If either reviewer deemed a study relevant, we retrieved it for full-text review. We performed title and abstract screening independently and in duplicate using the Covidence online software (Veritas Health Innovation, Melbourne, Australia). We included comparative studies that examined the effect of dietary nitrate supplementation on endurance activities. Figure 1 gives details on the potential mechanisms that nitrate supplementation can, eventually, result in improved physical performance. Increased levels of NO in tissues and peripheral circulation may lead to improved oxygen transport and uptake in muscles during exercise. A vasodilator, it is believed to influence muscle function by modulating skeletal muscle function through its role in blood flow regulation, contractility, glucose and calcium homeostasis, and mitochondrial biogenesis. Classically, NO was thought to be generated by oxidation of L-arginine, resulting in endogenous production of nitrate (NO3-) and nitrite (NO2-). While the exact mechanism underlying the ergogenic benefits of nitrate supplementation has not yet been established, it has been proposed that dietary nitrate, once ingested, is reduced to nitric oxide (NO). Beetroot juice, pomegranate extract and green leafy vegetables such as collard greens, lettuce, and spinach constitute substantial sources of dietary nitrate. Specifically, nitrates are thought to potentially improve athletic performance. Different macronutrients and micronutrients have been used as ergogenic aids to potentially improve performance. The performance of athletes training and competing in sports such as distance running, triathlons, swimming, biking and rowing depends on their endurance capacity. Endurance capacity is an important component of physical fitness that relates to the ability of the circulatory and respiratory systems to support sustained physical activity.
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