King's College London British Heart Foundation Centre, Cardiovascular Division, Department of Clinical Pharmacology, St.Thomas' Hospital, London, UK.
Br J Clin Pharmacol. 2013 Mar;75(3):677-96. doi: 10.1111/j.1365-2125.2012.04420.x.
The discovery that dietary (inorganic) nitrate has important vascular effects came from the relatively recent realization of the 'nitrate-nitrite-nitric oxide (NO) pathway'. Dietary nitrate has been demonstrated to have a range of beneficial vascular effects, including reducing blood pressure, inhibiting platelet aggregation, preserving or improving endothelial dysfunction, enhancing exercise performance in healthy individuals and patients with peripheral arterial disease. Pre-clinical studies with nitrate or nitrite also show the potential to protect against ischaemia-reperfusion injury and reduce arterial stiffness, inflammation and intimal thickness. However, there is a need for good evidence for hard endpoints beyond epidemiological studies. Whilst these suggest reduction in cardiovascular risk with diets high in nitrate-rich vegetables (such as a Mediterranean diet), others have suggested possible small positive and negative associations with dietary nitrate and cancer, but these remain unproven. Interactions with other nutrients, such as vitamin C, polyphenols and fatty acids may enhance or inhibit these effects. In order to provide simple guidance on nitrate intake from different vegetables, we have developed the Nitrate 'Veg-Table' with 'Nitrate Units' [each unit being 1 mmol of nitrate (62 mg)] to achieve a nitrate intake that is likely to be sufficient to derive benefit, but also to minimize the risk of potential side effects from excessive ingestion, given the current available evidence. The lack of data concerning the long term effects of dietary nitrate is a limitation, and this will need to be addressed in future trials.
饮食（无机）硝酸盐对血管具有重要影响的发现源自相对较新的“硝酸盐-亚硝酸盐-一氧化氮（NO）途径”的认识。饮食硝酸盐已被证明具有一系列有益的血管作用，包括降低血压、抑制血小板聚集、保护或改善内皮功能、提高健康个体和外周动脉疾病患者的运动表现。硝酸盐或亚硝酸盐的临床前研究也显示出具有预防缺血再灌注损伤和降低动脉僵硬、炎症和内膜厚度的潜力。然而，除了流行病学研究之外，还需要有良好的硬终点证据。虽然这些研究表明富含硝酸盐的蔬菜（如地中海饮食）的饮食可降低心血管风险，但其他研究表明饮食硝酸盐与癌症可能存在轻微的正相关和负相关，但这些仍未得到证实。与其他营养素（如维生素 C、多酚和脂肪酸）的相互作用可能会增强或抑制这些作用。为了从不同的蔬菜中提供简单的硝酸盐摄入量指南，我们开发了带有“硝酸盐单位”（每个单位为 1mmol 硝酸盐（62mg）的硝酸盐“蔬菜表”，以达到摄入硝酸盐的量可能足以受益，但也最大限度地降低了因摄入过多而导致潜在副作用的风险，鉴于目前现有的证据。缺乏关于饮食硝酸盐长期影响的数据是一个限制，这将需要在未来的试验中解决。
