Cited by 158Nitric Oxide and Endothelin EffectsCardiovascular and exercise physiologyCardiovascular Health and Disease Prevention

Dietary Nitrate and Nitric Oxide Metabolism: Mouth, Circulation, Skeletal Muscle, and Exercise Performance

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Jones, Andrew M., Vanhatalo, Anni, Seals, Douglas R., Rossman, Matthew J., Piknova, Barbora, Jonvik, Kristin L.·2021·Medicine & Science in Sports & Exercise

Abstract

Nitric oxide (NO) is a gaseous signaling molecule that plays an important role in myriad physiological processes, including the regulation of vascular tone, neurotransmission, mitochondrial respiration, and skeletal muscle contractile function. NO may be produced via the canonical NO synthase–catalyzed oxidation of l -arginine and also by the sequential reduction of nitrate to nitrite and then NO. The body’s nitrate stores can be augmented by the ingestion of nitrate-rich foods (primarily green leafy vegetables). NO bioavailability is greatly enhanced by the activity of bacteria residing in the mouth, which reduce nitrate to nitrite, thereby increasing the concentration of circulating nitrite, which can be reduced further to NO in regions of low oxygen availability. Recent investigations have focused on promoting this nitrate–nitrite–NO pathway to positively affect indices of cardiovascular health and exercise tolerance. It has been reported that dietary nitrate supplementation with beetroot juice lowers blood pressure in hypertensive patients, and sodium nitrite supplementation improves vascular endothelial function and reduces the stiffening of large elastic arteries in older humans. Nitrate supplementation has also been shown to enhance skeletal muscle function and to improve exercise performance in some circumstances. Recently, it has been established that nitrate concentration in skeletal muscle is much higher than that in blood and that muscle nitrate stores are exquisitely sensitive to dietary nitrate supplementation and deprivation. In this review, we consider the possibility that nitrate represents an essential storage form of NO and discuss the integrated function of the oral microbiome, circulation, and skeletal muscle in nitrate–nitrite–NO metabolism, as well as the practical relevance for health and performance.

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Crossref · 10.1249/mss.0000000000002470

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Authors
Jones, A. M., Vanhatalo, A., Seals, D. R., Rossman, M. J., Piknova, B., & Jonvik, K. L.
Affiliations
  • University of Exeter (GB)
  • University of Colorado Boulder (US)
  • National Institutes of Health (US)
  • Maastricht University Medical Centre (NL)
Corresponding author
Jones, Andrew M.
Venue
Medicine & Science in Sports & Exercise
Published
2020-07-29
Volume
53
Issue
2
Pages
280-294
ISSN
  • 0195-9131 (ISSN-L)
  • 1530-0315
OpenAlex
W3046780524
Cited by
156
References
156
Citations by year
2026: 26 · 2025: 30 · 2024: 30 · 2023: 28 · 2022: 29 · 2021: 13
FWCI
2.23
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Medicine & Science in Sports & Exercise (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • Research Publications (Maastricht University) (submittedVersion)
Funders
  • National Institute on Aging (R37AG013038, T32AG000279)
  • National Heart, Lung, and Blood Institute (R21HL107105)
  • 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
dietary nitrate, nitric oxide metabolism, nitrate-nitrite-NO pathway, oral microbiota, nitrite, exercise performance, blood pressure, hypertension, endothelial function, arterial stiffness, beetroot juice, sodium nitrite, nitric oxide synthase, vascular tone
MeSH terms
Animals, Biological Availability, Blood Circulation, Cardiovascular Diseases, Endothelium, Vascular, Homeostasis, Humans, Mouth, Nitrates, Nitric Oxide, Risk Factors, Exercise, Muscle, Skeletal, Dietary Supplements, Microbiota

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