Health Benefits of “Well Chewing” during Meals via Enterosalivary Nitrate–Nitrite–Nitric Oxide Pathway

Abstract

Saliva contains nitrates recycled from ingested foods (e.g., vegetables) via the enterosalivary pathway. Chewing thoroughly during meals increases salivary flow and the conversion of salivary nitrate to nitrite by oral commensal bacteria, resulting in a nitrite-rich gastric environment. As a result, rather than N-nitroso compounds, the acidic stomach produces nitric oxide (NO) and S-nitrosothiols. These molecules may provide gastric and systemic health benefits by transducing NO-mediated signals, especially in patients with vascular endothelial dysfunction and metabolic syndrome, both of which are associated with decreased endogenous NO generation and impaired NO synthase activity. This article examines the evidence that thorough chewing of food creates a nitrite-rich gastric environment that encourages health benefits rather than carcinogenicity by increasing NO bioavailability via the enterosalivary nitrate-nitrite-NO pathway.