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Fenuta AM, Drouin PJ, Kohoko ZIN, Lynn MJT, Tschakovsky ME. Influence of acute dietary nitrate supplementation on oxygen delivery/consumption and critical impulse during maximal effort forearm exercise in males: a randomized crossover trial. Appl Physiol Nutr Metab 2024; 49:1184-1201. [PMID: 38728747 DOI: 10.1139/apnm-2023-0606] [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] [Indexed: 05/12/2024]
Abstract
Beetroot juice supplementation (BRJ) should increase nitric oxide bioavailability under conditions of muscle deoxygenation and acidosis that are a normal consequence of the maximal effort exercise test used to identify forearm critical impulse. We hypothesized BRJ would improve oxygen delivery:demand matching and forearm critical impulse performance. Healthy males (20.8 ± 2.4 years) participated in a randomized crossover trial between October 2017 and May 2018 (Queen's University, Kingston, ON). Participants completed 10 min of rhythmic maximal effort forearm handgrip exercise 2.5 h post placebo (PL) vs. BRJ (9 completed PL/BRJ vs. 4 completed BRJ/PL) within a 2 week period. Data are presented as mean ± SD. There was a main effect of drink (PL > BRJ) for oxygen extraction (P = 0.033, ηp2 = 0.351) and oxygen consumption/force (P = 0.017, ηp2 = 0.417). There was a drink × time interaction (PL > BRJ) for oxygen consumption/force (P = 0.035, ηp2 = 0.216) between 75 and 360 s (1.25-6 min) from exercise onset. BRJ did not influence oxygen delivery (P = 0.953, ηp2 = 0.000), oxygen consumption (P = 0.064, ηp2 = 0.278), metabolites ((lactate) (P = 0.196, ηp2 = 0.135), pH (P = 0.759, ηp2 = 0.008)) or power-duration performance parameters (critical impulse (P = 0.379, d = 0.253), W' (P = 0.733, d = 0.097)). BRJ during all-out handgrip exercise does not influence oxygen delivery or exercise performance. Oxygen cost of contraction with BRJ is reduced as contraction impulse is declining during maximal effort exercise resulting in less oxygen extraction.
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Affiliation(s)
- Alyssa M Fenuta
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Patrick J Drouin
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Zach I N Kohoko
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Mytchel J T Lynn
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Benjamim CJR, Lopes da Silva LS, Valenti VE, Gonçalves LS, Porto AA, Tasinafo Júnior MF, Walhin JP, Garner DM, Gualano B, Bueno Júnior CR. Effects of dietary inorganic nitrate on blood pressure during and post-exercise recovery: A systematic review and meta-analysis of randomized placebo-controlled trials. Free Radic Biol Med 2024; 215:25-36. [PMID: 38403254 DOI: 10.1016/j.freeradbiomed.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/15/2024] [Accepted: 02/10/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES A systematic review with meta-analysis was completed to study the effects of dietary inorganic nitrate (NO3-) oral ingestion from vegetables and salts on blood pressure responses during and following exercise. BACKGROUND NO3- is a hypotensive agent with the potential to reduce blood pressure peaks during exercise and amplify exercise-induced hypotensive effects. Several randomized and controlled trials have investigated the effects of NO3- on hemodynamic responses to physical exercise, however this still has yet to be studied systematically. METHODS The searches were conducted on EMBASE, Medline, and SPORTSDiscus databases. The study included masked randomized controlled trials (RCTs) with participants ≥18 years old. The NO3-intervention group received at least 50 mg NO3-/day with similar sources amid NO3- and placebo conditions. Included studies reported systolic blood pressure (SBP) or diastolic blood pressure (DBP) values during or following exercise performance. RESULTS 1903 studies were identified, and twenty-six achieved the inclusion criteria. NO3- daily dosages ranged from 90 to 800 mg/day. Throughout exercise, SBP had smaller increases in the NO3- group (-2.81 mmHg (95%CI: -5.20 to -0.41), p=0.02. DBP demonstrated lower values in the NO3- group (-2.41 mmHg (95%CI: -4.02 to -0.79), p=0.003. In the post-exercise group, the NO3- group presented lower SBP values (-3.53 mmHg (95%CI: -5.65 to 1.41), p=0.001, while no changes were identified in DBP values between NO3- and placebo groups (p=0.31). Subgroup meta-analysis revealed that SBP baseline values, exercise type, duration of NO3- ingestion, and its dosages mediated blood pressure responses during and following exercise. CONCLUSIONS NO3- ingestion prior to exercise attenuated the increases in SBP and DBP during exercise, and increased the decline in SBP after exercise. These results are dependent on factors that moderate the blood pressure responses (e.g., health status, type of exercise, resting blood pressure values).
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Affiliation(s)
- Cicero Jonas R Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | | | | | - Leonardo S Gonçalves
- School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | - Jean-Philippe Walhin
- Centre for Nutrition, Exercise and Metabolism, University of Bath, Bath, United Kingdom
| | - David M Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, United Kingdom
| | - Bruno Gualano
- Center of Lifestyle Medicine, Applied Physiology & Nutrition Research Group, University of São Paulo, Medical School (FMUSP), São Paulo, SP, Brazil
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Benjamim CJR, da Silva LSL, Sousa YBA, Rodrigues GDS, Pontes YMDM, Rebelo MA, Gonçalves LDS, Tavares SS, Guimarães CS, da Silva Sobrinho AC, Tanus-Santos JE, Gualano B, Bueno Júnior CR. Acute and short-term beetroot juice nitrate-rich ingestion enhances cardiovascular responses following aerobic exercise in postmenopausal women with arterial hypertension: A triple-blinded randomized controlled trial. Free Radic Biol Med 2024; 211:12-23. [PMID: 38092272 DOI: 10.1016/j.freeradbiomed.2023.11.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/19/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The increase in blood pressure (BP) levels in the postmenopausal period can be partly explained by the decrease in nitric oxide synthases (NOS). OBJECTIVE To investigate the acute and one-week effects of beetroot juice nitrate-rich (BRJ-NO3-rich) ingestion on cardiovascular and autonomic performance in response to submaximal aerobic exercise in postmenopausal women with systemic arterial hypertension (SAH) who are physically inactive. METHODS Fourteen postmenopausal women with SAH [mean (SD) age: 59(4) y; BMI (kg/m2): 29.2(3.1)] completed submaximal aerobic exercise bouts after an acute and a one-week intervention with BRJ in a placebo-controlled, randomized, triple-blind, crossover design. Participants ingested either BRJ (800 mg of NO3-) or placebo acutely and drank either BRJ (400 mg of NO3-) or placebo every day for the next six days. After two and ½ hours, they performed a session of aerobic submaximal aerobic exercise, and their systolic BP (SBP) and diastolic BP (DBP), flow-mediated dilation (FMD), heart rate (HR) recovery, and HR variability were measured. RESULTS In the post-exercise recovery period, SBP dropped significantly in the BRJ-NO3-rich group (-9.28 mmHg [95%CI: -1.68 to -16.88] ES: -0.65, p = 0.019) compared to placebo after acute ingestion. The FMD values increased after acute BRJ-NO3-rich on post-exercise (3.18 % [0.36 to 5.99] ES: 0.87, p = 0.031). After the one-week intervention, FMD values were higher in the BRJ-NO3-rich group before (4.5 % [1.62 to 7.37] ES: 1.21, p = 0.005) and post-exercise measurements (4.2 % [1.52 to 6.87] ES: 1.22, p = 0.004) vs. placebo. HRV indices with remarkable parasympathetic modulation to heart recovered faster on the BRJ-NO3-rich group than placebo group. No between-group differences were identified in values of HR post-exercise recovery in the 30s, 60s, 120s, 180s, and 300s. CONCLUSIONS Acute and short-term BRJ-NO3-rich ingestion may enhance cardiovascular and autonomic behavior in response to aerobic exercise in postmenopausal women diagnosed with SAH. CLINICAL TRIAL REGISTRY NUMBER https://clinicaltrials.gov/ct2/show/NCT05384340.
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Affiliation(s)
- Cicero Jonas R Benjamim
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil.
| | - Leonardo Santos L da Silva
- School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil
| | - Yaritza B Alves Sousa
- Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, USP, Ribeirao Preto, Sao Paulo, Brazil
| | - Guilherme da Silva Rodrigues
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Macario Arosti Rebelo
- Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil
| | | | - Simone Sakagute Tavares
- School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil
| | - Carolina S Guimarães
- Ribeirao Preto Nursing School, University of São Paulo (EERP/USP), Ribeirão Preto, SP, Brazil
| | - Andressa C da Silva Sobrinho
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil
| | - Jose E Tanus-Santos
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, SP, Brazil
| | - Bruno Gualano
- Center of Lifestyle Medicine, Applied Physiology & Nutrition Research Group, University of São Paulo, Medical School (FMUSP), São Paulo, SP, Brazil
| | - Carlos R Bueno Júnior
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP/USP), Ribeirão Preto, São Paulo, Brazil; School of Physical Education of Ribeirão Preto, University of São Paulo (EEFERP/USP) Ribeirão Preto, Brazil; Ribeirao Preto Nursing School, University of São Paulo (EERP/USP), Ribeirão Preto, SP, Brazil
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Jockel-Schneider Y, Goßner SK, Stölzel P, Haubitz I, Carle R, Petersen N, Baulmann J, Schlagenhauf U. Impact of Dietary Nitrate on the Recovery of Therapy-related Vascular Health Impairments Following Standard Periodontal Aftercare Therapy: a Hypothesis-generating Subanalysis. PLANTA MEDICA 2023; 89:1045-1051. [PMID: 37315934 DOI: 10.1055/a-2110-1897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This follow-up study assessed the impact of a nitrate-rich diet on salivary nitrate/nitrite levels and the recovery of therapy-induced vascular impairments in a cohort of 39 periodontitis patients treated by standard subgingival mechanical plaque removal (PMPR). At baseline, saliva samples for nitrate/nitrite analysis were collected, and peripheral/central blood and augmentation pressure was documented using the Arteriograph recording system. Immediately after, PMPR vascular parameters were reassessed. All study patients received a randomly allocated supply of a lettuce beverage to be consumed for 14 days, containing either a daily dosage of 200 mg nitrate (test group, n = 20) or being void of nitrate (placebo group, n = 19). At day 14, salivary and vascular parameters were reassessed. Initial salivary and vascular parameters did not differ significantly between the groups. PMPR impaired all vascular parameters in both groups with no differences between the groups. At day 14, salivary nitrate/nitrite levels of the test group were significantly elevated compared to baseline. All vascular parameters had significantly recovered from the impairment inflicted by PMPR. In the placebo group, by contrast, salivary parameters did not differ significantly from baseline, and the recovery of impaired vascular parameters was restricted to a significant improvement of diastolic blood pressure. Correlation analysis identified a significant inverse correlation between salivary nitrate/nitrite sum and central/peripheral blood pressure and augmentation pressure. In conclusion, the data of this subanalysis suggest that increasing salivary nitrate/nitrite levels by a diet rich in nitrate may improve recovery of therapy-induced vascular impairments after PMPR.
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Affiliation(s)
| | - Sophia K Goßner
- Institute of Food Science and Biotechnology, Chair Plant Foodstuff Technology and Analysis, University of Hohenheim, Stuttgart, Germany
| | - Peggy Stölzel
- Department of Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Imme Haubitz
- Department of Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Reinhold Carle
- Institute of Food Science and Biotechnology, Chair Plant Foodstuff Technology and Analysis, University of Hohenheim, Stuttgart, Germany
- King Abdulaziz University, Faculty of Science, Biological Science Department, Jeddah, Saudi Arabia
| | - Nicole Petersen
- Department of Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Johannes Baulmann
- Private Practice for Cardiology and Internal Medicine, Bonn, Germany
| | - Ulrich Schlagenhauf
- Department of Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
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