaemic contraction. In a randomised, double-blinded, crossover design, 14 healthy active young adults underwent BP measurements after 5 days of either NO3− (NIT) or placebo (PLA) supplementation. Beat-by-beat BP was measured at pre- and post-exercise rest, and during a short (20 s) isometric contraction at 25% maximal strength and throughout a sustained ischaemic contraction. Plasma nitrite (NO2−) concentration increased significantly after NO3− supplementation compared to placebo (475 ± 93 nmol·L−1 vs. 198 ± 46 nmol·L−1, p < 0.001, d = 3.37). Systolic BP was significantly lower at pre- (p = 0.051) and post-exercise rest (p = 0.006), during a short isometric contraction (p = 0.030), and throughout a sustained ischaemic contraction (p = 0.040) after NO3− supplementation. Mean arterial pressure was significantly lower at pre- (p = 0.004) and post-exercise rest (p = 0.043), during a short isometric contraction (p = 0.041), and throughout a sustained ischaemic contraction (p = 0.021) after NO3− supplementation. Diastolic BP was lower at pre-exercise rest (p = 0.032), but not at post-exercise rest, during a short isometric contraction, and during a sustained ischaemic contraction (all p > 0.05). Five days of NO3− supplementation elevated plasma NO2− concentration and reduced BP during a short isometric contraction and a sustained ischaemic contraction in healthy adults. These observations indicate that multiple-day nitrate supplementation can decrease BP at rest and attenuate the increased BP response during isometric exercise. These findings support that NO3− supplementation is an effective nutritional intervention in reducing SBP and MAP in healthy young males during submaximal exercise.
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Affiliation(s)
- Ozcan Esen
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK
- Correspondence: ; Tel.: +44-191-232-60-02
| | - Ladislav Cepicka
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic
| | - Tomasz Gabrys
- Department of Physical Education and Sport, Faculty of Education, University of West Bohemia, 30100 Pilsen, Czech Republic
| | - Raci Karayigit
- Department of Coaching Education, Faculty of Sport Sciences, Ankara University, Ankara 06830, Turkey
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12
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Lundberg JO, Weitzberg E. Nitric oxide signaling in health and disease. Cell 2022; 185:2853-2878. [DOI: 10.1016/j.cell.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 10/16/2022]
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13
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Shariffi B, Dillon K, Gillum T, Boyer W, Sullivan S, Lee E, Kim JK. Effect of Combined Grape Seed Extract and L-Citrulline Supplementation on Hemodynamic Responses to Exercise in Young Males. J Diet Suppl 2022. [DOI: 10.1080/19390211.2021.2023246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Brian Shariffi
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Katherine Dillon
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Trevor Gillum
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - William Boyer
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Sean Sullivan
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
| | - Esther Lee
- Division of Natural and Mathematical Sciences, California Baptist University, Riverside, CA, USA
| | - Jong-Kyung Kim
- Department of Kinesiology, California Baptist University, Riverside, CA, USA
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14
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Thurston TS, Weavil JC, Hureau TJ, Gifford JR, Georgescu VP, Wan HY, La Salle DT, Richardson RS, Amann M. On the implication of dietary nitrate supplementation for the hemodynamic and fatigue response to cycling exercise. J Appl Physiol (1985) 2021; 131:1691-1700. [PMID: 34672767 PMCID: PMC8714979 DOI: 10.1152/japplphysiol.00400.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/22/2021] [Accepted: 10/14/2021] [Indexed: 11/22/2022] Open
Abstract
This study investigated the impact of dietary nitrate supplementation on peripheral hemodynamics, the development of neuromuscular fatigue, and time to task failure during cycling exercise. Eleven recreationally active male participants (27 ± 5 yr, V̇o2max: 42 ± 2 mL/kg/min) performed two experimental trials following 3 days of either dietary nitrate-rich beetroot juice (4.1 mmol NO3-/day; DNS) or placebo (PLA) supplementation in a blinded, counterbalanced order. Exercise consisted of constant-load cycling at 50, 75, and 100 W (4 min each) and, at ∼80% of peak power output (218 ± 12 W), to task-failure. All participants returned to repeat the shorter of the two trials performed to task failure, but with the opposite supplementation regime (iso-time comparison; ISO). Mean arterial pressure (MAP), leg blood flow (QL; Doppler ultrasound), leg vascular conductance (LVC), and pulmonary gas exchange were continuously assessed during exercise. Locomotor muscle fatigue was determined by the change in pre to postexercise quadriceps twitch-torque (ΔQtw) and voluntary activation (ΔVA; electrical femoral nerve stimulation). Following DNS, plasma [nitrite] (∼670 vs. ∼180 nmol) and [nitrate] (∼775 vs. ∼11 μmol) were significantly elevated compared with PLA. Unlike PLA, DNS lowered both QL and MAP by ∼8% (P < 0.05), but did not alter LVC (P = 0.31). V̇O2 across work rates, as well as cycling time to task-failure (∼7 min) and locomotor muscle fatigue following the ISO-time comparison were not different between the two conditions (ΔQtw ∼42%, ΔVA ∼4%). Thus, despite significant hemodynamic changes, DNS did not alter the development of locomotor muscle fatigue and, ultimately, cycling time to task failure.NEW & NOTEWORTHY This study sought to characterize the impact of dietary nitrate supplementation on the hemodynamic response, locomotor muscle fatigue, and time to task failure during cycling exercise. Although nitrate supplementation lowered mean arterial pressure and exercising leg blood flow, leg vascular conductance and oxygen utilization were unaffected. Despite significant hemodynamic changes, there was no effect of dietary nitrate on neuromuscular fatigue development and, ultimately, cycling time to task failure.
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Affiliation(s)
- Taylor S Thurston
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Joshua C Weavil
- Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah
| | - Thomas J Hureau
- Department of Medicine, University of Utah, Salt Lake City, Utah
| | - Jayson R Gifford
- Department of Medicine, University of Utah, Salt Lake City, Utah
| | - Vincent P Georgescu
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Hsuan-Yu Wan
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
| | - D Taylor La Salle
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
| | - Russell S Richardson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
- Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah
- Department of Medicine, University of Utah, Salt Lake City, Utah
| | - Markus Amann
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
- Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah
- Department of Medicine, University of Utah, Salt Lake City, Utah
- Department of Anesthesiology, University of Utah, Salt Lake City, Utah
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15
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Chen L, Zhu Y, Hu Z, Wu S, Jin C. Beetroot as a functional food with huge health benefits: Antioxidant, antitumor, physical function, and chronic metabolomics activity. Food Sci Nutr 2021; 9:6406-6420. [PMID: 34760270 PMCID: PMC8565237 DOI: 10.1002/fsn3.2577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/06/2021] [Accepted: 08/19/2021] [Indexed: 12/19/2022] Open
Abstract
Previously, beetroot is mainly consumed as a food additive. In recent years, the beetroot, especially the betalains (betanin) and nitrates it contains, now has received increasing attention for their effective biological activity. Betalains have been proven to eliminate oxidative and nitrative stress by scavenging DPPH, preventing DNA damage, and reducing LDL. It also has been found to exert antitumor activity by inhibiting cell proliferation, angiogenesis, inducing cell apoptosis, and autophagy. In some chronic diseases, nitrate is the main component for lowing blood lipids, glucose, and pressure, while its role in treating hypertension and hyperglycemia has not been clearly stated. Moreover, the intake of nitrate-rich beetroot could enhance athletic performance and attenuate muscle soreness in certain types of exercise. The objective of this review is to provide sufficient evidence for the clarification of health benefits of beetroot, especially in the aspect of biooxidation, neoplastic diseases, some chronic diseases, and energy supplementation.
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Affiliation(s)
- Liping Chen
- Department of PharmacySchool of MedicineSir Run Run Shaw HospitalZhejiang UniversityHangzhouChina
| | - Yuankang Zhu
- College of Second Clinical MedicalWenzhou Medical UniversityWenzhouChina
| | - Zijing Hu
- Chemical Biology Research CenterCollege of Pharmaceutical SciencesWenzhou Medical UniversityWenzhouChina
| | - Shengjie Wu
- Department of PharmacySchool of MedicineSir Run Run Shaw HospitalZhejiang UniversityHangzhouChina
| | - Chengtao Jin
- Department of PharmacySchool of MedicineSir Run Run Shaw HospitalZhejiang UniversityHangzhouChina
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16
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Repeated administration of inorganic nitrate on blood pressure and arterial stiffness: a systematic review and meta-analysis of randomized controlled trials. J Hypertens 2021; 38:2122-2140. [PMID: 32723980 DOI: 10.1097/hjh.0000000000002524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
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.
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Bahrami LS, Arabi SM, Feizy Z, Rezvani R. The effect of beetroot inorganic nitrate supplementation on cardiovascular risk factors: A systematic review and meta-regression of randomized controlled trials. Nitric Oxide 2021; 115:8-22. [PMID: 34119659 DOI: 10.1016/j.niox.2021.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/18/2021] [Accepted: 06/07/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Inorganic nitrate is one of the most effective compounds in beetroot for improving cardiovascular function due to its conversion to nitric oxide in the body. This review and meta-analysis aimed to investigate the role of beetroot inorganic nitrate supplementation on adults' cardiovascular risk factors. METHODS We conducted a systematic literature review of articles published without time limitation until November 2020 in PubMed, Embase, ISI Web of Science, Scopus, Cochrane Library, and gray literature databases. We included the original randomized clinical trials (RCTs) in which the effect of beetroot inorganic nitrate supplementation on endothelial function, arterial stiffness, and blood pressure was studied. RESULTS 43 studies were included for qualitative synthesis, out of which 27 were eligible for meta-analysis. Beetroot inorganic nitrate supplementation significantly decreased Arterial Stiffness (Pulse Wave Velocity (-0.27 m/s, p = 0.04)) and increased Endothelial function (Flow Mediated Dilation: 0.62%, p = 0.002) but did not change other parameters (p > 0.05). CONCLUSION Beetroot inorganic nitrate supplementation might have a beneficial effect on cardiovascular risk factors. Further high-quality investigations will be needed to provide sufficient evidence.
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Affiliation(s)
- Leila Sadat Bahrami
- Metabolic Syndrome Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyyed Mostafa Arabi
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran.
| | - Zahra Feizy
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX79414, USA.
| | - Reza Rezvani
- Metabolic Syndrome Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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18
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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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19
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Chen J, Hamm LL, Bundy JD, Kumbala DR, Bodana S, Chandra S, Chen CS, Starcke CC, Guo Y, Schaefer CM, Lustigova E, Mahone E, Vadalia AM, Livingston T, Obst K, Hernandez J, Bokhari SR, Kleinpeter M, Alper AB, Lukitsch I, He H, Nieman DC, He J. Combination Treatment with Sodium Nitrite and Isoquercetin on Endothelial Dysfunction among Patients with CKD: A Randomized Phase 2 Pilot Trial. Clin J Am Soc Nephrol 2020; 15:1566-1575. [PMID: 33023894 PMCID: PMC7646238 DOI: 10.2215/cjn.02020220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 08/28/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Endothelial dysfunction is common among patients with CKD. We tested the efficacy and safety of combination treatment with sodium nitrite and isoquercetin on biomarkers of endothelial dysfunction in patients with CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This randomized, double-blind, placebo-controlled phase 2 pilot trial enrolled 70 patients with predialysis CKD. Thirty-five were randomly assigned to combination treatment with sodium nitrite (40 mg twice daily) and isoquercetin (225 mg once daily) for 12 weeks, and 35 were randomly assigned to placebo. The primary outcome was mean change in flow-mediated vasodilation over the 12-week intervention. Secondary and safety outcomes included biomarkers of endothelial dysfunction, inflammation, and oxidative stress as well as kidney function, methemoglobin, and adverse events. Intention-to-treat analysis was conducted. RESULTS Baseline characteristics, including age, sex, race, cigarette smoking, history of hypertension and diabetes, use of renin-angiotensin system blockers, BP, fasting glucose, lipid profile, kidney function, urine albumin-creatinine ratio, and endothelial biomarkers, were comparable between groups. Over the 12-week intervention, flow-mediated vasodilation increased 1.1% (95% confidence interval, -0.1 to 2.3) in the treatment group and 0.3% (95% confidence interval, -0.9 to 1.5) in the placebo group, and net change was 0.8% (95% confidence interval, -0.9 to 2.5). In addition, changes in biomarkers of endothelial dysfunction (vascular adhesion molecule-1, intercellular adhesion molecule-1, E-selectin, vWf, endostatin, and asymmetric dimethylarginine), inflammation (TNF-α, IL-6, C-reactive protein, IL-1 receptor antagonist, and monocyte chemoattractant protein-1), and oxidative stress (oxidized LDL and nitrotyrosines) were not significantly different between the two groups. Furthermore, changes in eGFR, urine albumin-creatinine ratio, methemoglobin, and adverse events were not significantly different between groups. CONCLUSIONS This randomized phase 2 pilot trial suggests that combination treatment with sodium nitrite and isoquercetin did not significantly improve flow-mediated vasodilation or other endothelial function biomarkers but also did not increase adverse events compared with placebo among patients with CKD. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Nitrite, Isoquercetin, and Endothelial Dysfunction (NICE), NCT02552888.
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Affiliation(s)
- Jing Chen
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
- Department of Medicine, Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana
| | - L. Lee Hamm
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Joshua D. Bundy
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | | | - Shirisha Bodana
- Department of Nephrology, Ochsner Health System, New Orleans, Louisiana
| | - Sehgal Chandra
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Chung-Shiuan Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Charlton C. Starcke
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Yajun Guo
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Caroline M. Schaefer
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Eva Lustigova
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Erin Mahone
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Aarti M. Vadalia
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Terra Livingston
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Katherine Obst
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - Jesus Hernandez
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Syed Rizwan Bokhari
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Myra Kleinpeter
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Arnold B. Alper
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
| | - Ivo Lukitsch
- Department of Nephrology, Ochsner Health System, New Orleans, Louisiana
| | - Hua He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
| | - David C. Nieman
- Human Performance Lab, Appalachian State University, Kannapolis, North Carolina
| | - Jiang He
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Tulane University Translational Science Institute, New Orleans, Louisiana
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Augmented Hemodynamic Responses in Obese Young Men during Dynamic Exercise: Role of the Muscle Metaboreflex. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197321. [PMID: 33036416 PMCID: PMC7579031 DOI: 10.3390/ijerph17197321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 02/03/2023]
Abstract
Studies found that cardiovascular responses to exercise are enhanced in individuals with obesity and are associated with a greater cardiac output (CO) response compared to normal weight controls. However, the mechanisms underlying these altered responses during dynamic exercise are not clear. We investigated whether the cardiovascular responses mediated by the muscle metaboreflex (MMR) activation are augmented in obese men during both static and dynamic exercise. Twenty males (10 obese (OG) and 10 non-obese (NOG)) were studied. Changes in CO, mean arterial pressure (MAP), and total vascular conductance (TVC) were compared between the two groups during dynamic handgrip exercise (DHE), post-exercise muscular ischemia (PEMI), and dynamic exercise corresponding to 40%, 60% and 80% workloads. Subjects completed 2 min of DHE at 30% of MVC, followed by 2 min of PEMI. MAP, CO, and TVC responses to DHE and dynamic exercise were significantly higher in OG, whereas there were no differences during PEMI. Increases in CO and MAP during mild to heavy dynamic exercise were seen in both groups, but the changes in these variables were greater in the OG. There were no significant differences in TVC between the two groups. Compared to NOG, the augmented blood pressure response to DHE and dynamic exercise in OG was associated with a greater increase in CO. Thus, the augmented CO and MAP responses were not associated with the activation of the MMR. Consequently, additional factors specific to obesity, such as the mechanoreflex, may have been involved.
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Hughan KS, Levine A, Helbling N, Anthony S, DeLany JP, Stefanovic-Racic M, Goodpaster BH, Gladwin MT. Effects of Oral Sodium Nitrite on Blood Pressure, Insulin Sensitivity, and Intima-Media Arterial Thickening in Adults With Hypertension and Metabolic Syndrome. Hypertension 2020; 76:866-874. [PMID: 32755471 PMCID: PMC7429358 DOI: 10.1161/hypertensionaha.120.14930] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The nitrate-nitrite-NO pathway regulates NO synthase-independent vasodilation and NO signaling. Ingestion of inorganic nitrite has vasodilatory and blood pressure-lowering effects. Preclinical studies in rodent models suggest there may be a benefit of nitrite in lowering serum triglyceride levels and improving the metabolic syndrome. In a phase 2 study, we evaluated the safety and efficacy of chronic oral nitrite therapy in patients with hypertension and the metabolic syndrome. Twenty adult subjects with stage 1 or 2 hypertension and the metabolic syndrome were enrolled in an open-label safety and efficacy study. The primary efficacy end point was blood pressure reduction; secondary end points included insulin-dependent glucose disposal and endothelial function measured by flow-mediated dilation of the brachial artery and intima-media diameter of the carotid artery. Chronic oral nitrite therapy (40 mg/3× daily) was well tolerated. Oral nitrite significantly lowered systolic, diastolic, and mean arterial pressures, but tolerance was observed after 10 to 12 weeks of therapy. There was significant improvement in the intima-media thickness of the carotid artery and trends toward improvements in flow-mediated dilation of the brachial artery and insulin sensitivity. Chronic oral nitrite therapy is safe in patients with hypertension and the metabolic syndrome. Despite an apparent lack of enzymatic tolerance to nitrite, we observed tolerance after 10 weeks of chronic therapy, which requires additional mechanistic studies and possible therapeutic dose titration in clinical trials. Nitrite may be a safe therapy to concominantly improve multiple features of the metabolic syndrome including hypertension, insulin resistance, and endothelial dysfunction. Registration- URL: https://www.clinicaltrials.gov; Unique identifier: NCT01681810.
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Affiliation(s)
- Kara S Hughan
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University of Pittsburgh, Pittsburgh, PA
- Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA
| | - Andrea Levine
- Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
- Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Nicole Helbling
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA
| | - Steven Anthony
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA
| | - James P DeLany
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA
| | - Maja Stefanovic-Racic
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA
| | - Bret H. Goodpaster
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA
| | - Mark T. Gladwin
- Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA
- Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
- Department of Medicine, Division of Endocrinology, University of Pittsburgh, Pittsburgh, PA
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22
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Kapil V, Khambata RS, Jones DA, Rathod K, Primus C, Massimo G, Fukuto JM, Ahluwalia A. The Noncanonical Pathway for In Vivo Nitric Oxide Generation: The Nitrate-Nitrite-Nitric Oxide Pathway. Pharmacol Rev 2020; 72:692-766. [DOI: 10.1124/pr.120.019240] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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23
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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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24
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Sundqvist ML, Larsen FJ, Carlström M, Bottai M, Pernow J, Hellénius ML, Weitzberg E, Lundberg JO. A randomized clinical trial of the effects of leafy green vegetables and inorganic nitrate on blood pressure. Am J Clin Nutr 2020; 111:749-756. [PMID: 32091599 PMCID: PMC7338722 DOI: 10.1093/ajcn/nqaa024] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/30/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A diet rich in fruits and vegetables is associated with lowering of blood pressure (BP), but the nutrient(s) responsible for these effects remain unclear. Research suggests that inorganic nitrate present in leafy green vegetables is converted into NO in vivo to improve cardiovascular function. OBJECTIVE In this study, we evaluated the effect of leafy green vegetables on BP in subjects with elevated BP, with the aim of elucidating if any such effect is related to their high nitrate content. DESIGN We enrolled 243 subjects, 50-70 y old, with a clinic systolic BP (SBP) of 130-159 mm Hg. After a 2-wk run-in period on a nitrate-restricted diet the subjects were randomly assigned to receive 1 of the following 3 interventions daily for 5 wk: low-nitrate vegetables + placebo pills, low-nitrate vegetables + nitrate pills (300 mg nitrate), or leafy green vegetables containing 300 mg nitrate + placebo pills. The primary end point measure was the difference in change in 24 h ambulatory SBP between the groups. RESULTS A total of 231 subjects (95%) completed the study. The insignificant change in ambulatory SBP (mean ± standard deviation) was -0.6 ± 6.2 mm Hg in the placebo group, -1.2 ± 6.8 mm Hg in the potassium nitrate group, and -0.5 ± 6.6 mm Hg in the leafy green vegetable group. There was no significant difference in change between the 3 groups. CONCLUSIONS A 5-wk dietary supplementation with leafy green vegetables or pills containing the same amount of inorganic nitrate does not decrease ambulatory SBP in subjects with elevated BP. This trial was registered at clinicaltrials.gov as NCT02916615.
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Affiliation(s)
- Michaela L Sundqvist
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
| | - Filip J Larsen
- Department of Sport and Health Sciences, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Mattias Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - John Pernow
- Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mai-Lis Hellénius
- Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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25
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de Vries CJ, DeLorey DS. Effect of acute dietary nitrate supplementation on sympathetic vasoconstriction at rest and during exercise. J Appl Physiol (1985) 2019; 127:81-88. [PMID: 31095461 DOI: 10.1152/japplphysiol.01053.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Dietary nitrate ( NO3- ) supplementation has been shown to reduce resting blood pressure. However, the mechanism responsible for the reduction in blood pressure has not been identified. Dietary NO3- supplementation may increase nitric oxide (NO) bioavailability, and NO has been shown to inhibit sympathetic vasoconstriction in resting and contracting skeletal muscle. Therefore, the purpose of this study was to investigate the hypothesis that acute dietary NO3- supplementation would attenuate sympathetic vasoconstrictor responsiveness at rest and during exercise. In a double-blind randomized crossover design, 12 men (23 ± 5 yr) performed a cold-pressor test (CPT) at rest and during moderate- and heavy-intensity alternate-leg knee-extension exercise after consumption of NO3- rich beetroot juice (~12.9 mmol NO3- ) or a NO3- -depleted placebo (~0.13 mmol NO3- ). Venous blood was sampled before and 2.5 h after the consumption of beetroot juice for the measurement of total plasma nitrite/ NO3- [NOx]. Beat-by-beat blood pressure was measured by Finometer. Leg blood flow was measured at the femoral artery via Doppler ultrasound, and leg vascular conductance (LVC) was calculated. Sympathetic vasoconstrictor responsiveness was calculated as the percentage decrease in LVC in response to the CPT. Total plasma [NOx] was greater (P < 0.001) in the NO3- (285 ± 120 µM) compared with the placebo (65 ± 30 µM) condition. However, mean arterial blood pressure and plasma catecholamines were not different (P > 0.05) between NO3- and placebo conditions at rest or during moderate- and heavy-intensity exercise. Sympathetic vasoconstrictor responsiveness (Δ% LVC) was not different (P > 0.05) between NO3- and placebo conditions at rest ( NO3- : -33 ± 10%; placebo: -35 ± 11%) or during moderate ( NO3- : -18 ± 8%; placebo: -20 ± 10%)- and heavy ( NO3- : -12 ± 8%; placebo: -11 ± 9%)-intensity exercise. These data demonstrate that acute dietary NO3- supplementation does not alter sympathetic vasoconstrictor responsiveness at rest or during exercise in young healthy males. NEW & NOTEWORTHY Dietary nitrate may increase nitric oxide bioavailability, and nitric oxide has been shown to attenuate sympathetic vasoconstriction in resting and contracting skeletal muscle and enhance functional sympatholysis. However, the effect of dietary nitrate on sympathetic vasoconstrictor responsiveness is unknown. Acute dietary nitrate supplementation did not alter blood pressure or sympathetic vasoconstrictor responsiveness at rest or during exercise in young healthy males.
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Affiliation(s)
- Christopher J de Vries
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta , Edmonton, Alberta , Canada
| | - Darren S DeLorey
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta , Edmonton, Alberta , Canada
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26
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Richards JC, Racine ML, Hearon CM, Kunkel M, Luckasen GJ, Larson DG, Allen JD, Dinenno FA. Acute ingestion of dietary nitrate increases muscle blood flow via local vasodilation during handgrip exercise in young adults. Physiol Rep 2019; 6. [PMID: 29380952 PMCID: PMC5789727 DOI: 10.14814/phy2.13572] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 12/04/2022] Open
Abstract
Dietary nitrate (NO3−) is converted to nitrite (NO2−) and can be further reduced to the vasodilator nitric oxide (NO) amid a low O2 environment. Accordingly, dietary NO3− increases hind limb blood flow in rats during treadmill exercise; however, the evidence of such an effect in humans is unclear. We tested the hypothesis that acute dietary NO3− (via beetroot [BR] juice) increases forearm blood flow (FBF) via local vasodilation during handgrip exercise in young adults (n = 11; 25 ± 2 years). FBF (Doppler ultrasound) and blood pressure (Finapres) were measured at rest and during graded handgrip exercise at 5%, 15%, and 25% maximal voluntary contraction (MVC) lasting 4 min each. At the highest workload (25% MVC), systemic hypoxia (80% SaO2) was induced and exercise continued for three additional minutes. Subjects ingested concentrated BR (12.6 mmol nitrate (n = 5) or 16.8 mmol nitrate (n = 6) and repeated the exercise bout either 2 (12.6 mmol) or 3 h (16.8 mmol) postconsumption. Compared to control, BR significantly increased FBF at 15% MVC (184 ± 15 vs. 164 ± 15 mL/min), 25% MVC (323 ± 27 vs. 286 ± 28 mL/min), and 25% + hypoxia (373 ± 39 vs. 343 ± 32 mL/min) and this was due to increases in vascular conductance (i.e., vasodilation). The effect of BR on hemodynamics was not different between the two doses of BR ingested. Forearm VO2 was also elevated during exercise at 15% and 25% MVC. We conclude that acute increases in circulating NO3− and NO2− via BR increases muscle blood flow during moderate‐ to high‐intensity handgrip exercise via local vasodilation. These findings may have important implications for aging and diseased populations that demonstrate impaired muscle perfusion and exercise intolerance.
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Affiliation(s)
- Jennifer C Richards
- Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Center for Cardiovascular Research, Colorado State University, Fort Collins, Colorado, USA
| | - Matthew L Racine
- Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Center for Cardiovascular Research, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher M Hearon
- Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Center for Cardiovascular Research, Colorado State University, Fort Collins, Colorado, USA
| | - Megan Kunkel
- Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Center for Cardiovascular Research, Colorado State University, Fort Collins, Colorado, USA
| | - Gary J Luckasen
- Medical Center of the Rockies Foundation, Poudre Valley Health System, Loveland, Colorado, USA
| | - Dennis G Larson
- Medical Center of the Rockies Foundation, Poudre Valley Health System, Loveland, Colorado, USA
| | - Jason D Allen
- Department of Kinesiology, Curry School of Education, University of Virginia, Charlottesville, Virginia, USA.,Duke Molecular Physiology Institute, Duke University, Durham, North Carolina, USA
| | - Frank A Dinenno
- Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Center for Cardiovascular Research, Colorado State University, Fort Collins, Colorado, USA
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27
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Zafeiridis A, Triantafyllou A, Papadopoulos S, Koletsos N, Touplikioti P, Zafeiridis AS, Gkaliagkousi E, Dipla K, Douma S. Dietary nitrate improves muscle microvascular reactivity and lowers blood pressure at rest and during isometric exercise in untreated hypertensives. Microcirculation 2019; 26:e12525. [DOI: 10.1111/micc.12525] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/15/2018] [Accepted: 11/19/2018] [Indexed: 01/30/2023]
Affiliation(s)
- Andreas Zafeiridis
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Areti Triantafyllou
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Stavros Papadopoulos
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Nikolaos Koletsos
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | | | - Alexandros S. Zafeiridis
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Eugenia Gkaliagkousi
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
| | - Konstantina Dipla
- Laboratory of Exercise Physiology and BiochemistryDepartment of Physical Education and Sports Science at SerresAristotle University of Thessaloniki Serres Greece
| | - Stella Douma
- Third Department of Internal MedicinePapageorgiou HospitalAristotle University of Thessaloniki Thessaloniki Greece
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28
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Finkel A, Röhrich MA, Maassen N, Lützow M, Blau LS, Hanff E, Tsikas D, Maassen M. Long-term effects of NO3- on the relationship between oxygen uptake and power after three weeks of supplemented HIHVT. J Appl Physiol (1985) 2018; 125:1997-2007. [PMID: 30359537 DOI: 10.1152/japplphysiol.00176.2018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The aim of this study was to investigate the later effects of daily NO3- supplementation over 3 wk of training on the relationship between O2 uptake and power at different intensities with an incremental test (IT), a double-wingate test (WT), and an endurance capacity test at 80% Wmax (ECT) before and after the supplementation period. Seventeen male recreational athletes participated in this double-blind placebo (PL)-controlled study. Subjects participated in a 3-wk intermittent high-intensity, high-volume training period with 45 intervals of Wmax - 10 W and an active recovery period of 10 W in between with dietary NO3- (NaNO3) or placebo supplementation (NaCl) (both 8.5 mg·kg-1·day-1) on a cycle ergometer. During a training session, plasma [ NO3- ] ( P < 0.001) and plasma [ NO2- ] ( P < 0.01) were higher in nitrate (N), whereas in pre- and posttests mean plasma [ NO3- ] and [ NO2- ] were not different between groups. In the WT [48 h after cessation of supplementation (C)], the ratio between V̇o2 and power decreased in N ( P < 0.01) with no changes in PL. Endurance capacity (4-5 days after C) similarly increased in both groups ( P < 0.01). However, the total oxygen consumption decreased by 5% ( P < 0.01) in N, with no change in PL. The slope of V̇o2·W-1 in IT (5-7 days after C) decreased in N ( P < 0.01), whereas no changes were found in PL. During low- and moderate-intensity workloads, no changes and differences in V̇o2 could be detected. We conclude that nitrate supplementation causes a sustaining reduction of the oxygen cost per watt during exercise with a large recruitment of type II muscle fibers without affecting endurance capacity. NEW & NOTEWORTHY Because most studies focused on the acute effects of NO3- supplementation on exercise performance during a supplementation period, the sustainability of the effects of the NO3- supplementation remain unknown. We followed the development of V̇o2/W at different intensities during the first week after cessation of daily NO3- supplementation over 3 wk. The results indicate that NO3- supplementation has a long-term effect for at least 7 days after cessation during heavy all-out workloads without affecting endurance capacity.
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Affiliation(s)
- Armin Finkel
- Institute of Sport Medicine, Hannover Medical School , Hannover , Germany.,Institute of Sports Science, Leibniz University Hannover , Hannover , Germany
| | | | - Norbert Maassen
- Institute of Sport Medicine, Hannover Medical School , Hannover , Germany.,Institute of Sports Science, Leibniz University Hannover , Hannover , Germany
| | - Moritz Lützow
- Institute of Sport Medicine, Hannover Medical School , Hannover , Germany
| | - Larissa Sarah Blau
- Institute of Sport Medicine, Hannover Medical School , Hannover , Germany
| | - Erik Hanff
- Institute of Toxicology, Core-Unit, Proteomics, Hannover Medical School , Hannover , Germany
| | - Dimitrios Tsikas
- Institute of Toxicology, Core-Unit, Proteomics, Hannover Medical School , Hannover , Germany
| | - Mirja Maassen
- Institute of Sport Medicine, Hannover Medical School , Hannover , Germany.,Institute of Sports Science, Leibniz University Hannover , Hannover , Germany
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29
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Schneider AC, Hughes WE, Ueda K, Bock JM, Casey DP. Reduced blood pressure responsiveness to skeletal muscle metaboreflex activation in older adults following inorganic nitrate supplementation. Nitric Oxide 2018; 78:81-88. [DOI: 10.1016/j.niox.2018.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/24/2018] [Accepted: 05/31/2018] [Indexed: 01/25/2023]
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30
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Fan JL, Bourdillon N, Meyer P, Kayser B. Oral Nitrate Supplementation Differentially Modulates Cerebral Artery Blood Velocity and Prefrontal Tissue Oxygenation During 15 km Time-Trial Cycling in Normoxia but Not in Hypoxia. Front Physiol 2018; 9:869. [PMID: 30061839 PMCID: PMC6054990 DOI: 10.3389/fphys.2018.00869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/18/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Nitrate is a precursor of nitric oxide (NO), an important regulator of cerebral perfusion in normoxic and hypoxic conditions. Nitrate supplementation could be used to improve cerebral perfusion and oxygenation during exercise in hypoxia. The effects of dietary nitrate supplementation on cerebral haemodynamics during exercise in severe hypoxia (arterial O2 saturation < 70%) have not been explored. Methods: In twelve trained male cyclists, we measured blood pressure (BP), middle cerebral artery blood velocity (MCAv), cerebrovascular resistance (CVR) and prefrontal oxyhaemoglobin and deoxyhaemoglobin concentration (O2Hb and HHb, respectively) during 15 km cycling time trials (TT) in normoxia and severe hypoxia (11% inspired O2, peripheral O2 saturation ∼66%) following 3-day oral supplementation with placebo or sodium nitrate (0.1 mmol/kg/day) in a randomised, double-blinded manner. We tested the hypothesis that dietary nitrate supplementation increases MCAv and cerebral O2Hb during TT in severe hypoxia. Results: During TT in normoxia, nitrate supplementation lowered MCAv by ∼2.3 cm/s and increased cerebral O2Hb by ∼6.8 μM and HHb by ∼2.1 μM compared to normoxia placebo (p ≤ 0.01 for all), while BP tended to be lowered (p = 0.06). During TT in severe hypoxia, nitrate supplementation elevated MCAv (by ∼2.5 cm/s) and BP (by ∼5 mmHg) compared to hypoxia placebo (p < 0.01 for both), while it had no effect on cerebral O2Hb (p = 0.98), HHb (p = 0.07) or PETCO2 (p = 0.12). Dietary nitrate had no effect of CVR during TT in normoxia or hypoxia (p = 0.19). Conclusion: Our findings indicate that during normoxic TT, the modulatory effect of dietary nitrate on regional and global cerebral perfusion is heterogeneous. Meanwhile, the lack of major changes in cerebral perfusion with dietary nitrate during hypoxic TT alludes to an exhausted cerebrovascular reserve.
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Affiliation(s)
- Jui-Lin Fan
- Wellington Medical Technology Group, Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.,Centre for Translational Physiology, University of Otago, Wellington, New Zealand
| | - Nicolas Bourdillon
- Institute of Sports Sciences, University of Lausanne, Lausanne, Switzerland
| | - Philippe Meyer
- Cardiology Service, Geneva University Hospital, Geneva, Switzerland
| | - Bengt Kayser
- Institute of Sports Sciences, University of Lausanne, Lausanne, Switzerland
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31
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Amano T, Okushima D, Breese BC, Bailey SJ, Koga S, Kondo N. Influence of dietary nitrate supplementation on local sweating and cutaneous vascular responses during exercise in a hot environment. Eur J Appl Physiol 2018; 118:1579-1588. [DOI: 10.1007/s00421-018-3889-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/10/2018] [Indexed: 01/03/2023]
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32
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Al-Dashti YA, Holt RR, Stebbins CL, Keen CL, Hackman RM. Dietary Flavanols: A Review of Select Effects on Vascular Function, Blood Pressure, and Exercise Performance. J Am Coll Nutr 2018; 37:553-567. [PMID: 29718795 DOI: 10.1080/07315724.2018.1451788] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An individual's diet affects numerous physiological functions and can play an important role in reducing the risk of cardiovascular disease. Epidemiological and clinical studies suggest that dietary flavanols can be an important modulator of vascular risk. Diets and plant extracts rich in flavanols have been reported to lower blood pressure, especially in prehypertensive and hypertensive individuals. Flavanols may act in part through signaling pathways that affect vascular function, nitric oxide availability, and the release of endothelial-derived relaxing and constricting factors. During exercise, flavanols have been reported to modulate metabolism and respiration (e.g., maximal oxygen uptake, O2 cost of exercise, and energy expenditure), and reduce oxidative stress and inflammation, resulting in increased skeletal muscle efficiency and endurance capacity. Flavanol-induced reductions in blood pressure during exercise may decrease the work of the heart. Collectively, these effects suggest that flavanols can act as an ergogenic aid to help delay the onset of fatigue. More research is needed to better clarify the effects of flavanols on vascular function, blood pressure regulation, and exercise performance and establish safe and effective levels of intake. Flavanol-rich foods and food products can be useful components of a healthy diet and lifestyle program for those seeking to better control their blood pressure or to enhance their physical activity. Key teaching points • Epidemiological and clinical studies indicate that dietary flavanols can reduce the risk of vascular disease. • Diets and plant extracts rich in flavanols have been reported to lower blood pressure and improve exercise performance in humans. • Mechanisms by which flavanols may reduce blood pressure function include alterations in signaling pathways that affect vascular function, nitric oxide availability, and the release of endothelial-derived relaxation and constriction factors. • Mechanisms by which flavanols may enhance exercise performance include modulation of metabolism and respiration (e.g., maximal oxygen uptake, O2 cost of exercise, and energy expenditure) and reduction of oxidative stress and inflammation. These effects can result in increased skeletal muscle efficiency and endurance capacity. • Further research is needed to clarify the amount, timing, and frequency of flavanol intake for blood pressure regulation and exercise performance.
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Affiliation(s)
- Yousef A Al-Dashti
- a Department of Nutrition , University of California, Davis , Davis , California , USA
| | - Roberta R Holt
- a Department of Nutrition , University of California, Davis , Davis , California , USA
| | - Charles L Stebbins
- b Department of Internal Medicine , University of California, Davis , Davis , California , USA
| | - Carl L Keen
- a Department of Nutrition , University of California, Davis , Davis , California , USA.,b Department of Internal Medicine , University of California, Davis , Davis , California , USA
| | - Robert M Hackman
- a Department of Nutrition , University of California, Davis , Davis , California , USA
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33
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Kim JK, Kim KA, Choi HM, Park SK, Stebbins CL. Grape Seed Extract Supplementation Attenuates the Blood Pressure Response to Exercise in Prehypertensive Men. J Med Food 2018; 21:445-453. [DOI: 10.1089/jmf.2017.0133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Jong-Kyung Kim
- Graduate School of Physical Education, Kyung Hee University, Yongin, Korea
| | - Kyung-Ae Kim
- Graduate School of Physical Education, Kyung Hee University, Yongin, Korea
| | - Hyun-Min Choi
- Graduate School of Physical Education, Kyung Hee University, Yongin, Korea
| | - Seung-Kook Park
- College of Life Science, Kyung Hee University, Yongin, Korea
| | - Charles L. Stebbins
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of California at Davis, Davis, California, USA
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Ashor AW, Lara J, Siervo M. Medium-term effects of dietary nitrate supplementation on systolic and diastolic blood pressure in adults: a systematic review and meta-analysis. J Hypertens 2018; 35:1353-1359. [PMID: 28319596 DOI: 10.1097/hjh.0000000000001305] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Dietary nitrate supplementation has been shown to lower blood pressure (BP) particularly in short-term clinical trials. Whether these effects are sustained in the long-term remains to be established. The objective was to conduct a meta-analysis of randomized controlled trials that examined whether dietary nitrate supplementation for more than 1 week has beneficial effects on SBP and DBP. METHODS Electronic databases were searched from inception until May 2016. Specific inclusion criteria were duration at least 1 week, report of effects on SBP or DBP or both and comparison of inorganic nitrate or beetroot juice supplementation with placebo control groups. Random-effects models were used to calculate the pooled BP effect sizes. RESULTS Thirteen trials met eligibility criteria. The trials included a total of 325 participants with seven to 65 participants per study. The duration of each intervention ranged from 1 to 6 weeks. Ten trials assessed BP in resting clinic conditions, whereas 24-h ambulatory and daily home monitorings were used in six and three trials, respectively. Overall, dietary nitrate was associated with a significant decline in SBP [-4.1 mmHg (95% confidence interval: -6.1, -2.2); P < 0.001] and DBP [-2.0 mmHg (95% confidence interval: -3.0, -0.9); P < 0.001]. However, the effect was only significant when measured in resting clinical settings as no significant changes in BP were observed using 24-h ambulatory and daily home BP monitorings. CONCLUSION Positive effects of medium-term dietary nitrate supplementation on BP were only observed in clinical settings, which were not corroborated by more accurate methods such as 24-h ambulatory and daily home monitorings.
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Affiliation(s)
- Ammar W Ashor
- aHuman Nutrition Research Centre, Institute of Cellular Medicine, Campus for Ageing and Vitality, Newcastle University bDepartment of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Papadopoulos S, Dipla K, Triantafyllou A, Nikolaidis MG, Kyparos A, Touplikioti P, Vrabas IS, Zafeiridis A. Beetroot Increases Muscle Performance and Oxygenation During Sustained Isometric Exercise, but Does Not Alter Muscle Oxidative Efficiency and Microvascular Reactivity at Rest. J Am Coll Nutr 2018; 37:361-372. [DOI: 10.1080/07315724.2017.1401497] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Stavros Papadopoulos
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Konstantina Dipla
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Areti Triantafyllou
- Third Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michalis G Nikolaidis
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Antonios Kyparos
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | | | - Ioannis S Vrabas
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Andreas Zafeiridis
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
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Kent GL, Dawson B, Cox GR, Abbiss CR, Smith KJ, Croft KD, Lim ZX, Eastwood A, Burke LM, Peeling P. Effect of dietary nitrate supplementation on thermoregulatory and cardiovascular responses to submaximal cycling in the heat. Eur J Appl Physiol 2018; 118:657-668. [DOI: 10.1007/s00421-018-3809-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/15/2018] [Indexed: 12/19/2022]
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Bahadoran Z, Mirmiran P, Kabir A, Azizi F, Ghasemi A. The Nitrate-Independent Blood Pressure-Lowering Effect of Beetroot Juice: A Systematic Review and Meta-Analysis. Adv Nutr 2017; 8:830-838. [PMID: 29141968 PMCID: PMC5683004 DOI: 10.3945/an.117.016717] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Beetroot is considered a complementary treatment for hypertension because of its high content of inorganic NO3 This systematic review and meta-analysis aimed to clarify several aspects of beetroot juice supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP). We searched PubMed, Scopus, and Embase databases, and the reference lists of previous reviews. Randomized clinical trials that investigated the effects of beetroot juice on resting blood pressure in humans were recruited for quality assessment, meta-analyses, subgroup analyses, and meta-regressions; of these, 22 were conducted between 2009 and 2017 and included a total of 47 intervention (n = 650) and 43 control (n = 598) groups. Overall, SBP (-3.55 mm Hg; 95% CI: -4.55, -2.54 mm Hg) and DBP (-1.32 mm Hg; 95% CI: -1.97, -0.68 mm Hg) were significantly lower in the beetroot juice-supplemented groups than in the control groups. The mean difference of SBP was larger between beetroot juice-supplemented and control groups in the longer than in the shorter (≥14 compared with <14 d) study durations (-5.11 compared with -2.67 mm Hg) and the highest compared with the lowest (500 compared with 70 and 140 mL/d) doses of beetroot juice (-4.78 compared with -2.37 mm Hg). A positive correlation was observed between beetroot juice doses and the mean differences of blood pressures. In contrast, a smaller effect size of blood pressures was observed after supplementation with higher NO3 (milligrams per 100 mL beetroot juice). A weak effect size was observed in a meta-analysis of trials that used NO3-depleted beetroot juice as a placebo compared with other interventions (-3.09 compared with -4.51 mm Hg for SBP and -0.81 compared with -2.01 mm Hg for DBP). Our results demonstrate the blood pressure-lowering effects of beetroot juice and highlight its potential NO3-independent effects.
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Affiliation(s)
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Asghar Ghasemi
- Endocrine Physiology Center, Research Institute for Endocrine Sciences
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Oggioni C, Jakovljevic DG, Klonizakis M, Ashor AW, Ruddock A, Ranchordas M, Williams E, Siervo M. Dietary nitrate does not modify blood pressure and cardiac output at rest and during exercise in older adults: a randomised cross-over study. Int J Food Sci Nutr 2017; 69:74-83. [PMID: 28562133 PMCID: PMC5952182 DOI: 10.1080/09637486.2017.1328666] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Dietary nitrate (NO3-) supplementation has been associated with improved vascular and metabolic health. We conducted a double-blind, cross-over, placebo-controlled RCT to investigate the effects of 7-d consumption of beetroot juice compared with placebo on (1) blood pressure (BP) measured in resting conditions and during exercise, (2) cardiac and peripheral vascular function and (3) biomarkers of inflammation, oxidative stress and endothelial integrity. Twenty non-smoking healthy participants aged 60–75 years and BMI 20.0–29.9 kg/m2 were recruited. Measurement was conducted before and after each 7-d intervention period. Consumption of NO3- had no effect on resting systolic and diastolic BP. NO3- consumption did not improve indexes of central and peripheral cardiac function responses during cardiopulmonary exercise testing. Dietary NO3- supplementation did not modify biomarkers of inflammation, oxidative stress and endothelial integrity. This study does not support the short-term benefits of dietary NO3- supplementation on physiological and biochemical markers of vascular health in older healthy adults.
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Affiliation(s)
- C Oggioni
- a Human Nutrition Research Centre, Institute of Cellular Medicine , Newcastle University , Newcastle on Tyne , UK
| | - D G Jakovljevic
- b Institute of Cellular Medicine, MoveLab , Newcastle University , Newcastle upon Tyne , UK
| | - M Klonizakis
- c Centre for Sport and Exercise Science , Sheffield Hallam University , Sheffield , UK
| | - A W Ashor
- a Human Nutrition Research Centre, Institute of Cellular Medicine , Newcastle University , Newcastle on Tyne , UK
| | - A Ruddock
- c Centre for Sport and Exercise Science , Sheffield Hallam University , Sheffield , UK
| | - M Ranchordas
- c Centre for Sport and Exercise Science , Sheffield Hallam University , Sheffield , UK
| | - E Williams
- d Human Nutrition Unit, Department of Oncology & Metabolism, Faculty of Medicine, Dentistry and Health , University of Sheffield , Sheffield , UK
| | - M Siervo
- a Human Nutrition Research Centre, Institute of Cellular Medicine , Newcastle University , Newcastle on Tyne , UK
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Le Roux-Mallouf T, Vibert F, Doutreleau S, Verges S. Effect of acute nitrate and citrulline supplementation on muscle microvascular response to ischemia-reperfusion in healthy humans. Appl Physiol Nutr Metab 2017; 42:901-908. [PMID: 28460182 DOI: 10.1139/apnm-2017-0081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Nitric oxide (NO) is implicated in vasomotor control mechanisms altering the diameter of the vessels under various physiological and pathological conditions. There are 2 main NO production pathways, 1 NO synthase (NOS) independent (nitrate-nitrite-NO) and the other is NOS dependent (citrulline-arginine-NO). The objective of the study was to evaluate the effect of acute nitrate and citrulline supplementation on post-ischemic vascular response in healthy subjects. Fourteen subjects performed 2-leg vascular occlusion tests, 3 days apart. They were randomly assigned to consume a drink containing 1200 mg (19.4 mmol) of nitrate and 6 g of citrulline (N+C) or a placebo (Pl). Changes in total hemoglobin (Hbtot) and oxyhemoglobin (HbO2) concentrations were recorded by near-infrared spectroscopy on the thigh and calf muscles. No differences between N+C and Pl were observed during the ischemic period. Hbtot increased to a larger extent during the reperfusion period for the thigh (e.g., area under the curve, 821 ± 324 vs. 627 ± 381 mmol·s-1, p = 0.003) and the calf (515 ± 285 vs. 400 ± 275 mmol·s-1, p = 0.029) in the N+C versus Pl conditions. Similar results were found regarding HbO2 for the thigh (e.g., area under the curve, 842 ± 502 vs. 770 ± 491 mmol·s-1, p = 0.077) and the calf (968 ± 536 vs. 865 ± 275 mmol·s-1, p = 0.075). The larger postocclusive Hbtot and HbO2 responses observed after N+C intake suggests a greater post-ischemic vasodilation, which may be due to increased NO availability, via the activation of the 2 main NO production pathways.
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Affiliation(s)
- Thibault Le Roux-Mallouf
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
| | - Florence Vibert
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
| | - Stéphane Doutreleau
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
| | - Samuel Verges
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
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Koch CD, Gladwin MT, Freeman BA, Lundberg JO, Weitzberg E, Morris A. Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health. Free Radic Biol Med 2017; 105:48-67. [PMID: 27989792 PMCID: PMC5401802 DOI: 10.1016/j.freeradbiomed.2016.12.015] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/18/2016] [Accepted: 12/12/2016] [Indexed: 02/07/2023]
Abstract
Recent insights into the bioactivation and signaling actions of inorganic, dietary nitrate and nitrite now suggest a critical role for the microbiome in the development of cardiac and pulmonary vascular diseases. Once thought to be the inert, end-products of endothelial-derived nitric oxide (NO) heme-oxidation, nitrate and nitrite are now considered major sources of exogenous NO that exhibit enhanced vasoactive signaling activity under conditions of hypoxia and stress. The bioavailability of nitrate and nitrite depend on the enzymatic reduction of nitrate to nitrite by a unique set of bacterial nitrate reductase enzymes possessed by specific bacterial populations in the mammalian mouth and gut. The pathogenesis of pulmonary hypertension (PH), obesity, hypertension and CVD are linked to defects in NO signaling, suggesting a role for commensal oral bacteria to shape the development of PH through the formation of nitrite, NO and other bioactive nitrogen oxides. Oral supplementation with inorganic nitrate or nitrate-containing foods exert pleiotropic, beneficial vascular effects in the setting of inflammation, endothelial dysfunction, ischemia-reperfusion injury and in pre-clinical models of PH, while traditional high-nitrate dietary patterns are associated with beneficial outcomes in hypertension, obesity and CVD. These observations highlight the potential of the microbiome in the development of novel nitrate- and nitrite-based therapeutics for PH, CVD and their risk factors.
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Affiliation(s)
- Carl D Koch
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA.
| | - Mark T Gladwin
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA; Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh PA 15261, USA
| | - Bruce A Freeman
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh PA 15261, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, S-17177 Stockholm, Sweden
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, S-17177 Stockholm, Sweden
| | - Alison Morris
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA; Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh PA 15261, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA 15261, USA; Department of Physiology and Pharmacology, Karolinska Institutet, S-17177 Stockholm, Sweden
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Potentiation of the NO-cGMP pathway and blood flow responses during dynamic exercise in healthy humans. Eur J Appl Physiol 2016; 117:237-246. [PMID: 28013386 DOI: 10.1007/s00421-016-3523-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Previous work has shown nitric oxide (NO) contributes to ~15% of the hyperemic response to dynamic exercise in healthy humans. This NO-mediated vasodilation occurs, in part, via increases in intracellular cyclic guanosine monophosphate (cGMP), which is catabolized by phosphodiesterase. We sought to examine the effect of phosphodiesterase-5 (PDE-5) inhibition on forearm blood flow (FBF) responses to dynamic handgrip exercise in healthy humans and the role of NO. We hypothesized exercise hyperemia would be augmented by sildenafil citrate (SDF, PDE-5 inhibitor). We further hypothesized any effect of SDF on exercise hyperemia would be abolished with intra-arterial infusion of the NO synthase (NOS) inhibitor L-NG-monomethyl arginine (L-NMMA). METHODS FBF (Doppler ultrasound) was assessed at rest and during 5 min of dynamic forearm handgrip exercise at 15% of maximal voluntary contraction under control (saline) conditions and during 3 experimental protocols: (1) oral SDF (n = 10), (2) intra-arterial L-NMMA (n = 20), (3) SDF and L-NMMA (n = 10). FBF responses to intra-arterial sodium nitroprusside (NTP, NO donor) were also assessed. RESULTS FBF increased with exercise (p < 0.01). Intra-arterial infusion of L-NMMA resulted in a reduction in exercise hyperemia (17 ± 1 to 15 ± 1 mL/dL/min, p < 0.01). Although the hyperemic response to NTP was augmented by SDF (area under the curve: 41 ± 7 vs 61 ± 11 AU, p < 0.01), there was no effect of SDF on exercise hyperemia (p = 0.33). CONCLUSIONS Despite improving NTP-mediated vasodilation, oral SDF failed to augment exercise hyperemia in young, healthy adults. These observations reflect a minor contribution of NO and the cGMP pathway during exercise hyperemia in healthy young humans.
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Chirinos JA, Zamani P. The Nitrate-Nitrite-NO Pathway and Its Implications for Heart Failure and Preserved Ejection Fraction. Curr Heart Fail Rep 2016; 13:47-59. [PMID: 26792295 DOI: 10.1007/s11897-016-0277-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The pathogenesis of exercise intolerance in patients with heart failure and preserved ejection fraction (HFpEF) is likely multifactorial. In addition to cardiac abnormalities (diastolic dysfunction, abnormal contractile reserve, chronotropic incompetence), several peripheral abnormalities are likely to be involved. These include abnormal pulsatile hemodynamics, abnormal arterial vasodilatory responses to exercise, and abnormal peripheral O2 delivery, extraction, and utilization. The nitrate-nitrite-NO pathway is emerging as a potential target to modify key physiologic abnormalities, including late systolic left ventricular (LV) load from arterial wave reflections (which has deleterious short- and long-term consequences for the LV), arterial vasodilatory reserve, muscle O2 delivery, and skeletal muscle mitochondrial function. In a recently completed randomized trial, the administration of a single dose of exogenous inorganic nitrate has been shown to exert various salutary arterial hemodynamic effects, ultimately leading to enhanced aerobic capacity in patients with HFpEF. These effects have the potential for both immediate improvements in exercise tolerance and for long-term "disease-modifying" effects. In this review, we provide an overview of key mechanistic contributors to exercise intolerance in HFpEF, and of the potential therapeutic role of drugs that target the nitrate-nitrite-NO pathway.
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Affiliation(s)
- Julio A Chirinos
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. .,Hospital of the University of Pennsylvania, Philadelphia, PA, USA. .,Ghent University, Ghent, Belgium.
| | - Payman Zamani
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Kouw IWK, Cermak NM, Burd NA, Churchward-Venne TA, Senden JM, Gijsen AP, van Loon LJC. Sodium nitrate co-ingestion with protein does not augment postprandial muscle protein synthesis rates in older, type 2 diabetes patients. Am J Physiol Endocrinol Metab 2016; 311:E325-34. [PMID: 27221118 DOI: 10.1152/ajpendo.00122.2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/19/2016] [Indexed: 12/24/2022]
Abstract
The age-related anabolic resistance to protein ingestion is suggested to be associated with impairments in insulin-mediated capillary recruitment and postprandial muscle tissue perfusion. The present study investigated whether dietary nitrate co-ingestion with protein improves muscle protein synthesis in older, type 2 diabetes patients. Twenty-four men with type 2 diabetes (72 ± 1 yr, 26.7 ± 1.4 m/kg(2) body mass index, 7.3 ± 0.4% HbA1C) received a primed continuous infusion of l-[ring-(2)H5]phenylalanine and l-[1-(13)C]leucine and ingested 20 g of intrinsically l-[1-(13)C]phenylalanine- and l-[1-(13)C]leucine-labeled protein with (PRONO3) or without (PRO) sodium nitrate (0.15 mmol/kg). Blood and muscle samples were collected to assess protein digestion and absorption kinetics and postprandial muscle protein synthesis rates. Upon protein ingestion, exogenous phenylalanine appearance rates increased in both groups (P < 0.001), resulting in 55 ± 2% and 53 ± 2% of dietary protein-derived amino acids becoming available in the circulation over the 5h postprandial period in the PRO and PRONO3 groups, respectively. Postprandial myofibrillar protein synthesis rates based on l-[ring-(2)H5]phenylalanine did not differ between groups (0.025 ± 0.004 and 0.021 ± 0.007%/h over 0-2 h and 0.032 ± 0.004 and 0.030 ± 0.003%/h over 2-5 h in PRO and PRONO3, respectively, P = 0.7). No differences in incorporation of dietary protein-derived l-[1-(13)C]phenylalanine into de novo myofibrillar protein were observed at 5 h (0.016 ± 0.002 and 0.014 ± 0.002 mole percent excess in PRO and PRONO3, respectively, P = 0.8). Dietary nitrate co-ingestion with protein does not modulate protein digestion and absorption kinetics, nor does it further increase postprandial muscle protein synthesis rates or the incorporation of dietary protein-derived amino acids into de novo myofibrillar protein in older, type 2 diabetes patients.
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Affiliation(s)
- Imre W K Kouw
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Naomi M Cermak
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nicholas A Burd
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Tyler A Churchward-Venne
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Joan M Senden
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Annemarie P Gijsen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Luc J C van Loon
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
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