This article provides an overview of the current literature relating to the efficacy of dietary nitrate (NO3−) ingestion in altering aspects of cardiovascular and metabolic health and exercise capacity in healthy and diseased individuals. The consumption of NO3−-rich vegetables, such as spinach and beetroot, have been variously shown to promote nitric oxide bioavailability, reduce systemic blood pressure, enhance tissue blood flow, modulate muscle O2 utilisation and improve exercise tolerance both in normoxia and in hypoxia, as is commonly observed in a number of disease states. NO3− ingestion may, therefore, act as a natural means for augmenting performance and attenuating complications associated with limited O2 availability or transport, hypertension and the metabolic syndrome. Recent studies indicate that dietary NO3− might also augment intrinsic skeletal muscle contractility and improve the speed and power of muscle contraction. Moreover, several investigations suggest that NO3− supplementation may improve aspects of cognitive performance both at rest and during exercise. Collectively, these observations position NO3− as more than a putative ergogenic aid and suggest that increasing natural dietary NO3− intake may act as a prophylactic in countering the predations of senescence and certain cardiovascular-metabolic diseases.
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