Dietary inorganic nitrate as an ergogenic aid : An expert consensus derived via the modified Delphi technique

• INTRODUCTION: Dietary inorganic nitrate is a popular nutritional supplement, which augments nitric oxide bioavailability and may enhance exercise performance. Despite considerable research exploring the effects of dietary nitrate during exercise, there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Additionally, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. METHODS: In this study, we used the modified Delphi technique to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via video conferencing), the expert panel members voted on 222 statements relating to the use of dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e., yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research. RESULTS: The 12 panel members contributed to voting in all three rounds. A total of 39 (17.6%) statements reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60%) of the statements, and were unable to agree on the outcome of the remaining statements. CONCLUSION: This study outlines the current expert consensus on dietary nitrate as an ergogenic aid, which may be of value to athletes, coaches, practitioners and researchers. Findings suggest that the effects of dietary nitrate are reduced in individuals with higher aerobic fitness (VO2peak > 60 ml/kg/min) and therefore aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes hoping to benefit from dietary nitrate supplementation should consume 8–16 mmol nitrate acutely or 4–16 mmol/d nitrate chronically (with the final dose ingested 2–4 hours pre-exercise) to maximise ergogenic effects. From a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe. However, the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, which highlights the need, and considerable scope, for additional research in this area. 

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MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Idrottsvetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Sport and Fitness Sciences (hsv//eng)

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