Inorganic nitrate supplementation and blood flow restricted exercise tolerance in post-menopausal women

Exercise tolerance appears to benefit most from dietary nitrate (NO₃^-) supplementation when muscle oxygen (O₂) availability is low. Using a double-blind, randomized cross-over design, we tested the hypothesis that acute NO₃^- supplementation would improve blood flow restricted exercise duration in post-menopausal women, a population with reduced endogenous nitric oxide bioavailability. Thirteen women (57-76 yr) performed rhythmic isometric handgrip contractions (10% MVC, 30 per min) during progressive forearm blood flow restriction (upper arm cuff gradually inflated 20 mmHg each min) on three study visits, with 7-10 days between visits. Approximately one week following the first (familiarization) visit, participants consumed 140 ml of NO₃^- concentrated (9.7 mmol, 0.6 gm NO₃^-) or NO₃^-depleted beetroot juice (placebo) on separate days (≥7 days apart), with handgrip exercise beginning 100 min post-consumption. Handgrip force recordings were analyzed to determine if NO₃^- supplementation enhanced force development as blood flow restriction progressed. Nitrate supplementation increased plasma NO₃^- (16.2-fold) and NO₂^- (4.2-fold) and time to volitional fatigue (61.8 ± 56.5 s longer duration vs. placebo visit; p = 0.03). Nitrate supplementation increased the rate of force development as forearm muscle ischemia progressed (p = 0.023 between 50 and 75% of time to fatigue) with non-significant effects thereafter (p = 0.052). No effects of nitrate supplementation were observed for mean duration of contraction or relaxation rates (all p > 0.150). These results suggest that acute NO₃^- supplementation prolongs time-to-fatigue and speeds grip force development during progressive forearm muscle ischemia in postmenopausal women.