Dietary nitrate supplementation: effects on plasma nitrite and pulmonary O2 uptake dynamics during exercise in hypoxia and normoxia
We investigated the effects of dietary nitrate (NO3−) supplementation on the concentration of plasma nitrite ([NO2−]), oxygen uptake (V̇o2) kinetics, and exercise tolerance in normoxia (N) and hypoxia (H). In a double-blind, crossover study, 12 healthy subjects completed cycle exercise tests, twice in N (20.9% O2) and twice in H (13.1% O2). Subjects ingested either 140 ml/day of NO3−-rich beetroot juice (8.4 mmol NO3; BR) or NO3−-depleted beetroot juice (PL) for 3 days prior to moderate-intensity and severe-intensity exercise tests in H and N. Preexercise plasma [NO2−] was significantly elevated in H-BR and N-BR compared with H-PL ( P < 0.01) and N-PL ( P < 0.01). The rate of decline in plasma [NO2−] was greater during severe-intensity exercise in H-BR [−30 ± 22 nM/min, 95% confidence interval (CI); −44, −16] compared with H-PL (−7 ± 10 nM/min, 95% CI; −13, −1; P < 0.01) and in N-BR (−26 ± 19 nM/min, 95% CI; −38, −14) compared with N-PL (−1 ± 6 nM/min, 95% CI; −5, 2; P < 0.01). During moderate-intensity exercise, steady-state pulmonary V̇o2 was lower in H-BR (1.91 ± 0.28 l/min, 95% CI; 1.77, 2.13) compared with H-PL (2.05 ± 0.25 l/min, 95% CI; 1.93, 2.26; P = 0.02), and V̇o2 kinetics was faster in H-BR (τ: 24 ± 13 s, 95% CI; 15, 32) compared with H-PL (31 ± 11 s, 95% CI; 23, 38; P = 0.04). NO3− supplementation had no significant effect on V̇o2 kinetics during severe-intensity exercise in hypoxia, or during moderate-intensity or severe-intensity exercise in normoxia. Tolerance to severe-intensity exercise was improved by NO3− in hypoxia (H-PL: 197 ± 28; 95% CI; 173, 220 vs. H-BR: 214 ± 43 s, 95% CI; 177, 249; P = 0.04) but not normoxia. The metabolism of NO2− during exercise is altered by NO3− supplementation, exercise, and to a lesser extent, hypoxia. In hypoxia, NO3− supplementation enhances V̇o2 kinetics during moderate-intensity exercise and improves severe-intensity exercise tolerance. These findings may have important implications for individuals exercising at altitude.