Dietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patients

Berry, Michael J.; Justus, Nicholas W.; Hauser, Jordan I.; Case, Ashlee H.; Helms, Christine C.; Basu, Swati; Rogers, Zachary; Lewis, Marc T.; Miller, Gary D.

doi:10.1016/j.niox.2014.10.007

Cited by 134Cardiovascular and exercise physiologyExercise and Physiological ResponsesNitric Oxide and Endothelin Effects

Dietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patients

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Berry, Michael J., Justus, Nicholas W., Hauser, Jordan I., Case, Ashlee H., Helms, Christine C., Basu, Swati, Rogers, Zachary, Lewis, Marc T. +1 more·2015·Nitric Oxide

DOI 10.1016/j.niox.2014.10.007PMC PMC4411191

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Abstract

Dietary nitrate (NO3(-)) supplementation via beetroot juice has been shown to increase the exercise capacity of younger and older adults. The purpose of this study was to investigate the effects of acute NO3(-) ingestion on the submaximal constant work rate exercise capacity of COPD patients. Fifteen patients were assigned in a randomized, single-blind, crossover design to receive one of two treatments (beetroot juice then placebo or placebo then beetroot juice). Submaximal constant work rate exercise time at 75% of the patient's maximal work capacity was the primary outcome. Secondary outcomes included plasma NO3(-) and nitrite (NO2(-)) levels, blood pressure, heart rate, oxygen consumption (VO2), dynamic hyperinflation, dyspnea and leg discomfort. Relative to placebo, beetroot ingestion increased plasma NO3(-) by 938% and NO2(-) by 379%. Median (+interquartile range) exercise time was significantly longer (p = 0.031) following the ingestion of beetroot versus placebo (375.0 + 257.0 vs. 346.2 + 148.0 s, respectively). Compared with placebo, beetroot ingestion significantly reduced iso-time (p = 0.001) and end exercise (p = 0.008) diastolic blood pressures by 6.4 and 5.6 mmHg, respectively. Resting systolic blood pressure was significantly reduced (p = 0.019) by 8.2 mmHg for the beetroot versus the placebo trial. No other variables were significantly different between the beetroot and placebo trials. These results indicate that acute dietary NO3(-) supplementation can elevate plasma NO3(-) and NO2(-) concentrations, improve exercise performance, and reduce blood pressure in COPD patients.

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Dietary nitrate has been shown to improve exercise tolerance in chronic obstructive pulmonary disease (COPD) patients.
“and in chronic obstructive pulmonary disease (COPD) patients (12).”
From Dietary Nitrate and Physical Performance (2018) · cites this paper as [12]
Over 14 studies have confirmed reduced VO2 and increased work capacity in response to nitrate during submaximal exercise in healthy individuals and in certain chronic diseases.
“an effect that over 14 studies have confirmed with reduced VO2 and increased work capacity in response to nitrate during submaximal exercise in healthy individuals[128,129] (reviewed in:[130,131]) and in certain chronic diseases[127,132].”
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 [132]
Recent human studies demonstrated that dietary nitrate (beetroot juice containing approximately 200-400 mg of nitrate) improved exercise performance and reduced blood pressure in COPD patients.
“Recent human studies have demonstrated that dietary nitrate (beetroot juice containing approximately 200–400 mg of nitrate) improved the exercise performance and reduced blood pressure in COPD patients [130,131].”
From NO-Rich Diet for Lifestyle-Related Diseases (2015) · cites this paper as [130]

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M144 Acute Dietary Nitrate Supplementation Reduces The Oxygen Cost Of Submaximal Exercise In Copd
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Dietary nitrate supplementation in COPD: An acute, double-blind, randomized, placebo-controlled, crossover trial
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Authors: Berry, M. J., Justus, N. W., Hauser, J. I., Case, A. H., Helms, C. C., Basu, S., Rogers, Z., Lewis, M. T., & Miller, G. D.
Affiliations: Wake Forest University (US)
Corresponding author: Berry, Michael J.
ORCID: Berry, Michael J.
Helms, Christine C.
Basu, Swati
Rogers, Zachary
Lewis, Marc T.
Miller, Gary D.
Venue: Nitric Oxide
Publisher: Elsevier BV
Published: 2015-08
Volume: 48
Pages: 22-30
ISSN: 1089-8603 (ISSN-L)
DOI: 10.1016/j.niox.2014.10.007
PMC: PMC4411191
OpenAlex: W2082804715
Cited by: 134
References: 58
Citations by year: 2026: 4 · 2025: 2 · 2024: 13 · 2023: 3 · 2022: 9 · 2021: 8 · 2020: 15 · 2019: 14 · 2018: 14 · 2017: 22 · 2016: 14 · 2015: 15 · 2014: 1
FWCI: 37.30
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Nitric Oxide (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Translational Science Center
National Institutes of Health Grant (NR011186)
Topics: Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
Keywords: dietary nitrate, beetroot juice, chronic obstructive pulmonary disease, exercise capacity, blood pressure, plasma nitrate, plasma nitrite, submaximal exercise, dyspnea, oxygen consumption, heart rate
MeSH terms: Aged, Beverages, Blood Pressure, Dyspnea, Female, Heart Rate, Humans, Male, Middle Aged, Nitrates, Nitrites, Oxygen, Exercise, Treatment Outcome, Dietary Supplements, Beta vulgaris, Pulmonary Disease, Chronic Obstructive

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Dietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patients

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