Dietary Nitrate Supplementation and Exercise Performance in Athletes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
- 1School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK.
- 2School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China.
- 3School of Medical and Health Sciences, Centre for Human Performance, Edith Cowan University, Joondalup 6027, Australia.
Abstract
Background/Objectives: Dietary nitrate supplementation improves exercise performance in recreationally active individuals, but efficacy in athletes remains debated. This meta-analysis evaluated the effects of dietary nitrate supplementation on six exercise performance and physiological/perceptual outcomes-peak power (PP), mean power (MP), maximal oxygen uptake (VO₂max), heart rate (HR), blood lactate (LAC), and rating of perceived exertion (RPE)-in athletes across diverse sports and protocols. Methods: Forty-five randomized, placebo-controlled trials involving 659 healthy athletes (Tier 2 or higher) were included. Random-effects meta-analyses calculated pooled Hedges' g. Subgroup, sensitivity, and publication bias analyses were conducted. Results: No statistically significant overall effect was found for any of the six outcomes (all p > 0.05). In exploratory subgroup analyses, PP showed a positive effect in male-only studies (g = 0.29, 95% CI 0.02 to 0.56, p = 0.04), but the interaction with mixed-sex studies was not significant (p = 0.11). Beetroot and nitrate salts did not differ in VO₂max. And trim-and-fill imputed five studies, reducing this estimate to zero. Subgroup analyses by sport type and exercise type (endurance, intermittent team sports, strength/power) revealed no significant differences. Conclusions: Dietary nitrate supplementation produced no statistically significant pooled ergogenic effects in athletes. Any potential benefit appears small and context-dependent, and the possible role of vascular endothelial function in high-performance athletes warrants further investigation. The absence of statistically significant effects should not be regarded as definitive evidence of no effect.
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BibTeX
@article{xie2026dietary,
title = {{Dietary Nitrate Supplementation and Exercise Performance in Athletes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.}},
author = {Yiqing Xie and Yemin Han and Qing Du and Kai Xu},
journal = {Sports (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/sports14100466},
url = {https://europepmc.org/article/MED/42931603},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dietary Nitrate Supplementation and Exercise Performance in Athletes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
AU - Yiqing Xie
AU - Yemin Han
AU - Qing Du
AU - Kai Xu
PY - 2026
DA - 2026/10/20
JO - Sports (Basel, Switzerland)
DO - 10.3390/sports14100466
UR - https://europepmc.org/article/MED/42931603
AB - Background/Objectives: Dietary nitrate supplementation improves exercise performance in recreationally active individuals, but efficacy in athletes remains debated. This meta-analysis evaluated the effects of dietary nitrate supplementation on six exercise performance and physiological/perceptual outcomes-peak power (PP), mean power (MP), maximal oxygen uptake (VO₂max), heart rate (HR), blood lactate (LAC), and rating of perceived exertion (RPE)-in athletes across diverse sports and protocols. Methods: Forty-five randomized, placebo-controlled trials involving 659 healthy athletes (Tier 2 or higher) were included. Random-effects meta-analyses calculated pooled Hedges' g. Subgroup, sensitivity, and publication bias analyses were conducted. Results: No statistically significant overall effect was found for any of the six outcomes (all p > 0.05). In exploratory subgroup analyses, PP showed a positive effect in male-only studies (g = 0.29, 95% CI 0.02 to 0.56, p = 0.04), but the interaction with mixed-sex studies was not significant (p = 0.11). Beetroot and nitrate salts did not differ in VO₂max. And trim-and-fill imputed five studies, reducing this estimate to zero. Subgroup analyses by sport type and exercise type (endurance, intermittent team sports, strength/power) revealed no significant differences. Conclusions: Dietary nitrate supplementation produced no statistically significant pooled ergogenic effects in athletes. Any potential benefit appears small and context-dependent, and the possible role of vascular endothelial function in high-performance athletes warrants further investigation. The absence of statistically significant effects should not be regarded as definitive evidence of no effect.
SN - 2075-4663
ER -