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Critical Reviews in Food Science and Nutrition Volume 59, 2019 - Issue 15
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Effects of inorganic nitrate and nitrite consumption on cognitive function and cerebral blood flow: A systematic review and meta-analysis of randomized clinical trials

Tom CliffordHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UKORCID Iconhttps://orcid.org/0000-0003-0484-2953View further author information
ORCID Icon,
Abrar BabateenHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UK;Faculty of Applied Medical Sciences, Clinical Nutrition Department, Umm Al-Qura University, Makkah, Saudi ArabiaView further author information
,
Oliver M. ShannonHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UK;Research Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, UKView further author information
,
Tess CapperHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UKView further author information
,
Ammar AshorHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UK;College of Medicine, University of Al-Mustansiriyah, Baghdad, IraqView further author information
,
Blossom StephanInstitute of Health and Society, Newcastle University, Newcastle upon Tyne, UKView further author information
,
Louise RobinsonInstitute of Health and Society, Newcastle University, Newcastle upon Tyne, UKView further author information
,
John P. O'HaraResearch Institute for Sport, Physical Activity, and Leisure, Leeds Beckett University, Leeds, UKORCID Iconhttps://orcid.org/0000-0003-1589-7984View further author information
ORCID Icon,
John C. MathersHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UKView further author information
,
Emma StevensonHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UKView further author information
&
Mario SiervoHuman Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle on Tyne, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-5515-0944View further author information
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Pages 2400-2410 | Published online: 10 Jul 2018
 
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ABSTRACT

We conducted a systematic review and meta-analysis of randomized clinical trials examining the effect of inorganic nitrate or nitrite supplementation on cognitive function (CF) and cerebral blood flow (CBF). Two databases (PubMed, Embase) were searched for articles from inception until May 2017. Inclusion criteria were: randomized clinical trials; participants >18 years old; trials comparing a nitrate/nitrite intervention with a control. Thirteen and nine trials were included in the meta-analysis to assess CF and CBF, respectively. Random-effects models were used and the effect size described as standardized mean differences (SMDs). A total of 297 participants (median of 23 per trial) were included for CF; 163 participants (median of 16 per trial) were included for CBF. Nitrate/nitrite supplementation did not influence CF (SMD +0.06, 95% CI: -0.06, 0.18, P = 0.32) or CBF under resting (SMD +0.14, 95% CI: -0.13, 0.41, P = 0.31), or stimulated conditions (SMD + 0.23, 95% CI: -0.11, 0.56, P = 0.19). The meta-regression showed an inverse association between duration of the intervention and CBF (P = 0.02) but no influence of age, BMI or dose (P < 0.05). Nitrate and nitrite supplementation did not modify CBF or CF. Further trials employing larger samples sizes and interventions with longer duration are warranted.

Acknowledgments

We would like to thank Dr Rattray for sharing the data from his studies.

Disclosure of potential conflicts of interest

No potential conflicts of interest were disclosed.

Additional information

Funding

This work was supported by the NIHR National Institute of Health Research/Support (Grant Number: 16/137/62) The write up of this work was undertaken within the framework of the NIHR Global Group: DePEC (Grant Number: 16/137/62).

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