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Brauwers B, Machado FVC, Beijers RJHCG, Spruit MA, Franssen FME. Combined Exercise Training and Nutritional Interventions or Pharmacological Treatments to Improve Exercise Capacity and Body Composition in Chronic Obstructive Pulmonary Disease: A Narrative Review. Nutrients 2023; 15:5136. [PMID: 38140395 PMCID: PMC10747351 DOI: 10.3390/nu15245136] [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: 11/29/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that is associated with significant morbidity, mortality, and healthcare costs. The burden of respiratory symptoms and airflow limitation can translate to reduced physical activity, in turn contributing to poor exercise capacity, muscle dysfunction, and body composition abnormalities. These extrapulmonary features of the disease are targeted during pulmonary rehabilitation, which provides patients with tailored therapies to improve the physical and emotional status. Patients with COPD can be divided into metabolic phenotypes, including cachectic, sarcopenic, normal weight, obese, and sarcopenic with hidden obesity. To date, there have been many studies performed investigating the individual effects of exercise training programs as well as nutritional and pharmacological treatments to improve exercise capacity and body composition in patients with COPD. However, little research is available investigating the combined effect of exercise training with nutritional or pharmacological treatments on these outcomes. Therefore, this review focuses on exploring the potential additional beneficial effects of combinations of exercise training and nutritional or pharmacological treatments to target exercise capacity and body composition in patients with COPD with different metabolic phenotypes.
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Affiliation(s)
- Bente Brauwers
- Department of Research and Development, Ciro, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands; (M.A.S.); (F.M.E.F.)
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine, Life Sciences, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Felipe V. C. Machado
- BIOMED (Biomedical Research Institute), REVAL (Rehabilitation Research Centre), Hasselt University, 3590 Hasselt, Belgium;
| | - Rosanne J. H. C. G. Beijers
- Department of Respiratory Medicine, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6200 MD Maastricht, The Netherlands;
| | - Martijn A. Spruit
- Department of Research and Development, Ciro, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands; (M.A.S.); (F.M.E.F.)
- Department of Respiratory Medicine, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6200 MD Maastricht, The Netherlands;
| | - Frits M. E. Franssen
- Department of Research and Development, Ciro, Centre of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands; (M.A.S.); (F.M.E.F.)
- Department of Respiratory Medicine, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, 6200 MD Maastricht, The Netherlands;
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Huang X, Zhang Z, Wang X, Wang G, Wang Y, Tang K, Gao B. Influence of Chronic Nitrate-Rich Beetroot Juice Supplementation on the Endurance Performance of Active Winter Triathletes: A Randomized Controlled Trial. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:195-206. [PMID: 35512758 DOI: 10.1080/07315724.2021.2021562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The impact of high-nitrate beetroot juice (BRJ) supplementation has seen a recent explosion of interest in sports science. This study examined the potential influence of 7-day BRJ supplementation on the endurance performance of winter triathletes. METHODS Eighty young active winter triathletes (44 males, age = 21.50 ± 1.15 yrs; 36 females, age = 20.66 ± 1.45 yrs) participated in this study and were provided with either BRJ (6.5 mmol NO3-/70 mL) or a placebo (PL, 0.065 mmol NO3-/70 mL) for 7 days (a dose of ×3 per day) in a randomized, double-blind design. The athletes then completed a submaximal treadmill run, intraday cycling exhaustion testing, and a 10-km cross country (XC) skiing competition on the second day. RESULTS There was a significant decrease in the oxygen uptake, respiratory exchange ratio, and blood lactic acid level (p < 0.05) between the BRJ and PL treatment groups during V3 speed running (males: 13.3 km·h-1, females: 11.6 km·h-1). BRJ treatment also remarkably increased the time to exhaustion (TTE) during cycling exhaustion testing (males: p = 0.02, females: p = 0.04). No significant differences were observed in medium- or low-speed submaximal treadmill runs and 10-km XC skiing performance. CONCLUSIONS One week of daily nitrate-rich BRJ supplementation improved running economy at high speed during the submaximal treadmill running test and extended the TTE of athletes during cycling exhaustion testing. However, BRJ supplementation did not improve the performance in 10-km on-snow time trials in XC skiing. Regarding nutritional strategies to improve endurance performance in exercise training and competition, these results should be carefully considered owing to the different motor skill levels and competitive abilities of participants.
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Affiliation(s)
- Xizhang Huang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China.,Key Laboratory of Winter Sports Training Monitoring and Control, Heilongjiang Research Institute of Sports Science, Harbin, China
| | - Zheng Zhang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Xiu Wang
- Harbin No. 26 Middle School, Harbin, China
| | - Gang Wang
- Key Laboratory of Winter Sports Training Monitoring and Control, Heilongjiang Research Institute of Sports Science, Harbin, China
| | - Yan Wang
- China Winter Triathlon National Team, Heilongjiang Snow Sports Training Center, Harbin, China
| | - Kun Tang
- Key Laboratory of Winter Sports Training Monitoring and Control, Heilongjiang Research Institute of Sports Science, Harbin, China
| | - Binghong Gao
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
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Shannon OM, Allen JD, Bescos R, Burke L, Clifford T, Easton C, Gonzalez JT, Jones AM, Jonvik KL, Larsen FJ, Peeling P, Piknova B, Siervo M, Vanhatalo A, McGawley K, Porcelli S. Dietary Inorganic Nitrate as an Ergogenic Aid: An Expert Consensus Derived via the Modified Delphi Technique. Sports Med 2022; 52:2537-2558. [PMID: 35604567 PMCID: PMC9474378 DOI: 10.1007/s40279-022-01701-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Dietary inorganic nitrate is a popular nutritional supplement, which increases nitric oxide bioavailability and may improve exercise performance. Despite over a decade of research into the effects of dietary nitrate supplementation during exercise there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Moreover, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. This study aimed to address these research gaps. METHODS The modified Delphi technique was used to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via videoconferencing), the expert panel members voted on 222 statements relating to dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e. yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research. RESULTS The 12 panel members contributed to voting in all three rounds. A total of 39 statements (17.6%) reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60.4%) of the statements, and were unable to agree on the outcome of the remaining statements. CONCLUSIONS This study provides information on the current expert consensus on dietary nitrate, which may be of value to athletes, coaches, practitioners and researchers. The effects of dietary nitrate appear to be diminished in individuals with a higher aerobic fitness (peak oxygen consumption [V̇O2peak] > 60 ml/kg/min), and therefore, aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes looking to benefit from dietary nitrate supplementation should consume 8-16 mmol nitrate acutely or 4-16 mmol/day nitrate chronically (with the final dose ingested 2-4 h pre-exercise) to maximise ergogenic effects, taking into consideration that, from a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe, although the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, highlighting the need for future research in this area.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Jason D Allen
- Department of Kinesiology, School of Education and Human Development and Division of Cardiovascular Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Raul Bescos
- School of Health Professions, Faculty of Health, Plymouth Institute of Health and Care Research (PIHR), University of Plymouth, Plymouth, UK
| | - Louise Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Sciences, University of the West of Scotland, Blantyre, UK
| | - Javier T Gonzalez
- Department for Health, University of Bath, Bath, UK
- Centre for Nutrition and Exercise Metabolism, University of Bath, Bath, UK
| | - Andrew M Jones
- Sport and Health Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Kristin L Jonvik
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Filip J Larsen
- Department of Physiology, Nutrition and Biomechanics, Åstrand Laboratory, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Peter Peeling
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia
| | | | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Anni Vanhatalo
- Sport and Health Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Kerry McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Simone Porcelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Hennis PJ, Cumpstey AF, O'Doherty AF, Fernandez BO, Gilbert-Kawai ET, Mitchell K, Moyses H, Cobb A, Meale P, Pöhnl H, Mythen MG, Grocott MPW, Levett DZH, Martin DS, Feelisch M. Dietary Nitrate Supplementation Does Not Alter Exercise Efficiency at High Altitude - Further Results From the Xtreme Alps Study. Front Physiol 2022; 13:827235. [PMID: 35295581 PMCID: PMC8918982 DOI: 10.3389/fphys.2022.827235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Nitrate supplementation in the form of beetroot juice (BRJ) ingestion has been shown to improve exercise tolerance during acute hypoxia, but its effect on exercise physiology remains unstudied during sustained terrestrial high altitude exposure. We hypothesized that performing exercise at high altitude would lower circulating nitrate and nitrite levels and that BRJ ingestion would reverse this phenomenon while concomitantly improving key determinants of aerobic exercise performance. Methods Twenty seven healthy volunteers (21 male) underwent a series of exercise tests at sea level (SL, London, 75 m) and again after 5-8 days at high altitude (HA, Capanna Regina Margherita or "Margherita Hut," 4,559 m). Using a double-blind protocol, participants were randomized to consume a beetroot/fruit juice beverage (three doses per day) with high levels of nitrate (∼0.18 mmol/kg/day) or a nitrate-depleted placebo (∼11.5 μmoles/kg/day) control drink, from 3 days prior to the exercise trials until completion. Submaximal constant work rate cycle tests were performed to determine exercise efficiency and a maximal incremental ramp exercise test was undertaken to measure aerobic capacity, using breath-by-breath pulmonary gas exchange measurements throughout. Concentrations of nitrate, nitrite and nitrosation products were quantified in plasma samples collected at 5 timepoints during the constant work rate tests. Linear mixed modeling was used to analyze data. Results At both SL and HA, plasma nitrate concentrations were elevated in the nitrate supplementation group compared to placebo (P < 0.001) but did not change throughout increasing exercise work rate. Delta exercise efficiency was not altered by altitude exposure (P = 0.072) or nitrate supplementation (P = 0.836). V̇O2peak decreased by 24% at high altitude (P < 0.001) and was lower in the nitrate-supplemented group at both sea level and high altitude compared to placebo (P = 0.041). Dietary nitrate supplementation did not alter other peak exercise variables or oxygen consumption at anaerobic threshold. Circulating nitrite and S-nitrosothiol levels unexpectedly rose in a few individuals right after cessation of exercise at high altitude. Conclusion Whilst regularly consumed during an 8 days expedition to terrestrial high altitude, nitrate supplementation did not alter exercise efficiency and other exercise physiological variables, except decreasing V̇O2peak. These results and those of others question the practical utility of BRJ consumption during prolonged altitude exposure.
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Affiliation(s)
- Philip J Hennis
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom.,SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Andrew F Cumpstey
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Bernadette O Fernandez
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Edward T Gilbert-Kawai
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Kay Mitchell
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Helen Moyses
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Alexandra Cobb
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Paula Meale
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Helmut Pöhnl
- AURAPA Würzungen GmbH, Bietigheim-Bissingen, Germany
| | - Monty G Mythen
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom
| | - Michael P W Grocott
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Denny Z H Levett
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Daniel S Martin
- Centre for Altitude Space and Extreme Environment Medicine, University College London Hospital NIHR Biomedical Research Centre, Institute of Sport, Exercise and Health, London, United Kingdom.,Peninsula Medical School, University of Plymouth, Plymouth, United Kingdom
| | - Martin Feelisch
- Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Sousa A, Viana JL, Milheiro J, Reis VM, Millet GP. Dietary Nitrate Supplementation Is Not Helpful for Endurance Performance at Simulated Altitude Even When Combined With Intermittent Normobaric Hypoxic Training. Front Physiol 2022; 13:839996. [PMID: 35360239 PMCID: PMC8964050 DOI: 10.3389/fphys.2022.839996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionTraining intensity and nutrition may influence adaptations to training performed in hypoxia and consequently performance outcomes at altitude. This study investigates if performance at simulated altitude is improved to a larger extent when high-intensity interval training is performed in normobaric hypoxia and if this is potentiated when combined with chronic dietary nitrate (NO3−) supplementation.MethodsThirty endurance-trained male participants were allocated to one of three groups: hypoxia (13% FiO2) + NO3−; hypoxia + placebo; and normoxia (20.9% FiO2) + placebo. All performed 12 cycling sessions (eight sessions of 2*6 × 1 min at severe intensity with 1 min recovery and four sessions of 4*6*10 s all-out with 20 s recovery) during a 4-week period (three sessions/week) with supplementation administered 3–2.5 h before each session. An incremental exhaustion test, a severe intensity exercise bout to exhaustion (Tlim) and a 3 min all-out test (3AOT) in hypoxia (FiO2 = 13%) with pulmonary oxygen uptake (V˙O2), V˙O2 kinetics, and changes in vastus lateralis local O2 saturation (SmO2) measured were completed by each participant before and after training.ResultsIn all tests, performance improved to the same extent in hypoxia and normoxia, except for SmO2 after Tlim (p = 0.04, d = 0.82) and 3AOT (p = 0.03, d = 1.43) which were lower in the two hypoxic groups compared with the normoxic one. Dietary NO3− supplementation did not bring any additional benefits.ConclusionPerformance at simulated altitude was not improved to a larger extent when high-intensity interval training was undertaken in normobaric hypoxic conditions, when compared with normoxic training. Additionally, dietary NO3− supplementation was ineffective in further enhancing endurance performance at simulated altitude.
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Affiliation(s)
- Ana Sousa
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Instituto Universitário da Maia (ISMAI), Maia, Portugal
- *Correspondence: Ana Sousa,
| | - João L. Viana
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Instituto Universitário da Maia (ISMAI), Maia, Portugal
| | - Jaime Milheiro
- CMEP - Exercise Medical Center & Spa, Porto, Portugal
- Olympic Committee of Portugal, Lisbon, Portugal
| | - Vítor M. Reis
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-Os-Montes and Alto Douro, Vila Real, Portugal
| | - Grégoire P. Millet
- ISSUL, Institute of Sport Sciences and Physical Education (ISSEP), University of Lausanne, Lausanne, Switzerland
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Córdova-Martínez A, Caballero-García A, Bello HJ, Pons-Biescas A, Noriega DC, Roche E. l-Arginine and Beetroot Extract Supplementation in the Prevention of Sarcopenia. Pharmaceuticals (Basel) 2022; 15:ph15030290. [PMID: 35337088 PMCID: PMC8954952 DOI: 10.3390/ph15030290] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/19/2022] [Accepted: 02/24/2022] [Indexed: 12/13/2022] Open
Abstract
Aging is associated with a significant decline in neuromuscular function, leading to a reduction in muscle mass and strength. The aim of the present report was to evaluate the effect of supplementation with nitric oxide precursors (l-arginine and beetroot extract) in muscular function during a training period of 6 weeks in elderly men and women. The study (double-blind, placebo-controlled) involved 66 subjects randomly divided into three groups: placebo, arginine-supplemented and beetroot extract-supplemented. At the end of this period, no changes in anthropometric parameters were observed. Regarding other circulating parameters, urea levels were significantly (p < 0.05) lower in women of the beetroot-supplemented group (31.6 ± 5.9 mg/dL) compared to placebo (41.3 ± 8.5 mg/dL) after 6 weeks of training. In addition, the circulating creatine kinase activity, as an index of muscle functionality, was significantly (p < 0.05) higher in women of the arginine- (214.1 ± 162.2 mIU/L) compared to the beetroot-supplemented group (84.4 ± 36.8 mIU/L) at the end of intervention. No significant effects were noticed with l-arginine or beetroot extract supplementation regarding strength, endurance and SPPB index. Only beetroot extract supplementation improved physical fitness significantly (p < 0.05) in the sprint exercise in men after 6 weeks (2.33 ± 0.59 s) compared to the baseline (2.72 ± 0.41 s). In conclusion, beetroot seems to be more efficient during short-term training while supplementing, preserving muscle functionality in women (decreased levels of circulating creatine kinase) and with modest effects in men.
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Affiliation(s)
- Alfredo Córdova-Martínez
- Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain
- Correspondence: (A.C.-M.); (E.R.)
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain;
| | - Hugo J. Bello
- Department of Mathematics, School of Forestry, Agronomy and Bioenergy Engineering, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain;
| | - Antoni Pons-Biescas
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Balearic Islands, Spain;
| | - David C. Noriega
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, Hospital Clínico Universitario de Valladolid, 03010 Valladolid, Spain;
| | - Enrique Roche
- Department of Mathematics, School of Forestry, Agronomy and Bioenergy Engineering, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain;
- Department of Applied Biology-Nutrition, Institute of Bioengineering, University Miguel Hernández, 03202 Elche, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (A.C.-M.); (E.R.)
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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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Piknova B, Schechter AN, Park JW, Vanhatalo A, Jones AM. Skeletal Muscle Nitrate as a Regulator of Systemic Nitric Oxide Homeostasis. Exerc Sport Sci Rev 2021; 50:2-13. [PMID: 34669624 DOI: 10.1249/jes.0000000000000272] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Non-enzymatic nitric oxide (NO) generation via the reduction of nitrate and nitrite ions, along with remarkably high levels of nitrate ions in skeletal muscle, have been recently described. Skeletal muscle nitrate storage may be critical for maintenance of NO homeostasis in healthy ageing and nitrate supplementation may be useful for treatment of specific pathophysiologies as well as enhancing normal functions.
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Affiliation(s)
- Barbora Piknova
- Molecular Medicine Branch, NIDDK, National Institutes of Health,Bethesda, MD 20892, U.S. Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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9
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Miraftabi H, Avazpoor Z, Berjisian E, Sarshin A, Rezaei S, Domínguez R, Reale R, Franchini E, Samanipour MH, Koozehchian MS, Willems MET, Rafiei R, Naderi A. Effects of Beetroot Juice Supplementation on Cognitive Function, Aerobic and Anaerobic Performances of Trained Male Taekwondo Athletes: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910202. [PMID: 34639501 PMCID: PMC8507686 DOI: 10.3390/ijerph181910202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/21/2022]
Abstract
Studies have shown that nitrate (NO3−)-rich beetroot juice (BJ) supplementation improves endurance and high-intensity intermittent exercise. The dose–response effects on taekwondo following BJ supplementation are yet to be determined. This study aimed to investigate two acute doses of 400 mg of NO3− (BJ-400) and 800 mg of NO3− (BJ-800) on taekwondo-specific performance and cognitive function tests compared with a placebo (PL) and control (CON) conditions. Eight trained male taekwondo athletes (age: 20 ± 4 years, height: 180 ± 2 cm, body mass: 64.8 ± 4.0 kg) completed four experimental trials using a randomized, double-blind placebo-controlled design: BJ-400, BJ-800, PL, and CON. Participants consumed two doses of BJ-400 and BJ-800 or nitrate-depleted PL at 2.5 h prior to performing the Multiple Frequency Speed of Kick Test (FSKT). Countermovement jump (CMJ) was performed before the (FSKT) and PSTT, whereas cognitive function was assessed (via the Stroop test) before and after supplementation and 10 min following PSTT. Blood lactate was collected before the CMJ tests immediately and 3 min after the FSKT and PSST; rating of perceived exertion (RPE) was recorded during and after both specific taekwondo tests. No significant differences (p > 0.05), with moderate and large effect sizes, between conditions were observed for PSTT and FSKT performances. In addition, blood lactate, RPE, heart rate, and CMJ height were not significantly different among conditions (p > 0.05). However, after the PSTT test, cognitive function was higher in BJ-400 compared to other treatments (p < 0.05). It was concluded that acute intake of 400 and 800 mg of NO3− rich BJ reported a moderate to large effect size in anaerobic and aerobic; however, no statistical differences were found in taekwondo-specific performance.
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Affiliation(s)
- Hossein Miraftabi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Tehran University, Tehran 1417935840, Iran; (H.M.); (Z.A.); (E.B.); (R.R.)
| | - Zahra Avazpoor
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Tehran University, Tehran 1417935840, Iran; (H.M.); (Z.A.); (E.B.); (R.R.)
| | - Erfan Berjisian
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Tehran University, Tehran 1417935840, Iran; (H.M.); (Z.A.); (E.B.); (R.R.)
| | - Amir Sarshin
- Clinical Care and Health Promotion Research Center, Karaj Branch, Islamic Azad University, Karaj 3149968111, Iran;
| | - Sajjad Rezaei
- Department of Physical Education & Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran 1411713116, Iran;
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento Deportivo, Faculty of Education Sciences, Universidad de Sevilla, 41018 Sevilla, Spain;
- Studies Research Group in Neuromuscular Responses (GEPREN), University of Lavras, Lavras 37200-000, Brazil
| | - Reid Reale
- USA.UFC Performance Institute, Shanghai 200072, China;
| | - Emerson Franchini
- School of Physical Education and Sport, University of São Paulo, São Paulo 05508-030, Brazil;
| | | | - Majid S. Koozehchian
- Department of Kinesiology, Jacksonville State University, Jacksonville, AL 36265, USA;
| | - Mark E. T. Willems
- Institute of Sport, Nursing and Allied Health, College Lane, University of Chichester, Chichester PO19 6PE, UK;
| | - Ramin Rafiei
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Tehran University, Tehran 1417935840, Iran; (H.M.); (Z.A.); (E.B.); (R.R.)
| | - Alireza Naderi
- Department of Sport Physiology, Boroujerd Branch, Islamic Azad University, Boroujerd 6915136111, Iran
- Correspondence: ; Tel.: +98-91-0448-6440
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10
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Macuh M, Knap B. Effects of Nitrate Supplementation on Exercise Performance in Humans: A Narrative Review. Nutrients 2021; 13:3183. [PMID: 34579061 PMCID: PMC8465461 DOI: 10.3390/nu13093183] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 12/20/2022] Open
Abstract
Nitrates have become increasingly popular for their potential role as an ergogenic aid. The purpose of this article was to review the current scientific evidence of nitrate supplementation on human performance. The current recommendation of nitrate supplementation is discussed, as well as possible health complications associated with nitrate intake for athletes, and dietary strategies of covering nitrate needs through sufficient intake of nitrate-rich foods alone are presented. Pubmed, Scopus, and Web of Science were searched for articles on the effects of nitrate supplementation in humans. Nitrates are an effective ergogenic aid when taken acutely or chronically in the range of ~5-16.8 mmol (~300-1041 mg) 2-3 h before exercise and primarily in the case of exercise duration of ~10-17 min in less trained individuals (VO2max < 65 mL/kg/min). Nitrate needs are most likely meet by ingesting approximately 250-500 g of leafy and root vegetables per day; however, dietary supplements might represent a more convenient and accurate way of covering an athlete's nitrate needs. Athletes should refrain from mouthwash usage when nitrate supplementation benefits are desired. Future research should focus on the potential beneficial effects of nitrate supplementation on brain function, possible negative impacts of chronic nitrate supplementation through different nitrate sources, and the effectiveness of nitrate supplementation on strength and high-intensity intermittent exercise.
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Affiliation(s)
- Matjaž Macuh
- Department of Food Science and Technology, Biotechnical Faculty, University of Ljubljana; Jamnikarjeva 10, 1000 Ljubljana, Slovenia
| | - Bojan Knap
- Department of Nephrology, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia;
- Faculty of Medicine, University of Ljubljana, Korytkova ulica 2, 1000 Ljubljana, Slovenia
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11
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Rokkedal-Lausch T, Franch J, Poulsen MK, Thomsen LP, Weitzberg E, Kamavuako EN, Karbing DS, Larsen RG. Multiple-day high-dose beetroot juice supplementation does not improve pulmonary or muscle deoxygenation kinetics of well-trained cyclists in normoxia and hypoxia. Nitric Oxide 2021; 111-112:37-44. [PMID: 33831566 DOI: 10.1016/j.niox.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
Dietary nitrate (NO3-) supplementation via beetroot juice (BR) has been reported to lower oxygen cost (i.e., increased exercise efficiency) and speed up oxygen uptake (VO2) kinetics in untrained and moderately trained individuals, particularly during conditions of low oxygen availability (i.e., hypoxia). However, the effects of multiple-day, high dose (12.4 mmol NO3- per day) BR supplementation on exercise efficiency and VO2 kinetics during normoxia and hypoxia in well-trained individuals are not resolved. In a double-blinded, randomized crossover study, 12 well-trained cyclists (66.4 ± 5.3 ml min-1∙kg-1) completed three transitions from rest to moderate-intensity (~70% of gas exchange threshold) cycling in hypoxia and normoxia with supplementation of BR or nitrate-depleted BR as placebo. Continuous measures of VO2 and muscle (vastus lateralis) deoxygenation (ΔHHb, using near-infrared spectroscopy) were acquired during all transitions. Kinetics of VO2 and deoxygenation (ΔHHb) were modeled using mono-exponential functions. Our results showed that BR supplementation did not alter the primary time constant for VO2 or ΔHHb during the transition from rest to moderate-intensity cycling. While BR supplementation lowered the amplitude of the VO2 response (2.1%, p = 0.038), BR did not alter steady state VO2 derived from the fit (p = 0.258), raw VO2 data (p = 0.231), moderate intensity exercise efficiency (p = 0.333) nor steady state ΔHHb (p = 0.224). Altogether, these results demonstrate that multiple-day, high-dose BR supplementation does not alter exercise efficiency or oxygen uptake kinetics during normoxia and hypoxia in well-trained athletes.
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Affiliation(s)
- Torben Rokkedal-Lausch
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark.
| | - Jesper Franch
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark
| | - Mathias K Poulsen
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark
| | - Lars P Thomsen
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Ernest N Kamavuako
- Center for Robotics Research, Department of Engineering, King's College London, London, United Kingdom
| | - Dan S Karbing
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark
| | - Ryan G Larsen
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark
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12
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Senefeld JW, Wiggins CC, Regimbal RJ, Dominelli PB, Baker SE, Joyner MJ. Ergogenic Effect of Nitrate Supplementation: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2021; 52:2250-2261. [PMID: 32936597 PMCID: PMC7494956 DOI: 10.1249/mss.0000000000002363] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Supplemental digital content is available in the text. Although over 100 studies and reviews have examined the ergogenic effects of dietary nitrate (NO3−) supplementation in young, healthy men and women, it is unclear if participant and environmental factors modulate the well-described ergogenic effects—particularly relevant factors include biological sex, aerobic fitness, and fraction of inspired oxygen (FiO2) during exercise. To address this limitation, the literature was systematically reviewed for randomized, crossover, placebo-controlled studies reporting exercise performance outcome metrics with NO3− supplementation in young, healthy adults. Of the 2033 articles identified, 80 were eligible for inclusion in the meta-analysis. Random-effects meta-analysis demonstrated that exercise performance improved with NO3− supplementation compared with placebo (d = 0.174; 95% confidence interval (CI), 0.120–0.229; P < 0.001). Subgroup analyses conducted on biological sex, aerobic fitness, and FiO2 demonstrated that the ergogenic effect of NO3− supplementation was as follows: 1) not observed in studies with only women (n = 6; d = 0.116; 95% CI, −0.126 to 0.358; P = 0.347), 2) not observed in well-trained endurance athletes (≥65 mL·kg−1·min−1; n = 26; d = 0.021; 95% CI, −0.103 to 0.144; P = 0.745), and 3) not modulated by FiO2 (hypoxia vs normoxia). Together, the meta-analyses demonstrated a clear ergogenic effect of NO3− supplementation in recreationally active, young, healthy men across different exercise paradigms and NO3− supplementation parameters; however, the effect size of NO3− supplementation was objectively small (d = 0.174). NO3− supplementation has more limited utility as an ergogenic aid in participants with excellent aerobic fitness that have optimized other training parameters. Mechanistic research and studies incorporating a wide variety of subjects (e.g., women) are needed to advance the study of NO3− supplementation; however, additional descriptive studies of young, healthy men may have limited utility.
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Affiliation(s)
- Jonathon W Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Riley J Regimbal
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | | | - Sarah E Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
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13
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Influence of Dietary Nitrate Supplementation on High-Intensity Intermittent Running Performance at Different Doses of Normobaric Hypoxia in Endurance-Trained Males. Int J Sport Nutr Exerc Metab 2020; 31:1-8. [PMID: 33260146 DOI: 10.1123/ijsnem.2020-0198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022]
Abstract
This study investigated whether supplementation with nitrate-rich beetroot juice (BR) can improve high-intensity intermittent running performance in trained males in normoxia and different doses of normobaric hypoxia. Eight endurance-trained males (V˙O2peak, 62 ± 6 ml·kg-1·min-1) completed repeated 90 s intervals at 110% of peak treadmill velocity, from an initial step incremental test, interspersed by 60 s of passive recovery until exhaustion (Tlim). Participants completed the first three experimental trials during days 3, 5, and 7 of BR or nitrate-depleted beetroot juice (PLA) supplementation and completed the remaining experimental visits on the alternative supplement following at least 7 days of washout. The fraction of inspired oxygen during visits 1-3 was either 0.209, 0.182, or 0.157, equivalent to an altitude of 0, 1,200, and 2,400 m, respectively, and this order was replicated on visits 4-6. Arterial oxygen saturation declined dose dependently as fraction of inspired oxygen was lowered (p < .05). Plasma nitrite concentration was higher pre- and postexercise after BR compared with PLA supplementation (p < .05). There was no difference in Tlim between PLA and BR at 0 m (445 [324, 508] and 410 [368, 548] s); 1,200 m (341 [270, 390] and 332 [314, 356] s); or 2,400 m (233 [177, 373] and 251 [221, 323] s) (median and [interquartile range]; p > .05). The findings from this study suggest that short-term BR supplementation does not improve high-intensity intermittent running performance in endurance-trained males in normoxia or at doses of normobaric hypoxia that correspond to altitudes at which athletes typically train while on altitude training camps.
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14
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Effects of Dietary Nitrates on Time Trial Performance in Athletes with Different Training Status: Systematic Review. Nutrients 2020; 12:nu12092734. [PMID: 32911636 PMCID: PMC7551808 DOI: 10.3390/nu12092734] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/04/2020] [Indexed: 12/14/2022] Open
Abstract
Much research has been done in sports nutrition in recent years as the demand for performance-enhancing substances increases. Higher intake of nitrates from the diet can increase the bioavailability of nitric oxide (NO) via the nitrate-nitrite-NO pathway. Nevertheless, the increased availability of NO does not always lead to improved performance in some individuals. This review aims to evaluate the relationship between the athlete's training status and the change in time trial performance after increased dietary nitrate intake. Articles indexed by Scopus and PubMed published from 2015 to 2019 were reviewed. Thirteen articles met the eligibility criteria: clinical trial studies on healthy participants with different training status (according to VO2max), conducting time trial tests after dietary nitrate supplementation. The PRISMA guidelines were followed to process the review. We found a statistically significant relationship between VO2max and ergogenicity in time trial performance using one-way ANOVA (p = 0.001) in less-trained athletes (VO2 < 55 mL/kg/min). A strong positive correlation was observed in experimental situations using a chronic supplementation protocol but not in acute protocol situations. In the context of our results and recent histological observations of muscle fibres, there might be a fibre-type specific role in nitric oxide production and, therefore, supplement of ergogenicity.
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15
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Abstract
Over the last decade, there has been a growing interest in the utility of nitrate (NO3-) supplementation to improve exercise-related performance. After consumption, dietary NO3- can be reduced to nitric oxide, a free radical gas involved in numerous physiological actions including blood vessel vasodilation, mitochondrial respiration, and skeletal muscle contractile function. Emerging evidence indicates that dietary NO3- supplementation has a small but nevertheless significant beneficial effect on endurance performance through the combined effects of enhanced tissue oxygenation and metabolic efficiency in active skeletal muscle. There is further evidence to suggest that dietary NO3- exerts a direct influence on contractile mechanisms within the skeletal muscle through alterations in calcium availability and sensitivity. Response heterogeneity and sizeable variability in the nitrate content of beetroot juice products influence the effectiveness of dietary NO3- for exercise performance, and so dosing and product quality, as well as training history, sex, and individual-specific characteristics, should be considered.
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16
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Kozłowska L, Mizera O, Gromadzińska J, Janasik B, Mikołajewska K, Mróz A, Wąsowicz W. Changes in Oxidative Stress, Inflammation, and Muscle Damage Markers Following Diet and Beetroot Juice Supplementation in Elite Fencers. Antioxidants (Basel) 2020; 9:antiox9070571. [PMID: 32630279 PMCID: PMC7402086 DOI: 10.3390/antiox9070571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to assess the impact of diet and active substances in beetroot juice on the parameters of oxidative stress, inflammation, and muscle damage as well as on the maximum rate of oxygen uptake (VO2max) in elite fencers (10 women, 10 men). Athletes during four weeks realized dietary recommendations (ID) and, after that, diet with freeze-dried beetroot juice supplementation (ID&BEET). At baseline and after each stage, fasting antioxidants, biomarkers of oxidative stress, inflammation, and skeletal muscle damage were measured, and a VO2max test was performed. Only after ID&BEET was a significant increase of VO2max observed, and changes of this parameter were negatively related with changes of serum lactate dehydrogenase (∆LDH) activity, as well as with serum ∆β-carotene and malondialdehyde concentration (∆MDA). Additionally, positive relationships were observed between ∆β-carotene versus changes of the serum concentration of advanced oxidation protein products (∆AOPP), changes of serum glutathione peroxidase activity (∆GPx3) versus both changes of physical activity level and ∆LDH, as well as erythrocyte glutathione peroxidase activity (∆GPx1) versus ∆LDH. To summarize, we showed that long-term beetroot juice supplementation increases lipid peroxidation, and improvement of VO2max after ID&BEET seems to be dependent on LDH activity, as well as on the serum concentration of MDA and β-carotene.
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Affiliation(s)
- Lucyna Kozłowska
- Department of Dietetics, Warsaw University of Life Sciences, Institute of Human Nutrition Sciences, Nowoursynowska 15c, 02-776 Warsaw, Poland;
| | - Olga Mizera
- Department of Dietetics, Warsaw University of Life Sciences, Institute of Human Nutrition Sciences, Nowoursynowska 15c, 02-776 Warsaw, Poland;
- Correspondence:
| | - Jolanta Gromadzińska
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
| | - Beata Janasik
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
| | - Karolina Mikołajewska
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
| | - Anna Mróz
- Department of Physiology and Sport Medicine, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland;
| | - Wojciech Wąsowicz
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Sw. Teresy 8, 91-348 Łódź, Poland; (J.G.); (B.J.); (K.M.); (W.W.)
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17
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Berry MJ, Miller GD, Kim-Shapiro DB, Fletcher MS, Jones CG, Gauthier ZD, Collins SL, Basu S, Heinrich TM. A randomized controlled trial of nitrate supplementation in well-trained middle and older-aged adults. PLoS One 2020; 15:e0235047. [PMID: 32574223 PMCID: PMC7310701 DOI: 10.1371/journal.pone.0235047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/05/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Nitrate (NO3-), through its conversion to nitrite (NO2-) and nitric oxide, has been shown to increase exercise tolerance in healthy younger adults and older diseased patients. Nitrate’s effect in well-trained middle to older-aged adults has not been studied. Therefore, the purpose of this investigation was to examine the effects of a NO3- rich beverage on submaximal constant work rate exercise time in well-trained middle to older-aged adults. Methods This was a randomized controlled cross-over trial with 15 well-trained middle to older-aged adults, 41–64 year-old, who received one of two treatments (NO3- rich beverage then placebo or placebo then NO3- rich beverage), after which an exercise test at 75 percent of the subject’s maximal work rate was completed. Results The NO3- rich beverage increased plasma NO3- and NO2- levels by 260 μM and 0.47 μM, respectively (p<0.001). Exercise time was not significantly different (p = 0.31) between the NO3- rich versus placebo conditions (1130±151 vs 1060±132 sec, respectively). Changes in exercise time between the two conditions ranged from a 55% improvement to a 40% decrease with the NO3- rich beverage. Oxygen consumption and rating of perceived exertion were not significantly different between the two conditions. Conclusion In middle to older-aged well-trained adults, NO3- supplementation has non-significant, albeit highly variable, effects on exercise tolerance. ClinicalTrials.gov Identifier: NCT03371966
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Affiliation(s)
- Michael J. Berry
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
- * E-mail:
| | - Gary D. Miller
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Daniel B. Kim-Shapiro
- Physics Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Macie S. Fletcher
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Caleb G. Jones
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Zachary D. Gauthier
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Summer L. Collins
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Swati Basu
- Physics Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Timothy M. Heinrich
- Health and Exercise Department, Wake Forest University, Winston-Salem, North Carolina, United States of America
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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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Lorenzo Calvo J, Alorda-Capo F, Pareja-Galeano H, Jiménez SL. Influence of Nitrate Supplementation on Endurance Cyclic Sports Performance: A Systematic Review. Nutrients 2020; 12:nu12061796. [PMID: 32560317 PMCID: PMC7353291 DOI: 10.3390/nu12061796] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022] Open
Abstract
Endurance can be defined as the capacity to maintain one’s velocity or power output for the longest possible time. Maintaining such activity can lead to the onset of fatigue. Dietary nitrate supplementation produces an ergogenic effect due to the improvement of mitochondrial oxygen efficiency through a reduction in the oxygen cost of exercise that increases vasodilation and blood flow to the skeletal muscle in recreationally active subjects. However, the effects of dietary nitrate supplementation on well-trained endurance athletes remain unclear; such supplementation could affect more performance areas. In the present study, a systematic review of the literature was conducted to clarify the use and effects of nitrate as a dietary supplement in endurance athletes trained in cyclic sports (repetitive movement sports). A systematic search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in the databases of SCOPUS, Web of Science (WOS), Medline (PubMed), and Sport Discus from 1 January 2010 to 30 November 2019. Twenty-seven studies were included in the study. The methodological quality of the articles was assessed using the McMaster Critical Review Form. Statistically significant ergogenic results were obtained in 8 (29.63%) of the 27 studies investigated, with significant results obtained for cardiorespiratory parameters and performance measures. Improvement in exercise tolerance was obtained, which could help with exhaustion over time, while the improvement in exercise economics was not as clear. Additionally, the dose necessary for this ergogenic effect seems to have a direct relationship with the physical condition of the athlete. The acute dose is around 6–12.4 mmol/day of nitrate administered 2–3 h before the activity, with the same amount given as a chronic dose over 6–15 days. Further studies are required to understand the factors that affect the potential ergogenic impacts of nitrate on athletic performance among endurance athletes.
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Affiliation(s)
- Jorge Lorenzo Calvo
- Sport Department, Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: (J.L.C.); (S.L.J.); Tel.: +34-670-723-696 (S.L.J.)
| | - Francesca Alorda-Capo
- Faculty of Sport Sciences, Universidad Europea De Madrid, 28670 Madrid, Spain; (F.A.-C.); (H.P.-G.)
| | - Helios Pareja-Galeano
- Faculty of Sport Sciences, Universidad Europea De Madrid, 28670 Madrid, Spain; (F.A.-C.); (H.P.-G.)
| | - Sergio L. Jiménez
- Faculty of Sport Sciences, Universidad Europea De Madrid, 28670 Madrid, Spain; (F.A.-C.); (H.P.-G.)
- Correspondence: (J.L.C.); (S.L.J.); Tel.: +34-670-723-696 (S.L.J.)
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20
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Reynolds CME, Evans M, Halpenny C, Hughes C, Jordan S, Quinn A, Hone M, Egan B. Acute ingestion of beetroot juice does not improve short-duration repeated sprint running performance in male team sport athletes. J Sports Sci 2020; 38:2063-2070. [DOI: 10.1080/02640414.2020.1770409] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Ciara M. E. Reynolds
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Mark Evans
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
- Florida Institute for Human and Machine Cognition, Pensacola, FL, USA
| | - Catherine Halpenny
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Caoimhe Hughes
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Stephen Jordan
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Alyssa Quinn
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Michelle Hone
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Brendan Egan
- UCD Institute for Sport & Health, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
- Florida Institute for Human and Machine Cognition, Pensacola, FL, USA
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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21
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Gholami F, Rahmani L, Amirnezhad F, Cheraghi K. High doses of sodium nitrate prior to exhaustive exercise increases plasma peroxynitrite levels in well-trained subjects: randomized, double-blinded, crossover study. Appl Physiol Nutr Metab 2019; 44:1305-1310. [DOI: 10.1139/apnm-2018-0816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The aim of this study was to investigate the effect of different doses of pre-workout sodium nitrate supplementation on nitric oxide, peroxynitrite levels, and performance parameters. Ten well-trained male subjects participated in a randomized, double-blinded, crossover study. They ingested 8, 16, and 24 mmol sodium nitrate or placebo (NaCl) dissolved in water at 2.5 h before an incremental exercise test. Respiratory gases (oxygen consumption, carbon dioxide production, respiratory exchange ratio) were measured throughout the exercise trials and 3 blood samples (pre-ingestion, 2.5 h post-ingestion and postexercise) were taken to analyze nitrate/nitrite (NOx) and peroxynitrite levels. Data were analyzed using repeated-measures ANOVA at significance level of P < 0.05. NOx levels significantly increased following sodium nitrate ingestion compared with placebo (placebo: 40.86 ± 10.7 μmol/L, 8 mmol: 203.69 ± 25.1 μmol/L, 16 mmol: 289.41 ± 30.1 μmol/L, and 24 mmol: 300.95 ± 42.4 μmol/L, respectively) (P = 0.0001). However, this did not induce any significant change in oxygen consumption (P = 0.351), blood lactate concentration (P = 0.245), and time-to-exhaustion (P = 0.147). Peroxynitrite levels were similar compared with placebo when participants ingested 8 and 16 mmol of inorganic nitrate but a significant increase was observed after exercise at maximal intensity when participants were supplemented with 24 mmol (mean = 14.60 ± 1.3 μmol/L, P = 0.001). Pre-workout ingestion of high dose of sodium nitrate (24 mmol) induced peroxynitrate formation, a marker of oxidative stress. Caution must be taken regarding administration of higher doses before benefits or adverse effects are established in this population.
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Affiliation(s)
- Farhad Gholami
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
| | - Leila Rahmani
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
| | - Fatemeh Amirnezhad
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
| | - Khadijeh Cheraghi
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
- Faculty of Sport Sciences, Shahrood University of Technology, Shahrood, Iran
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22
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Riis S, Møller AB, Dollerup O, Høffner L, Jessen N, Madsen K. Acute and sustained effects of a periodized carbohydrate intake using the sleep-low model in endurance-trained males. Scand J Med Sci Sports 2019; 29:1866-1880. [PMID: 31430404 DOI: 10.1111/sms.13541] [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] [Received: 12/20/2018] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 12/19/2022]
Abstract
Repeated periodization of carbohydrate (CHO) intake using a diet-exercise strategy called the sleep-low model can potentially induce mitochondrial biogenesis and improve endurance performance in endurance-trained individuals. However, more studies are needed to confirm the performance-related effects and to investigate the sustained effects on maximal fat oxidation (MFO) rate and proteins involved in intramuscular lipid metabolism. Thirteen endurance-trained males (age 23-44 years; V ˙ O2 -max, 63.9 ± 4.6 mL·kg-1 ·min-1 ) were randomized into two groups: sleep-low (LOW-CHO) or high CHO availability (HIGH-CHO) in three weekly training blocks over 4 weeks. The acute metabolic response was investigated during 60 minutes of exercise within the last 3 weeks of the intervention. Pre- and post-intervention, 30-minute time-trial performance was investigated after a 90-minute pre-load, which as a novel approach included nine intense intervals (and estimation of MFO). Additionally, muscle biopsies (v. lateralis) were obtained to investigate expression of proteins involved in intramuscular lipid metabolism using Western blotting. During acute exercise, average fat oxidation rate was ~36% higher in LOW-CHO compared to HIGH-CHO (P = .03). This did not translate into sustained effects on MFO. Time-trial performance increased equally in both groups (overall time effect: P = .005). We observed no effect on intramuscular proteins involved in lipolysis (ATGL, G0S2, CGI-58, HSL) or fatty acid transport and β-oxidation (CD-36 and HAD, respectively). In conclusion, the sleep-low model did not induce sustained effects on MFO, endurance performance, or proteins involved in intramuscular lipid metabolism when compared to HIGH-CHO. Our study therefore questions the transferability of acute effects of the sleep-low model to superior sustained adaptations.
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Affiliation(s)
- Simon Riis
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.,Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Andreas Buch Møller
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Dollerup
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Medical Research Laboratory, Department of Clinical Medicine, Aarhus University Hospital, Denmark
| | - Line Høffner
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.,Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niels Jessen
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Klavs Madsen
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.,Norwegian School of Sport Sciences, Oslo, Norway
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23
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Influence of Equimolar Doses of Beetroot Juice and Sodium Nitrate on Time Trial Performance in Handcycling. Nutrients 2019; 11:nu11071642. [PMID: 31323779 PMCID: PMC6683039 DOI: 10.3390/nu11071642] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 12/17/2022] Open
Abstract
This study aimed to investigate the influence of a single dose of either beetroot juice (BR) or sodium nitrate (NIT) on performance in a 10 km handcycling time trial (TT) in able-bodied individuals and paracyclists. In total, 14 able-bodied individuals [mean ± SD; age: 28 ± 7 years, height: 183 ± 5 cm, body mass (BM): 82 ± 9 kg, peak oxygen consumption (VO2peak): 33.9 ± 4.2 mL/min/kg] and eight paracyclists (age: 40 ± 11 years, height: 176 ± 9cm, BM: 65 ± 9 kg, VO2peak: 38.6 ± 10.5 mL/min/kg) participated in the study. All participants had to perform three TT on different days, receiving either 6 mmol nitrate as BR or NIT or water as a placebo. Time-to-complete the TT, power output (PO), as well as oxygen uptake (VO2) were measured. No significant differences in time-to-complete the TT were found between the three interventions in able-bodied individuals (p = 0.80) or in paracyclists (p = 0.61). Furthermore, VO2 was not significantly changed after the ingestion of BR or NIT in either group (p < 0.05). The PO to VO2 ratio was significantly higher in some kilometers of the TT in able-bodied individuals (p < 0.05). The ingestion of BR or NIT did not increase handcycling performance in able-bodied individuals or in paracyclists.
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24
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Gallardo EJ, Coggan AR. What's in Your Beet Juice? Nitrate and Nitrite Content of Beet Juice Products Marketed to Athletes. Int J Sport Nutr Exerc Metab 2019; 29:345–349. [PMID: 30299195 PMCID: PMC8512783 DOI: 10.1123/ijsnem.2018-0223] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Consumption of beetroot juice (BRJ) supplements has become popular among athletes, because beets tend to be rich in nitrate (NO3-), which can enhance exercise performance by increasing nitric oxide production. The NO3- content of beets can vary significantly, however, making it difficult to know how much NO3- any product actually contains. Samples from 45 different lots of 24 different BRJ products from 21 different companies were therefore analyzed for NO3- (and nitrite; NO2-) concentration using high performance liquid chromatography. The NO3- and NO2- content, i.e., amount per serving, was then calculated based on either 1) the manufacturer's recommended serving size (for prepackaged/single dose products) or 2) as used in previous studies, a volume of 500 mL (for BRJ sold in bulk containers). There was moderate-to-large variability in NO3- content between samples of the same product, with a mean coefficient of variation of 30±26% (range 2 to 83%). There was even greater variability between products, with a ~50-fold range in NO3- content between the lowest and highest. Only five products consistently provided ≥5 mmol of NO3- per serving, which seems to be the minimal dose required to enhance exercise performance in most individuals. NO2- contents were generally low (i.e., ≤0.5% compared to NO3-), although two products contained 10 and 14%. The present results may be useful to athletes and their support staff contemplating which (if any) BRJ product to utilize. These data may also offer insight into variability in the literature with respect to the effects of BRJ on exercise performance.
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Affiliation(s)
| | - Andrew R Coggan
- 1 Departments of Kinesiology
- 2 Cellular and Integrative Physiology, Indiana University Purdue University Indianapolis, Indianapolis, IN
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25
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Abstract
Nitric oxide (NO) plays a plethora of important roles in the human body. Insufficient production of NO (for example, during older age and in various disease conditions) can adversely impact health and physical performance. In addition to its endogenous production through the oxidation of l-arginine, NO can be formed nonenzymatically via the reduction of nitrate and nitrite, and the storage of these anions can be augmented by the consumption of nitrate-rich foodstuffs such as green leafy vegetables. Recent studies indicate that dietary nitrate supplementation, administered most commonly in the form of beetroot juice, can ( a) improve muscle efficiency by reducing the O2 cost of submaximal exercise and thereby improve endurance exercise performance and ( b) enhance skeletal muscle contractile function and thereby improve muscle power and sprint exercise performance. This review describes the physiological mechanisms potentially responsible for these effects, outlines the circumstances in which ergogenic effects are most likely to be evident, and discusses the effects of dietary nitrate supplementation on physical performance in a range of human populations.
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Affiliation(s)
- Andrew M Jones
- Department of Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, United Kingdom;
| | - Christopher Thompson
- Department of Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, United Kingdom;
| | - Lee J Wylie
- Department of Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, United Kingdom;
| | - Anni Vanhatalo
- Department of Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, United Kingdom;
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26
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Affiliation(s)
- Nathan S. Bryan
- Department of Molecular and Human GeneticsBaylor College of Medicine One Baylor Plaza Alkek Building for Biomedical Research R-850 Houston TX 77030
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27
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Nitrate supplementation improves physical performance specifically in non-athletes during prolonged open-ended tests: a systematic review and meta-analysis. Br J Nutr 2019; 119:636-657. [PMID: 29553034 DOI: 10.1017/s0007114518000132] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Nitrate (NO3 -) is an ergogenic nutritional supplement that is widely used to improve physical performance. However, the effectiveness of NO3 - supplementation has not been systematically investigated in individuals with different physical fitness levels. The present study analysed whether different fitness levels (non-athletes v. athletes or classification of performance levels), duration of the test used to measure performance (short v. long duration) and the test protocol (time trials v. open-ended tests v. graded-exercise tests) influence the effects of NO3 - supplementation on performance. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science, SPORTDiscus and ProQuest, was performed in August 2017. On the basis of the search and inclusion criteria, fifty-four and fifty-three placebo-controlled studies evaluating the effects of NO3 - supplementation on performance in humans were included in the systematic review and meta-analysis, respectively. NO3 - supplementation was ergogenic in non-athletes (mean effect size (ES) 0·25; 95 % CI 0·11, 0·38), particularly in evaluations of performance using long-duration open-ended tests (ES 0·47; 95 % CI 0·23, 0·71). In contrast, NO3 - supplementation did not enhance the performance of athletes (ES 0·04; 95 % CI -0·05, 0·15). After objectively classifying the participants into different performance levels, the frequency of trials showing ergogenic effects in individuals classified at lower levels was higher than that in individuals classified at higher levels. Thus, the present study indicates that dietary NO3 - supplementation improves physical performance in non-athletes, particularly during long-duration open-ended tests.
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28
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Chronic high-dose beetroot juice supplementation improves time trial performance of well-trained cyclists in normoxia and hypoxia. Nitric Oxide 2019; 85:44-52. [PMID: 30685420 DOI: 10.1016/j.niox.2019.01.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/14/2019] [Accepted: 01/18/2019] [Indexed: 11/21/2022]
Abstract
Dietary nitrate (NO3-) supplementation via beetroot juice (BR) is known to improve endurance performance in untrained and moderately trained individuals. However, conflicting results exist in well-trained individuals. Evidence suggests that the effects of NO3- are augmented during conditions of reduced oxygen availability (e.g., hypoxia), thereby increasing the probability of performance improvements for well-trained athletes in hypoxia vs. normoxia. This randomized, double-blinded, counterbalanced-crossover study examined the effects of 7 days of BR supplementation with 12.4 mmol NO3- per day on 10-km cycling time trial (TT) performance in 12 well-trained cyclists in normoxia (N) and normobaric hypoxia (H). Linear mixed models for repeated measures revealed increases in plasma NO3- and NO2- after supplementation with BR (both p < 0.001). Further, TT performance increased with BR supplementation (∼1.6%, p < 0.05), with no difference between normoxia and hypoxia (p = 0.92). For respiratory variables there were significant effects of supplementation on VO2 (p < 0.05) and VE (p < 0.05) such that average VO2 and VE during the TT increased with BR, with no difference between normoxia and hypoxia (p ≥ 0.86). We found no effect of supplementation on heart rate, oxygen saturation or muscle oxygenation during the TT. Our results provide new evidence that chronic high-dose NO3- supplementation improves cycling performance of well-trained cyclists in both normoxia and hypoxia.
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29
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Shannon OM, McGawley K, Nybäck L, Duckworth L, Barlow MJ, Woods D, Siervo M, O'Hara JP. "Beet-ing" the Mountain: A Review of the Physiological and Performance Effects of Dietary Nitrate Supplementation at Simulated and Terrestrial Altitude. Sports Med 2018; 47:2155-2169. [PMID: 28577258 PMCID: PMC5633647 DOI: 10.1007/s40279-017-0744-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Exposure to altitude results in multiple physiological consequences. These include, but are not limited to, a reduced maximal oxygen consumption, drop in arterial oxygen saturation, and increase in muscle metabolic perturbations at a fixed sub-maximal work rate. Exercise capacity during fixed work rate or incremental exercise and time-trial performance are also impaired at altitude relative to sea level. Recently, dietary nitrate (NO3−) supplementation has attracted considerable interest as a nutritional aid during altitude exposure. In this review, we summarise and critically evaluate the physiological and performance effects of dietary NO3− supplementation during exposure to simulated and terrestrial altitude. Previous investigations at simulated altitude indicate that NO3− supplementation may reduce the oxygen cost of exercise, elevate arterial and tissue oxygen saturation, improve muscle metabolic function, and enhance exercise capacity/performance. Conversely, current evidence suggests that NO3− supplementation does not augment the training response at simulated altitude. Few studies have evaluated the effects of NO3− at terrestrial altitude. Current evidence indicates potential improvements in endothelial function at terrestrial altitude following NO3− supplementation. No effects of NO3− supplementation have been observed on oxygen consumption or arterial oxygen saturation at terrestrial altitude, although further research is warranted. Limitations of the present body of literature are discussed, and directions for future research are provided.
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Affiliation(s)
- Oliver Michael Shannon
- Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, LS6 3QS, UK.
| | - Kerry McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Linn Nybäck
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Lauren Duckworth
- Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, LS6 3QS, UK
| | - Matthew John Barlow
- Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, LS6 3QS, UK
| | - David Woods
- Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, LS6 3QS, UK.,Defence Medical Services, Royal Centre for Defence Medicine, Birmingham, B152TH, UK
| | - Mario Siervo
- Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, NE45PL, UK
| | - John Paul O'Hara
- Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, LS6 3QS, UK
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30
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Van De Walle GP, Vukovich MD. The Effect of Nitrate Supplementation on Exercise Tolerance and Performance: A Systematic Review and Meta-Analysis. J Strength Cond Res 2018; 32:1796-1808. [PMID: 29786633 DOI: 10.1519/jsc.0000000000002046] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Van De Walle, GP and Vukovich, MD. The effect of nitrate supplementation on exercise tolerance and performance: a systematic review and meta-analysis. J Strength Cond Res 32(6): 1796-1808, 2018-The purpose of this article was to systematically review the current literature and evaluate the overall efficacy of nitrate supplementation on exercise tolerance and performance by meta-analysis. Studies were eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English peer-reviewed journal; (b) compared the effects of inorganic nitrate consumption with a non-bioactive supplement control or placebo; (c) used a quantifiable measure of exercise performance; and (d) was carried out in apparently healthy participants without disease. A total of 29 studies were identified that investigated the effects of nitrate supplementation on exercise tolerance or performance in accordance with the criteria outlined. Analysis using time to exhaustion as the outcome variable revealed a significant effect of nitrate supplementation on exercise tolerance (ES = 0.28; 95% confidence interval [CI]: 0.08-0.47; p = 0.006) compared with placebo. Analysis using time to complete a specific distance as the outcome variable revealed no significant effect of nitrate supplementation on exercise performance (ES = -0.05; 95% CI: -0.28 to 0.17; p = 0.64) compared with placebo. Nitrate supplementation is likely to improve exercise tolerance and capacity that may improve exercise performance. More research is required to determine the optimal dose and duration of nitrate supplementation. It would also be important to consider the type of athlete performing the exercise and the duration, intensity, and mode of the exercise performed because these factors are likely to influence the efficacy of nitrate supplementation.
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Affiliation(s)
- Gavin P Van De Walle
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings, South Dakota
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31
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Allan PD, Tzeng YC, Gowing EK, Clarkson AN, Fan JL. Dietary nitrate supplementation reduces low frequency blood pressure fluctuations in rats following distal middle cerebral artery occlusion. J Appl Physiol (1985) 2018; 125:862-869. [DOI: 10.1152/japplphysiol.01081.2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
It is known that high blood pressure variability (BPV) in acute ischemic stroke is associated with adverse outcomes, yet there are no therapeutic treatments to reduce BPV. Studies have found increasing nitric oxide (NO) bioavailability improves neurological function following stroke, but whether dietary nitrate supplementation could reduce BPV remains unknown. We investigated the effects of dietary nitrate supplementation on heart rate (HR), blood pressure (BP), and beat-to-beat BPV using wireless telemetry in a rat model of distal middle cerebral artery occlusion. Blood pressure variability was characterized by spectral power analysis in the low frequency (LF; 0.2–0.6 Hz) range prestroke and during the 7 days poststroke in a control group ( n = 8) and a treatment group ( n = 8, 183 mg/l sodium nitrate in drinking water). Dietary nitrate supplementation moderately reduced systolic BPV in the LF range by ~11% compared with the control group ( P = 0.03), while resting BP and HR were not different between the two groups ( P = 0.28 and 0.33, respectively). Despite systolic BPV being reduced with dietary nitrate, we found no difference in infarct volumes between the treatment and the control groups (1.59 vs. 1.62 mm3, P = 0.86). These findings indicate that dietary nitrate supplementation is effective in reducing systolic BPV following stroke without affecting absolute BP. In light of mounting evidence linking increased BPV with poor stroke patient outcome, our data support the role of dietary nitrate as an adjunct treatment following ischemic stroke. NEW & NOTEWORTHY Using a rat model of stroke, we found that dietary nitrate supplementation reduced low frequency blood pressure fluctuations following stroke without affecting absolute blood pressure values. Since blood pressure fluctuations are associated with poor clinical outcome in stroke patients, our findings indicate that dietary nitrate could be an effective strategy for reducing blood pressure fluctuations, which could help reduce stroke severity and improve patient recovery.
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Affiliation(s)
- Philip D. Allan
- Department of Surgery and Anaesthesia, Centre for Translational Physiology, University of Otago, Wellington, New Zealand
- Wellington Medical Technology Group, Department of Surgery & Anaesthesia, University of Otago, Wellington, New Zealand
| | - Yu-Chieh Tzeng
- Department of Surgery and Anaesthesia, Centre for Translational Physiology, University of Otago, Wellington, New Zealand
- Wellington Medical Technology Group, Department of Surgery & Anaesthesia, University of Otago, Wellington, New Zealand
| | - Emma K. Gowing
- Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Andrew N. Clarkson
- Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
- Faculty of Pharmacy, The University of Sydney, New South Wales, Australia
| | - Jui-Lin Fan
- Department of Surgery and Anaesthesia, Centre for Translational Physiology, University of Otago, Wellington, New Zealand
- Wellington Medical Technology Group, Department of Surgery & Anaesthesia, University of Otago, Wellington, New Zealand
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32
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McDonagh ST, Wylie LJ, Morgan PT, Vanhatalo A, Jones AM. A randomised controlled trial exploring the effects of different beverages consumed alongside a nitrate-rich meal on systemic blood pressure. Nutr Health 2018; 24:183-192. [PMID: 30099933 DOI: 10.1177/0260106018790428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Ingestion of nitrate (NO3-)-containing vegetables, alcohol and polyphenols, separately, can reduce blood pressure (BP). However, the pharmacokinetic response to the combined ingestion of NO3- and polyphenol-rich or low polyphenol alcoholic beverages is unknown. AIM: The aim of this study was to investigate how the consumption of low and high polyphenolic alcoholic beverages combined with a NO3--rich meal can influence NO3- metabolism and systemic BP. METHODS: In a randomised, crossover trial, 12 normotensive males (age 25 ± 5 years) ingested an acute dose of NO3- (∼6.05 mmol) in the form of a green leafy salad, in combination with either a polyphenol-rich red wine (NIT-RW), a low polyphenol alcoholic beverage (vodka; NIT-A) or water (NIT-CON). Participants also consumed a low NO3- salad and water as a control (CON; ∼0.69 mmol NO3-). BP and plasma, salivary and urinary [NO3-] and nitrite ([NO2-]) were determined before and up to 5 h post ingestion. RESULTS: Each NO3--rich condition elevated nitric oxide (NO) biomarkers when compared with CON ( P < 0.05). The peak rise in plasma [NO2-] occurred 1 h after NIT-RW (292 ± 210 nM) and 2 h after NIT-A (318 ± 186 nM) and NIT-CON (367 ± 179 nM). Systolic BP was reduced 2 h post consumption of NIT-RW (-4 mmHg), NIT-A (-3 mmHg) and NIT-CON (-2 mmHg) compared with CON ( P < 0.05). Diastolic BP and mean arterial pressure were also lower in NIT-RW and NIT-A compared with NIT-CON ( P < 0.05). CONCLUSIONS: A NO3--rich meal, consumed with or without an alcoholic beverage, increases plasma [NO2-] and lowers systemic BP for 2-3 h post ingestion.
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Affiliation(s)
| | - Lee J Wylie
- Sport and Health Sciences, University of Exeter, UK
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33
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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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McMahon NF, Leveritt MD, Pavey TG. The Effect of Dietary Nitrate Supplementation on Endurance Exercise Performance in Healthy Adults: A Systematic Review and Meta-Analysis. Sports Med 2018; 47:735-756. [PMID: 27600147 DOI: 10.1007/s40279-016-0617-7] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Recent research into the use of dietary nitrates and their role in vascular function has led to it becoming progressively more popular amongst athletes attempting to enhance performance. OBJECTIVE The objective of this review was to perform a systematic review and meta-analysis of the literature to evaluate the effect of dietary nitrate (NO3-) supplementation on endurance exercise performance. An additional aim was to determine whether the performance outcomes are affected by potential moderator variables. DATA SOURCES Relevant databases such as Cochrane Library, Embase, PubMed, Ovid, Scopus and Web of Science were searched for the following search terms 'nitrates OR nitrate OR beetroot OR table beet OR garden beet OR red beet AND exercise AND performance' from inception to October 2015. STUDY SELECTION Studies were included if a placebo versus dietary nitrate-only supplementation protocol was able to be compared, and if a quantifiable measure of exercise performance was ≥30 s (for a single bout of exercise or the combined total for multiple bouts). STUDY APPRAISAL AND SYNTHESIS The literature search identified 1038 studies, with 47 (76 trials) meeting the inclusion criteria. Data from the 76 trials were extracted for inclusion in the meta-analysis. A fixed-effects meta-analysis was conducted for time trial (TT) (n = 28), time to exhaustion (TTE) (n = 22) and graded-exercise test (GXT) (n = 8) protocols. Univariate meta-regression was used to assess potential moderator variables (exercise type, dose duration, NO3- type, study quality, fitness level and percentage nitrite change). RESULTS Pooled analysis identified a trivial but non-significant effect in favour of dietary NO3- supplementation [effect size (ES) = -0.10, 95 % Cl = -0.27 to 0.06, p > 0.05]. TTE trials had a small to moderate statistically significant effect in favour of dietary NO3- supplementation (ES = 0.33, 95 % Cl = 0.15-0.50, p < 0.01). GXT trials had a small but non-significant effect in favour of dietary NO3- supplementation in GXT performance measures (ES = 0.25, 95 % Cl = -0.06 to 0.56, p > 0.05). No significant heterogeneity was detected in the meta-analysis. No statistically significant effects were observed from the meta-regression analysis. CONCLUSION Dietary NO3- supplementation is likely to elicit a positive outcome when testing endurance exercise capacity, whereas dietary NO3- supplementation is less likely to be effective for time-trial performance. Further work is needed to understand the optimal dosing strategies, which population is most likely to benefit, and under which conditions dietary nitrates are likely to be most effective for performance.
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Affiliation(s)
- Nicholas F McMahon
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia.
| | - Michael D Leveritt
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
| | - Toby G Pavey
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Getzin AR, Milner C, Harkins M. Fueling the Triathlete: Evidence-Based Practical Advice for Athletes of All Levels. Curr Sports Med Rep 2018; 16:240-246. [PMID: 28696986 DOI: 10.1249/jsr.0000000000000386] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Triathletes need to effectively fuel during training and racing to maximize their potential for success. While most research on fueling has focused on elite male triathletes, triathlon participation encompasses a broader demographic of racers ranging from those with aspirations of winning to those whose goals are completion. Carbohydrate is the primary macronutrient for fueling endurance activities. Athletes can usually tolerate 60 to 90 mg·h in the form of multiple different carbohydrate sources. Athletes should drink as thirst dictates and consider sodium replacement of sweat loss especially in individuals with a history of exercise-associated muscle cramps. Caffeine is a known ergogenic aid that could be dosed at 3 mg·kg to maximize benefits of mental alertness while limiting potential side effects. Athletes need to balance fueling with development of exercise-induced gastrointestinal syndrome. As demographics of race participants change, understanding the special fueling needs of obese triathletes can encourage participation while minimizing bad outcomes.
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Affiliation(s)
- Andrew R Getzin
- 1Cayuga Medical Center, Ithaca, NY; 2Cayuga Center for Healthy Living, Cayuga Medical Center, Ithaca, NY; and 3Cayuga Center for Metabolic and Bariatric Surgery, Cayuga Medical Center, Ithaca, NY
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Woessner MN, McIlvenna LC, Ortiz de Zevallos J, Neil CJ, Allen JD. Dietary nitrate supplementation in cardiovascular health: an ergogenic aid or exercise therapeutic? Am J Physiol Heart Circ Physiol 2018; 314:H195-H212. [DOI: 10.1152/ajpheart.00414.2017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Oral consumption of inorganic nitrate, which is abundant in green leafy vegetables and roots, has been shown to increase circulating plasma nitrite concentration, which can be converted to nitric oxide in low oxygen conditions. The associated beneficial physiological effects include a reduction in blood pressure, modification of platelet aggregation, and increases in limb blood flow. There have been numerous studies of nitrate supplementation in healthy recreational and competitive athletes; however, the ergogenic benefits are currently unclear due to a variety of factors including small sample sizes, different dosing regimens, variable nitrate conversion rates, the heterogeneity of participants’ initial fitness levels, and the types of exercise tests used. In clinical populations, the study results seem more promising, particularly in patients with cardiovascular diseases who typically present with disruptions in the ability to transport oxygen from the atmosphere to working tissues and reduced exercise tolerance. Many of these disease-related, physiological maladaptations, including endothelial dysfunction, increased reactive oxygen species, reduced tissue perfusion, and muscle mitochondrial dysfunction, have been previously identified as potential targets for nitric oxide restorative effects. This review is the first of its kind to outline the current evidence for inorganic nitrate supplementation as a therapeutic intervention to restore exercise tolerance and improve quality of life in patients with cardiovascular diseases. We summarize the factors that appear to limit or maximize its effectiveness and present a case for why it may be more effective in patients with cardiovascular disease than as ergogenic aid in healthy populations.
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Affiliation(s)
- Mary N. Woessner
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
- Western Health, Melbourne, Victoria, Australia
| | - Luke C. McIlvenna
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
| | - Joaquin Ortiz de Zevallos
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Christopher J. Neil
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
- Western Health, Melbourne, Victoria, Australia
| | - Jason D. Allen
- Clinical Exercise Science Research Program, Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
- Western Health, Melbourne, Victoria, Australia
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
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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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Influence of dietary nitrate food forms on nitrate metabolism and blood pressure in healthy normotensive adults. Nitric Oxide 2018; 72:66-74. [DOI: 10.1016/j.niox.2017.12.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/31/2017] [Accepted: 12/03/2017] [Indexed: 12/11/2022]
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Ghiarone T, Ataide-Silva T, Bertuzzi R, McConell GK, Lima-Silva AE. Effect of acute nitrate ingestion on V̇O2 response at different exercise intensity domains. Appl Physiol Nutr Metab 2017; 42:1127-1134. [DOI: 10.1139/apnm-2017-0198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
While nitrate supplementation influences oxygen uptake (V̇O2) response to exercise, this effect may be intensity dependent. The purpose of this study was to investigate the effect of acute nitrate supplementation on V̇O2 response during different exercise intensity domains in humans. Eleven men ingested 10 mg·kg−1 body mass (8.76 ± 1.35 mmol) of sodium nitrate or sodium chloride (placebo) 2.5 h before cycling at moderate (90% of gas exchange threshold; GET), heavy (GET + 40% of the difference between GET and peak oxygen uptake (V̇O2peak), Δ 40) or severe (GET + 80% of the difference between GET and V̇O2peak, Δ 80) exercise intensities. Volunteers performed exercise for 10 min (moderate), 15 min (heavy) or until exhaustion (severe). Acute nitrate supplementation had no effect on any V̇O2 response parameters during moderate and severe exercise intensities. However, the V̇O2 slow amplitude (nitrate: 0.93 ± 0.36 L·min−1 vs. placebo: 1.13 ± 0.59 L·min−1, p = 0.04) and V̇O2 slow gain (nitrate: 5.81 ± 2.37 mL·min–1·W−1 vs. placebo: 7.09 ± 3.67 mL·min–1·W−1, p = 0.04) were significantly lower in nitrate than in placebo during the heavy exercise intensity. There was no effect of nitrate on plasma lactate during any exercise intensity (p > 0.05). Time to exhaustion during the severe exercise intensity was also not affected by nitrate (p > 0.05). In conclusion, acute nitrate supplementation reduced the slow component of V̇O2 only when performing heavy-intensity exercise, which might indicate an intensity-dependent effect of nitrate on V̇O2 response.
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Affiliation(s)
- Thaysa Ghiarone
- Sport Science Research Group, Department of Physical Education and Sports Science, Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco 55608680, Brazil
| | - Thays Ataide-Silva
- Sport Science Research Group, Department of Physical Education and Sports Science, Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco 55608680, Brazil
| | - Romulo Bertuzzi
- Endurance Performance Research Group (GEDAE-USP), University of Sao Paulo, Sao Paulo 05508-030, Brazil
| | - Glenn Kevin McConell
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria 3011, Australia
| | - Adriano Eduardo Lima-Silva
- Sport Science Research Group, Department of Physical Education and Sports Science, Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco 55608680, Brazil
- Human Performance Research Group, Technological Federal University of Parana, Parana 81310900, Brazil
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40
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Moore AN, Haun CT, Kephart WC, Holland AM, Mobley CB, Pascoe DD, Roberts MD, Martin JS. Red Spinach Extract Increases Ventilatory Threshold during Graded Exercise Testing. Sports (Basel) 2017; 5:sports5040080. [PMID: 29910440 PMCID: PMC5969023 DOI: 10.3390/sports5040080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/06/2017] [Accepted: 10/11/2017] [Indexed: 12/03/2022] Open
Abstract
Background: We examined the acute effect of a red spinach extract (RSE) (1000 mg dose; ~90 mg nitrate (NO3−)) on performance markers during graded exercise testing (GXT). Methods: For this randomized, double-blind, placebo (PBO)-controlled, crossover study, 15 recreationally-active participants (aged 23.1 ± 3.3 years; BMI: 27.2 ± 3.7 kg/m2) reported >2 h post-prandial and performed GXT 65–75 min post-RSE or PBO ingestion. Blood samples were collected at baseline (BL), pre-GXT (65–75 min post-ingestion; PRE), and immediately post-GXT (POST). GXT commenced with continuous analysis of expired gases. Results: Plasma concentrations of NO3− increased PRE (+447 ± 294%; p < 0.001) and POST (+378 ± 179%; p < 0.001) GXT with RSE, but not with PBO (+3 ± 26%, −8 ± 24%, respectively; p > 0.05). No effect on circulating nitrite (NO2−) was observed with RSE (+3.3 ± 7.5%, +7.7 ± 11.8% PRE and POST, respectively; p > 0.05) or PBO (−0.5 ± 7.9%, −0.2 ± 8.1% PRE and POST, respectively; p > 0.05). When compared to PBO, there was a moderate effect of RSE on plasma NO2− at PRE (g = 0.50 [−0.26, 1.24] and POST g = 0.71 [−0.05, 1.48]). During GXT, VO2 at the ventilatory threshold was significantly higher with RSE compared to PBO (+6.1 ± 7.3%; p < 0.05), though time-to-exhaustion (−4.0 ± 7.7%; p > 0.05) and maximal aerobic power (i.e., VO2 peak; −0.8 ± 5.6%; p > 0.05) were non-significantly lower with RSE. Conclusions: RSE as a nutritional supplement may elicit an ergogenic response by delaying the ventilatory threshold.
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Affiliation(s)
- Angelique N Moore
- Department of Cell Biology and Physiology, Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL 36832, USA.
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
| | - Cody T Haun
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
| | - Wesley C Kephart
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
| | | | | | - David D Pascoe
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
| | - Michael D Roberts
- Department of Cell Biology and Physiology, Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL 36832, USA.
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
| | - Jeffrey S Martin
- Department of Cell Biology and Physiology, Edward Via College of Osteopathic Medicine-Auburn Campus, Auburn, AL 36832, USA.
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA.
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Christensen PM, Petersen NK, Friis SN, Weitzberg E, Nybo L. Effects of nitrate supplementation in trained and untrained muscle are modest with initial high plasma nitrite levels. Scand J Med Sci Sports 2017; 27:1616-1626. [DOI: 10.1111/sms.12848] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 01/18/2023]
Affiliation(s)
- P. M. Christensen
- Department of Nutrition, Exercise and Sports; Section of Integrated Physiology; University of Copenhagen; Copenhagen Denmark
- Team Danmark (Danish elite sport organization); Copenhagen Denmark
| | - N. K. Petersen
- Department of Nutrition, Exercise and Sports; Section of Integrated Physiology; University of Copenhagen; Copenhagen Denmark
| | - S. N. Friis
- Department of Nutrition, Exercise and Sports; Section of Integrated Physiology; University of Copenhagen; Copenhagen Denmark
| | - E. Weitzberg
- Department of Physiology and Pharmacology; Swedish School of Sport and Health Sciences; Karolinska Institutet; Stockholm Sweden
| | - L. Nybo
- Department of Nutrition, Exercise and Sports; Section of Integrated Physiology; University of Copenhagen; Copenhagen Denmark
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Dietary nitrate supplementation enhances short but not longer duration running time-trial performance. Eur J Appl Physiol 2017; 117:775-785. [PMID: 28251402 DOI: 10.1007/s00421-017-3580-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/19/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE This study evaluated the effects of dietary nitrate (NO3-) supplementation on physiological functioning and exercise performance in trained runners/triathletes conducting short and longer-distance treadmill running time-trials (TT). METHOD Eight trained male runners or triathletes completed four exercise performance tests comprising a 10 min warm up followed by either a 1500 or 10,000 m treadmill TT. Exercise performance tests were preceded 3 h before the exercise by supplementation with either 140 ml concentrated nitrate-rich (~12.5 mmol nitrate) (BRJ) or nitrate-deplete (~0.01 mmol nitrate) (PLA) beetroot juice. RESULTS BRJ supplementation significantly elevated plasma [NO2-] (P < 0.05). Resting blood pressure and exercise [Formula: see text] were not significantly different between BRJ and PLA (P > 0.05). However, post-exercise blood [lactate] was significantly greater in BRJ following the 1500 m TT (6.6 ± 1.2 vs. 6.1 ± 1.5 mM; P < 0.05), but not significantly different between conditions in the 10,000 m TT (P > 0.05). Performance in the 1500 m TT was significantly faster in BRJ vs. PLA (319.6 ± 36.2 vs. 325.7 ± 38.8 s; P < 0.05). Conversely, there was no significant difference in 10,000 m TT performance between conditions (2643.1 ± 324. 1 vs. 2649.9 ± 319.8 s, P > 0.05). CONCLUSION Acute BRJ supplementation significantly enhanced 1500 m, but not 10,000 m TT performance. These findings suggest that BRJ might be ergogenic during shorter distance TTs which allow for a high work rate, but not during longer distance TTs, completed at a lower work rate.
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Siervo M, Oggioni C, Jakovljevic DG, Trenell M, Mathers JC, Houghton D, Celis-Morales C, Ashor AW, Ruddock A, Ranchordas M, Klonizakis M, Williams EA. Dietary nitrate does not affect physical activity or outcomes in healthy older adults in a randomized, cross-over trial. Nutr Res 2016; 36:1361-1369. [PMID: 27890482 DOI: 10.1016/j.nutres.2016.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 12/17/2022]
Abstract
Although dietary nitrate (NO3-) ingestion appears to enhance exercise capacity and performance in young individuals, inconclusive findings have been reported in older people. Therefore, we conducted a double-blind, crossover randomized clinical trial using beetroot juice in older healthy participants, who were classified as normal weight and overweight. We tested whether consumption of beetroot juice (a rich source of NO3-) for 1 week would increase nitric oxide bioavailability via the nonenzymatic pathway and enhance (1) exercise capacity during an incremental exercise test, (2) physical capability, and (3) free-living physical activity. Twenty nonsmoking, healthy participants between 60 and 75 years of age and with a body mass index of 20.0 to 29.9 kg/m2 were included. Presupplementation and postsupplementation resting, submaximal, maximal, and recovery gas exchanges were measured. Physical capability was measured by hand-grip strength, time-up-and-go, repeated chair rising test, and 10-m walking speed. Free-living physical activity was assessed by triaxal accelerometry. Changes in urinary and plasmaNO3-concentrations were measured by gas chromatography-mass spectrometry. Nineteen participants (male-to-female ratio, 9:10) completed the study.Beetroot juice increased significantly both plasma and urinary NO3-concentrations (P<.001) when compared with placebo. Beetroot juice did not influence resting or submaximal and maximal oxygen consumption during the incremental exercise test. In addition, measures of physical capability and physical activity levels measured in free-living conditions were not modified by beetroot juice ingestion. The positive effects of beetroot juice ingestion on exercise performance seen in young individuals were not replicated in healthy, older adults. Whether aging represents a modifier of the effects of dietary NO3-on muscular performance is not known, and mechanistic studies and larger trials are needed to test this hypothesis.
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Affiliation(s)
- Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
| | - Clio Oggioni
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Djordje G Jakovljevic
- Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK; RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Michael Trenell
- Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK; RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK; RCUK Centre for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - David Houghton
- Institute of Cellular Medicine, MoveLab, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Ammar W Ashor
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Alan Ruddock
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Mayur Ranchordas
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Markos Klonizakis
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Elizabeth A Williams
- Human Nutrition Unit, Department of Oncology, Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, S10 2RX, UK
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Jones AM, Ferguson SK, Bailey SJ, Vanhatalo A, Poole DC. Fiber Type-Specific Effects of Dietary Nitrate. Exerc Sport Sci Rev 2016; 44:53-60. [PMID: 26829247 DOI: 10.1249/jes.0000000000000074] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Dietary nitrate supplementation increases circulating nitrite concentration, and the subsequent reduction of nitrite to nitric oxide is promoted in hypoxic environments. Given that PO2 is lower in Type II compared with Type I muscle, this article examines the hypothesis that the ergogenicity of nitrate supplementation is linked to specific effects on vascular, metabolic, and contractile function in Type II muscle.
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Affiliation(s)
- Andrew M Jones
- 1Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom; and 2Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS
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Sureda A, Bibiloni MDM, Martorell M, Buil-Cosiales P, Marti A, Pons A, Tur JA, Martinez-Gonzalez MÁ. Mediterranean diets supplemented with virgin olive oil and nuts enhance plasmatic antioxidant capabilities and decrease xanthine oxidase activity in people with metabolic syndrome: The PREDIMED study. Mol Nutr Food Res 2016; 60:2654-2664. [PMID: 27600061 DOI: 10.1002/mnfr.201600450] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 07/26/2016] [Accepted: 08/01/2016] [Indexed: 12/11/2022]
Abstract
SCOPE This study assessed plasmatic antioxidant capabilities and xanthine oxidase (XOX) activity in metabolic syndrome patients after 5 years intervention with Mediterranean diet (MeDiet) supplemented with extra-virgin olive oil or with nuts or with low-fat diet (the PREDIMED [PREvención con Dieta MEDiterránea] study). METHODS AND RESULTS Seventy-five participants were randomly selected. Daily energy and nutrient intake were assessed with a validated 137-item food frequency questionnaire, and adherence to the MeDiet was assessed using a 14-item questionnaire. Catalase, superoxide dismutase (SOD), myeloperoxidase, XOX activities and protein levels, and protein carbonyl derivatives, nitrotyrosine, nitrite and nitrate levels were determined in overnight fasting venous blood samples. The plasma activity and protein levels of SOD and catalase were significantly higher and XOX activity was lower in MeDiet supplemented with extra-virgin olive oil and MeDiet supplemented with nuts than in the control group. Participants in both MeDiet groups showed higher plasma nitrate levels than in the control group. Adherence to the MeDiet showed a positive correlation with SOD and catalase plasma antioxidant activities. CONCLUSION A MeDiet enriched with either virgin olive oil or nuts enhances the plasma antioxidant capabilities and decreases XOX activity in patients with the metabolic syndrome but we did not observe changes in myeloperoxidase or markers of oxidative damage.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain.,RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Del Mar Bibiloni
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain.,RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Martorell
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain.,Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, Concepción, Chile
| | - Pilar Buil-Cosiales
- RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra-IDISNA, Pamplona, Spain
| | - Amelia Marti
- RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra-IDISNA, Pamplona, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain.,RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep A Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain.,RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ángel Martinez-Gonzalez
- RD 06/0045 and CIBEROBN (Fisiopatología de la Obesidad y la Nutrición), Instituto de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra-IDISNA, Pamplona, Spain
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Sureda A, Batle JM, Martorell M, Capó X, Tejada S, Tur JA, Pons A. Antioxidant Response of Chronic Wounds to Hyperbaric Oxygen Therapy. PLoS One 2016; 11:e0163371. [PMID: 27654305 PMCID: PMC5031445 DOI: 10.1371/journal.pone.0163371] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 09/06/2016] [Indexed: 01/24/2023] Open
Abstract
We analyzed the effects of the clinical hyperbaric oxygen therapy (HBOT) on the plasma antioxidant response and levels of endothelin-1, Interleukine-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with chronic wounds (20.2±10.0 months without healing). They received 20 HBOT sessions (five sessions/week), and blood samples were obtained at sessions 1, 5 and 20 before and 2 hours after the HBOT. An additional blood sample was collected 1 month after wound recovery. Serum creatine kinase activity decreased progressively in accordance with the wound healing. Plasma catalase activity significantly increased after the first and fifth sessions of HBOT. Plasma myeloperoxidase activity reported significantly lower values after sessions. Plasma VEGF and IL-6 increased after sessions. Endothelin-1 levels were progressively decreasing during the HBOT, being significant at the session 20. Plasma malondialdehyde concentration was significantly reduced at the last session. Both creatine kinase activity and malondialdehyde levels were maintained lower 1 month after wound recovery respect to initial values. In conclusion, HBOT enhanced the plasma antioxidant defenses and may contribute to activate the healing resolution, angiogenesis and vascular tone regulation by increasing the VEGF and IL-6 release and the endothelin-1 decrease, which may be significant factors in stimulating wound healing.
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Affiliation(s)
- Antoni Sureda
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, and CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain
| | - Juan M. Batle
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, and CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain
| | - Miquel Martorell
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, and CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain
- Departamento de Nutrición y Dietética, Facultad de Farmacia, Universidad de Concepción, E-4070386, Concepción, Chile
| | - Xavier Capó
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, and CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain
| | - Silvia Tejada
- Experimental Laboratory, Research Unit, Son Llàtzer Hospital, IUNICS, Ctra. Manacor km 4, E-07198, Palma de Mallorca, Balearic Islands, Spain
| | - Josep A. Tur
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, and CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, and CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain
- * E-mail:
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Roelofs EJ, Smith-Ryan AE, Trexler ET, Hirsch KR, Mock MG. Effects of pomegranate extract on blood flow and vessel diameter after high-intensity exercise in young, healthy adults. Eur J Sport Sci 2016; 17:317-325. [PMID: 27644475 DOI: 10.1080/17461391.2016.1230892] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effects of pomegranate extract (PE) supplementation were evaluated on high-intensity exercise performance, blood flow, vessel diameter, oxygen saturation (SPO2), heart rate (HR), and blood pressure (BP). In a randomized, crossover design, nineteen recreationally resistance-trained participants were randomly assigned to PE (1000 mg) or placebo (PL), which were consumed 30 min prior to a repeated sprint ability (RSA) test and repetitions to fatigue (RTF) on bench and leg press. The RSA consisted of ten six-second sprints on a friction-loaded cycle ergometer with 30 s recovery. Brachial artery blood flow and vessel diameter were assessed by ultrasound. Blood flow, vessel diameter, SPO2, HR, and BP were assessed at baseline, 30 min post ingestion, immediately post exercise (IPost), and 30 min post exercise (30minPost). With PE, blood flow significantly increased IPost RSA (mean difference = 18.49 mL min-1; P < .05), and IPost and 30minPost RTF (P < .05) according to confidence intervals (CI). Vessel diameter increased significantly 30minPost RSA according to CI and resulted in a significant interaction IPost and 30minPost RTF (P < .05). With PE, according to CI, average and peak power output increased significantly in sprint 5 of the RSA (P < .05). There was no significant difference between PE and PL for bench (P = .25) or leg press (P = .15) repetitions. Acute PE supplementation enhanced vessel diameter and blood flow, suggesting possible exercise performance enhancement from increased delivery of substrates and oxygen. The acute timing and capsule form of PE may be advantageous to athletic populations due to ergogenic effects, taste, and convenience.
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Affiliation(s)
- Erica J Roelofs
- a Applied Physiology Laboratory, Department of Exercise and Sport Science , University of North Carolina , Chapel Hill , NC , USA.,b Human Performance Lab, Department of Nutrition, Health, and Human Performance , Meredith College , Raleigh , NC , USA
| | - Abbie E Smith-Ryan
- a Applied Physiology Laboratory, Department of Exercise and Sport Science , University of North Carolina , Chapel Hill , NC , USA.,c Human Movement Science Curriculum, Department of Allied Health Science , University of North Carolina , Chapel Hill , NC , USA
| | - Eric T Trexler
- a Applied Physiology Laboratory, Department of Exercise and Sport Science , University of North Carolina , Chapel Hill , NC , USA.,c Human Movement Science Curriculum, Department of Allied Health Science , University of North Carolina , Chapel Hill , NC , USA
| | - Katie R Hirsch
- a Applied Physiology Laboratory, Department of Exercise and Sport Science , University of North Carolina , Chapel Hill , NC , USA
| | - Meredith G Mock
- a Applied Physiology Laboratory, Department of Exercise and Sport Science , University of North Carolina , Chapel Hill , NC , USA
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Shannon OM, Duckworth L, Barlow MJ, Woods D, Lara J, Siervo M, O'Hara JP. Dietary nitrate supplementation enhances high-intensity running performance in moderate normobaric hypoxia, independent of aerobic fitness. Nitric Oxide 2016; 59:63-70. [DOI: 10.1016/j.niox.2016.08.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 07/25/2016] [Accepted: 08/11/2016] [Indexed: 12/31/2022]
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Jonvik KL, Nyakayiru J, Pinckaers PJ, Senden JM, van Loon LJ, Verdijk LB. Nitrate-Rich Vegetables Increase Plasma Nitrate and Nitrite Concentrations and Lower Blood Pressure in Healthy Adults. J Nutr 2016; 146:986-93. [PMID: 27075914 DOI: 10.3945/jn.116.229807] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/07/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Dietary nitrate is receiving increased attention due to its reported ergogenic and cardioprotective properties. The extent to which ingestion of various nitrate-rich vegetables increases postprandial plasma nitrate and nitrite concentrations and lowers blood pressure is currently unknown. OBJECTIVE We aimed to assess the impact of ingesting different nitrate-rich vegetables on subsequent plasma nitrate and nitrite concentrations and resting blood pressure in healthy normotensive individuals. METHODS With the use of a semirandomized crossover design, 11 men and 7 women [mean ± SEM age: 28 ± 1 y; mean ± SEM body mass index (BMI, in kg/m(2)): 23 ± 1; exercise: 1-10 h/wk] ingested 4 different beverages, each containing 800 mg (∼12.9 mmol) nitrate: sodium nitrate (NaNO3), concentrated beetroot juice, a rocket salad beverage, and a spinach beverage. Plasma nitrate and nitrite concentrations and blood pressure were determined before and up to 300 min after beverage ingestion. Data were analyzed using repeated-measures ANOVA. RESULTS Plasma nitrate and nitrite concentrations increased after ingestion of all 4 beverages (P < 0.001). Peak plasma nitrate concentrations were similar for all treatments (all values presented as means ± SEMs: NaNO3: 583 ± 29 μmol/L; beetroot juice: 597 ± 23 μmol/L; rocket salad beverage: 584 ± 24 μmol/L; spinach beverage: 584 ± 23 μmol/L). Peak plasma nitrite concentrations were different between treatments (NaNO3: 580 ± 58 nmol/L; beetroot juice: 557 ± 57 nmol/L; rocket salad beverage: 643 ± 63 nmol/L; spinach beverage: 980 ± 160 nmol/L; P = 0.016). When compared with baseline, systolic blood pressure declined 150 min after ingestion of beetroot juice (from 118 ± 2 to 113 ± 2 mm Hg; P < 0.001) and rocket salad beverage (from 122 ± 3 to 116 ± 2 mm Hg; P = 0.007) and 300 min after ingestion of spinach beverage (from 118 ± 2 to 111 ± 3 mm Hg; P < 0.001), but did not change with NaNO3 Diastolic blood pressure declined 150 min after ingestion of all beverages (P < 0.05) and remained lower at 300 min after ingestion of rocket salad (P = 0.045) and spinach (P = 0.001) beverages. CONCLUSIONS Ingestion of nitrate-rich beetroot juice, rocket salad beverage, and spinach beverage effectively increases plasma nitrate and nitrite concentrations and lowers blood pressure to a greater extent than sodium nitrate. These findings show that nitrate-rich vegetables can be used as dietary nitrate supplements. This trial was registered at clinicaltrials.gov as NCT02271633.
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Affiliation(s)
- Kristin L Jonvik
- Nutrition and Toxicology Research Institute Maastricht, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, Netherlands; and Institute of Sport and Exercise Studies, Hogeschool van Arnhem en Nijmegen, University of Applied Sciences, Nijmegen, Netherlands
| | - Jean Nyakayiru
- Nutrition and Toxicology Research Institute Maastricht, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, Netherlands; and
| | - Philippe Jm Pinckaers
- Nutrition and Toxicology Research Institute Maastricht, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, Netherlands; and
| | - Joan Mg Senden
- Nutrition and Toxicology Research Institute Maastricht, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, Netherlands; and
| | - Luc Jc van Loon
- Nutrition and Toxicology Research Institute Maastricht, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, Netherlands; and Institute of Sport and Exercise Studies, Hogeschool van Arnhem en Nijmegen, University of Applied Sciences, Nijmegen, Netherlands
| | - Lex B Verdijk
- Nutrition and Toxicology Research Institute Maastricht, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, Netherlands; and
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50
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Betteridge S, Bescós R, Martorell M, Pons A, Garnham AP, Stathis CC, McConell GK. No effect of acute beetroot juice ingestion on oxygen consumption, glucose kinetics, or skeletal muscle metabolism during submaximal exercise in males. J Appl Physiol (1985) 2016; 120:391-8. [DOI: 10.1152/japplphysiol.00658.2015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/26/2015] [Indexed: 01/08/2023] Open
Abstract
Beetroot juice, which is rich in nitrate (NO3−), has been shown in some studies to decrease oxygen consumption (V̇o2) for a given exercise workload, i.e., increasing efficiency and exercise tolerance. Few studies have examined the effect of beetroot juice or nitrate supplementation on exercise metabolism. Eight healthy recreationally active males participated in three trials involving ingestion of either beetroot juice (Beet; ∼8 mmol NO3−), Placebo (nitrate-depleted Beet), or Beet + mouthwash (Beet+MW), all of which were performed in a randomized single-blind crossover design. Two-and-a-half hours later, participants cycled for 60 min on an ergometer at 65% of V̇o2 peak. [6,6-2H]glucose was infused to determine glucose kinetics, blood samples obtained throughout exercise, and skeletal muscle biopsies that were obtained pre- and postexercise. Plasma nitrite [NO2−] increased significantly (∼130%) with Beet, and this was attenuated in MW+Beet. Beet and Beet+MW had no significant effect on oxygen consumption, blood glucose, blood lactate, plasma nonesterified fatty acids, or plasma insulin during exercise. Beet and Beet+MW also had no significant effect on the increase in glucose disposal during exercise. In addition, Beet and Beet+MW had no significant effect on the decrease in muscle glycogen and phosphocreatine and the increase in muscle creatine, lactate, and phosphorylated acetyl CoA carboxylase during exercise. In conclusion, at the dose used, acute ingestion of beetroot juice had little effect on skeletal muscle metabolism during exercise.
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Affiliation(s)
- Scott Betteridge
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
- Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Raúl Bescós
- Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Miquel Martorell
- Laboratory of Physical Activity Science, Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma Mallorca, Spain
- Nutrition and Dietetics Department, School of Pharmacy, University of Concepcion, Concepcion, Chile
| | - Antoni Pons
- Laboratory of Physical Activity Science, Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, Palma Mallorca, Spain
| | - Andrew P. Garnham
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia; and
| | - Christos C. Stathis
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Glenn K. McConell
- College of Health and Biomedicine, Victoria University, Melbourne, Australia
- Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne, Australia
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