Nitrate Metabolism and Physical Activity: A Systematic Review

Abstract

Nitrate is a natural compound that stands out as a nutritional ergogenic supplement in sports nutrition. Dietary inorganic nitrate (notably from beetroot and leafy green vegetables) has been reported to convert to nitric oxide, thereby enhancing vasodilation, improving muscle oxygenation, and supporting energy metabolism. In this review, literature searches were conducted in PubMed, ScienceDirect, SpringerLink, Taylor & Francis, EBSCOhost, and Google Scholar for the period January 2020–January 2025, using the keywords “nitrate”, “nitric oxide”, “exercise performance”, “ergogenic aid”, “aerobic performance”, “anaerobic exercise”, “resistance training”, and “cognitive performance” Based on predefined inclusion and exclusion criteria, 15 studies were selected and reported thematically. The findings indicate that nitrate-based nutritional ergogenic support exerts positive effects particularly on aerobic performance by enhancing endurance, reducing oxygen consumption, and increasing exercise tolerance. The effects on anaerobic performance are more heterogeneous; some studies have reported increased power output in repeated sprint and resistance exercises, while others found no significant changes. Additionally, nitrate appears to offer potential benefits for cognitive function, oxidative stress regulation, and high-altitude adaptation, although further evidence is needed. Overall, nitrate metabolism demonstrates considerable potential for enhancing sports performance; nevertheless, there remains a need for future randomized, controlled, and long-term investigations that systematically account for individual variability in responses, as well as factors such as dosage, duration of administration, and training status.

Keywords

• Nitrate
• Nitric oxide
• Exercise performance

Nitrat Metabolizması ve Fiziksel Aktivite: Sistematik İnceleme

Abstract

Nitrat, sporcu beslenmesinde besinsel ergojenik destek olarak öne çıkan doğal bir bileşendir. Diyetle alınan inorganik nitratın (özellikle pancar ve yeşil yapraklı sebzelerden) nitrik okside dönüşerek vazodilatasyonu artırdığı, kas oksijenlenmesini iyileştirdiği ve enerji metabolizmasını desteklediği rapor edilmiştir. Bu derlemede, Ocak 2020 – Ocak 2025 arasında PubMed, ScienceDirect, SpringerLink, Taylor & Francis, EBSCOhost ve Google Scholar veri tabanları taranmış; “nitrate”, “nitric oxide”, “exercise performance”, “ergogenic aid”, “aerobic performance”, “anaerobic exercise”, “resistance training” ve “cognitive performance” anahtar kelimeleriyle ulaşılan çalışmalar incelenmiştir. Dahil etme ve hariç tutma kriterlerine göre seçilen 15 makale tematik olarak rapor edilmiştir. Bulgular, nitrat besinsel ergojenik desteğinin özellikle aerobik performansta dayanıklılığı artırma, oksijen tüketimini azaltma ve egzersiz toleransını yükseltme yönünde olumlu etkiler sağladığını göstermektedir. Anaerobik performans üzerindeki etkiler ise heterojendir; bazı çalışmalarda tekrarlı sprint ve direnç egzersizlerinde güç artışı görülürken, bazılarında anlamlı değişim rapor edilmemiştir. Ayrıca nitratın bilişsel işlev, oksidatif stres regülasyonu ve yüksek irtifa adaptasyonunda potansiyel katkılar sunduğu ancak daha fazla kanıta ihtiyaç duyulduğu belirtilmiştir. Genel olarak, nitrat metabolizması spor performansını destekleme açısından umut vericidir; ancak bireysel yanıt farklılıkları, dozaj, kullanım süresi ve antrenman düzeyi gibi faktörler göz önünde bulundurularak gelecekte randomize kontrollü ve uzun süreli çalışmalara ihtiyaç vardır.

Keywords

• Nitrat
• Nitrik oksit
• Egzersiz performansı

References

1. Blau, L. S., Gerber, J., Finkel, A., Lützow, M., Maassen, N., Röhrich, M. A., Hanff, E., Tsikas, D., Shushakov, V., ve Jantz, M. (2023). Effects of short-term sodium nitrate versus sodium chloride supplementation on energy and lipid metabolism during high-intensity intermittent exercise in athletes. Applied Sciences, 13(11), 6849. https://doi.org/10.3390/app13116849
2. Christensen, P. M., Nyberg, M., ve Bangsbo, J. (2013). Influence of nitrate supplementation on VO2 kinetics and endurance of elite cyclists. Scandinavian Journal of Medicine ve Science in Sports, 23(1), e21–e31. https://doi.org/ 10.1111/sms.12005
3. Clifford, T., Howatson, G., West, D. J., ve Stevenson, E. J. (2015). The potential benefits of red beetroot supplementation in health and disease. Nutrients, 7(4), 2801–2822. https://doi.org/10.3390/nu7042801
4. Esen, O., Bailey, S. J., Stashuk, D. W., Howatson, G., ve Goodall, S. (2024). Influence of nitrate supplementation on motor unit activity during recovery following a sustained ischemic contraction in recreationally active young males. European Journal of Nutrition, 63(6), 2379–2387. https://doi.org/10.1007/s00394-024-03440-9
5. Fenuta, A. M., Drouin, P. J., Kohoko, Z. I. N., Lynn, M. J. T., ve Tschakovsky, M. E. (2024). Influence of acute dietary nitrate supplementation on oxygen delivery/consumption and limit of tolerance during progressive forearm exercise in men: a randomized crossover trial. Applied Physiology, Nutrition, and Metabolism, 49(5), 635–648. https://doi.org/10.1139/apnm-2023-0236
6. Garnacho-Castaño, M. V., Sánchez-Nuño, S., Molina-Raya, L., Carbonell, T., Maté-Muñoz, J. L., Pleguezuelos-Cobo, E., ve Serra-Payá, N. (2022). Circulating nitrate-nitrite reduces oxygen uptake for improving resistance exercise performance after rest time in well-trained CrossFit athletes. Scientific Reports, 12(1), 9671. https://doi.org/10.1038/s41598-022-13786-x
7. Hennis, P. J., Cumpstey, A. F., O’Doherty, A. F., Fernandez, B. O., Gilbert-Kawai, E. T., Mitchell, K., Moyses, H., Cobb, A., Meale, P., ve Pöhnl, H. (2022). Dietary nitrate supplementation does not alter exercise efficiency at high altitude–further results from the Xtreme Alps study. Frontiers in Physiology, 13, 827235. https://doi.org/10.3389/fphys.2022.827235
8. Jones, A. M. (2014). Dietary nitrate supplementation and exercise performance. Sports Medicine, 44(Suppl 1), 35–45. https://doi.org/10.1007/s40279-014-0149-y

9. Jones, A. M., Thompson, C., Wylie, L. J., ve Vanhatalo, A. (2018). Dietary nitrate and physical performance. Annual Review of Nutrition, 38(1), 303-328. https://doi.org/10.1146/annurev-nutr-082117-051622
10. Kelly, J., Vanhatalo, A., Bailey, S. J., Wylie, L. J., Tucker, C., List, S., ... ve Jones, A. M. (2014). Dietary nitrate supplementation: effects on plasma nitrite and pulmonary O2 uptake dynamics during exercise in hypoxia and normoxia. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 307(7), R920-R930. https://doi.org/10.1152/ajpregu.00068.2014
11. Larsen, F. J., Weitzberg, E., Lundberg, J. O., ve Ekblom, B. (2010). Dietary nitrate reduces maximal oxygen consumption while maintaining work performance in maximal exercise. Free Radical Biology and Medicine, 48(2), 342–347. https://doi.org/10.1016/j.freeradbiomed.2009.11.006
12. Leal, L. D. dos S., Abreu, W. C. de, Gonçalves, R., Dominguez, R., ve Silva, S. F. da. (2024). Acute nitrate supplementation affects transition points in progressive incremental testing? MHSalud, 21(2), 15–31. https://doi.org/10.15359/mhs.21-2.19264
13. Lundberg, J. O., ve Govoni, M. (2004). Inorganic nitrate is a possible source for systemic generation of nitric oxide. Free Radical Biology and Medicine, 37(3), 395–400. https://doi.org/10.1038/nrd2466
14. Lundberg, J. O., Weitzberg, E., ve Gladwin, M. T. (2008). The nitrate–nitrite–nitric oxide pathway in physiology and therapeutics. Nature Reviews Drug Discovery, 7(2), 156–167. https://doi.org/10.1038/nrd246
15. Majerczak, J., Drzymala‐Celichowska, H., Grandys, M., Kij, A., Kus, K., Celichowski, J., Krysciak, K., Molik, W. A., Szkutnik, Z., ve Zoladz, J. A. (2024). Exercise training decreases nitrite concentration in the heart and locomotory muscles of rats without changing the muscle nitrate content. Journal of the American Heart Association, 13(2), e031085. https://doi.org/10.1161/JAHA.123.031085
16. Ortiz de Zevallos, J., Hogwood, A. C., Kruse, K., De Guzman, J., Buckley, M., Weltman, A. L., ve Allen, J. D. (2023). Sex differences in the effects of inorganic nitrate supplementation on exercise economy and endurance capacity in healthy young adults. Journal of Applied Physiology, 135(5), 1157–1166. https://doi.org/10.1152/japplphysiol.00220.2023
17. Oue, A., Iimura, Y., Shinagawa, A., Miyakoshi, Y., ve Ota, M. (2022). Effect of acute dietary nitrate supplementation on the venous vascular response to static exercise in healthy young adults. Nutrients, 14(21), 4464. https://doi.org/10.3390/nu14214464
18. Pavitt, M. J., Lewis, A., Buttery, S. C., Fernandez, B. O., Mikus-Lelinska, M., Banya, W. A. S., Feelisch, M., Polkey, M. I., ve Hopkinson, N. S. (2022). Dietary nitrate supplementation to enhance exercise capacity in hypoxic COPD: EDEN-OX, a double-blind, placebo-controlled, randomised cross-over study. Thorax, 77(10), 968–975. https://doi.org/10.1136/thoraxjnl-2021-217147
19. Rowland, S. N., James, L. J., O’Donnell, E., ve Bailey, S. J. (2024). Influence of acute dietary nitrate supplementation timing on nitrate metabolism, central and peripheral blood pressure and exercise tolerance in young men. European Journal of Applied Physiology, 124(5), 1381–1396. https://doi.org/10.1007/s00421-023-05369-z
20. Sacramento, H. S., Zagatto, A. M., Caperuto, E., dos Santos, R., Acevedo, E. O., ve Campos, E. Z. (2024). Sodium Nitrate Attenuates Session Perceived Exertion During and After High-Intensity Intermittent Exercise. https://doi.org/10.21203/rs.3.rs-4824291/v1
21. Saleh, M. M., Dev, R. D. O., Linoby, A., Norhamazi, I., Ab Razak, R., Sulaiman, N., ve Jaapar, S. (2024). Effects of a Single Dose of Dietary Nitrate via Beetroot Crystals on High Intensity Intermittent Exercise Performance in Recreational Collegiate Athletes. Fizjoterapia Polska, 3. https://doi.org/10.56984/8ZG020AQYL
22. Sousa, A., Chambion-Diaz, M., Pialoux, V., Carin, R., Viana, J. L., Milheiro, J., Reis, V. M., ve Millet, G. (2025). Dietary nitrate supplementation very slightly mitigates the oxidative stress induced by high-intensity training performed in normobaric hypoxia. Biology of Sport, 42(1), 243–251. https://doi.org/10.5114/biolsport.2025.139851
23. Tan, R., Vanhatalo, A., ve Jones, A. M. (2022). Multiple Exercise Transitions Reveal Effects Of Dietary Nitrate On Pulmonary Oxygen Uptake. Medicine and Science in Sports and Exercise, 54(9), 651. https://doi.org/10.1249/01.mss.0000883196.02417.19
24. Webb, A. J., Patel, N., Loukogeorgakis, S., Okorie, M., Aboud, Z., Misra, S., Rashid, R., Miall, P., Deanfield, J., ve Benjamin, N. (2008). Acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite. Hypertension, 51(3), 784–790. https://doi.org/10.1161/HYPERTENSIONAHA.107.103523
25. Wylie, L. J., Kelly, J., Bailey, S. J., Blackwell, J. R., Skiba, P. F., Winyard, P. G., Jeukendrup, A. E., Vanhatalo, A., ve Jones, A. M. (2013). Beetroot juice and exercise: pharmacodynamic and dose-response relationships. Journal of Applied Physiology, 115, 325-336. https://doi.org/10.1152/japplphysiol.00372.2013