The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease

Beijers, Rosanne J.H.C.G.; Huysmans, S.; Bool, Coby van de; Kingma, Boris; Verdijk, Lex B.; Loon, Luc J. C. van; Meex, Steven J.R.; Gosker, Harry R.; Schols, A.M.W.J.

doi:10.1016/j.clnu.2017.10.011

Cited by 26 publications

(27 citation statements)

References 52 publications

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“…However, exercise capacity, reflected by the onset of claudication pain and maximal walking time, was not improved (Figure 4). Others have found no improvement in exercise capacity after nitrate supplementation in patients with heart failure (Hirai et al, 2016), chronic obstructive pulmonary disease (Beijers et al, 2018), or Type 2 diabetes mellitus (Shepherd et al, 2015). These and our results contrast with other clinical studies showing an improvement in exercise performance in heart failure (Eggebeen et al, 2016;Zamani et al, 2015) and in patients with chronic obstructive pulmonary disease (Berry et al, 2015).…”

Section: Discussioncontrasting

confidence: 99%

Acute Effects of Dietary Nitrate on Exercise Tolerance, Muscle Oxygenation, and Cardiovascular Function in Patients With Peripheral Arterial Disease

Avoort

Loon

Verdijk

et al. 2021

International Journal of Sport Nutrition and Exercise Metabolism

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Previous studies have used supplements to increase dietary nitrate intake in clinical populations. Little is known about whether effects can also be induced through vegetable consumption. Therefore, the aim of this study was to assess the impact of dietary nitrate, through nitrate-rich vegetables (NRV) and beetroot juice (BRJ) supplementation, on plasma nitrate and nitrite concentrations, exercise tolerance, muscle oxygenation, and cardiovascular function in patients with peripheral arterial disease. In a randomized crossover design, 18 patients with peripheral arterial disease (age: 73 ± 8 years) followed a nitrate intake protocol (∼6.5 mmol) through the consumption of NRV, BRJ, and nitrate-depleted BRJ (placebo). Blood samples were taken, blood pressure and arterial stiffness were measured in fasted state and 150 min after intervention. Each intervention was followed by a maximal walking exercise test to determine claudication onset time and peak walking time. Gastrocnemius oxygenation was measured by near-infrared spectroscopy. Blood samples were taken and blood pressure was measured 10 min after exercise. Mean plasma nitrate and nitrite concentrations increased (nitrate; Time × Intervention interaction; p < .001), with the highest concentrations after BRJ (494 ± 110 μmol/L) compared with NRV (202 ± 89 μmol/L) and placebo (80 ± 19 μmol/L; p < .001). Mean claudication onset time and peak walking time did not differ between NRV (413 ± 187 s and 745 ± 220 s, respectively), BRJ (392 ± 154 s and 746 ± 176 s), and placebo (403 ± 176 s and 696 ± 222 s) (p = .762 and p = .165, respectively). Gastrocnemius oxygenation, blood pressure, and arterial stiffness were not affected by the intervention. NRV and BRJ intake markedly increase plasma nitrate and nitrite, but this does not translate to improved exercise tolerance, muscle oxygenation, and/or cardiovascular function.

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Section: Discussioncontrasting

confidence: 99%

Acute Effects of Dietary Nitrate on Exercise Tolerance, Muscle Oxygenation, and Cardiovascular Function in Patients With Peripheral Arterial Disease

Avoort

Loon

Verdijk

et al. 2021

International Journal of Sport Nutrition and Exercise Metabolism

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“…One study provided both acute effect and short-term data. 26 The total number of participants was 282, including 15 with pulmonary arterial hypertension 27 and 267 with COPD 16–19 26 28–32 with sample sizes ranging from 8 to 122. Age of participants (mean±SD) was 66±3 years, and the majority (57%) were men.…”

Section: Resultsmentioning

confidence: 99%

“…Ten trials used BRJ as the source of NO 3 - (n=10), and one used sodium NO 3 - (NaNO 3 - ). 26 The dose of NO 3 - used ranged from 6.45 mmol 28 to 16 mmol 27 . A full description of the included studies is presented in table 1 .…”

Section: Resultsmentioning

confidence: 99%

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Impact of dietary nitrate supplementation on exercise capacity and cardiovascular parameters in chronic respiratory disease: a systematic review and meta-analysis

et al. 2021

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BackgroundDietary nitrate supplementation, usually in the form of beetroot juice, may improve exercise performance and endothelial function. We undertook a systematic review and meta-analysis to establish whether this approach has beneficial effects in people with respiratory disease.MethodsA systematic search of records up to March 2021 was performed on PubMed, CINAHL, MEDLINE (Ovid), Cochrane and Embase to retrieve clinical trials that evaluated the efficacy of dietary nitrate supplementation on cardiovascular parameters and exercise capacity in chronic respiratory conditions. Two authors independently screened titles, abstracts and full texts of potential studies and performed the data extraction.ResultsAfter full-text review of 67 papers, eleven (two randomised controlled trials and nine crossover trials) involving 282 participants met the inclusion criteria. Three were single dose; seven short term; and one, the largest (n=122), done in the context of pulmonary rehabilitation. Pooled analysis showed that dietary nitrate supplementation reduced systolic blood pressure (BP), diastolic BP and mean arterial pressure (mean difference (95% CI), −3.39 mm Hg (−6.79 to 0.01); p=0.05 and –2.20 mm Hg (−4.36 to −0.03); p=0.05 and −4.40 mm Hg (−7.49 to −1.30); p=0.005, respectively). It was associated with increased walk distance in the context of pulmonary rehabilitation (standardised mean difference (95% CI), 0.47 (0.11 to 0.83), p=0.01), but no effect was identified in short-term studies (0.08 (−0.32 to 0.49).ConclusionDietary nitrate supplementation may have a beneficial effect on BP and augment the effect of pulmonary rehabilitation on exercise capacity. Short-term studies do not suggest a consistent benefit on exercise capacity.PROSPERO registration numberCRD42019130123.

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“…The DE observed in patients with COVID‐19 (19.9%) were slightly lower (no significant) than those obtained in patients with COPD and IHD (~23%), and significantly lower compared to the control group (~27%). Other studies have reported mean DE values of ~25–26% in patients with COPD and with heart failure with reduced ejection fraction during submaximal cycling 23,24 . Perrault et al .…”

Section: Discussionmentioning

confidence: 97%

Severe loss of mechanical efficiency in COVID‐19 patients

Pleguezuelos

Carmen

Llorensi

et al. 2021

J cachexia sarcopenia muscle

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Background There is limited information about the impact of coronavirus disease (COVID‐19) on the muscular dysfunction, despite the generalized weakness and fatigue that patients report after overcoming the acute phase of the infection. This study aimed to detect impaired muscle efficiency by evaluating delta efficiency (DE) in patients with COVID‐19 compared with subjects with chronic obstructive pulmonary disease (COPD), ischaemic heart disease (IHD), and control group (CG). Methods A total of 60 participants were assigned to four experimental groups: COVID‐19, COPD, IHD, and CG ( n = 15 each group). Incremental exercise tests in a cycle ergometer were performed to obtain peak oxygen uptake (VO 2 peak). DE was obtained from the end of the first workload to the power output where the respiratory exchange ratio was 1. Results A lower DE was detected in patients with COVID‐19 and COPD compared with those in CG ( P ≤ 0.033). However, no significant differences were observed among the experimental groups with diseases ( P > 0.05). Lower VO 2 peak, peak ventilation, peak power output, and total exercise time were observed in the groups with diseases than in the CG ( P < 0.05). A higher VO 2 , ventilation, and power output were detected in the CG compared with those in the groups with diseases at the first and second ventilatory threshold ( P < 0.05). A higher power output was detected in the IHD group compared with those in the COVID‐19 and COPD groups ( P < 0.05) at the first and second ventilatory thresholds and when the respiratory exchange ratio was 1. A significant correlation ( P < 0.001) was found between the VO 2 peak and DE and between the peak power output and DE ( P < 0.001). Conclusions Patients with COVID‐19 showed marked mechanical inefficiency similar to that observed in COPD and IHD patients. Patients with COVID‐19 and COPD showed a significant decrease in power output compared to IHD during pedalling despite having similar response in VO 2 at each intensity. Resistance training should be considered during the early phase of rehabilitation.

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The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease

Abstract: Acute as well as 7-days sodium nitrate supplementation does not modulate mechanical efficiency, blood pressure or cardiac biomarkers in mild-to-moderate COPD patients.

Cited by 26 publications

References 52 publications

Acute Effects of Dietary Nitrate on Exercise Tolerance, Muscle Oxygenation, and Cardiovascular Function in Patients With Peripheral Arterial Disease

Acute Effects of Dietary Nitrate on Exercise Tolerance, Muscle Oxygenation, and Cardiovascular Function in Patients With Peripheral Arterial Disease

Impact of dietary nitrate supplementation on exercise capacity and cardiovascular parameters in chronic respiratory disease: a systematic review and meta-analysis

Severe loss of mechanical efficiency in COVID‐19 patients

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