Nitric oxide, aging and aerobic exercise: Sedentary individuals to Master's athletes
Open accessAbstract
Aging is associated with a decline in physiological function and exercise performance. These effects are mediated, at least in part, by an age-related decrease in the bioavailability of nitric oxide (NO), a ubiquitous gasotransmitter and regulator of myriad physiological processes. The decrease in NO bioavailability with aging is especially apparent in sedentary individuals, whereas older, physically active individuals maintain higher levels of NO with advancing age. Strategies which enhance NO bioavailability (including nutritional supplementation) have been proposed as a potential means of reducing the age-related decrease in physiological function and enhancing exercise performance and may be of interest to a range of older individuals including those taking part in competitive sport. In this brief review we discuss the effects of aging on physiological function and endurance exercise performance, and the potential role of changes in NO bioavailability in these processes. We also provide a summary of current evidence for dietary supplementation with substrates for NO production - including inorganic nitrate and nitrite, l-arginine and l-citrulline - for improving exercise capacity/performance in older adults. Additionally, we discuss the (limited) evidence on the effects of (poly)phenols and other dietary antioxidants on NO bioavailability in older individuals. Finally, we provide suggestions for future research.
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Older individuals may exhibit greater responsiveness to dietary nitrate interventions despite having lower baseline NO levels.
“Consequently, older individuals may exhibit greater responsiveness to dietary nitrate interventions despite having lower baseline NO levels [59].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [59]
Dietary nitrate increases NO bioavailability via the nitrate-nitrite-NO pathway, particularly in conditions of hypoxia or high metabolic demand characteristic of ageing muscle.
“Dietary nitrate, which is found in high concentrations in vegetables such as beetroot, increases NO bioavailability via the nitrate-nitrite-NO pathway, particularly in conditions of hypoxia or high metabolic demand, which are characteristic of ageing muscle [41,59,185,186].”
From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [59]
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- Authors
- Shannon, O. M., Clifford, T., Seals, D. R., Craighead, D. H., & Rossman, M. J.
- Affiliations
- Newcastle University (GB)
- Loughborough University (GB)
- University of Colorado Boulder (US)
- Corresponding author
- Shannon, Oliver M.
- Venue
- Nitric Oxide
- Publisher
- Elsevier BV
- Published
- 2022-08
- Volume
- 125-126
- Pages
- 31-39
- ISSN
- 1089-8603 (ISSN-L)
- OpenAlex
- W4282560001
- Cited by
- 51
- References
- 144
- Citations by year
- 2026: 5 · 2025: 19 · 2024: 12 · 2023: 14 · 2022: 1
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nitric Oxide (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Loughborough University Research Repository (Loughborough University) (submittedVersion, cc-by)
- Newcastle University ePrints (Newcastle Univesity) (cc-by)
- Funders
- National Institute for Health and Care Research (MR/T001852/1)
- National Institutes of Health
- Directorate for Biological Sciences
- Medical Research Council (MR/T001852/1)
- Biotechnology and Biological Sciences Research Council
- National Institute on Aging (R01AG013038)
- National Heart, Lung, and Blood Institute (K01HL153326)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK115524)
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- nitric oxide bioavailability, aging, aerobic exercise, endurance exercise performance, sedentary older adults, older athletes, inorganic nitrate, nitrite, L-arginine, citrulline, dietary supplementation, polyphenols, dietary antioxidants
- MeSH terms
- Aged, Aging, Citrulline, Humans, Nitrates, Nitric Oxide, Exercise, Dietary Supplements, Athletes
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