Effect of acute and chronic nitrate supplementation on the performance of endurance athletes: a systematic review

Ludmila Dias dos Santos Leal; Miller Pereira Guimarães; Yuri de Almeida Costa Campos; Wilson Cesar Abreu; Sandro  Fernandes da Silva

doi:10.31893/multirev.2022009

Keywords:

Abstract

Evidence that dietary supplementation with nitrate-rich beet juice (NO3-) can improve endurance exercise performance. This paper aimed critically assess the effects of acute and chronic NO3- supplementation in the performance of trained healthy adult individuals and/or athletes. This systematic review analyzed 12 randomized, blinded, crossover clinical trials with control, which investigated the effect of acute and/or chronic supplementation of NO3- through juice or fresh beet on physical performance in endurance exercises. These studies involved 185 subjects. Four of the six acute studies in this review demonstrated improvements in sports performance in running and cycling. Among the eight chronic studies, only two showed no improvement in performance. Six studies with secondary supplementation yield favorable results. Of the six studies conducted with athletes, five demonstrated increases in VO2MAX. The current literature points to the positive effects of dietary supplementation of NO3- acute and chronic in trained and/or athletes. However, there are limitations regarding research on the results of NO3- supplementation in women and if there is an optimal time for observing effects on athletic performance.
References
1. Alvares TS, Oliveira GVD, Volino-Souza M, Conte-Junior CA, Murias JM (2022) Effect of dietary nitrate ingestion on muscular performance: A systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition 62:5284-5306.
2. Amano T, Okushima D, Breese BC, Bailey SJ, Koga S, Kondo N (2018) Influence of dietary nitrate supplementation on local sweating and cutaneous vascular responses during exercise in a hot environment. European journal of applied physiology 118:1579-1588.
3. Andersen P, Henriksson J (1977) Capillary supply of the quadriceps femoris muscle of man: adaptive response to exercise. The Journal of physiology 270:677-690.
4. Bailey SJ, Vanhatalo A, Winyard PG, Jones AM (2012) The nitrate-nitrite-nitric oxide pathway: Its role in human exercise physiology. European Journal of Sport Science 12:309-320.
5. Bond V, Curry BH, Adams RG, Asadi MS, Millis RM, Haddad GE (2013) Effects of dietary nitrates on systemic and cerebrovascular hemodynamics. Cardiology research and practice 34:54.
6. Bondonno CP, Croft KD, Hodgson JM (2016) Dietary nitrate, nitric oxide, and cardiovascular health. Critical reviews in food science and nutrition 56:2036-2052.
7. Boorsma RK, Whitfield J, Spriet LL (2014) Beetroot juice supplementation does not improve performance of elite 1500-m runners. Medicine Science Sports Exercise 46:2326-2334.
8. Boynton JR, Stein TD, Wuenstel JG, Fitzgerald KA, Gregoire DM, Albrechtsen SJ (2014) Beet Shot Supplements to Improve Endurance Performance in Cyclists and Runners: 552 May 28, 2: 45 PM-3: 00 PM. Medicine & Science in Sports & Exercise 46:132.
9. Burke LM, Peeling P (20180 Methodologies for investigating performance changes with supplement use. International Journal of Sport Nutrition and Exercise Metabolism 28:159-169.
10. Carlström M, Persson AEG, Larsson E, Hezel M, Scheffer PG, Teerlink T, Lundberg JO (2011) Dietary nitrate attenuates oxidative stress, prevents cardiac and renal injuries, and reduces blood pressure in salt-induced hypertension. Cardiovascular research 89:574-585.
11. Cermak NM, Stinkens R, Lundberg JO, Gibala MJ, Van Loon LJ (2012) No improvement in endurance performance after a single dose of beetroot juice. International journal of sport nutrition and exercise metabolism 22:470-478.
12. Cermak NM, Gibala MJ, Van Loon LJ (2012) Nitrate supplementation’s improvement of 10-km time-trial performance in trained cyclists. International journal of sport nutrition and exercise metabolism 22:64-71.
13. Christensen PM, Nyberg M, Bangsbo J (2013) Influence of nitrate supplementation on VO2 kinetics and endurance of elite cyclists. Scandinavian journal of medicine & science in sports 23:21-31.
14. Clifford T, Berntzen B, Davison GW, West DJ, Howatson G, Stevenson EJ (2016) Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 8:506.
15. Cocks M, Shaw CS, Shepherd SO, Fisher JP, Ranasinghe AM, Barker TA, Wagenmakers AJ (2013) Sprint interval and endurance training are equally effective in increasing muscle microvascular density and eNOS content in sedentary males. The Journal of physiology 591:641-656
16. Coggan AR, Leibowitz JL, Kadkhodayan A, Thomas DP, Ramamurthy S, Spearie CA, Peterson LR (2015) Effect of acute dietary nitrate intake on maximal knee extensor speed and power in healthy men and women. Nitric Oxide 48:16-21.
17. Costa MS, Toscano LT, Toscano LDLT, Luna VR, Torres RA, Silva JA, Silva AS (2022) Ergogenic potential of foods for performance and recovery: a new alternative in sports supplementation? A systematic review. Critical Reviews in Food Science and Nutrition 62:1480-1501.
18. Cuenca E, Jodra P, Pérez-López A, González-Rodríguez LG, Fernandes da Silva S, Veiga-Herreros P, Domínguez R (2018) Effects of beetroot juice supplementation on performance and fatigue in a 30-s all-out sprint exercise: a randomized, double-blind cross-over study. Nutrients 10:1222
19. De Castro TF, de Assis Manoel F, Figueiredo DH, Figueiredo DH, Machado FA (2019) Effects of chronic beetroot juice supplementation on maximum oxygen uptake, velocity associated with maximum oxygen uptake, and peak velocity in recreational runners: a double-blinded, randomized and crossover study. European Journal of Applied Physiology 119:1043-1053.
20. Faria TDO, Targueta GP, Angeli JK, Almeida EAS, Stefanon I, Vassallo DV, Lizardo J HDF (2010) Acute resistance exercise reduces blood pressure and vascular reactivity, and increases endothelium-dependent relaxation in spontaneously hypertensive rats. European journal of applied physiology 110:359-366.
21. Díaz MM, Bocanegra OL, Teixeira RR, Soares SS, Espindola FS (2013) Salivary nitric oxide and alpha-amylase as indexes of training intensity and load. International journal of sports medicine 34:8-13
22. Dietetics A. (2016). Evidence Analysis Manual: Steps in the Academy Evidence Analysis Process 23:90-97.
23. Domínguez R, Garnacho-Castaño MV, Cuenca E, García-Fernández P, Muñoz-González A, De Jesús F, Maté-Muñoz JL (2017) Effects of beetroot juice supplementation on a 30-s high-intensity inertial cycle ergometer test. Nutrients 9:1360.
24. Gago B, Lundberg JO, Barbosa RM, Laranjinha J (2007) Red wine-dependent reduction of nitrite to nitric oxide in the stomach. Free Radical Biology and Medicine 43:1233-1242.
25. Gollnick PD, Matoba H (1984) The muscle fiber composition of skeletal muscle as a predictor of athletic success: An overview. The American journal of sports medicine 12:212-217.
26. Gross SS, Wolin MS (1995) Nitric oxide: pathophysiological mechanisms. Annual Review of Physiology 57:37-769.
27. Guerrero K, Wuyam B, Mezin P, Vivodtzev I, Vendelin M, Borel JC, Pison C (2005) Functional coupling of adenine nucleotide translocase and mitochondrial creatine kinase is enhanced after exercise training in lung transplant skeletal muscle. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 289:1144-1154.
28. Haider G, Folland JP (2014) Nitrate supplementation enhances the contractile properties of human skeletal muscle. Medicine and science in sports and exercise 46:2234-2243.
29. Harty PS, Cottet ML, Malloy JK, Kerksick CM (2019) Nutritional and supplementation strategies to prevent and attenuate exercise-induced muscle damage: A brief review. Sports medicine-open 5:1-17.
30. Hernández A, Schiffer TA, Ivarsson N, Cheng AJ, Bruton JD, Lundberg JO, Westerblad H (2012) Dietary nitrate increases tetanic [Ca2+] i and contractile force in mouse fast‐twitch muscle. The Journal of physiology 590:3575-3583.
31. Hord NG, Tang Y, Bryan NS (2009) Food sources of nitrates and nitrites: the physiologic context for potential health benefits. The American journal of clinical nutrition 9:1-10.
32. James PE, Willis GR, Allen JD, Winyard PG, Jones AM (2015) Nitrate pharmacokinetics: Taking note of the difference. Nitric Oxide 48:44-50.
33. Jensen L, Bangsbo J, Hellsten Y (2004) Effect of high intensity training on capillarization and presence of angiogenic factors in human skeletal muscle. The Journal of physiology 557:571-582.
34. Jonvik KL, Nyakayiru J, Van Loon LJ, Verdijk LB (2015) Can elite athletes benefit from dietary nitrate supplementation? Journal of applied physiology 119:759-761.
35. Kent GL, Dawson B, McNaughton LR, Cox GR, Burke LM,Peeling P (2019) The effect of beetroot juice supplementation on repeat-sprint performance in hypoxia. Journal of sports sciences 37:339-346.
36. Kramer SJ, Baur DA, Spicer MT, Vukovich MD, Ormsbee MJ (2016) The effect of six days of dietary nitrate supplementation on performance in trained CrossFit athletes. Journal of the International Society of Sports Nutrition 13:39.
37. Lansley KE, Winyard PG, Bailey SJ, Vanhatalo A, Wilkerson DP, Blackwell JR, Jones AM (2011) Acute dietary nitrate supplementation improves cycling time trial performance. Medicine Science Sports Exercise 43:125-1131.
38. Larsen FJ, Weitzberg E, Lundberg JO, Ekblom B (2007) Effects of dietary nitrate on oxygen cost during exercise. Acta physiologica 191:59-66
39. Lee JS, Stebbins CL, Jung E, Nho H, Kim JK, Chang MJ, Choi HM (2015) Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 309:459-466.
40. Maughan RJ, Burke LM, Dvorak J, Larson-Meyer DE, Peeling P, Phillips. SM, Engebretsen L (2018) IOC consensus statement: dietary supplements and the high-performance athlete. International journal of sport nutrition and exercise metabolism 2:104-125.
41. McConell GK, Bradley SJ, Stephens TJ, Canny BJ, Kingwell BA, Lee-Young RS (2007) Skeletal muscle nNOSμ protein content is increased by exercise training in humans. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 293:821-828.
42. McDonagh ST, Wylie LJ, Webster JM, Vanhatalo A, Jones AM (2018) Influence of dietary nitrate food forms on nitrate metabolism and blood pressure in healthy normotensive adults. Nitric Oxide 72:66-74.
43. Mogensen M, Bagger M, Pedersen PK, Fernström M, Sahlin K (2006) Cycling efficiency in humans is related to low UCP3 content and to type I fibres but not to mitochondrial efficiency. The Journal of physiology 571:669-681.
44. Murphy M, Eliot K, Heuertz RM,Weiss E (2012) Whole beetroot consumption acutely improves running performance. Journal of the Academy of Nutrition and Dietetics 112:548-552.
45. Peri L, Pietraforte D, Scorza G, Napolitano A, Fogliano V, Minetti M (2005) Apples increase nitric oxide production by human saliva at the acidic pH of the stomach: a new biological function for polyphenols with a catechol group? Free Radical Biology and Medicine 39:668-681.
46. Poveda JJ, Riestra A, Salas E, Cagigas ML, López‐Somoza C, Amado JA, Berrazueta J R (1997). Contribution of nitric oxide to exercise‐induced changes in healthy volunteers: effects of acute exercise and long‐term physical training. European journal of clinical investigation 27:967-971.
47. Prior BM, Yang HT, Terjung RL (2004). What makes vessels grow with exercise training? Journal of applied physiology 97:1119-1128.
48. Puype J, Ramaekers M, Van Thienen R, Deldicque L, Hespel P (2015) No effect of dietary nitrate supplementation on endurance training in hypoxia. Scandinavian journal of medicine & science in sports 25:234-241.
49. Rojas-Valverde D, Montoya-Rodriguez J, Azofeifa-Mora C, Sanchez-Urena B (2021) Effectiveness of beetroot juice derived nitrates supplementation on fatigue resistance during repeated-sprints: A systematic review. Critical reviews in food science and nutrition 61:3395-3406.
50. Rokkedal-Lausch T, Franch J, Poulsen MK, Thomsen LP, Weitzberg E, Kamavuako E N,Larsen RG (2019) Chronic high-dose beetroot juice supplementation improves time trial performance of well-trained cyclists in normoxia and hypoxia. Nitric Oxide 85:44-52.
51. Rothschild JA, Bishop DJ (2020) Effects of dietary supplements on adaptations to endurance training. Sports Medicine 50:25-53.
52. Stamler JS, Meissner G (2001) Physiology of nitric oxide in skeletal muscle. Physiological reviews 81:209-237.
53. Thomas DT, Erdman KA, Burke LM (2016) Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. Journal of the Academy of Nutrition and Dietetics 116:501-528.
54. Tiso M, Schechter AN (2015) Nitrate reduction to nitrite, nitric oxide and ammonia by gut bacteria under physiological conditions. PloS one 10:119-712.
55. Totzeck M, Hendgen-Cotta UB, Rammos C, Frommke LM, Knackstedt C, Predel HG, Rassaf T (2012) Higher endogenous nitrite levels are associated with superior exercise capacity in highly trained athletes. Nitric Oxide 27:75-81.
56. Vanhatalo A, Bailey SJ, Blackwell JR, DiMenna FJ, Pavey TG, Wilkerson DP, Jones AM (2010) Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 34:76 -80.
57. Whitfield J, Ludzki A, Heigenhauser GJF, Senden JM, Verdijk LB,Van Loon LJ,Holloway GP (2016) Beetroot juice supplementation reduces whole body oxygen consumption but does not improve indices of mitochondrial efficiency in human skeletal muscle. The Journal of physiology 594:421-435.
58. Wilkerson DP, Hayward GM, Bailey SJ, Vanhatalo A, Blackwell JR, Jones AM (2012) Influence of acute dietary nitrate supplementation on 50 mile time trial performance in well-trained cyclists. European journal of applied physiology 112:4127- 4134.
59. Wylie LJ, Mohr M, Krustrup P, Jackman SR, Ermιdis G, Kelly J, Jones AM (2013) Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. European journal of applied physiology 113:1673-1684.
60. Zago AS, Reis Silveira L, Kokubun E (2010) Effects of aerobic exercise on the blood pressure, oxidative stress and eNOS gene polymorphism in pre-hypertensive older people. European journal of applied physiology 110:825-832.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Leal, L. D. dos S., Guimarães, M. P., Campos, Y. de A. C., Abreu, W. C., & Fernandes da Silva, S. . (2022). Effect of acute and chronic nitrate supplementation on the performance of endurance athletes: a systematic review. Multidisciplinary Reviews, 5(2), 2022009. https://doi.org/10.31893/multirev.2022009

[1] Alvares TS, Oliveira GVD, Volino-Souza M, Conte-Junior CA, Murias JM (2022) Effect of dietary nitrate ingestion on muscular performance: A systematic review and meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition 62:5284-5306.

[2] Amano T, Okushima D, Breese BC, Bailey SJ, Koga S, Kondo N (2018) Influence of dietary nitrate supplementation on local sweating and cutaneous vascular responses during exercise in a hot environment. European journal of applied physiology 118:1579-1588.

[3] Andersen P, Henriksson J (1977) Capillary supply of the quadriceps femoris muscle of man: adaptive response to exercise. The Journal of physiology 270:677-690.

[4] Bailey SJ, Vanhatalo A, Winyard PG, Jones AM (2012) The nitrate-nitrite-nitric oxide pathway: Its role in human exercise physiology. European Journal of Sport Science 12:309-320.

[5] Bond V, Curry BH, Adams RG, Asadi MS, Millis RM, Haddad GE (2013) Effects of dietary nitrates on systemic and cerebrovascular hemodynamics. Cardiology research and practice 34:54.

[6] Bondonno CP, Croft KD, Hodgson JM (2016) Dietary nitrate, nitric oxide, and cardiovascular health. Critical reviews in food science and nutrition 56:2036-2052.

[7] Boorsma RK, Whitfield J, Spriet LL (2014) Beetroot juice supplementation does not improve performance of elite 1500-m runners. Medicine Science Sports Exercise 46:2326-2334.

[8] Boynton JR, Stein TD, Wuenstel JG, Fitzgerald KA, Gregoire DM, Albrechtsen SJ (2014) Beet Shot Supplements to Improve Endurance Performance in Cyclists and Runners: 552 May 28, 2: 45 PM-3: 00 PM. Medicine & Science in Sports & Exercise 46:132.

[9] Burke LM, Peeling P (20180 Methodologies for investigating performance changes with supplement use. International Journal of Sport Nutrition and Exercise Metabolism 28:159-169.

[10] Carlström M, Persson AEG, Larsson E, Hezel M, Scheffer PG, Teerlink T, Lundberg JO (2011) Dietary nitrate attenuates oxidative stress, prevents cardiac and renal injuries, and reduces blood pressure in salt-induced hypertension. Cardiovascular research 89:574-585.

[11] Cermak NM, Stinkens R, Lundberg JO, Gibala MJ, Van Loon LJ (2012) No improvement in endurance performance after a single dose of beetroot juice. International journal of sport nutrition and exercise metabolism 22:470-478.

[12] Cermak NM, Gibala MJ, Van Loon LJ (2012) Nitrate supplementation’s improvement of 10-km time-trial performance in trained cyclists. International journal of sport nutrition and exercise metabolism 22:64-71.

[13] Christensen PM, Nyberg M, Bangsbo J (2013) Influence of nitrate supplementation on VO2 kinetics and endurance of elite cyclists. Scandinavian journal of medicine & science in sports 23:21-31.

[14] Clifford T, Berntzen B, Davison GW, West DJ, Howatson G, Stevenson EJ (2016) Effects of beetroot juice on recovery of muscle function and performance between bouts of repeated sprint exercise. Nutrients 8:506.

[15] Cocks M, Shaw CS, Shepherd SO, Fisher JP, Ranasinghe AM, Barker TA, Wagenmakers AJ (2013) Sprint interval and endurance training are equally effective in increasing muscle microvascular density and eNOS content in sedentary males. The Journal of physiology 591:641-656

[16] Coggan AR, Leibowitz JL, Kadkhodayan A, Thomas DP, Ramamurthy S, Spearie CA, Peterson LR (2015) Effect of acute dietary nitrate intake on maximal knee extensor speed and power in healthy men and women. Nitric Oxide 48:16-21.

[17] Costa MS, Toscano LT, Toscano LDLT, Luna VR, Torres RA, Silva JA, Silva AS (2022) Ergogenic potential of foods for performance and recovery: a new alternative in sports supplementation? A systematic review. Critical Reviews in Food Science and Nutrition 62:1480-1501.

[18] Cuenca E, Jodra P, Pérez-López A, González-Rodríguez LG, Fernandes da Silva S, Veiga-Herreros P, Domínguez R (2018) Effects of beetroot juice supplementation on performance and fatigue in a 30-s all-out sprint exercise: a randomized, double-blind cross-over study. Nutrients 10:1222

[19] De Castro TF, de Assis Manoel F, Figueiredo DH, Figueiredo DH, Machado FA (2019) Effects of chronic beetroot juice supplementation on maximum oxygen uptake, velocity associated with maximum oxygen uptake, and peak velocity in recreational runners: a double-blinded, randomized and crossover study. European Journal of Applied Physiology 119:1043-1053.

[20] Faria TDO, Targueta GP, Angeli JK, Almeida EAS, Stefanon I, Vassallo DV, Lizardo J HDF (2010) Acute resistance exercise reduces blood pressure and vascular reactivity, and increases endothelium-dependent relaxation in spontaneously hypertensive rats. European journal of applied physiology 110:359-366.

[21] Díaz MM, Bocanegra OL, Teixeira RR, Soares SS, Espindola FS (2013) Salivary nitric oxide and alpha-amylase as indexes of training intensity and load. International journal of sports medicine 34:8-13

[22] Dietetics A. (2016). Evidence Analysis Manual: Steps in the Academy Evidence Analysis Process 23:90-97.

[23] Domínguez R, Garnacho-Castaño MV, Cuenca E, García-Fernández P, Muñoz-González A, De Jesús F, Maté-Muñoz JL (2017) Effects of beetroot juice supplementation on a 30-s high-intensity inertial cycle ergometer test. Nutrients 9:1360.

[24] Gago B, Lundberg JO, Barbosa RM, Laranjinha J (2007) Red wine-dependent reduction of nitrite to nitric oxide in the stomach. Free Radical Biology and Medicine 43:1233-1242.

[25] Gollnick PD, Matoba H (1984) The muscle fiber composition of skeletal muscle as a predictor of athletic success: An overview. The American journal of sports medicine 12:212-217.

[26] Gross SS, Wolin MS (1995) Nitric oxide: pathophysiological mechanisms. Annual Review of Physiology 57:37-769.

[27] Guerrero K, Wuyam B, Mezin P, Vivodtzev I, Vendelin M, Borel JC, Pison C (2005) Functional coupling of adenine nucleotide translocase and mitochondrial creatine kinase is enhanced after exercise training in lung transplant skeletal muscle. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 289:1144-1154.

[28] Haider G, Folland JP (2014) Nitrate supplementation enhances the contractile properties of human skeletal muscle. Medicine and science in sports and exercise 46:2234-2243.

[29] Harty PS, Cottet ML, Malloy JK, Kerksick CM (2019) Nutritional and supplementation strategies to prevent and attenuate exercise-induced muscle damage: A brief review. Sports medicine-open 5:1-17.

[30] Hernández A, Schiffer TA, Ivarsson N, Cheng AJ, Bruton JD, Lundberg JO, Westerblad H (2012) Dietary nitrate increases tetanic [Ca2+] i and contractile force in mouse fast‐twitch muscle. The Journal of physiology 590:3575-3583.

[31] Hord NG, Tang Y, Bryan NS (2009) Food sources of nitrates and nitrites: the physiologic context for potential health benefits. The American journal of clinical nutrition 9:1-10.

[32] James PE, Willis GR, Allen JD, Winyard PG, Jones AM (2015) Nitrate pharmacokinetics: Taking note of the difference. Nitric Oxide 48:44-50.

[33] Jensen L, Bangsbo J, Hellsten Y (2004) Effect of high intensity training on capillarization and presence of angiogenic factors in human skeletal muscle. The Journal of physiology 557:571-582.

[34] Jonvik KL, Nyakayiru J, Van Loon LJ, Verdijk LB (2015) Can elite athletes benefit from dietary nitrate supplementation? Journal of applied physiology 119:759-761.

[35] Kent GL, Dawson B, McNaughton LR, Cox GR, Burke LM,Peeling P (2019) The effect of beetroot juice supplementation on repeat-sprint performance in hypoxia. Journal of sports sciences 37:339-346.

[36] Kramer SJ, Baur DA, Spicer MT, Vukovich MD, Ormsbee MJ (2016) The effect of six days of dietary nitrate supplementation on performance in trained CrossFit athletes. Journal of the International Society of Sports Nutrition 13:39.

[37] Lansley KE, Winyard PG, Bailey SJ, Vanhatalo A, Wilkerson DP, Blackwell JR, Jones AM (2011) Acute dietary nitrate supplementation improves cycling time trial performance. Medicine Science Sports Exercise 43:125-1131.

[38] Larsen FJ, Weitzberg E, Lundberg JO, Ekblom B (2007) Effects of dietary nitrate on oxygen cost during exercise. Acta physiologica 191:59-66

[39] Lee JS, Stebbins CL, Jung E, Nho H, Kim JK, Chang MJ, Choi HM (2015) Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 309:459-466.

[40] Maughan RJ, Burke LM, Dvorak J, Larson-Meyer DE, Peeling P, Phillips. SM, Engebretsen L (2018) IOC consensus statement: dietary supplements and the high-performance athlete. International journal of sport nutrition and exercise metabolism 2:104-125.

[41] McConell GK, Bradley SJ, Stephens TJ, Canny BJ, Kingwell BA, Lee-Young RS (2007) Skeletal muscle nNOSμ protein content is increased by exercise training in humans. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 293:821-828.

[42] McDonagh ST, Wylie LJ, Webster JM, Vanhatalo A, Jones AM (2018) Influence of dietary nitrate food forms on nitrate metabolism and blood pressure in healthy normotensive adults. Nitric Oxide 72:66-74.

[43] Mogensen M, Bagger M, Pedersen PK, Fernström M, Sahlin K (2006) Cycling efficiency in humans is related to low UCP3 content and to type I fibres but not to mitochondrial efficiency. The Journal of physiology 571:669-681.

[44] Murphy M, Eliot K, Heuertz RM,Weiss E (2012) Whole beetroot consumption acutely improves running performance. Journal of the Academy of Nutrition and Dietetics 112:548-552.

[45] Peri L, Pietraforte D, Scorza G, Napolitano A, Fogliano V, Minetti M (2005) Apples increase nitric oxide production by human saliva at the acidic pH of the stomach: a new biological function for polyphenols with a catechol group? Free Radical Biology and Medicine 39:668-681.

[46] Poveda JJ, Riestra A, Salas E, Cagigas ML, López‐Somoza C, Amado JA, Berrazueta J R (1997). Contribution of nitric oxide to exercise‐induced changes in healthy volunteers: effects of acute exercise and long‐term physical training. European journal of clinical investigation 27:967-971.

[47] Prior BM, Yang HT, Terjung RL (2004). What makes vessels grow with exercise training? Journal of applied physiology 97:1119-1128.

[48] Puype J, Ramaekers M, Van Thienen R, Deldicque L, Hespel P (2015) No effect of dietary nitrate supplementation on endurance training in hypoxia. Scandinavian journal of medicine & science in sports 25:234-241.

[49] Rojas-Valverde D, Montoya-Rodriguez J, Azofeifa-Mora C, Sanchez-Urena B (2021) Effectiveness of beetroot juice derived nitrates supplementation on fatigue resistance during repeated-sprints: A systematic review. Critical reviews in food science and nutrition 61:3395-3406.

[50] Rokkedal-Lausch T, Franch J, Poulsen MK, Thomsen LP, Weitzberg E, Kamavuako E N,Larsen RG (2019) Chronic high-dose beetroot juice supplementation improves time trial performance of well-trained cyclists in normoxia and hypoxia. Nitric Oxide 85:44-52.

[51] Rothschild JA, Bishop DJ (2020) Effects of dietary supplements on adaptations to endurance training. Sports Medicine 50:25-53.

[52] Stamler JS, Meissner G (2001) Physiology of nitric oxide in skeletal muscle. Physiological reviews 81:209-237.

[53] Thomas DT, Erdman KA, Burke LM (2016) Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. Journal of the Academy of Nutrition and Dietetics 116:501-528.

[54] Tiso M, Schechter AN (2015) Nitrate reduction to nitrite, nitric oxide and ammonia by gut bacteria under physiological conditions. PloS one 10:119-712.

[55] Totzeck M, Hendgen-Cotta UB, Rammos C, Frommke LM, Knackstedt C, Predel HG, Rassaf T (2012) Higher endogenous nitrite levels are associated with superior exercise capacity in highly trained athletes. Nitric Oxide 27:75-81.

[56] Vanhatalo A, Bailey SJ, Blackwell JR, DiMenna FJ, Pavey TG, Wilkerson DP, Jones AM (2010) Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 34:76 -80.

[57] Whitfield J, Ludzki A, Heigenhauser GJF, Senden JM, Verdijk LB,Van Loon LJ,Holloway GP (2016) Beetroot juice supplementation reduces whole body oxygen consumption but does not improve indices of mitochondrial efficiency in human skeletal muscle. The Journal of physiology 594:421-435.

[58] Wilkerson DP, Hayward GM, Bailey SJ, Vanhatalo A, Blackwell JR, Jones AM (2012) Influence of acute dietary nitrate supplementation on 50 mile time trial performance in well-trained cyclists. European journal of applied physiology 112:4127- 4134.

[59] Wylie LJ, Mohr M, Krustrup P, Jackman SR, Ermιdis G, Kelly J, Jones AM (2013) Dietary nitrate supplementation improves team sport-specific intense intermittent exercise performance. European journal of applied physiology 113:1673-1684.

[60] Zago AS, Reis Silveira L, Kokubun E (2010) Effects of aerobic exercise on the blood pressure, oxidative stress and eNOS gene polymorphism in pre-hypertensive older people. European journal of applied physiology 110:825-832.

Abstract

References

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