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Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis

BACKGROUND: Previous narrative reviews have concluded that dietary nitrate (NO(3)(−)) improves maximal neuromuscular power in humans. This conclusion, however, was based on a limited number of studies, and no attempt has been made to quantify the exact magnitude of this beneficial effect. Such infor...

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Autores principales: Coggan, Andrew R., Baranauskas, Marissa N., Hinrichs, Rachel J., Liu, Ziyue, Carter, Stephen J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501726/
https://www.ncbi.nlm.nih.gov/pubmed/34625064
http://dx.doi.org/10.1186/s12970-021-00463-z
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author Coggan, Andrew R.
Baranauskas, Marissa N.
Hinrichs, Rachel J.
Liu, Ziyue
Carter, Stephen J.
author_facet Coggan, Andrew R.
Baranauskas, Marissa N.
Hinrichs, Rachel J.
Liu, Ziyue
Carter, Stephen J.
author_sort Coggan, Andrew R.
collection PubMed
description BACKGROUND: Previous narrative reviews have concluded that dietary nitrate (NO(3)(−)) improves maximal neuromuscular power in humans. This conclusion, however, was based on a limited number of studies, and no attempt has been made to quantify the exact magnitude of this beneficial effect. Such information would help ensure adequate statistical power in future studies and could help place the effects of dietary NO(3)(−) on various aspects of exercise performance (i.e., endurance vs. strength vs. power) in better context. We therefore undertook a systematic review and individual participant data meta-analysis to quantify the effects of NO(3)(−) supplementation on human muscle power. METHODS: The literature was searched using a strategy developed by a health sciences librarian. Data sources included Medline Ovid, Embase, SPORTDiscus, Scopus, Clinicaltrials.gov, and Google Scholar. Studies were included if they used a randomized, double-blind, placebo-controlled, crossover experimental design to measure the effects of dietary NO(3)(−) on maximal power during exercise in the non-fatigued state and the within-subject correlation could be determined from data in the published manuscript or obtained from the authors. RESULTS: Nineteen studies of a total of 268 participants (218 men, 50 women) met the criteria for inclusion. The overall effect size (ES; Hedge’s g) calculated using a fixed effects model was 0.42 (95% confidence interval (CI) 0.29, 0.56; p = 6.310 × 10(− 11)). There was limited heterogeneity between studies (i.e., I(2) = 22.79%, H(2) = 1.30, p = 0.3460). The ES estimated using a random effects model was therefore similar (i.e., 0.45, 95% CI 0.30, 0.61; p = 1.064 × 10(− 9)). Sub-group analyses revealed no significant differences due to subject age, sex, or test modality (i.e., small vs. large muscle mass exercise). However, the ES in studies using an acute dose (i.e., 0.54, 95% CI 0.37, 0.71; p = 6.774 × 10(− 12)) was greater (p = 0.0211) than in studies using a multiple dose regimen (i.e., 0.22, 95% CI 0.01, 0.43; p = 0.003630). CONCLUSIONS: Acute or chronic dietary NO(3)(−) intake significantly increases maximal muscle power in humans. The magnitude of this effect–on average, ~ 5%–is likely to be of considerable practical and clinical importance. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12970-021-00463-z.
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spelling pubmed-85017262021-10-20 Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis Coggan, Andrew R. Baranauskas, Marissa N. Hinrichs, Rachel J. Liu, Ziyue Carter, Stephen J. J Int Soc Sports Nutr Review BACKGROUND: Previous narrative reviews have concluded that dietary nitrate (NO(3)(−)) improves maximal neuromuscular power in humans. This conclusion, however, was based on a limited number of studies, and no attempt has been made to quantify the exact magnitude of this beneficial effect. Such information would help ensure adequate statistical power in future studies and could help place the effects of dietary NO(3)(−) on various aspects of exercise performance (i.e., endurance vs. strength vs. power) in better context. We therefore undertook a systematic review and individual participant data meta-analysis to quantify the effects of NO(3)(−) supplementation on human muscle power. METHODS: The literature was searched using a strategy developed by a health sciences librarian. Data sources included Medline Ovid, Embase, SPORTDiscus, Scopus, Clinicaltrials.gov, and Google Scholar. Studies were included if they used a randomized, double-blind, placebo-controlled, crossover experimental design to measure the effects of dietary NO(3)(−) on maximal power during exercise in the non-fatigued state and the within-subject correlation could be determined from data in the published manuscript or obtained from the authors. RESULTS: Nineteen studies of a total of 268 participants (218 men, 50 women) met the criteria for inclusion. The overall effect size (ES; Hedge’s g) calculated using a fixed effects model was 0.42 (95% confidence interval (CI) 0.29, 0.56; p = 6.310 × 10(− 11)). There was limited heterogeneity between studies (i.e., I(2) = 22.79%, H(2) = 1.30, p = 0.3460). The ES estimated using a random effects model was therefore similar (i.e., 0.45, 95% CI 0.30, 0.61; p = 1.064 × 10(− 9)). Sub-group analyses revealed no significant differences due to subject age, sex, or test modality (i.e., small vs. large muscle mass exercise). However, the ES in studies using an acute dose (i.e., 0.54, 95% CI 0.37, 0.71; p = 6.774 × 10(− 12)) was greater (p = 0.0211) than in studies using a multiple dose regimen (i.e., 0.22, 95% CI 0.01, 0.43; p = 0.003630). CONCLUSIONS: Acute or chronic dietary NO(3)(−) intake significantly increases maximal muscle power in humans. The magnitude of this effect–on average, ~ 5%–is likely to be of considerable practical and clinical importance. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12970-021-00463-z. BioMed Central 2021-10-09 /pmc/articles/PMC8501726/ /pubmed/34625064 http://dx.doi.org/10.1186/s12970-021-00463-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Coggan, Andrew R.
Baranauskas, Marissa N.
Hinrichs, Rachel J.
Liu, Ziyue
Carter, Stephen J.
Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
title Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
title_full Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
title_fullStr Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
title_full_unstemmed Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
title_short Effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
title_sort effect of dietary nitrate on human muscle power: a systematic review and individual participant data meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501726/
https://www.ncbi.nlm.nih.gov/pubmed/34625064
http://dx.doi.org/10.1186/s12970-021-00463-z
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