Acute effect of a high nitrate diet on brain perfusion in older adults
Open accessAbstract
Aims Poor blood flow and hypoxia/ischemia contribute to many disease states and may also be a factor in the decline of physical and cognitive function in aging. Nitrite has been discovered to be a vasodilator that is preferentially harnessed in hypoxia. Thus, both infused and inhaled nitrite are being studied as therapeutic agents for a variety of diseases. In addition, nitrite derived from nitrate in the diet has been shown to decrease blood pressure and improve exercise performance. Thus, dietary nitrate may also be important when increased blood flow in hypoxic or ischemic areas is indicated. These conditions could include age-associated dementia and cognitive decline. The goal of this study was to determine if dietary nitrate would increase cerebral blood flow in older adults.Methods and results In this investigation we administered a high vs. low nitrate diet to older adults (74.7±6.9 years) and measured cerebral perfusion using arterial spin labeling magnetic resonance imaging. We found that the high nitrate diet did not alter global cerebral perfusion, but did lead to increased regional cerebral perfusion in frontal lobe white matter, especially between the dorsolateral prefrontal cortex and anterior cingulate cortex.Conclusion These results suggest that dietary nitrate may be useful in improving regional brain perfusion in older adults in critical brain areas known to be involved in executive functioning.
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Enhancing the nitrate-nitrite-NO pathway through dietary nitrate intake may help restore neurovascular function and support brain perfusion.
“Enhancing the nitrate-nitrite-NO pathway through dietary nitrate intake may therefore help to restore neurovascular function and support brain perfusion [170,171].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [170]
The Discussion reports that oral nitrate increased plasma nitrite and cerebral blood flow in the white matter of older adults, and describes nitrite-to-NO conversion as a proposed vasodilatory mechanism. The paper supports a possible benefit for brain perfusion, but it does not establish that dietary nitrate restores neurovascular function more broadly. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn older adults, acute nitrate intake increased blood flow in periventricular white matter, as observed using arterial spin labelling MRI.
“Using arterial spin labelling MRI, increased blood flow in periventricular white matter was observed in older adults following acute nitrate intake”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [170]
The Abstract (Methods and Results) reports increased regional perfusion in frontal-lobe white matter in older adults after a high-nitrate diet, measured with arterial spin labeling MRI. The Results specify subcortical and deep frontal-lobe white matter, but do not identify the increased-flow regions as periventricular. No page numbers are available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredNitrate supplementation enhances perfusion in white matter regions susceptible to age-related hypoxia.
“nitrate supplementation has been demonstrated to enhance perfusion in white matter regions susceptible to age-related hypoxia.”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [170]
Nitrate supplementation increases cerebral blood flow, particularly in frontal brain regions associated with executive function.
“Nitrate supplementation has been shown to increase cerebral blood flow, particularly in frontal brain regions associated with executive function [169,170].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [170]
Recent evidence suggests that dietary nitrate may also be important in the health of the aging brain.
“and recent evidence suggests that dietary NO 3 -may also be important in the health of the aging brain (122).”
From Dietary Nitrate and Physical Performance (2018) · cites this paper as [122]
Some studies have indicated that nitric oxide donors and nitrate supplementation may enhance cerebral perfusion, particularly to areas responsible for executive functioning, and enhance coupling of cerebral blood flow to neuronal activity.
“Some studies have indicated that NO donors and NO 3 -supplementation may enhance cerebral perfusion (52, 122), particularly to areas responsible for executive functioning (122), and enhance coupling of cerebral blood flow to neuronal activity (1, 119).”
From Dietary Nitrate and Physical Performance (2018) · cites this paper as [122]
Acute nitrate intake in older adults was accompanied by improvements in attention and processing speed.
“accompanied by improvements in attention and processing speed [170].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [170]
The Conclusions report increased frontal-lobe white-matter perfusion after a high-nitrate diet in older adults, not improvements in attention or processing speed. The Discussion proposes possible cognitive benefits, but the passages found when searching for attention, processing speed, and cognitive testing do not report either claimed improvement. (LLM, conf=0.76)
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“Nitrate supplementation has been shown to increase cerebral blood flow, particularly in frontal brain regions associated with executive function [169,170].”
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- Authors
- Presley, T. D., Morgan, A. R., Bechtold, E., Clodfelter, W., Dove, R. W., Jennings, J. M., Kraft, R. A., Bruce King, S., Laurienti, P. J., Jack Rejeski, W., Burdette, J. H., Kim-Shapiro, D. B., & Miller, G. D.
- Affiliations
- Wake Forest University (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Burdette, Jonathan H.
- Miller, Gary D.
- ORCID
- Venue
- Nitric Oxide
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 24
- Issue
- 1
- Pages
- 34-42
- ISSN
- 1089-8603 (ISSN-L)
- PMC
- PMC3018552
- OpenAlex
- W2164981686
- Cited by
- 238
- References
- 64
- Citations by year
- 2026: 15 · 2025: 13 · 2024: 11 · 2023: 16 · 2022: 20 · 2021: 22 · 2020: 21 · 2019: 17 · 2018: 19 · 2017: 15 · 2016: 11 · 2015: 23 · 2014: 9 · 2013: 6 · 2012: 11
- FWCI
- 5.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nitric Oxide (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Wake Forest University
- Translational Science Center, Wake Forest University
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- dietary nitrate, cerebral blood flow, regional cerebral blood flow, older adults, arterial spin labeling, frontal lobe white matter, dorsolateral prefrontal cortex, anterior cingulate cortex, executive function, aging, cognitive decline
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Brain, Humans, Magnetic Resonance Imaging, Nitrates, Nitrites, Regional Blood Flow, Dietary Supplements
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