Nitrate and Exercise Performance in Middle to Older Aged Adults

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.

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