Influence of dietary nitrate supplementation on exercise tolerance and performance.

Several recent studies indicate that supplementation of the diet with inorganic nitrate results in a significant reduction in pulmonary O2 uptake during sub-maximal exercise, an effect that appears to be related to enhanced skeletal muscle efficiency. The physiological mechanisms responsible for this effect are not completely understood but are presumably linked to the bioconversion of ingested nitrate into nitrite and thence to nitric oxide. Nitrite and/or nitric oxide may influence muscle contractile efficiency perhaps via effects on sarcoplasmic reticulum calcium handling or actin-myosin interaction, and may also improve the efficiency of mitochondrial oxidative phosphorylation. A reduced O2 cost of exercise can be observed within 3 h of the consumption of 5-6 mmol of nitrate, and this effect can be preserved for at least 15 days provided that the same 'dose' of nitrate is consumed daily. A reduced O2 cost of exercise following nitrate supplementation has now been reported for several types of exercise including cycling, walking, running, and knee extension exercise. Dietary nitrate supplementation has been reported to extend the time to exhaustion during high-intensity constant work rate exercise by 16-25% and to enhance cycling performance over 4, 10, and 16.1 km by 1-2% in recreationally active and moderately trained subjects. Although nitrate appears to be a promising 'new' ergogenic aid, additional research is required to determine the scope of its effects in different populations and different types of exercise.