Nitrate and Exercise Performance in Middle to Older Aged Adults

Study Overview
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Brief Summary
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Research with young healthy individuals has shown that beetroot juice beverages that contain large amounts of nitrate can improve exercise performance. Currently, it is not know whether the consumption of beetroot juice beverages high in nitrate can improve exercise performance in higher functioning middle- to older-aged adults. Therefore, the purpose of this study is to compare the effect of two different beetroot juice beverages (one high in nitrate and one low in nitrate) on exercise performance in middle- to older-aged adults.

Detailed Description
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Nitric oxide (NO) has been identified as an important biological messenger involved in a number of physiological processes and is produced from L-arginine and molecular oxygen by NO-synthases or the more recently identified nitrate to nitrite to NO pathway. Dietary nitrate can be found in green leafy vegetables and is particularly abundant in beetroot and has been shown to be a potential ergogenic agent. The nitrate to nitrite to NO pathway has been shown to be involved in a number of physiological processes that could account for the improved exercise response following nitrate ingestion. However, the benefits of nitrate as an ergogenic aid have been shown to be effected by numerous factors that can influence its efficacy. These include age, training level, dosage and the mode, duration and intensity of the exercise. Research with healthy younger moderately trained adults has repeatedly shown that ingestion of dietary nitrate can reduce the oxygen cost of submaximal exercise and improve exercise performance during high intensity exercise; whereas research with younger more highly trained endurance athletes is equivocal, since some studies have failed to demonstrate an improvement in exercise performance following nitrate ingestion. The effects of nitrate have also been shown to be influenced by age. It has been documented that there are alterations in NO metabolism in older adults thought to result from impairment of the NO-synthases pathway. The investigators have shown that consumption of a supplement high in nitrate, such as beetroot juice, leads to elevated plasma nitrite levels and may help restore NO metabolism in older adults; whereas a diet high in nitrate without supplementation was insufficient at increasing plasma nitrite levels. The investigators research, along with that of others has shown nitrate supplementation to have positive effects in older adults with chronic diseases. However, research examining the effects of dietary nitrate on exercise performance in healthy older adults is scarce. Presently, it is unclear as to whether nitrate supplementation is beneficial to exercise performance in older adults and there is no data examining the effect of nitrate supplementation on exercise performance in active older adults. Therefore, the purpose of this study is to examine the effect of chronic nitrate supplementation on exercise performance in active higher functioning older adults.

Official Title
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The Effects of Chronic Dietary Nitrate Supplementation on Constant Work Rate Exercise in High Functioning Middle Aged and Older Adults

Conditions
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Aging

Intervention / Treatment
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* Dietary Supplement: High Nitrate Beetroot Juice
* Dietary Supplement: Low Nitrate Beetroot Juice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Competitive runner or cyclist. Able to pedal a stationary bike. Engage in moderate physical activity for at least 150 minutes per week or engage in strenuous physical activity for at least 75 minutes per week. Able to provide own transportation to study testing visits. Able to provide own transportation to study testing visits. Able to consume study beverages. Willingness to provide informed consent and participate in the intervention. Exclusion Criteria: tobacco user (smoke or chew) participating in another intervention research study diabetes (type 1 or 2) atrophic gastritis hypo-or hyperthyroidism gout history of kidney stones history of hypotension aversion to the study-related testing procedures allergy/sensitivity/aversion to beetroot beverages medical conditions with contraindications for engaging in the vigorous aerobic exercise current treatment for cancer thyroid disorders, cardiovascular disease, chronic obstructive pulmonary disease, inflammatory bowel diseases impaired liver or kidney function taking phosphodiesterase type 5 inhibitors taking nitroglycerin or nitrate preparations taking proton pump inhibitors taking medication for hypothyroidism

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: High Nitrate Beetroot Juice<br>Beetroot juice high in nitrate will contain approximately 10.0 mmole nitrate per 120 ml. | Dietary Supplement: High Nitrate Beetroot Juice<br>* High nitrate beetroot juice (120 ml) will be administered for 7 days consecutively followed by a 7 day washout period then 7 consecutive days of low nitrate beetroot juice.<br>|
| Placebo Comparator: Low Nitrate Beetroot Juice<br>Beetroot juice low in nitrate will contain approximately 0.5 mmole nitrate per 120 ml. | Dietary Supplement: Low Nitrate Beetroot Juice<br>* Low nitrate beetroot juice (120 ml) will be administered for 7 days consecutively followed by a 7 day washout period then 7 consecutive days of high nitrate beetroot juice..<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Constant Work Rate (CWR) Exercise Time | Exercise duration measured as the length of the exercise period at a submaximal exercise work rate. | Seven days of treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Isotime Oxygen Consumption (VO2) | VO2 during the constant work rate exercise test measured at the minimum exercise time from any of the tests (isotime). | Seven days of treatment | 
| Isotime Borg Rating of Perceived Exertion (RPE) | RPE during the constant work rate exercise test measured at the minimum exercise time from any of the tests (isotime). | Seven days of treatment | 
| Isotime Systolic Blood Pressure (Systolic BP) | Systolic BP during the constant work rate exercise test measured at the minimum exercise time from any of the tests (isotime). | Seven days of treatment | 
| Isotime Diastolic Blood Pressure (Systolic BP) | Diastolic BP during the constant work rate exercise test measured at the minimum exercise time from any of the tests (isotime). | Seven days of treatment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Beetroot Juice, Older Adults, Nitrate, Nitrite, Nitric Oxide