Effect of nitrate supplementation on hepatic blood flow and glucose homeostasis: A double-blind, placebo controlled, randomised control trial.

Nitric oxide alters gastric blood flow, improves vascular function and mediates glucose uptake within the intestines and skeletal muscle. Dietary nitrate, acting as a source of nitric oxide, appears to be a potential low cost therapy that may help maintain glucose homeostasis. In a randomised, double-blind, placebo-controlled crossover study, 31 young and older adult participants had a standardised breakfast, supplemented with either nitrate rich beetroot juice (11.91 mmol nitrate) or nitrate depleted beetroot juice as placebo (0.01 mmol nitrate). MRI was used to assess apparent diffusion coefficient (ADC), portal vein flux and velocity. Plasma glucose, incretin and C-peptide concentrations and BP were assessed. Outcome variables were measured at baseline and hourly for 3 hours. Compared with a placebo, beetroot juice resulted in a significant elevation in plasma nitrate and plasma nitrite concentration. No differences were seen for the young or older adult cohorts between placebo and beetroot juice for ADC, or portal vein flux. There was an interaction effect in the young adults, which was absent in the older adults between visits for portal vein velocity. Nitrate supplementation did not reduce plasma glucose active GLP-1, total GLP-1 or plasma C-peptide concentrations for the young or older adult cohorts. Despite a significant elevation in plasma nitrite concentration following an acute dose of 11.91 mmol of nitrate, there was no effect on hepatic blood flow, plasma glucose, C-peptide, or incretin concentration in healthy adults

The effect of dietary nitrate supplementation on the oxygen cost of cycling, walking performance and resting blood pressure in individuals with chronic obstructive pulmonary disease: A double blind placebo controlled, randomised control trial

BACKGROUND: Chronic obstructive pulmonary disease (COPD) results in exercise intolerance. Dietary nitrate supplementation has been shown to lower blood pressure (BP), reduce the oxygen cost of exercise, and enhance exercise tolerance in healthy volunteers. This study assessed the effects of dietary nitrate on the oxygen cost of cycling, walking performance and BP in individuals with mild-moderate COPD. METHODS: Thirteen patients with mild-moderate COPD were recruited. Participants consumed 70 ml of either nitrate-rich (6.77 mmol nitrate; beetroot juice) or nitrate-depleted beetroot juice (0.002 mmol nitrate; placebo) twice a day for 2.5 days, with the final supplement ~3 hours before testing. BP was measured before completing two bouts of moderate-intensity cycling, where pulmonary gas exchange was measured throughout. The six-minute walk test (6 MWT) was completed 30 minutes subsequent to the second cycling bout. RESULTS: Plasma nitrate concentration was significantly elevated following beetroot juice vs. placebo (placebo; 48 +/- 86 vs. beetroot juice; 215 +/- 84 microM, P = 0.002). No significant differences were observed between placebo vs. beetroot juice for oxygen cost of exercise (933 +/- 323 vs. 939 +/- 302 ml: min(-1); P = 0.88), distance covered in the 6 MWT (456 +/- 86 vs. 449 +/- 79 m; P = 0.37), systolic BP (123 +/- 14 vs. 123 +/- 14 mmHg; P = 0.91), or diastolic BP (77 +/- 9 vs. 79 +/- 9 mmHg; P = 0.27). CONCLUSION: Despite a large rise in plasma nitrate concentration, two days of nitrate supplementation did not reduce the oxygen cost of moderate intensity cycling, increase distance covered in the 6 MWT, or lower BP

Effects of dietary nitrate supplementation on the oxygen cost of exercise and walking performance in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled crossover trial

Dietary nitrate supplementation has been shown to reduce the oxygen (O2) cost of exercise and enhance exercise tolerance in healthy individuals. This study assessed whether similar effects could be observed in individuals with type 2 diabetes (T2DM). In a randomized, double-blind, placebo-controlled crossover study, 48 participants with T2DM supplemented their diet for 4 days with either nitrate-rich beetroot juice (70ml/day, 6.43mmol nitrate/day) or nitrate-depleted beetroot juice as placebo (70ml/day, 0.07mmol nitrate/day). After each intervention period, resting plasma nitrate and nitrite concentrations were measured subsequent to participants completing moderate-paced walking. Pulmonary gas exchange was measured to assess the O2 cost of walking. After a rest period, participants performed the 6-min walk test (6MWT). Relative to placebo, beetroot juice resulted in a significant increase in plasma nitrate (placebo, 57+/-66 vs beetroot, 319+/-110microM; P < 0.001) and plasma nitrite concentration (placebo, 680+/-256 vs beetroot, 1065+/-607nM; P < 0.001). There were no differences between placebo juice and beetroot juice for the O2 cost of walking (946+/-221 vs 939+/-223ml/min, respectively; P = 0.59) and distance covered in the 6MWT (550+/-83 vs 554+/-90m, respectively; P = 0.17). Nitrate supplementation did not affect the O2 cost of moderate-paced walking or improve performance in the 6MWT. These findings indicate that dietary nitrate supplementation does not modulate the response to exercise in individuals with T2DM