Nitrates, Nitrites, Nitric Oxide: All Things in Moderation Holds True

Recently, numerous weight loss and sports performance products have began to include nitric oxide in their ingredient listing. Nitric oxide is a metabolite of nitrate, and plays an important role in our cardiovascular health by helping to regulate vasodilation, or expansion, of blood vessels which helps control blood pressure. From a research standpoint, recent findings show a direct correlation between improved cardiovascular health and higher nitrate and nitrite intake.¹ Studies using beetroot juice, a concentrated source of nitrates, conducted by Kapil and colleagues resulted in higher amounts of plasma nitrate and nitrite which in turn caused a reduction in both systolic and diastolic blood pressure in those who participated in the study.² But haven’t we been told to avoid nitrates and nitrites in processed meats due to the increased risk of developing cancer due to their carcinogenic properties?

There is enough information presented through clinical studies to warrant concern about the carcinogenic effects of nitrates and nitrites in excessive concentrations. Cured and processed meats including bacon, bologna, corned beef, hot dogs, lunch meats, sausage, and canned and cured meat and ham, contain high amounts of nitrate and nitrite. The purpose of using nitrates and nitrites in these foods includes helping to improve flavor, preserve color, and slow microbial growth.

The conclusion presented through recent research results about ideal intake is the age old adage, “all things in moderation”. Consuming a diet rich in fruits and vegetables allows for a more balanced and appropriate concentration of nitrates and nitrites. Choosing arugula and butterhead lettuce, spinach, beets, celery, and carrots, for example, will provide a healthy intake of these nutrients.³ This dietitian continues to recommend avoiding or at least limiting those processed, cured meats that contain excessive concentrations of nitrates. Avoiding these foods not only moderates the intake of nitrates and nitrites, but allows more room for healthy, natural foods as part of your regular diet. Aiming for the recommended five to seven servings of vegetables and fruits daily is still an ideal dietary goal.

There is still the question of the safety of nitric oxide as an ingredient of many sports nutrition and weight loss supplements. The use of nitric oxide during exercise is associated with an increased risk of collapsing due to hypotension, or reduced blood pressure. Athletes at risk tend to be those not well hydrated, or participating in long, strenuous exercise or competition where dehydration may occur. Before using any supplement, an athlete’s or individual’s diet needs to be in place and consistently followed. The use of supplements without a balanced diet just covers the inadequacy, but doesn’t really support health or enhanced sports performance. Athletes wanting to include a nitric oxide containing product in their training should do so under direct supervision by a certified sports professional, and may or may not see beneficial results. Nitric oxide containing products are also not permissible for use by NCAA athletes.

Research is ongoing, and it is likely that the regulating organizations overseeing food safety and dietary recommendations may need to adjust and account for nitrates and nitrites as an actual beneficial nutrient to cardiovascular health in the near future.

1. Weitzberg E, Hezel M, Lundber JO. Nitrate-nitrite-nitric oxide pathway: implications for anesthesiology and intensive care. Anesthesiology. 2010;113:1460-1475.
2. Kapil V, Milson AB, Okorie M, et al. Inorganic nitrate supplementation lowers blood pressure in humans: role for nitrite-derived NO. Hypertension. 2010;56:274-281.
3. Hertzler S. Nitrate Supplementation for Cardiovascular Health and Exercise Performance. SCAN’s Pulse. 2012;31:7-11. 3. Haudum J. Commercially Available Sports Drinks: What to Look for, When to Consume. SCAN’s Pulse, 2013,32:1-5.