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Effects of inorganic nitrate and beetroot supplementation on endothelial function: a systematic review and meta-analysis
Open accessAbstract
Background Diets rich in inorganic nitrate are associated with lower blood pressure, an effect that may be mediated by an improvement of endothelial function (EF). Therefore, a systematic review and meta-analysis of randomised controlled trials (RCTs) were conducted to examine the effects of inorganic nitrate and beetroot supplementation on measures of EF.Methods MEDLINE, EMBASE and Scopus databases were searched from inception until November 2014. Specific inclusion criteria were as follows: (1) RCTs; (2) trials comparing inorganic nitrate or beetroot supplementation with placebo control groups; and (3) trials reporting effects of these interventions on outcomes of vascular function. Random-effect models were used to assess the pooled effect sizes showed as standardised mean differences (SMD).Results Nine crossover trials and three parallel trials met our inclusion criteria. The trials were conducted between 2008 and 2014 and included a total of 246 participants with 10-64 participants per study. The duration of each intervention ranged from 1.5 h to 28 days. Inorganic nitrate and beetroot consumption was associated with an improvement in vascular function (SMD 0.36; 95 % CI 0.16, 0.56; P < 0.001). The effect on EF was significantly associated with the dose of inorganic nitrate (β = 0.04, SE = 0.01, P < 0.001), age (β = -0.01, SE = 0.004, P = 0.02), baseline BMI (β = -0.04, SE = 0.02, P = 0.05) and systolic BP (β = -0.01, SE = 0.005, P = 0.02).Conclusions Inorganic nitrate and beetroot supplementation was associated with beneficial effects on EF. These effects appear to be reduced in older subjects and in subjects with greater cardiometabolic risk.
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“Oral supplementation with either nitrite or nitrate increases circulating nitrite levels and prevents and reverses endothelial dysfunction in a dose-dependent manner both in mice[68,69] and in healthy[70,71,97,111,112], hypertensive[113], and obese individuals[114], or in those with hypercholesterolemia[115] and peripheral arterial disease[116].”
From Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health (2017) · cites this paper as [71]
In the citing paper
“oral administration of nitrate and nitrite provides dose-dependent improvement in endothelial dysfunction, inflammation and vascular function[71]”
From Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health (2017) · cites this paper as [71]
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Metadata
- Authors
- Lara, J., Ashor, A. W., Oggioni, C., Ahluwalia, A., Mathers, J. C., & Siervo, M.
- Affiliations
- Mustansiriyah University (IQ)
- Newcastle University (GB)
- Queen Mary University of London (GB)
- Venue
- European Journal of Nutrition
- Published
- 2015-03-13
- Volume
- 55
- Issue
- 2
- Pages
- 451-459
- ISSN
- 1436-6207 (ISSN-L)
- 1436-6215
- OpenAlex
- W1996941873
- Semantic Scholar
- b395b7a8059c33596526d1da56b264a3564c0ede
- Cited by
- 163
- References
- 49
- Citations by year
- 2026: 16 · 2025: 11 · 2024: 13 · 2023: 13 · 2022: 16 · 2021: 14 · 2020: 17 · 2019: 17 · 2018: 17 · 2017: 14 · 2016: 9 · 2015: 6
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Medical Research Council (MR/N007921/1, MR/K006312/1)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Keywords
- inorganic nitrate, endothelial function, vascular function, dietary nitrate, blood pressure, dose-response relationship, age effects, body mass index, cardiometabolic risk
- MeSH terms
- Blood Pressure, Cardiovascular Diseases, Endothelium, Humans, Nitrates, Risk Factors, Body Mass Index, Randomized Controlled Trials as Topic, Treatment Outcome, Plant Roots, Dietary Supplements, Metabolic Syndrome, Beta vulgaris
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