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Nitrogen

Also known as: Nitrogen, Dietary nitrate (NO3−), Nitric oxide precursors (from nitrate/nitrite), Nitrogen-free analogs of essential amino acids, Nitrate

Overview

Nitrogen, as a standalone element, isn't a typical supplement. However, it's crucial in compounds like nitrate (NO3−) and amino acids, which are used in supplementation and clinical nutrition. Dietary nitrate, found in vegetables like beetroot and spinach, is used to enhance exercise performance. It converts to nitrite and then nitric oxide (NO), a vasodilator that improves blood flow and muscle oxygenation. Nitrogen balance is vital in clinical nutrition, especially for critically ill patients and those with chronic kidney disease (CKD). Nitrogen-free amino acid analogs are synthetic compounds used in specialized diets to reduce nitrogen load in CKD. Research on nitrate supplementation for exercise is well-established, while evidence for nitrogen balance and nitrogen-free analogs is still emerging.

Benefits

Nitrate supplementation improves exercise performance by approximately 3% in recreationally active young men. It also enhances resistance exercise performance, improving repetitions-to-failure, mean power, and mean velocity. Higher final nitrogen balance is associated with improved survival in critically ill patients. Nitrogen-free amino acid analogs may slow CKD progression by reducing nitrogen load, but the evidence is limited and heterogeneous. Nitrate-derived nitric oxide may improve muscle oxygenation and contraction force. Nitrogen balance improvement correlates with better clinical outcomes in critically ill patients. Nitrate supplementation benefits recreationally active young men more than well-trained athletes. Nitrogen-free analogs are relevant for CKD patients on low-protein diets.

How it works

Dietary nitrate is reduced to nitrite by oral bacteria, then to nitric oxide in the stomach and bloodstream. Nitric oxide acts as a vasodilator, enhancing blood flow and mitochondrial efficiency. Nitrogen balance reflects the net difference between nitrogen intake and loss, indicating protein metabolism status. Nitrogen-free analogs reduce nitrogen burden while providing essential amino acid functions to protect kidney function. NO-mediated vasodilation improves oxygen delivery to muscles. Enhanced muscle contractility and endurance. Reduced nitrogen load may slow CKD progression. Nitrogen balance affects overall protein metabolism and recovery.

Side effects

Nitrate supplementation is generally safe at studied doses with few adverse effects. Minor gastrointestinal discomfort has been reported with nitrate supplements in some cases. Possible hypotension with high nitrate doses, though rare. Methemoglobinemia risk with excessive nitrate intake is theoretical but not reported in clinical trials. Nitrate supplements may interact with antihypertensive drugs and PDE5 inhibitors, increasing hypotension risk. Caution is advised in patients with low blood pressure or those on vasodilators. Effects in women and highly trained athletes are less clear and require further research. CKD patients require individualized nitrogen intake management.

Dosage

The minimum effective dose is approximately 300-600 mg nitrate (~6-12 mmol) acutely before exercise. Doses up to 800 mg nitrate daily have been studied; timing 2-3 hours pre-exercise is common. Nitrogen-free analog dosing depends on clinical protocols for CKD. There is no established toxic dose in supplementation studies; excessive nitrate intake from non-supplement sources should be avoided. Nitrate supplementation is most effective when taken 2-3 hours before exercise. Beetroot juice and nitrate salts are common forms. Oral microbiome health is critical for nitrate conversion.

FAQs

Is nitrogen itself supplemented?

No, nitrogen as an element is not supplemented; rather, nitrate or nitrogen-containing compounds are used.

Is nitrate supplementation safe?

Yes, at studied doses it is safe for healthy individuals.

How quickly does nitrate improve performance?

Effects are seen within hours after ingestion.

Does nitrate improve body composition?

Current evidence does not support significant effects on body composition.

Can nitrate help in kidney disease?

Nitrogen-free amino acid analogs may help in CKD, but nitrate supplementation is not indicated for this purpose.

Research Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC7494956/ – This systematic review and meta-analysis of 26 studies found that nitrate supplementation improves exercise performance by approximately 3% in healthy young men. The effect size was small (d=0.174, p<0.001). The authors noted limited data on women and elite athletes and heterogeneity in exercise types.
https://pubmed.ncbi.nlm.nih.gov/37299456/ – This systematic review and meta-analysis of 6 RCTs found that nitrate improves repetitions-to-failure (SMD=0.43, p=0.002), mean power, and velocity in resistance-trained males. There was no effect on peak power. The authors noted a small number of studies and variability in dosing.
https://www.mdpi.com/1648-9144/61/3/423 – This meta-analysis examined the effects of nitrogen-free analogs in CKD patients across multiple RCTs. The findings suggest that nitrogen-free analogs may slow CKD progression by reducing nitrogen load. However, the authors noted that the evidence is limited and heterogeneous due to variations in study design and patient populations.
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.961207/full – This systematic review and meta-analysis of 8 RCTs involving 1409 critically ill patients found that higher final nitrogen balance was associated with improved survival (MD 3.69 g/day, p<0.0001). The authors noted moderate heterogeneity and a limited number of RCTs, suggesting the need for further research to confirm these findings.
https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/effects-of-beetroot-and-nitrate-supplementation-on-body-composition-a-gradeassessed-systematic-review-and-metaanalysis/949832E60B3818D6D849353FC0B117FE – This systematic review and meta-analysis of 12 RCTs involving 500 participants found no significant effect of nitrate or beetroot on body composition indices. The authors noted heterogeneity and that most studies involved healthy or clinical populations. The study suggests that nitrate supplementation is unlikely to significantly impact body composition.