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Cited by 231Exercise and Physiological ResponsesCardiovascular and exercise physiologyMuscle metabolism and nutrition

The Effect of Nitric-Oxide-Related Supplements on Human Performance

Bescós, Raúl, Sureda, Antoni, Tur, Josep A., Pons, Antoni·2012·Sports Medicine
DOI 10.2165/11596860-000000000-00000
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Abstract

Nitric oxide (NO) has led a revolution in physiology and pharmacology research during the last two decades. This labile molecule plays an important role in many functions in the body regulating vasodilatation, blood flow, mitochondrial respiration and platelet function. Currently, it is known that NO synthesis occurs via at least two physiological pathways: NO synthase (NOS) dependent and NOS independent. In the former, L-arginine is the main precursor. It is widely recognized that this amino acid is oxidized to NO by the action of the NOS enzymes. Additionally, L-citrulline has been indicated to be a secondary NO donor in the NOS-dependent pathway, since it can be converted to L-arginine. Nitrate and nitrite are the main substrates to produce NO via the NOS-independent pathway. These anions can be reduced in vivo to NO and other bioactive nitrogen oxides. Other molecules, such as the dietary supplement glycine propionyl-L-carnitine (GPLC), have also been suggested to increase levels of NO, although the physiological mechanisms remain to be elucidated. The interest in all these molecules has increased in many fields of research. In relation with exercise physiology, it has been suggested that an increase in NO production may enhance oxygen and nutrient delivery to active muscles, thus improving tolerance to physical exercise and recovery mechanisms. Several studies using NO donors have assessed this hypothesis in a healthy, trained population. However, the conclusions from these studies showed several discrepancies. While some reported that dietary supplementation with NO donors induced benefits in exercise performance, others did not find any positive effect. In this regard, training status of the subjects seems to be an important factor linked to the ergogenic effect of NO supplementation. Studies involving untrained or moderately trained healthy subjects showed that NO donors could improve tolerance to aerobic and anaerobic exercise. However, when highly trained subjects were supplemented, no positive effect on performance was indicated. In addition, all this evidence is mainly based on a young male population. Further research in elderly and female subjects is needed to determine whether NO supplements can induce benefit in exercise capacity when the NO metabolism is impaired by age and/or estrogen status.

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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 [42]

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Authors
Bescós, R., Sureda, A., Tur, J. A., & Pons, A.
Affiliations
  • Institut Nacional d'Educació Física de Catalunya (ES)
  • Universitat de les Illes Balears (ES)
ORCID
Venue
Sports Medicine
Publisher
Springer Science and Business Media LLC
Published
2012-02
Volume
42
Issue
2
Pages
99-117
ISSN
0112-1642 (ISSN-L)
DOI
10.2165/11596860-000000000-00000
OpenAlex
W2141111861
Cited by
231
References
20
Citations by year
2026: 11 · 2025: 9 · 2024: 19 · 2023: 18 · 2022: 16 · 2021: 21 · 2020: 21 · 2019: 22 · 2018: 15 · 2017: 15 · 2016: 10 · 2015: 16 · 2014: 18 · 2013: 15 · 2012: 4
FWCI
2.19
Type
journal article
Language
en
Open access
closed
Locations
  • Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Victoria University Research Repository (Victoria University) (submittedVersion)
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
nitric oxide, nitric oxide donors, dietary supplementation, exercise performance, L-arginine, citrulline, nitrate, nitrite, nitric oxide synthase, training status, exercise tolerance, post-exercise recovery, sex differences, aging
MeSH terms
Arginine, Citrulline, Humans, Malates, Nitrates, Nitric Oxide, Sodium Nitrite, Task Performance and Analysis, Exercise Tolerance, Nitric Oxide Synthase, Dietary Supplements, Endothelium-Dependent Relaxing Factors

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