Dietary Nitrate Intake is Associated with Muscle Function in Older Women

Background: In younger individuals, dietary nitrate supplementation has been shown to improve short-term vascular and muscle function. The role of higher habitual nitrate intake as part of a typical diet on muscle function in ageing has not been investigated. A cross-sectional study of relationships between dietary nitrate and measures of muscle function in older community-dwelling Australian women (n = 1420, ≥70 years) was undertaken.

Methods: Participants completed a semi-quantitative food frequency questionnaire assessing dietary intake over the previous year. Total nitrate from vegetables and non-vegetable sources was calculated from a validated instrument that quantified the nitrate content of food recorded within the food frequency questionnaire. Handgrip strength and timed-up-and-go (TUG) were assessed, representing muscle strength and physical function, respectively. Cut-points for weak grip strength (<22 kg) and slow TUG (>10.2 s) were selected due to their association with adverse outcomes. Linear and logistic regressions were used to examine the relationship between total nitrate intake and muscle function measures.

Results: Mean ± standard deviation (SD) total nitrate intake was 79.5 ± 31.2 mg/day, of which 84.5% came from vegetables. Across the unadjusted tertiles of nitrate intake (<64.2 mg/day; 64.2 to <89.0 mg/day; ≥89.0 mg/day), women in the highest tertile had a 4% stronger grip strength and a 5% faster TUG performance compared with the lowest tertile. In multivariable-adjusted models, each SD higher nitrate intake (31.2 mg/day) was associated with stronger grip strength (per kilogram, β 0.31, P = 0.027) and faster TUG (per second, β -0.27, P = 0.001). The proportion of women with weak grip strength (<22 kg) or slow TUG (>10.2 s) was 61.0% and 36.9%, respectively. Each SD higher nitrate intake (31.2 mg/day) was associated with lower odds for weak grip strength (OR 0.84, 95% CI 0.74-0.95, P = 0.005) and slow TUG (OR 0.86, 95% CI 0.76-0.98, P = 0.021). Compared with women in the lowest tertile of nitrate intake, women in the highest nitrate intake tertile had lower odds for weak grip strength (OR 0.65, 95% CI 0.49-0.87, P 0.004) and slow TUG (OR 0.72, 95% CI 0.53-0.97, P  = 0.044).

Conclusions: This investigation highlights potential benefits of nitrate-rich diets on muscle strength and physical function in a large cohort of older women. Considering poor muscle strength and physical function is associated with a range of adverse health outcomes such as falling, fractures, cardiovascular disease, and mortality, increasing dietary nitrate, especially though vegetable consumption may be an effective way to limit age-related declines in muscle function.