Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study

Bondonno, Catherine P.; Dalgaard, Frederik; Blekkenhorst, Lauren C.; Murray, Kevin; Lewis, Joshua R.; Croft, Kevin D.; Kyrø, Cecilie; Torp‐Pedersen, Christian; Gislason, Gunnar; Tjønneland, Anne; Overvad, Kim; Bondonno, Nicola P.; Hodgson, Jonathan M.

doi:10.1007/s10654-021-00747-3

Cited by 42 publications

(40 citation statements)

References 44 publications

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“…Now it is believed that nitrate may also have a positive effect. Bondonno et al [19] conducted clinical trials and found that a moderate vegetable nitrate intake was associated with 12-26% lower risk of hospitalisations due to ischaemic heart disease, heart failure, ischaemic stroke and peripheral artery disease. According to these authors, the daily consumption of at least 60 mg of vegetable nitrate may mitigate the risk of cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

The Effect of NaCl Stress on the Response of Lettuce (Lactuca sativa L.)

et al. 2022

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In recent decades, increasing human pressure has caused the gradual deterioration of the physical and chemical properties of water and soil. Salinity is an important factor influencing the quality of water. The aim of this comprehensive research was to determine the effect of increasing concentrations of sodium chloride, which is a salinity inducer, on the yield, photosynthesis efficiency (expressed with chlorophyll fluorescence measurement) and content of selected nutrients in the leaves of hydroponically grown lettuce (Lactuca sativa L.). Experiments were conducted at the following concentrations of NaCl: 0 (control treatment), 10, 20, 40, and 60 mmol L−1. Studies were conducted in two independent seasons: spring and autumn. The plants exposed to NaCl stress modified their chemical composition by lowering the uptake of (for 60 mmol L−1 NaCl in relation to control): N (−11%), K (−35.7%), and Mg (−24.5%), while increasing the sodium content (+2400%). The Na:K ratio was significantly narrowed (from 76:1 to 2.6:1). The increase in the Cl level in the lettuce leaves may also have caused a decrease in the content of nitrates. As a result of disturbed ionic balance, the RWC was significantly reduced (−6.2%). As a result of these changes, the yield of the biomass of the aerial parts decreased (more than two-fold for the highest NaCl concentration in relation to control) whereas the dry matter content increased (+32%). The measurement of fluorescence showed significant changes at the PSII level. Salinity modified the energy flow rate (F0, FM, FV, FV/FM) as well as the specific energy flows through the reaction centre (ABS/RC, TR0/RC, ET0/RC, DI0/RC). The PSII functioning index, calculated on the basis of energy absorption (PIAbs), also changed. The salinity induced with NaCl significantly worsened the physiological reactions of the plants in the PSII, changed the ionic balance, which resulted in a significantly lower yield of the plants. Due to increasing water quality problems, it will be necessary to use, in agriculture on a much larger scale than before, saline water treatment systems (e.g., highly effective nanofiltration and/or reverse osmosis).

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Section: Introductionmentioning

confidence: 99%

The Effect of NaCl Stress on the Response of Lettuce (Lactuca sativa L.)

et al. 2022

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“…Despite known beneficial associations of cardiovascular health with long-term intake of leafy vegetables (the primary contributor to dietary NO 3 − intake, although confounded with intake of phenolic compounds) [ 8 ], experimental studies of this relationship have tended to be short-term, less than 70 days [ 1 ]. However, whilst useful for elucidation and/or confirmation of mechanisms, short-term studies cannot predict long-term effects, and studies using enriched supplements cannot predict effects of actual foods [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…The scarcity of data comparing physiologically relevant intakes of phenolics with NO 3 − , may reflect the practical difficulties of this research. Intakes of NO 3 − and phenolics are difficult to distinguish in observational studies, because vegetables are major sources of both these compound types [ 8 ]; and in contrast to NO 3 − , many phenolic compounds are costly to isolate and difficult to study as pure compounds without substantially changing their bioavailability and probably other properties [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Double-blind controlled dietary cross-over intervention with differentially fertilised intact lettuce leaves shows acute reduction in blood pressure in young adults, associated with faster uptake of nitrate than of phenolics

et al. 2022

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Purpose To compare acute effects on blood pressure (BP) of ingestion of visually similar lettuce with controlled high and low content of either nitrate or phenolic compounds. Methods In a randomised cross-over design, 19 healthy participants (22–31 years) received 50 g of lettuce containing either 530 mg (8.4 mmol) nitrate + 11 mg (0.03 mmol) phenolic compounds (HNLP); or 3 mg nitrate (0.05 mmol) + 77 mg (0.2 mmol) phenolic compounds (LNHP), obtained by differential fertilisation. Ambulatory BP was recorded along with plasma, salivary and urinary nitrate and nitrite and plasma concentrations of cyclic guanosine monophosphate (cGMP), phenolic metabolites, Trolox equivalent antioxidant capacity (TEAC) and ferric reducing antioxidant power (FRAP). Results Compared with LNHP, 3 h post ingestion of HNLP, plasma nitrate increased 0.31 ± (95%CI) 0.12 mM (+ 240%), and salivary nitrate 5.5 ± 1.4 mM (+ 910%); accumulated urinary nitrate excretion increased 188 ± 72 mg (+ 296%) (all P < 0.001). Systolic BP was reduced 4.9 ± 4.2 mmHg (P = 0.031) between 3 and 6 h after ingestion of HNLP compared with LNHP; systolic BP differences were negatively correlated (P = 0.004) with differences in saliva nitrate concentrations. LNHP increased plasma phenolics at 6 h, predominantly 3ʹ-methoxycinnamic acid-4ʹ-glucuronide (ferulic acid-4ʹ-glucuronide), 116%, 204 ± 138 nM more than HNLP (P = 0.001); increased cGMP 14% (P = 0.019); and reduced FRAP 3.1% (P = 0.009). Conclusion The acute BP difference within 6 h of consumption matched the plasma/saliva nitrate peak, not the slower changes of plasma phenolics. This is the first double-blind controlled dietary intervention demonstrating differential effects on human physiology by consumption of an intact plant food, where compositional differences were obtained by controlling growing conditions, indicating potential opportunities for health claims relating to precision/vertical farming. Clinical trial registration The trial was retrospectively registered on ClinicalTrials.gov, with identifier NCT02701959, on March 8, 2016.

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“…128 Most recently, the Danish Diet, Cancer and Health (DDCH) study with 23 years of follow-up reported that moderate vegetable nitrate intake (∼60 mg day −1 = 1 cup of green leafy vegetables) was linked with 12%, 15%, 17% and 26% lower risk of ischemic heart disease, heart failure, ischemic stroke, and peripheral artery disease hospitalizations, respectively. 129 The disparate results of the American Nurses’ Health cohort study compared to the other three Australian cohort studies and the Danish cohort study could potentially be explained by the nitrate databases used to quantify intakes. Specifically, the nitrate database used by the American Nurses’ Health cohort study was less comprehensive 128 than the newer version utilised by the other four studies.…”

Section: Nitrate and Cardiovascular Diseasementioning

confidence: 99%