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Dietary Nitrate Supplementation and Exercise Performance: An Umbrella Review of 20 Published Systematic Reviews with Meta-analyses

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
Sports Medicine 2025 55(5):1213–1231

Bibliography

PubMed
PMID 40085422
PubMed Central
PMC12106159
Funding
The authors report no specific grant from public, commercial, or not-for-profit funding agencies.
Competing interests
All eight authors declare no conflicts of interest directly relevant to the article (publisher statement).

Study snapshot

DesignUmbrella review and meta-analysis of published systematic reviews
ModelHealthy adults undergoing exercise tests
Sample20 reviews; 180 primary studies; 2,672 unique participants
InterventionDietary nitrate supplements and nitrate-rich products versus placebo
DurationAcute and multi-day exercise protocols
EndpointsTime to exhaustion; Total distance; Muscular endurance; Peak power; Time to peak power; Other exercise outcomes

What the study showed, in plain terms

Across 20 reviews, dietary nitrate had mixed effects. Some endurance and power outcomes improved, while several others did not.

Key findings

Time-to-exhaustion pooled standardized mean difference 0.33 (95% CI 0.19–0.47); findings varied by exercise outcome. Most included reviews had low or critically low methodological quality.

What this study can and cannot tell us

Umbrella reviews overlap primary trials. Large exercise-test effects do not establish cardiovascular disease benefits or identical benefits for proprietary Nitralis.

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