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Dietary nitrate supplementation to enhance exercise capacity in hypoxic COPD: EDEN-OX a double-blind, placebo-controlled, randomised crossover study
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EDEN-Ox Manuscript symplectic 5-11-21.pdf | Accepted version | 955.64 kB | Adobe PDF | View/Open |
Title: | Dietary nitrate supplementation to enhance exercise capacity in hypoxic COPD: EDEN-OX a double-blind, placebo-controlled, randomised crossover study |
Authors: | Pavitt, M Lewis, A Buttery, S Fernandez, BO Mikus-Lelinska, M Banya, W Feelisch, M Polkey, M Hopkinson, N |
Item Type: | Journal Article |
Abstract: | Rationale: Dietary nitrate supplementation improves skeletal muscle oxygen utilisation and vascular endothelial function. We hypothesised that these effects might be sufficient to improve exercise performance in patients with COPD and hypoxia severe enough to require supplemental oxygen. Methods: We conducted a single-centre, double-blind, placebo-controlled, cross-over study, enrolling adults with COPD who were established users of long-term oxygen therapy. Participants performed an endurance shuttle walk test, using their prescribed oxygen, 3 hours after consuming either 140 mL of nitrate-rich beetroot juice (BRJ) (12.9 mmol nitrate) or placebo (nitrate-depleted BRJ). Treatment order was allocated (1:1) by computer-generated block randomisation. Measurements: The primary outcome was endurance shuttle walk test time. The secondary outcomes included area under the curve to isotime for fingertip oxygen saturation and heart rate parameters during the test, blood pressure, and endothelial function assessed using flow-mediated dilatation. Plasma nitrate and nitrite levels as well as FENO were also measured. Main results: 20 participants were recruited and all completed the study. Nitrate-rich BRJ supplementation prolonged exercise endurance time in all participants as compared with placebo: median (IQR) 194.6 (147.5–411.7) s vs 159.1 (121.9–298.5) s, estimated treatment effect 62 (33–106) s (p<0.0001). Supplementation also improved endothelial function: NR-BRJ group +4.1% (−1.1% to 14.8%) vs placebo BRJ group −5.0% (−10.6% to –0.6%) (p=0.0003). Conclusion: Acute dietary nitrate supplementation increases exercise endurance in patients with COPD who require supplemental oxygen. |
Issue Date: | 16-Sep-2022 |
Date of Acceptance: | 5-Nov-2021 |
URI: | http://hdl.handle.net/10044/1/92867 |
DOI: | 10.1136/thoraxjnl-2021-217147 |
ISSN: | 0040-6376 |
Publisher: | BMJ Publishing Group |
Start Page: | 968 |
End Page: | 975 |
Journal / Book Title: | Thorax |
Volume: | 77 |
Issue: | 10 |
Copyright Statement: | © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. This article has been accepted for publication in Thorax following peer review. The definitive copyedited, typeset version Pavitt MJ, Lewis A, Buttery SC, et alDietary nitrate supplementation to enhance exercise capacity in hypoxic COPD: EDEN-OX, a double-blind, placebo-controlled, randomised cross-over studyThorax 2022;77:968-975 is available online at: http://dx.doi.org/10.1136/thoraxjnl-2021-217147. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/ |
Sponsor/Funder: | J P Moulton Charitable Foundation |
Funder's Grant Number: | n/a |
Keywords: | Science & Technology Life Sciences & Biomedicine Respiratory System exercise COPD pharmacology long term oxygen therapy (LTOT) NITRIC-OXIDE PLASMA NITRITE MUSCLE OXYGEN PHYSIOLOGY VASODILATION PERFORMANCE EFFICIENCY WALKING COST COPD pharmacology exercise long term oxygen therapy (LTOT) Respiratory System 1103 Clinical Sciences |
Publication Status: | Published |
Online Publication Date: | 2021-12-01 |
Appears in Collections: | National Heart and Lung Institute Faculty of Medicine |
This item is licensed under a Creative Commons License