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Gao C, Gupta S, Adli T, Hou W, Coolsaet R, Hayes A, Kim K, Pandey A, Gordon J, Chahil G, Belley-Cote EP, Whitlock RP. The effects of dietary nitrate supplementation on endurance exercise performance and cardiorespiratory measures in healthy adults: a systematic review and meta-analysis. J Int Soc Sports Nutr 2021; 18:55. [PMID: 34243756 PMCID: PMC8268374 DOI: 10.1186/s12970-021-00450-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Nitrate supplementation is thought to improve performance in endurance sports. OBJECTIVE To meta-analyze studies evaluating the effect of nitrate supplementation on endurance sports performance among adults. DATA SOURCES We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Web of Science and CINAHL without language restrictions. METHODS We included studies that: 1) compared nitrate supplementation with placebo; 2) enrolled adults engaging in an endurance-based activity; and 3) reported a performance measure or surrogate physiologic outcome. We evaluated risk of bias using the Cochrane Collaboration tool and pooled data with a random-effects model. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate confidence in estimates. RESULTS We included 73 studies (n = 1061). Nitrate supplementation improved power output (MD 4.6 watts, P < 0.0001), time to exhaustion (MD 25.3 s, P < 0.00001), and distance travelled (MD 163.7 m, P = 0.03). We found no significant difference on perceived exertion, time trial performance and work done. Nitrate supplementation decreased VO2 (MD - 0.04 L/min, P < 0.00001) but had no significant effect on VO2max or blood lactate levels. CONCLUSION The available evidence suggests that dietary nitrate supplementation benefits performance-related outcomes for endurance sports.
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Affiliation(s)
- Chloe Gao
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Saurabh Gupta
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Taranah Adli
- Faculty of Biomedical Sciences, University of Western Ontario, London, Ontario, Canada
| | - Winston Hou
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Kevin Kim
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Arjun Pandey
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jacob Gordon
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Gurneet Chahil
- Population Health Research Institute, Hamilton, Ontario, Canada.,Saint James School of Medicine, Park Ridge, USA
| | - Emilie P Belley-Cote
- Population Health Research Institute, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Richard P Whitlock
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada. .,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada. .,Population Health Research Institute, Hamilton, Ontario, Canada. .,David Braley Cardiac, Vascular and Stroke Research Institute, 237 Barton St. E., Hamilton, Ontario, L8L 2X2, Canada.
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