Moderate doses of dietary nitrate elicit greater effects on blood pressure and endothelial function than a high dose: A 13-week pilot study

Babateen, Abrar; Shannon, Oliver M.; O’Brien, Gerard; Olgacer, Dilara; Koehl, Christina; Fostier, William; Mathers, John C.; Siervo, Mario

doi:10.1016/j.numecd.2023.02.024

Cited by 7 publications

(2 citation statements)

References 14 publications

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“…Additional longer-term RCTs are warranted to confirm this notion. However, interestingly, one recent study suggested that moderate doses of nitrate over a 13-week intervention may have more pronounced effects on BP than higher doses [34] (contrasting the more linear dose-response highlighted in acute studies, e.g., [35]).…”

Section: Discussionmentioning

confidence: 96%

Associations between Vegetable Nitrate Intake and Cardiovascular Disease Risk and Mortality: A Systematic Review

Tan,

Stagg,

Hanlon

et al. 2024

Nutrients

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Consumption of nitrate-rich vegetables increases nitric oxide bioavailability, lowers blood pressure, and improves endothelial function. These effects could also translate into reduced cardiovascular disease (CVD) risk and mortality. This systematic review aimed to investigate the associations between habitual vegetable nitrate intake and CVD incidence and mortality. A secondary aim was to identify factors that moderate the relationship between vegetable nitrate intake and CVD incidence/mortality. Seven databases (PubMed, MEDLINE, Embase, Scopus, Web of Science, CINAHL, and APA PsycINFO) were searched from inception to 13 February 2023. Observational studies quantifying vegetable nitrate intake in participants aged 18+ years through self-reported dietary exposure and assessing incidence or mortality from CVD overall, or individual CVD subtypes, were eligible. Five studies including a total of 63,155 participants were included. There was an inverse association between vegetable nitrate intake and most reported CVD outcomes. Reported risk reductions tended to plateau at moderate intake, suggesting a possible ceiling effect. The risk of bias across all studies was low. The results of this systematic review suggest a potential role for vegetable nitrate in reducing CVD risk and mortality. Further randomised controlled trials are now required to corroborate these findings.

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Section: Discussionmentioning

confidence: 96%

Associations between Vegetable Nitrate Intake and Cardiovascular Disease Risk and Mortality: A Systematic Review

Tan,

Stagg,

Hanlon

et al. 2024

Nutrients

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“…In contrast to this early body of evidence, which tended to focus on nitrate as a potentially harmful dietary compound, research emerging in recent years suggests that increasing dietary nitrate intake (and thus enhancing NO bioavailability) can improve markers of cardiovascular and cognitive function. For example, dietary nitrate supplementation has been shown to reduce blood pressure (BP) by between ~2 and 10 mmHg [16][17][18][19][20], and could represent a potential adjunct to traditional antihypertensive medications. In addition, dietary nitrate supplementation has been shown to improve endothelial function [17,21], decrease platelet aggregation [17,19], and, albeit less reliably, enhance cerebral blood flow and cognitive function [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Advantages and Disadvantages of a Whole Foods Approach for Elevating Dietary Nitrate Intake: Have Researchers Concentrated Too Much on Beetroot Juice?

Griffiths,

Alhulaefi,

Hayes

et al. 2023

Applied Sciences

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In recent years, a number of studies have explored the potential salutary effects of dietary nitrate, with promising findings emerging. Indeed, numerous investigations have now demonstrated that increasing intake of dietary nitrate can reduce blood pressure, improve endothelial function, decrease platelet aggregation, increase cognitive function and brain perfusion, and enhance exercise performance. Most researchers have explored the health and/or performance effects of dietary nitrate by providing participants with concentrated beetroot juice, which is rich in this compound. Another strategy for increasing/optimising dietary nitrate intake, which could be embraced alongside or instead of nitrate-rich supplements in research and non-research settings, is the consumption of whole nitrate-rich vegetables. In this review, we explore the potential advantages and disadvantages of increasing consumption of various whole nitrate-rich vegetables to augment dietary nitrate intake. We compare the cost, convenience, availability, feasibility/acceptability, and efficacy of consumption of nitrate via whole nitrate-rich vegetables against concentrated beetroot juice ‘shots’ as defined supplements. We also discuss possible strategies that could be used to help individuals maximise their intake of nitrate via whole vegetables, and outline potential avenues for future research.

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Higher plant-derived nitrate intake is associated with lower odds of frailty in a cross-sectional study of community-dwelling older women

Hayes,

Dent,

Shannon

et al. 2024

Eur J Nutr

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Purpose Dietary nitrate intake is inversely related to numerous contributors towards frailty, including cardiovascular disease and poor physical function. Whether these findings extend to frailty remain unknown. We investigated if habitual nitrate intake, derived from plants or animal-based foods, was cross-sectionally associated with frailty in women. Methods Community-dwelling older Australian women (n = 1390, mean age 75.1 ± 2.7 years) completed a validated semi-quantitative food frequency questionnaire (FFQ). Nitrate concentrations in food were obtained from international nitrate databases. We adopted the Rockwood frailty index (FI) of cumulative deficits comprising 33 variables across multiple health domains (scored 0 to 1), which predicts increased hospitalisation and mortality risk. A FI ≥ 0.25 indicated frailty. Cross-sectional associations between nitrate intake (total plant and animal nitrate, separately) and frailty were analysed using multivariable-adjusted logistic regression models (including lifestyle factors), as part of restricted cubic splines. Results A non-linear inverse relationship was observed between total plant nitrate intake and frailty. Compared to women with the lowest plant nitrate intake (Quartile [Q]1), women with greater intakes in Q2 (OR 0.69 95%CI 0.56–0.84), Q3 (OR 0.67 95%CI 0.50–0.90) and Q4 (OR 0.66 95%CI 0.45–0.98) had lower odds for frailty. A nadir in the inverse association was observed once intakes reached ~ 64 mg/d (median Q2). No relationship was observed between total animal nitrate and frailty. Conclusion Community-dwelling older women consuming low amounts of plant-derived nitrate were more likely to present with frailty. Consuming at least one daily serving (~ 75 g) of nitrate-rich green leafy vegetables may be beneficial in preventing frailty.

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Moderate doses of dietary nitrate elicit greater effects on blood pressure and endothelial function than a high dose: A 13-week pilot study

Cited by 7 publications

References 14 publications

Associations between Vegetable Nitrate Intake and Cardiovascular Disease Risk and Mortality: A Systematic Review

Associations between Vegetable Nitrate Intake and Cardiovascular Disease Risk and Mortality: A Systematic Review

Exploring the Advantages and Disadvantages of a Whole Foods Approach for Elevating Dietary Nitrate Intake: Have Researchers Concentrated Too Much on Beetroot Juice?

Higher plant-derived nitrate intake is associated with lower odds of frailty in a cross-sectional study of community-dwelling older women

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