Abstract

There have been recent calls for strategies to improve oral health in athletes. High carbohydrate diets, exercise induced dehydration and transient perturbations to immune function combine to increase oral disease risk in this group. We tested whether a single dose of nitrate (NO3-) would offset the reduction in salivary pH following carbohydrate ingestion before and after an exercise bout designed to cause mild dehydration. Eleven trained male runners ( 53 ± 9 ml∙kg-1∙min-1, age 30 ± 7 years) completed a randomised placebo-controlled study comprising four experimental trials. Participants ingested the following fluids one hour before each trial: (a) 140 ml of water (negative-control), (b) 140 ml of water (positive-control), (c) 140 ml of NO3- rich beetroot juice (~12.4 mmol NO3-) (NO3- trial) or (d) 140 ml NO3- depleted beetroot juice (placebo-trial). During the negative-control trial, participants ingested 795 ml of water in three equal aliquots: before, during, and after 90 min of submaximal running. In the other trials they received 795 ml of carbohydrate supplements in the same fashion. Venous blood was collected before and after the exercise bout and saliva was sampled before and repeatedly over the 20 min following carbohydrate or water ingestion. As expected, nitrite (NO2-) and NO3- were higher in plasma and saliva during the NO3- trial than all other trials (all P<0.001). Compared to the negative-control, salivary-pH was significantly reduced following the ingestion of carbohydrate in the positive-control and placebo trials (both P <0.05). Salivary-pH was similar between the negative-control and NO3- trials before and after exercise despite ingestion of carbohydrate in the NO3- trial (both P≥0.221). Ingesting NO3- attenuates the expected reduction in salivary-pH following carbohydrate supplements and exercise-induced dehydration. NO3- should be considered by athletes as a novel nutritional strategy to reduce the risk of developing acidity related oral health conditions.

Highlights

  • Carbohydrate-rich sports products are an important resource for sports performance in certain circumstances and are widely consumed throughout society [1,2,3,4]

  • The capacity of saliva to normalise oral pH and resist oral disease development may be limited in this population due to exercise-associated bouts of dehydration, transient perturbations to immune function and reduced salivary flow-rates induced by mouth breathing during exercise [17,18,19, 21,22,23]

  • There was a significant increase in plasma [NO2-] (P = 0.01, 95% confidence intervals (95%CI) 372–629 nM) and plasma [NO3-] (P

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Summary

Introduction

Carbohydrate-rich sports products are an important resource for sports performance in certain circumstances and are widely consumed throughout society [1,2,3,4] These products contain erosive components such as malic and/or citric acid [5,6,7] which can be detrimental to oral health due to the rapid drop in salivary pH that is experienced following consumption [5, 7,8,9,10,11,12,13].

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