The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease. Issue 6 (December 2018)

• Record Type: Journal Article
• Authors: Beijers, Rosanne J.H.C.G.; Huysmans, Stephanie M.D.; van de Bool, Coby; Kingma, Boris R.M.; Verdijk, Lex B.; van Loon, Luc J.C.; Meex, Steven J.R.; Gosker, Harry R.; Schols, Annemie M.W.J.
• Is Part Of: Clinical nutrition. Volume 37:Issue 6(2018)Part A
• Page Start: 1852
• Page End: 1861
• Publication Date: 2018-12
• Subjects: Blood pressure -- COPD -- Cardiac biomarkers -- Dietary nitrate and mechanical efficiency; BMD bone mineral density -- BMI body mass index -- BRJ beetroot juice -- CK creatinine kinase -- CKD-EPI estimated glomerular filtration rate -- COPD chronic obstructive pulmonary disease -- DEXA Dual Energy X-Ray Absorptiometry -- FEV1 forced expiratory volume in 1 s -- FFMI fat free mass index -- FVC forced vital capacity -- HDL high-density lipoprotein -- HOMA-IR homeostatic model assessment to estimate insulin resistance -- Hs-CRP high-sensitive C-reactive protein -- Hs-TNT high-sensitive troponin T -- LDL low-density lipoprotein -- ME mechanical efficiency -- MVPA moderate to vigorous physical activity -- NaNO3 sodium nitrate -- NO nitric oxide -- NT-proBNP N-terminal pro-B-type natriuretic peptide -- PA physical activity -- PR pulmonary rehabilitation -- SCT submaximal cycling test -- SMI skeletal muscle mass index -- REE resting energy expenditure -- RER respiratory exchange rate -- VCO2 carbon dioxide productions -- VO2 oxygen consumption -- Wmax maximal work load; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2017.10.011
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: Many COPD patients have a reduced exercise capacity and mechanical efficiency and are at increased cardiometabolic risk. This study aimed to assess acute and 7-days effects of dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with COPD. Methods: This double-blind, randomized cross-over placebo controlled trial included 20 mild-to-moderate COPD patients (66.6 ± 7.5 years) with moderate exercise impairments and decreased mechanical efficiency, normal BMI (26 ± 3 kg/m 2 ) but high prevalence of abdominal obesity (83.3%). Subjects were randomly allocated to the treatment order of 7 days sodium nitrate ingestion (∼8 mmol/day) and 7 days placebo (NaCl solution) or vice versa, separated by a washout period. Before (Day-1) and after (Day-7) both intervention periods resting metabolic rate and the metabolic response during submaximal cycle ergometry, cycling endurance time, plasma nitrate and nitrite levels, cardiac plasma biomarkers (e.g. cardiac troponin T, Nt-proBNP and creatinine kinase) and blood pressure were measured. Subsequently, gross, net and delta mechanical efficiency were calculated. Results: Plasma nitrate and nitrite concentrations increased at Day-1 and Day-7 after sodium nitrate but not after placebo ingestion. Systolic and diastolic blood pressure did not change following nitrate ingestion. Furthermore, no differences were observed in gross, net, and delta mechanical efficiency during submaximal exercise, cycling endurance time and cardiac biomarkers between nitrate and placebo on Day-1 and Day-7. Meta-analysis of all available studies in COPD also showed no beneficial effect of beetroot juice on systolic and diastolic blood pressure. Conclusion: Acute as well as 7-days sodium nitrate supplementation does not modulate mechanical efficiency, blood pressure or cardiac biomarkers in mild-to-moderate COPD patients.