Does nitrate improve exercise tolerance and exercise capacity in people with chronic obstructive pulmonary disease (COPD)?

    Last Updated: October 13, 2024

    Current evidence shows that nitrate supplementation can lower subjective perceptions of exertion during exercise in people with chronic obstructive pulmonary disease (COPD).[1] Therefore, nitrate might improve exercise tolerance in this population. However, while some trials have found that nitrate/beetroot juice can increase the distance people with COPD can walk,[2][3][4] all of the current evidence compiled in systematic reviews and meta-analyses shows large variability in the effect of nitrate on exercise capacity between studies.[5][1][6] Consequently, while there is potential for nitrate supplementation to improve exercise capacity in people with COPD, further high-quality randomized controlled trials are needed to fully understand its efficacy.[5][1][6]

    References

    1. ^Somia Alshafie, Ghidaa Osama El-Helw, Aya M Fayoud, Asmaa Ahmed Elrashedy, Mohamed Ibrahim Gbreel, Saba Saleh Alfayoumi, Islam Mayhoub Mohamed, Gehad Taha Abdelwadoud, Alaa Saad Isa, Khaled Mohamed Ragab, Anas Zakarya NoureldenEfficacy of dietary nitrate-rich beetroot juice supplementation in patients with chronic obstructive pulmonary disease (COPD): A systematic review and meta-analysisClin Nutr ESPEN.(2021 Apr)
    2. ^Matthew J Pavitt, Adam Lewis, Sara C Buttery, Bernadette O Fernandez, Monika Mikus-Lelinska, Winston A S Banya, Martin Feelisch, Michael I Polkey, Nicholas S HopkinsonDietary nitrate supplementation to enhance exercise capacity in hypoxic COPD: EDEN-OX, a double-blind, placebo-controlled, randomised cross-over studyThorax.(2022 Oct)
    3. ^Pavitt MJ, Tanner RJ, Lewis A, Buttery S, Mehta B, Jefford H, Curtis KJ, Banya WAS, Husain S, Satkunam K, Shrikrishna D, Man W, Polkey MI, Hopkinson NSOral nitrate supplementation to enhance pulmonary rehabilitation in COPD: ON-EPIC a multicentre, double-blind, placebo-controlled, randomised parallel group study.Thorax.(2020-07)
    4. ^Berry MJ, Justus NW, Hauser JI, Case AH, Helms CC, Basu S, Rogers Z, Lewis MT, Miller GDDietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patientsNitric Oxide.(2015 Aug 1)
    5. ^Wang J, Feng F, Zhao Y, Bai L, Xu Y, Wei Y, He H, Zhou XDietary nitrate supplementation to enhance exercise capacity in patients with COPD: Evidence from a meta-analysis of randomized controlled trials and a network pharmacological analysis.Respir Med.(2024-Feb)
    6. ^Hongkuan Yang, Shuifeng He, Fang Chen, Linbao Liang, Junjie PanEfficacy and safety of nitrate supplementation on exercise tolerance in chronic obstructive pulmonary disease: A systematic review and meta-analysisMedicine (Baltimore).(2022 Jan 14)