It’s more than just Valentine's Day that draws our attention to our hearts. February is Heart Month so I want to give you the nutrition essentials for a healthy heart. Nitric oxide may be the single most important molecule for cardiovascular function. In this post, learn where to get nutrients, which support nitric oxide levels, and how nitric oxide helps your entire cardiovascular and musculoskeletal systems.
Nitric Oxide & Vasodilators for Optimal Heart Health
Nitric oxide (“N-O” for short”) is a simple molecule with profound effects. It makes blood vessels dilate and relax. It improves oxygen use. Beyond that, nitric oxide’s effects on your gut, your brain, and even the mitochondria that power your cells are well researched, but not well known to the public.
Nitric oxide levels go down with age and heart disease (including hypertension), not to mention many other inflammatory chronic conditions. Since nitric oxide is the hormone for opening up blood vessels and increasing blood flow, it’s no surprise that every heart condition is associated with dysregulated nitric oxide levels.
It is one goal here at Resync to make sure every person knows about the powerful benefits plant-based nitrates can give you. You may have heard of red beet root, but do you know other and even better sources of plant-based nitrates?
You may have heard about L-arginine, which is another nitric oxide precursor, but it does not appear to be effective for people with heart disease, since it functions on the same pathway that heart disease dysregulates.
Here are also key things to take into consideration when addressing nitric oxide.
Do you use antibacterial mouthwash regularly? What about antacids like proton pump inhibitors (PPIs)? These two in particular destroy the bacteria you need in order to make the nitric oxide from plant-based nitrates.
With so many causes of low nitric oxide, a lot of research shows that raising nitric oxide levels with plant-based nitrates may potentially help with aspects of heart disease.
Now on the flip side, if you’re young and fit are nitrates going to make a difference?
Nitric oxide is used in research and by professional athletes to enhance endurance and boost performance (read more on that here), so you’ll have to decide for yourself if you want to rise to your potential, or get left in the dust.
Research on Resync and Heart Health
Over the course of 5 weeks (it was cut short due to the pandemic), systolic blood pressure decreased by an average of 7.8 points and diastolic blood pressure decreased by 2.3 points.
That’s the difference between a healthy heart and borderline hypertension.
When we separated patients based on whether their blood pressure was above or below the average person at cardiac rehab (139/89), the results made me say “wow” out loud. The 50% of patients with the highest initial blood pressure dropped an astounding 23.0/19.3 points!
So what does this mean for you?
This small, open-label study showed that taking 1 to 2 servings of Resync Recovery every day may help reduce blood pressure in cardiac rehab patients, especially in people with very high blood pressure. Talk to your cardiologist ー and pull up this page with all the results ー before making any major changes to your diet, lifestyle, supplements, and medication.
If you care about blood pressure and general heart health, my page on Cardiovascular Health & Resync is for you. Resync may be an up-and-coming contender to help you meet your heart health goals!
Nitric Oxide, Your Heart, and Your Structure
Your veins supply nutrients and oxygen to the surface of every tissue in your body, so we wanted to help you understand the unique effect nitric oxide can have on the layers of your musculoskeletal system (your bones, muscles, and connective tissues).
We took a deep dive on the effects of nitric oxide and bone in a recent blog on nitrates and bone health, but here are the takeaways. First, since your blood is made in your bone marrow, and nitric oxide has profound impacts on blood health, nitric oxide can be an essential nutrient for promoting optimal red blood cells. There’s a secondary effect as well, since the structure of the outside of your bones benefits from a healthy blood supply.
Nitric oxide might not be the first thing that comes to mind when you think of the best supplement for bone mineral density or the best supplements for osteoporosis, but decades of science show us when and how to supplement with nitric oxide for better bone health. With or without estrogen therapy, just boosting nitric oxide can strengthen bones in post-menopausal women.
Cartilage & Joints
It’s important to point out that nitric oxide can be made from multiple different enzymes. Inducible Nitric Oxide Synthase is associated with damage from arthritis, but other nitric oxide metabolites have protective anti-inflammatory potential, according to the research. Early-stage research shows that nitric oxide is essential for the inflammation-resolution process that comes after putting an injured joint in a cast. So far, no studies in humans have been done, so we are not entirely clear on the pro- and anti-inflammatory effects nitric oxide has on cartilage, but it appears that too much and too little is a bad thing.
One study suggests that, for tendons, low doses of nitric oxide can enhance collagen synthesis and protein deposition. Outside of this one study, nitric oxide probably helps to make sure these tissues are well-fed, but little research has been done on nitric oxide and tendons or ligaments.
The effect of nitric oxide on muscle tissues are pretty clear cut - markedly positive across the board. Nitrates can:
- Improve mitochondrial function, essential for making ATP for your slow-burning muscle cells
- Increase exercise tolerance (meaning you can use less oxygen and creatine ー the ATP source in resistance exercise ー to do the same amount of work as higher intensity exercise)
- Enhance muscle contraction efficiency
- Improve performance on time-to-failure and time-trial events.
Besides the performance enhancing effect of nitrates themselves, the antioxidants in chokeberry and other colorful fruits might also reduce inflammation post-workout.
The under-represented connective tissue that connects all your other tissues is fascia. Some research shows that nitric oxide is involved in the relaxation and signalling properties of fascia.
Nitric oxide is a regulator of the wound healing process, but like most things, there is a happy medium for optimal function. Other benefits for skin include the ability to mitigate damage from excessive sun exposure, minimize sagging skin caused by excessive oxidative stress, and promoting skin pigmentation in order to avoid further UV damage, according to a number of studies.
What Are The Best Sources of Plant-Based Nitrates? (Not Beets!)
In food, you can’t count on consistent nitrate levels. But at least you’ll be happy to know that the veggies highest in nitrates are also superfoods in their own right. The very best whole-food plant-based nitrates sources are:
- Red Spinach (aka. Amaranth)
- Spinach (the regular kind)
- Bok Choy
- Beet Juice (wildly inconsistent and full of sugar)
- Cilantro & Parsley
- Red leaf lettuce
- Carrots and carrot juice
- Spring Greens
- Beet Greens
- Collard Greens
- Chinese Cabbage
- Cole (aka cabbage and kale)
- Beets, yes not #1
If you want to know more about how these ingredients and others synergize to promote optimal health, check out my science-based ebook and cookbook: Recover Every Layer of Your Body. Here’s a sample of what you’ll find there:
If you like healthy food, you will love these recipes and the science that backs them up!
What does Nitric Oxide interact with? What does it synergize with?
Nitric oxide synergizes with other vasodilators since it works outside of the highly regulated arginine pathway. Here’s my short list of the best nutritional vasodilators that open up your blood vessels:
- Mango - especially known for its positive effects on microcirculation and on glucose metabolism in healthy subjects
- Omega-3 polyunsaturated fatty acids
Other Nutrients that may help with nitric oxide absorption and function include:
- B vitamins (B6, B12, folic acid (B9)) in one study of mice. You must use the active form of vitamin B12, methylcobalamin, since other types of B12 (oxocaobalamin, cobinamide) have negative effects on NO
- Vitamin C is an Antioxidant involved in recycling spent NO via the cofactor tetrahydrobiopterin
- Vitamin D has been shown to improve nitric oxide in Black Americans but not Whites, suggesting that it may only be useful for people with low vitamin D (23% of US are deficient/insufficient)
- Vitamin E was shown in one trial to increase nitric oxide levels in pregnant women.
The caveat here is that all studies are looking at production of nitric oxide from L-arginine via eNOS, not the Nitrate→ Nitrite → NO pathway. Notably, this study shows that beet juice plus vitamin C may help prevent the production of harmful nitroso compounds, but only in the short term.
What is the Best Dose of Nitrates? Can You Eat Too Many of Them?
As you probably have gathered, there’s a sweet spot for nitrate supplementation: not too much not too little. You see it with bone research, connective tissue research, and when it comes to your heart, excessive nitrate consumption is linked to methemoglobinemia, where your red blood cells aren’t able to hold onto oxygen very effectively.
5–9 mmol nitrate is the most common range of doses for performance enhancing effects, according to one of the foremost nitric oxide researchers. By eating one or two of the ingredients listed above, you can easily get that much in a day.
Is There a Best Time to Consume Plant-Based Nitrates or Take Nitric Oxide Supplement?
Some research suggests that nitrates should be taken intermittently, since taking it regularly can lead to so-called “nitrate resistance”. Additionally, your natural circadian rhythms affect N-O levels, with naturally lower levels around midday, and higher levels at night.
When it comes to performance: Research shows that nitrates have their strongest effect when 5 mmol (310 milligrams) is taken per day and when supplementation occured 2–3.5 hours before training or competition. These effects are most pronounced in people with lower baseline cardiovascular fitness.
When it comes to recovery, one study shows that taking nitrates after a workout can have substantial impacts on hypoxic (ie. high elevation and high intensity) exercise.
What is the Best Nitrate Based Supplement?
Since I make sure to bring you quality not seen in any other supplement on the market, I can confidently tell you that Resync Recovery is the highest quality plant-based nitrate supplement on the market. If you don’t believe me, head over to this blog ー where I rank each of the most popular nitrate supplements ー to see why dose, price, standardization, third party certification, and the addition of synergistic bioactive ingredients put Resync Recovery into a class of its own.
If you have never tried Resync products, now is a good time to do it. You’ll be joining some of the best athletes in the world when you try our blends. However keep in mind you don't need to be an athlete to treat your heart the right way. These are world-class supplements not just because of their safety, but because of their effectiveness. Even Pfizer has purchased our Resync Recovery to test the power of it. Resync stands out in the category of beet based products, because it has more to offer than just beets. Treat your heart this month and learn more about it here.
We want to hear from you!
Want the practical details on how to eat and supplement to support your exercise, heart health, beauty, and energy? Subscribe to our feed and never miss our best content! If you want more, leave a comment or question below, and we’ll get back to you!
While other companies try to sell you through clickbait and fake news, we back up what we say with hard data. We believe that when you have the right information, you are empowered to make the best decision possible. That’s why we break down complex science into practical takeaways you can use today.
Wishing you the best in your health,
The Resync Team
Abramson, Steven B. “Osteoarthritis and Nitric Oxide.” Osteoarthritis and Cartilage, vol. 16, June 2008, pp. S15–20. DOI.org (Crossref), doi:10.1016/S1063-4584(08)60008-4.
Adler, Brandon L., and Adam J. Friedman. “Nitric Oxide Therapy for Dermatologic Disease.” Future Science OA, vol. 1, no. 1, Aug. 2015. PubMed Central, doi:10.4155/fso.15.37.
Bailey, Stephen J., et al. “Dietary Nitrate Supplementation Enhances Muscle Contractile Efficiency during Knee-Extensor Exercise in Humans.” Journal of Applied Physiology (Bethesda, Md.: 1985), vol. 109, no. 1, July 2010, pp. 135–48. PubMed, doi:10.1152/japplphysiol.00046.2010.
Berends, Julia E., et al. “Consumption of Nitrate-Rich Beetroot Juice with or without Vitamin C Supplementation Increases the Excretion of Urinary Nitrate, Nitrite, and N-Nitroso Compounds in Humans.” International Journal of Molecular Sciences, vol. 20, no. 9, May 2019. PubMed, doi:10.3390/ijms20092277.
Bode-Böger, S. M., et al. “Role of Endogenous Nitric Oxide in Circadian Blood Pressure Regulation in Healthy Humans and in Patients with Hypertension or Atherosclerosis.” Journal of Investigative Medicine: The Official Publication of the American Federation for Clinical Research, vol. 48, no. 2, Mar. 2000, pp. 125–32.
Buchwald-Werner, Sybille, et al. “Effects of Mangifera Indica (Careless) on Microcirculation and Glucose Metabolism in Healthy Volunteers.” Planta Medica, vol. 83, no. 10, Georg Thieme Verlag KG, July 2017, pp. 824–29. www.thieme-connect.com, doi:10.1055/s-0043-103017.
Calabrese, Edward J. “Nitric Oxide: Biphasic Dose Responses.” Critical Reviews in Toxicology, vol. 31, no. 4–5, Taylor & Francis, Jan. 2001, pp. 489–501. Taylor and Francis+NEJM, doi:10.1080/20014091111776.
Ersoy, Y., et al. “Serum Nitrate and Nitrite Levels in Patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis.” Annals of the Rheumatic Diseases, vol. 61, no. 1, Jan. 2002, pp. 76–78. PubMed, doi:10.1136/ard.61.1.76.
Gerstgrasser, Alexandra, et al. “In Vitro Activation of ENOS by Mangifera Indica (CarelessTM) and Determination of an Effective Dosage in a Randomized, Double-Blind, Human Pilot Study on Microcirculation.” Planta Medica, vol. 82, no. 4, Mar. 2016, pp. 298–304. PubMed, doi:10.1055/s-0035-1558219.
Henrotin, Y. E., et al. “The Role of Reactive Oxygen Species in Homeostasis and Degradation of Cartilage.” Osteoarthritis and Cartilage, vol. 11, no. 10, Oct. 2003, pp. 747–55. ScienceDirect, doi:10.1016/S1063-4584(03)00150-X.
Ikuta, Tohru, et al. “Nitric Oxide-CGMP Signaling Stimulates Erythropoiesis through Multiple Lineage-Specific Transcription Factors: Clinical Implications and a Novel Target for Erythropoiesis.” PLOS ONE, vol. 11, no. 1, Public Library of Science, Jan. 2016, p. e0144561. PLoS Journals, doi:10.1371/journal.pone.0144561.
Jamilian, Mehri, et al. “A Randomized Controlled Clinical Trial Investigating the Effects of Omega-3 Fatty Acids and Vitamin E Co-Supplementation on Biomarkers of Oxidative Stress, Inflammation and Pregnancy Outcomes in Gestational Diabetes.” Canadian Journal of Diabetes, vol. 41, no. 2, Apr. 2017, pp. 143–49. PubMed, doi:10.1016/j.jcjd.2016.09.004.
Jones, Andrew M. “Dietary Nitrate Supplementation and Exercise Performance.” Sports Medicine (Auckland, N.z.), vol. 44, no. Suppl 1, 2014, pp. 35–45. PubMed Central, doi:10.1007/s40279-014-0149-y.
Kaneguchi, Akinori, et al. “Nitric Oxide Synthase Inhibitor L-NG-Nitroarginine Methyl Ester (L-NAME) Attenuates Remobilization-Induced Joint Inflammation.” Nitric Oxide, vol. 96, Mar. 2020, pp. 13–19. ScienceDirect, doi:10.1016/j.niox.2020.01.003.
McMahon, Nicholas F., et al. “The Effect of Dietary Nitrate Supplementation on Endurance Exercise Performance in Healthy Adults: A Systematic Review and Meta-Analysis.” Sports Medicine (Auckland, N.Z.), vol. 47, no. 4, Apr. 2017, pp. 735–56. PubMed, doi:10.1007/s40279-016-0617-7.
Menzel, Daniel, et al. “L-Arginine and B Vitamins Improve Endothelial Function in Subjects with Mild to Moderate Blood Pressure Elevation.” European Journal of Nutrition, vol. 57, no. 2, 2018, pp. 557–68. PubMed Central, doi:10.1007/s00394-016-1342-6.
Mortensen, Alan, and Jens Lykkesfeldt. “Does Vitamin C Enhance Nitric Oxide Bioavailability in a Tetrahydrobiopterin-Dependent Manner? In Vitro, in Vivo and Clinical Studies.” Nitric Oxide, vol. 36, Jan. 2014, pp. 51–57. ScienceDirect, doi:10.1016/j.niox.2013.12.001.
Myburgh, Kathryn H. “Polyphenol Supplementation: Benefits for Exercise Performance or Oxidative Stress?” Sports Medicine (Auckland, N.Z.), vol. 44 Suppl 1, May 2014, pp. S57-70. PubMed, doi:10.1007/s40279-014-0151-4.
Schleip, Robert, et al. Fascia Is Alive. 2012, pp. 157–64. ResearchGate, doi:10.1016/B978-0-7020-3425-1.00057-X.
Senefeld, Jonathon W., et al. “Ergogenic Effect of Nitrate Supplementation: A Systematic Review and Meta-Analysis.” Medicine and Science in Sports and Exercise, vol. 52, no. 10, Oct. 2020, pp. 2250–61. PubMed, doi:10.1249/MSS.0000000000002363.
Vanhatalo, Anni, et al. “Dietary Nitrate Accelerates Postexercise Muscle Metabolic Recovery and O2 Delivery in Hypoxia.” Journal of Applied Physiology, vol. 117, no. 12, American Physiological Society, Oct. 2014, pp. 1460–70. journals.physiology.org (Atypon), doi:10.1152/japplphysiol.00096.2014.
Weinberg, J. Brice, et al. “INHIBITION OF NITRIC OXIDE SYNTHASE BY COBALAMINS AND COBINAMIDES*.” Free Radical Biology & Medicine, vol. 46, no. 12, June 2009, pp. 1626–32. PubMed Central, doi:10.1016/j.freeradbiomed.2009.03.017.
Wilson, Andrew M., et al. “L-Arginine Supplementation in Peripheral Arterial Disease: No Benefit and Possible Harm.” Circulation, vol. 116, no. 2, July 2007, pp. 188–95. PubMed, doi:10.1161/CIRCULATIONAHA.106.683656.
Wimalawansa, Sunil. Targeting Nitric Oxide for Bone Disease. 2020.
Wolf, S. Tony, et al. “Four Weeks of Vitamin D Supplementation Improves Nitric Oxide-Mediated Microvascular Function in College-Aged African Americans.” American Journal of Physiology-Heart and Circulatory Physiology, vol. 319, no. 4, American Physiological Society, Aug. 2020, pp. H906–14. journals.physiology.org (Atypon), doi:10.1152/ajpheart.00631.2020.
Wylie, Lee J., et al. “Dietary Nitrate Supplementation Improves Team Sport-Specific Intense Intermittent Exercise Performance.” European Journal of Applied Physiology, vol. 113, no. 7, July 2013, pp. 1673–84. PubMed, doi:10.1007/s00421-013-2589-8.
Xia, Wei, et al. “Nitric Oxide Enhances Collagen Synthesis in Cultured Human Tendon Cells.” Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society, vol. 24, no. 2, Feb. 2006, pp. 159–72. PubMed, doi:10.1002/jor.20060.
This content is for general informational purposes only, and does not constitute the practice of any professional healthcare service, INCLUDING the giving of medical advice. No provider-patient relationship is formed. The use of this information, and the materials linked to this content is at the user's own risk. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should abide by the advice of their healthcare provider, and should not disregard or delay in obtaining medical advice for any medical condition they may have.