Dietary nitrate as modulator of physical performance and cardiovascular health

Curr Opin Clin Nutr Metab Care. 2017 Nov;20(6):440-446. doi: 10.1097/MCO.0000000000000414.


Purpose of review: Early interventional trials reported improvements in cardiac and exercise outcomes with inorganic nitrate ingestion. The current review aims to provide a brief update of recent evidence regarding ergogenic and cardiovascular effects of dietary nitrate and practical recommendations.

Recent findings: Recent evidence has been inconsistent and questions remain regarding effective dose, duration, and source of nitrate and cohorts likely to benefit. Dietary nitrate may be most relevant to those with vascular/metabolic impairments, those engaging in short-term, intense exercise, deconditioned individuals, and those with a low dietary nitrate intake.

Summary: The evidence for cardiovascular/exercise benefit is plausible but inconsistent. However, dietary nitrate, in contrast to pharmacological nitrate, has a high benefit-risk ratio. Although nitrate supplementation has grown in popularity, it is suggested that increased green vegetables consumption may provide similar/superior benefits to nitrate supplementation in a cheaper, safer, and potentially tastier context.

Publication types

  • Review

MeSH terms

  • Athletic Performance
  • Cardiovascular Diseases / prevention & control*
  • Cost-Benefit Analysis
  • Diet*
  • Dietary Supplements
  • Dose-Response Relationship, Drug
  • Exercise*
  • Humans
  • Meta-Analysis as Topic
  • Nitrates / administration & dosage*
  • Nitric Oxide / metabolism
  • Performance-Enhancing Substances / administration & dosage
  • Randomized Controlled Trials as Topic


  • Nitrates
  • Performance-Enhancing Substances
  • Nitric Oxide