The effect of dietary nitrate on macro- and microvascular function: A systematic review

Abstract

Previous studies have investigated the impact of dietary nitrate on vascular function due to the association between dietary nitrate ingestion and improvement in nitric oxide (NO) bioavailability. Considering that NO can present different effects through vascular beds (macro- vs. microvasculature) due to the specific characteristic (function and morphology) that each vessel exhibits, it is crucial to investigate the effect of dietary nitrate ingestion on the macro- and microvascular function to understand the effect of nitrate on vascular function. For this reason, this review aimed to evaluate the impact of dietary nitrate on macro- and microvascular function in humans. A total of 29 studies were included in the systematic review, of which 19 studies evaluated the effect of nitrate supplementation on macrovascular function, eight studies evaluated the effect on microvascular function, and two studies evaluated the impact on both macro- and microvascular function. The literature suggests that dietary nitrate ingestion seems to improve the vascular function in macrovasculature, whereas microvascular function appears to be modest. Future studies investigating the effect of nitrate ingestion on vascular function should focus on measuring macro- and microvascular function whenever possible so that the impact of nitrate-rich foods on vascular segments could be better understood.

Keywords:

• Beetroot
• vascular function
• nitric oxide
• flow-mediated dilation
• reactive hyperemia

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

MV-S and GVO acknowledge the financial support provided by CAPES (Brazil) and FAPERJ (E-26/200.021/2020), respectively. Dr. Thiago S. Alvares was supported by FAPERJ Young Scientist Grant Program (E-26/202.905/2019) and by National Council for Scientific and Technological Productivity Scholarship (304189/2020-0).