Nitric oxide (NO) is one of the most important signaling molecules in our body and is involved in virtually every organ system. Some researchers say that there’s a very clear progression of cardiovascular disease that begins with decreased NO production.
Every age-related disease and every chronic disease—whether it manifests in the kidney, brain, heart, or liver—has a vascular component, according to Nathan S. Bryan, an international leader in molecular medicine and NO biochemistry. Bryan says that the common trait among them is a lack of oxygen-rich blood reaching a part of the body, and this is dependent on NO.
A lack of NO production can lead to high blood pressure, sexual dysfunction, and chronic inflammatory vascular disease leading to heart attacks, strokes, or heart failure.
The body naturally begins to produce less NO as we age, but this gradual loss of NO can be sped up or slowed, based on lifestyle and diet.
Remarkably, all of the conditions mentioned above have been shown to be improved by dietary nitrite and nitrate interventions. It’s important to know, however, that although some natural foods high in these compounds are generally good for your health, others, such as processed meats, can create problems, especially when cooked at high heat, which can turn nitrite and nitrate into problematic nitrosamines.
Knowing what can damage our body’s ability to create NO and adopting healthy habits such as a good diet and exercise can prolong the inevitable drop in NO production with age and prevent age-related disease and chronic illness, particularly cardiovascular disease.
Essential for Health
Dr. Caldwell Esselstyn, director of the Cleveland Clinic’s Heart Disease Reversal Program, describes NO as the single most important factor affecting cardiovascular health, stressing that NO’s most important function is vasodilation.
This means it relaxes and widens the blood vessels, enabling your blood to move freely and delivering oxygen and nutrients to your whole body more efficiently.
Esselstyn also said that NO prevents inflammation and arterial thickening that can restrict blood flow, cause hypertension, and increase the workload on your heart.
NO reduces the stickiness of LDL and other elements in our blood that leads to plaque buildup in arteries, according to Esselstyn.
NO also has a profound predictive value for Alzheimer’s disease progression. The common denominator in any neurological disorder is a loss of regulation of blood flow, and that is all dependent on NO. Alzheimer’s and vascular dementia have reduced blood flow to the prefrontal cortex.
When the body can’t make NO, every organ in the body is affected.
Things That Affect NO Production
It has been well-established that the oral and gut bacteria microbiome plays a role in NO production. Because of this, anything that destroys your beneficial bacteria can cause your blood pressure to go up and put you at increased risk of heart attack, stroke, and dementia.
“The salivary glands and oral bacteria play an essential role in the conversion process from nitrate (NO3-) and nitrite (NO2-) to [NO] in the human body,” according to a review study published in the Journal of Dental Research.
That means antiseptic mouthwashes can reduce NO production by wiping out the nitrate-producing bacteria in your oral microbiome.
A study published in Frontiers in Cellular and Infection Microbiology in 2019 warns that research has found that “oral antiseptics resulted in increases in systolic blood pressure.”
The study looked specifically at chlorhexidine, an antiseptic used in mouthwash.
“Twice-daily chlorhexidine usage was associated with a significant increase in systolic blood pressure after 1 week of use and recovery from use resulted in an enrichment in nitrate-reducing bacteria on the tongue,” it reads.
Oral antibiotics can also unsettle these bacteria since they kill not only the bad bacteria but also the good in your gut microbiome. The same goes for antibacterial soaps and hand sanitizers.
Research has found that proton-pump inhibitors also decrease NO and are linked to a significantly increased risk of heart attack and stroke.
Usually, normal NO production falls long before a diagnosis is possible, so it’s important to look for symptoms and take action to address any deficiency.
Signs of Decreased NO
A decrease in NO production will lead to a decrease in blood flow, and, clinically, this manifests in several ways:
- Increased blood pressure
- Chronic inflammatory vascular disease with plaque deposition in the lining of blood vessels
- Dysfunctional arteries
- Erectile dysfunction
- Vasculogenic female sexual dysfunction
Because of NO’s critical role in keeping blood flowing through the veins, a reduction can lead to heart attack or stroke, the leading killers of men and women worldwide.
Lack of nitrite in the diet increases one’s risk of developing every age-related and chronic degenerative disease.
Adopting healthy habits such as a good diet and exercise can prolong the precipitous drop in NO production with age. Here are some foods that help support and boost your body’s production of NO.
Beetroot has one of the highest concentrations of dietary nitrate in the plant kingdom, ranking just after leafy greens. In one study, participants who were given 70 milliliters (4 tablespoons) of beetroot juice were shown to have NO levels elevated by 21.3 percent after 45 minutes and 20.3 percent after 90 minutes.
Green leafy vegetables contain large amounts of nitrates. One study showed that eating a high-nitrate meal containing spinach increased salivary nitrate levels eightfold. The study group also had significant arterial elasticity and decreased systolic blood pressure. The study concluded that “a nitrate-rich meal can lower systolic blood pressure and pulse pressure and increase large artery compliance acutely in healthy men and women.”
One study found that aged garlic extract temporarily increased NO production by 30 to 40 percent from 15 to 60 minutes after administration.
Meat is an excellent source of CoQ10, which is shown to increase NO levels. Studies show that getting enough CoQ10 can help athletes perform better, recover faster, and prevent injury.
Research shows that the flavanols found in cocoa can help maintain optimal levels of NO in your body, which is shown to lower blood pressure and promote cardiovascular health.
Citrus fruits are a great source of vitamin C, which can increase the amount of NO in the body.
Nuts and Seeds
Nuts and seeds are sources of L-arginine, an amino acid that plays a role in the production of NO. One study showed that eating L-arginine-rich foods was associated with higher levels of NO.
NO-Releasing Workout Strategy
Research finds that exercise is one of the most important ways to increase your available NO.
“Regular exercise helps arteries by boosting the endothelial cells’ [NO] production,” an article in Harvard Health reads.
“There is concrete evidence that physical activity enhances NO production,” according to a study published in The Journal of Sports Medicine and Physical Fitness in 2021.
Dr. Zach Bush is a physician specializing in internal medicine, endocrinology, and hospice care. You can find his The Four Minute Workout online. It’s designed to maximize the body’s ability to regenerate NO by exercising the 16 largest muscle groups in your body in just four minutes.
Because blood vessels only store about 90 seconds worth of NO before they need to manufacture more, working each major muscle group out for 90 seconds gives you the most efficient workout to tone and build muscles.
The body can also regenerate NO every couple of hours, so Bush says that “the most effective way to increase your muscle function is to work out very briefly every few hours.”