Evidence map›Paper›PMID 40202971›Full record

SynthesisPloS one2025

Effects of nitrate supplements on cardiopulmonary fitness at high altitude: A meta-analysis of nine randomized controlled trials.

Chao Kang, Ning Lin, Yanle Xiong, Yi Yang, Jiaojiao Shi, Kaihong Zeng, Xin Ma

Abstract readMeta-Analysis
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chao KangDepartment of Clinical Nutrition, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.ORCID 0000-0001-9602-9251
Ning LinDepartment of Clinical Nutrition, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.
Yanle XiongLi Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Yi YangDepartment of Rehabilitation Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.
Jiaojiao ShiDepartment of Clinical Nutrition, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.
Kaihong ZengDepartment of Health Management Center & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Xin MaDepartment of Rehabilitation Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNitrate is a dietary intervention commonly used to enhance exercise capacity, including cardiopulmonary fitness, yet its effectiveness has been recently questioned at high altitudes. This meta-analysis systematically evaluates the effects of dietary nitrate supplements on cardiopulmonary fitness at high altitude, as reflected in the biomarker of cardiopulmonary fitness, paving the way for informed dietary strategies.

methodsWe conducted a systematic assessment and meta-analysis of randomized controlled trials to examine the effects of dietary nitrate supplementation on biomarkers of cardiorespiratory health at high altitude. Studies were included if they involved healthy individuals (≥16 years of age) engaging in endurance activities such as hiking, long-distance running, mountain climbing, or bicycling at high altitude. Outcomes of interest included nitrite levels (NO2-), maximal oxygen uptake (VO2max), heart rate (HR), perceived exertion (RPE), and pulse oxygen saturation (SpO2). Exclusion criteria included duplicate publications, non-human studies, studies with missing data that could not be retrieved, non-randomized clinical trials, and non-original research articles such as conference papers, expert consensus, or reviews. Our search for articles was conducted across PubMed, Scopus, Web of Science, and Embase, without any language restrictions. A random effects model was employed for quantitative data analysis, utilizing Standardized Mean Difference (SMD) and 95% confidence intervals as summary statistics. The methods and results were reported according to the PRISMA2020 statement.

resultsA total of 9 studies with a sample size of 161 cases were included in the analysis. The meta-analysis indicated that dietary nitrate supplement significantly elevated NO2- concentration (95% CI: 1.38 to 3.12; SMD = 2.25, P < 0.00001; I2 = 70%). However, there was no significant effect observed on VO2max (95% CI: -0.58 to 0.23; SMD = -0.17, P = 0.76; I2 = 0%), HR (95% CI: -0.31 to 0.23; SMD = -0.04, P = 0.77; I2 = 0%), RPE scores (95% CI: -0.49 to 0.18; SMD = -0.16, P = 0.36; I2 = 0%), and SpO2 percentage (95% CI: -0.36 to 0.20; SMD = -0.08, P = 0.58; I2 = 0%).

conclusionsThe current meta-analysis indicates that dietary nitrate intake is less correlated with cardiopulmonary fitness at high altitudes, and further research is required to clarify its impact on exercise capacity.

Indexed as

AltitudeCardiorespiratory FitnessDietary SupplementsNitratesHeart RateHumansOxygen ConsumptionRandomized Controlled Trials as TopicNitrates

Identifiers

PMID40202971
PMCPMC11981189

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.