Dietary Nitrate from Plant Foods: A Conditionally Essential Nutrient for Cardiovascular Health

Pinaffi-Langley, Ana Clara da C; Dajani, Rosa M; Prater, M Catherine; Nguyen, Hoang Van M; Vrancken, Kurt; Hays, Franklin A.; Hord, Norman G

doi:10.1016/j.advnut.2023.100158

Cited by 30Nutritional Studies and DietNitric Oxide and Endothelin EffectsCardiovascular Health and Disease Prevention

Dietary Nitrate from Plant Foods: A Conditionally Essential Nutrient for Cardiovascular Health

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Pinaffi-Langley, Ana Clara da C, Dajani, Rosa M, Prater, M Catherine, Nguyen, Hoang Van M, Vrancken, Kurt, Hays, Franklin A., Hord, Norman G·2024·Advances in Nutrition

DOI 10.1016/j.advnut.2023.100158PMC PMC10776916

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Abstract

Under specific conditions, such as catabolic stress or systemic inflammation, endogenous nutrient production becomes insufficient and exogenous supplementation (for example, through dietary intake) is required. Herein, we propose consideration of a dietary nitrate from plant foods as a conditionally essential nutrient for cardiovascular health based on its role in nitric oxide homeostasis. Nitrate derived from plant foods may function as a conditionally essential nutrient, whereas nitrate obtained from other dietary sources, such as drinking water and cured/processed meats, warrants separate consideration because of the associated health risks. We have surveyed the literature and summarized epidemiological evidence regarding the effect of dietary nitrate on cardiovascular disease and risk factors. Meta-analyses and population-based observational studies have consistently demonstrated an inverse association of dietary nitrate with blood pressure and cardiovascular disease outcomes. Considering the available evidence, we suggest 2 different approaches to providing dietary guidance on nitrate from plant-based dietary sources as a nutrient: the Dietary Reference Intakes developed by the National Academies of Sciences, Engineering, and Medicine, and the dietary guidelines evaluated by the Academy of Nutrition and Dietetics. Ultimately, this proposal underscores the need for food-based dietary guidelines to capture the complex and context-dependent relationships between nutrients, particularly dietary nitrate, and health.

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This distinction highlights the potential benefits of dietary nitrate from vegetables for cardiovascular health.
“This distinction highlights the potential benefits of dietary nitrate from vegetables for cardiovascular health [284].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [284]

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Self-citation
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Authors: Pinaffi-Langley, A. C. D. C., Dajani, R. M., Prater, M. C., Nguyen, H. V. M., Vrancken, K., Hays, F. A., & Hord, N. G.
Affiliations: University of California, San Francisco (US)
University of Georgia (US)
University of Oklahoma Health Sciences Center (US)
Oklahoma State University (US)
Corresponding author: Hord, Norman G
ORCID: Prater, M Catherine
Nguyen, Hoang Van M
Hays, Franklin A.
Hord, Norman G
Venue: Advances in Nutrition
Publisher: Elsevier BV
Published: 2024-01
Volume: 15
Issue: 1
Pages: 100158
ISSN: 2156-5376 (ISSN-L)
2161-8313
DOI: 10.1016/j.advnut.2023.100158
PMC: PMC10776916
OpenAlex: W4388980247
Cited by: 30
References: 151
Citations by year: 2026: 9 · 2025: 13 · 2024: 8
FWCI: 7.68
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Advances in Nutrition (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: Oregon State University
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords: dietary nitrate, plant-based foods, nitric oxide homeostasis, cardiovascular health, cardiovascular risk, blood pressure, Dietary Reference Intakes, dietary guidelines, food-based dietary guidelines, catabolic stress, systemic inflammation
MeSH terms: Blood Pressure, Cardiovascular Diseases, Diet, Humans, Nitrates, Nitrites, Risk Factors

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Dietary Nitrate from Plant Foods: A Conditionally Essential Nutrient for Cardiovascular Health

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