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Top 9 Reasons to Optimize Your Nitric Oxide Production

Analysis by Dr. Joseph Mercola Fact Checked

heart-healthy benefits of nitrates

Story at-a-glance -

  • In the modern diet, nitrates can be found both in nitrate-rich plant foods and in processed meats. However, while nitrates from plant foods promote nitric oxide production, processed meats trigger conversion of nitrates into carcinogenic N-nitroso compounds
  • Nitrites from plants turn into beneficial nitric oxide due to the presence of antioxidants such as vitamin C and polyphenols
  • Nitric oxide is a soluble gas, and while it’s a free radical, it’s also an important biological signaling molecule that supports normal endothelial function, lowers blood pressure, protects your mitochondria and more
  • Plant foods high in nitrates include arugula, rhubarb, cilantro, butter leaf lettuce, spring greens, basil, beet greens, oak leaf lettuce, Swiss chard and red beets, especially fermented beets
  • To further augment nitric oxide production, combine nitrate-rich plant food with probiotics

30 Tips in 30 Days Designed to Help You Take Control of Your Health

This article is included in Dr. Mercola's All-Time Top 30 Health Tips series. Every day during the month of January, a new tip will be added that will help you take control of your health. Want to see the full list? Click here.

If you struggle with high blood pressure and/or less than ideal heart health, you'd be wise to tweak your diet to include more nitrate-rich foods. The devil's in the details, though; it's important to remember that not all dietary nitrates have the same beneficial influence. In fact, nitrates from the wrong source will do far more harm than good.

Dietary nitrates are found both in plant foods such as beets and arugula, and processed meats such as bacon and hotdogs. But while plant-based nitrates confer a number of health benefits, meat-based nitrates are known to be carcinogenic.1,2,3,4,5

So, to harness the heart-healthy benefits of nitrates, remember to get them from plant foods, not processed meats. The reason for this differentiation has to do with how nitrates are processed in your body, based on cofactors found in their source.6

Why Plant- and Animal-Based Nitrates Affect Your Health in Different Ways

Dietary nitrates are converted into nitrites by oral bacteria during chewing. Once the nitrites are swallowed and come into contact with stomach acid, they can be converted into one of two things:

  1. Beneficial nitric oxide
  2. Carcinogenic N-nitroso compounds such as nitrosamines

Several factors can influence this conversion:

Whether or not the nitrites are found in combination with protein and heme (an iron-containing compound that makes up part of the hemoglobin molecule in blood). This is what makes processed meats so detrimental to your health.7

Processed meat — and the key word here is processed — is actually classified as a Group 1 carcinogen.8,9 According to a review of more than 7,000 clinical studies, the World Cancer Research Fund concluded there's no safe lower limit for processed meats10 and that they should be avoided altogether to minimize your cancer risk.

As explained by Gunter Kuhnle, professor of food and nutritional sciences at the University of Reading, U.K.,11 "What makes processed meats so ideal for forming N-nitroso compounds is that they have a combination of nitrite and proteins from the meat. And the meat's heme seems to help convert them into N-nitroso compounds."

Dietary nitrates are also more prone to converting into carcinogenic nitrosamines when heated, which is what happens during the cooking and processing of meat. Most plant foods are typically not cooked or fried at high temperatures, which minimizes the chances that harmful substances will be produced.

Plants contain antioxidants (such as vitamin C and polyphenols) that impede the formation of harmful nitrosamines.12 The presence of these compounds help to ensure that the nitrites are converted into beneficial nitric oxide once they reach your stomach rather than harmful N-nitroso compounds.13

The composition of your gut bacteria may also play a role. Research suggests beneficial bacteria help break down nitrosamines, while bad gut bacteria increase nitrosamine production.14

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9 Reasons Why Boosting Nitric Oxide Is Important for Your Health

Nitric oxide is a soluble gas continually produced from the amino acid L-arginine inside your cells. While nitric oxide is a free radical, it's also an important biological signaling molecule that supports normal endothelial function and protects your mitochondria — the little "power stations" in your cells that produce a majority of your body's energy in the form of ATP.

It's a potent vasodilator, helping relax and widen the diameter of your blood vessels, and healthy blood flow allows for efficient oxygenation of tissues and organs, and aids in the removal of waste and carbon dioxide. Importantly, nitric oxide infuses into areas that are hypoxic, meaning in need of oxygen, and both your heart and brain15,16 are heavy oxygen users. Nitric oxide also:

1. Boosts your immune function, making your body better equipped to fight off foreign pathogens17

2. Has powerful antibacterial potential18 in and of itself — In vitro tests show it can kill most enteric pathogens within one hour. Mycobacterium tuberculosis, Salmonella and Shigella are particularly susceptible to nitric oxide

3. Helps maintain physiological homeostasis — For example, in your gut, NO regulates mucosal blood flow,19 intestinal motility and the thickness of mucus

4. Plays an important role in the homeostasis of reactive oxygen species, which can have a significant impact on metabolic pathways20

5. Helps suppress inflammation21

6. Promotes angiogenesis, the formation of new, healthy blood vessels22

7. Helps improve your physical fitness — For example, raw beets have been shown to boost stamina during exercise by as much as 16 percent23 as a result of the increase in nitric oxide production

8. Improves brain neuroplasticity by improving oxygenation of the somatomotor cortex, a brain area that is often affected in the early stages of dementia24,25

9. Helps reverse metabolic syndrome26 and has antidiabetic effects27,28

Nitrate-Rich Foods Help Normalize Blood Pressure and Protect Against Heart Attacks

Research29 confirms you can boost your body's nitric oxide production by eating nitrate-rich plant foods, thereby lowering your blood pressure and safeguarding yourself against heart attacks. As noted by cardiologist Dr. Stephen Sinatra:30

"Adequate nitric oxide production is the first step in a chain reaction that promotes healthy cardiovascular function, while insufficient nitric oxide triggers a cascade of destruction that eventually results in heart disease … Plus, it prevents red blood cells from sticking together to create dangerous clots and blockages."

Nitrates are actually used in conventional medicine to treat angina and congestive heart failure. However, you don't necessarily need a nitrate drug to get the job done. Research shows a glass of beetroot juice can lower blood pressure as well as or better than prescription medication;31,32,33,34 raw beets have been shown to lower blood pressure by an average of four to five points within a few hours.35

In one study,36 drinking 8 ounces of beet juice per day lowered blood pressure by an average of nearly eight points after the first week, which is more than most blood pressure medications. As noted in a systematic review and meta-analysis assessing the value of nitrate salts and beetroot supplementation for high blood pressure (hypertension):37

"Diets including food products rich in inorganic nitrate are associated with lower blood pressure (BP) … Inorganic nitrate and beetroot juice consumption were associated with greater changes in systolic BP [-4.4 mm Hg …] than diastolic BP [-1.1 mm Hg …] …

The meta-regression showed an association between daily dose of inorganic nitrate and changes in systolic BP. Inorganic nitrate and beetroot juice supplementation was associated with a significant reduction in systolic BP …

The daily amount of nitrate in the beetroot juice consumed varied between 5.1 and 45 mmol/dose (321 to 2790 mg). The volume of the beetroot juice drinks ranged from 140 to 500 mL/d and the beetroot juice was given as a concentrated solution in two studies …"

Beets and Arugula, Two Nitric Oxide-Boosting Powerhouses

While raw beets (and the beet greens!) do an excellent job of raising your nitric oxide production, they're actually not the most nitrate-rich of plant foods. What's more, they're high in natural sugars, which is why I recommend them only in limited amounts or in fermented form.

Fermenting your beets rather than eating them raw gives you all the health-boosting benefits of raw beets without the concerns of high sugar content, as the beneficial bacteria created during fermentation consume most of the naturally occurring sugars.

Aside from red beets, you have many other options. Topping the list of nitrate-rich plant foods is arugula, which typically averages 480 milligrams (mg) of nitrates per 100 grams. Compare that to raw red beets, which average only 110 mg of nitrates per 100-gram serving, and beet greens, averaging about 177 mg per 100 grams. Fermented beets, on the other hand, contain 2 to 3 grams of nitrates per 100 grams, making it an ideal source.

As for arugula, it also contains potassium, calcium and magnesium,38 all of which are important for healthy blood pressure. These nutrients also help decrease your risk of a stroke and heart attack, while folate assists in optimal amino acid metabolism. Insufficient folate can promote unwanted homocysteine levels in your blood, which elevates your heart disease risk.

As a cruciferous vegetable, arugula also helps protect against cancer, courtesy of its glucosinolate compounds, which contain sulfur. Loaded with chlorophyll, some small studies have shown it may even have detoxifying properties to counteract the poisoning effects of heavy metals in the system, particularly in the liver.39

Both arugula and beets are easy to grow, and you can easily ferment beets at home, allowing you to have a fresh supply of nitric oxide-boosting foods on hand. Other nitrate-rich plant foods you may want to consider growing and eating — all of which will raise your nitric oxide production — include:40

  1. Rhubarb, 281 mg
  2. Cilantro, 247 mg
  3. Butter leaf lettuce, 200 mg
  4. Spring greens like mesclun mix, 188 mg
  5. Basil, 183 mg
  6. Oak leaf lettuce, 155 mg
  7. Swiss chard, 151 mg

Probiotics Augment Conversion of Nitrates to Nitric Oxide

While eating nitrate-rich plant foods is a simple way to boost your nitric oxide production, you can augment this beneficial effect even further by combining these foods with probiotics41 — beneficial bacteria found in traditionally fermented foods and probiotic supplements.

The reason for this is because there's an intimate relationship between dietary nitrates and various gut bacteria. The nitrate/nitrite/nitric oxide metabolism chain, and the influence of gut bacteria, can be summarized as follows:

1. In step 1, probiotic bacteria such as Lactobacillus reduce nitrate to nitrite, the latter of which becomes a substrate for nitric oxide

2. Step 2 is the conversion of nitrite to nitric oxide, which can occur via several different processes — independently of the presence of probiotic bacteria — including the following:

Acidification in the stomach or localized parts of the intestine

Other gut bacteria capable of denitrifying nitrite to nitric oxide

Gut mucosa cells with peroxidase activity

What all of this means is that when you administer a probiotic such as Lactobacillus in conjunction with dietary nitrate, you'll gain an increase in nitric oxide, but only the first step of the process (the reduction of nitrate to nitrite) is a direct result of the probiotic.

Conversely, outside the human body, such as during fermentation, the probiotics can drive the entire process, first reducing nitrate to nitrite, and then generating nitric oxide through the lactic acid produced by the fermentation process itself.

While all of this may sound frustratingly complex, the take-home message is this: If you want to support your nitric oxide pathway and boost nitric oxide production, combining probiotics with nitrate-rich plant food is likely the best way to do that, and supplements that combine both are likely to be more effective.

Alternatively, if you're taking something like fermented beet powder or some other nitric oxide supplement to boost athletic performance and/or heart42 or brain health, consider adding a high-quality probiotic, and take them together.

Nourish and Protect Your Health With Nitrate-Rich Foods

Your body loses about 10 percent of its ability to produce nitric oxide for every decade of life, which is why it's important to take steps to increase your nitric oxide production, especially as you age.

One way to do this is by eating nitrate-rich plant foods such as arugula and fermented beets, as the plant-based nitrates are converted into nitric oxide in your body. Adding probiotics into the mix may optimize the effect even further.

Just remember that nitrates from processed meats will not have this effect. On the contrary, processed meats will encourage the creation of carcinogenic substances — again because of the combination of a lack of antioxidants and the presence of proteins and heme, which triggers the creation of N-nitroso compounds rather than nitric oxide. This is an important distinction, so don't get confused.

Beyond diet, two other strategies that will increase nitric oxide production are high-intensity exercises such as the Nitric Oxide Dump, and getting sensible sun exposure on large portions of your body, as nitric oxide is released into your bloodstream when UVA from sunlight touches your skin.43,44

Together, these lifestyle strategies can go a long way toward protecting your cardiovascular health as you age, and support overall good health, and are especially important if you struggle with high blood pressure.

+ Sources and References