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Cited by 56Exercise and Physiological ResponsesCardiovascular and exercise physiologyMuscle metabolism and nutrition

Effect of food sources of nitrate, polyphenols, L-arginine and L-citrulline on endurance exercise performance: a systematic review and meta-analysis of randomised controlled trials

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d’Unienville, Noah M. A., Blake, Henry T., Coates, Alison M., Hill, Alison M., Nelson, Maximillian J., Buckley, Jonathan D.·2021·Journal of the International Society of Sports Nutrition
DOI 10.1186/s12970-021-00472-yPMC PMC8715640
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Abstract

Background: Increasing nitric oxide bioavailability may induce physiological effects that enhance endurance exercise performance. This review sought to evaluate the performance effects of consuming foods containing compounds that may promote nitric oxide bioavailability. Methods: Scopus, Web of Science, Ovid Medline, EMBASE and SportDiscus were searched, with included studies assessing endurance performance following consumption of foods containing nitrate, L-arginine, L-citrulline or polyphenols. Random effects meta-analysis was conducted, with subgroup analyses performed based on food sources, sex, fitness, performance test type and supplementation protocol (e.g. duration). Results: One hundred and eighteen studies were included in the meta-analysis, which encompassed 59 polyphenol studies, 56 nitrate studies and three L-citrulline studies. No effect on exercise performance following consumption of foods rich in L-citrulline was identified (SMD=-0.03, p=0.24). Trivial but significant benefits were demonstrated for consumption of nitrate and polyphenol-rich foods (SMD=0.15 and 0.17, respectively, p <0.001), including performance in time-trial, time-to-exhaustion and intermittent-type tests, and following both acute and multiple-day supplementation, but no effect of nitrate or polyphenol consumption was found in females. Among nitrate-rich foods, beneficial effects were seen for beetroot, but not red spinach or Swiss chard and rhubarb. For polyphenol-rich foods, benefits were found for grape, (nitrate-depleted) beetroot, French maritime pine, Montmorency cherry and pomegranate, while no significant effects were evident for New Zealand blackcurrant, cocoa, ginseng, green tea or raisins. Considerable heterogeneity between polyphenol studies may reflect food-specific effects or differences in study designs and subject characteristics. Well-trained males (V̇O 2max ≥65 ml.kg.min -1 ) exhibited small, significant benefits following polyphenol, but not nitrate consumption. Conclusion: Foods rich in polyphenols and nitrate provide trivial benefits for endurance exercise performance, although these effects may be food dependent. Highly trained endurance athletes do not appear to benefit from consuming nitrate-rich foods but may benefit from polyphenol consumption. Further research into food sources, dosage and supplementation duration to optimise the ergogenic response to polyphenol consumption is warranted. Further studies should evaluate whether differential sex-based responses to nitrate and polyphenol consumption are attributable to physiological differences or sample size limitations. Other: The review protocol was registered on the Open Science Framework ( https://osf.io/u7nsj ) and no funding was provided.

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  • Dietary nitrate is sequentially reduced to nitrite and then to NO; this enhances oxygen delivery, reduces the oxygen cost of submaximal exercise, and improves endurance performance, likely due to improved mitochondrial efficiency and muscle perfusion.

    “Dietary nitrate is sequentially reduced to nitrite and then to NO. This enhances oxygen delivery, reduces the oxygen cost of submaximal exercise, and improves endurance performance. This is likely due to improved mitochondrial efficiency and muscle perfusion [41,42,43,44].”

    From Dietary Nitrate-Rich Vegetables as Natural Modulators of Health: Mechanisms and Benefits in Ageing Populations (2026) · cites this paper as [44]

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Cited by

Sorted by citations

Authors
d’Unienville, N. M. A., Blake, H. T., Coates, A. M., Hill, A. M., Nelson, M. J., & Buckley, J. D.
Affiliations
University of South Australia (AU)
Corresponding author
d’Unienville, Noah M. A.
ORCID
Venue
Journal of the International Society of Sports Nutrition
Publisher
Informa UK Limited
Published
2021-12
Volume
18
Issue
1
Pages
76-76
ISSN
1550-2783 (ISSN-L)
DOI
10.1186/s12970-021-00472-y
PMC
PMC8715640
OpenAlex
W4200297749
Cited by
56
References
36
Citations by year
2026: 8 · 2025: 16 · 2024: 14 · 2023: 7 · 2022: 11
FWCI
0.92
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the International Society of Sports Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UniSA Research Outputs Repository (University of South Australia) (submittedVersion, cc-by)
Funders
Australian Government
Topics
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
Keywords
polyphenols, L-arginine, citrulline, nitric oxide bioavailability, endurance exercise performance, beetroot, grapes, Punica granatum, time to exhaustion, sex differences, trained athletes, ergogenic aids, dietary supplementation, time trial performance, intermittent exercise, Montmorency cherry, Theobroma cacao, green tea
MeSH terms
Arginine, Citrulline, Female, Food, Food Analysis, Humans, Male, Nitrates, Nitric Oxide, Physical Endurance, Randomized Controlled Trials as Topic, Exercise Tolerance, Polyphenols

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