Eric Tsz-Chun Poon, Jason Chun-Kit Iu, Wesley Man-Kuk Sum, Po-San Wong, Kenneth Ka-Hei Lo, Ajmol Ali, Stephen F. Burns, Eric T. Trexler
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引用次数: 0
Abstract
Background
Dietary nitrate (NO3−) supplementation is purported to benefit exercise performance. However, previous studies have evaluated this nutritional strategy with various performance outcomes, exercise tasks, and dosing regimens, often yielding inconsistent results that limit the generalizability of the findings.
Objective
We aimed to synthesize the available evidence regarding the effect of NO3− supplementation on 11 domains of exercise performance.
Methods
An umbrella review was reported in accordance with the Preferred Reporting Items for Overviews of Reviews guideline. Seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) were searched from inception until July 2024. Systematic reviews with meta-analyses comparing NO3− supplementation and placebo-controlled conditions were included. Literature search, data extraction, and methodological quality assessment (A Measurement Tool to Assess Systematic Reviews Assessing the Methodological quality of SysTemAtic Review [AMSTAR-2]) were conducted independently by two reviewers.
Results
Twenty systematic reviews with meta-analyses, representing 180 primary studies and 2672 unique participants, met the inclusion criteria. Our meta-analyses revealed mixed effects of NO3− supplementation. It improved time-to-exhaustion tasks [standardized mean difference (SMD): 0.33; 95% confidence interval (CI) 0.19–0.47] with subgroup analyses indicating more pronounced improvements when a minimum dose of 6 mmoL/day (372 mg/day) and chronic (> 3 days) supplementation protocol was implemented. Additionally, ergogenic effects of NO3− supplementation were observed for total distance covered (SMD: 0.42; 95% CI 0.09–0.76), muscular endurance (SMD: 0.48; 95% CI 0.23–0.74), peak power output (PPO; SMD: 0.25; 95% CI 0.10 to 0.39), and time to PPO (SMD: − 0.76; 95% CI − 1.18, − 0.33). However, no significant improvements were found for other performance outcomes (all p > 0.05). The AMSTAR-2 ratings of most included reviews ranged from low to critically low.
Conclusions
This novel umbrella review with a large-scale meta-analysis provides an updated synthesis of evidence on the effects of NO3− supplementation across various aspects of exercise performance. Our review also highlights significant methodological quality issues that future systematic reviews in this field should address to enhance the reliability of evidence.
Clinical Trial Registration
This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42024577461).
期刊介绍：
Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports.
Types of Articles:
Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings.
Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field.
Original Research Articles: High-quality research articles.
Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content.
Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances.
Peer Review Process:
All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.
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