Trial reportThe American journal of clinical nutrition2026
A clinical study examining the effects of dietary nitrate on urinary N-nitrosamines.
Trial report in The American journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02916615 (Diet and Nitric Oxide), which is not on this map. Not yet cited in PubMed.
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The trial behind it
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Diet and Nitric Oxide (DINO): A Study on the Effects of Dietary Nitrate on Blood Pressure in Subjects With Prehypertension
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInorganic nitrate from dietary sources has raised health concerns due to its possible conversion into carcinogenic N-nitrosamines, leading to strict regulations on nitrate concentrations in food and drinking water.
objectivesIn this study, which was a part of a larger randomized controlled trial, we evaluated urinary excretion of N-nitrosamines in response to daily dietary nitrate intake over a 5-wk period using 2 different forms of nitrate administration.
methodsA total of 231 participants with mild hypertension were randomly assigned into 3 groups. Group 1 (n = 78) consumed vegetables low in nitrate along with a placebo capsule (300 mg potassium chloride). Group 2 (n = 77) consumed the same low-nitrate vegetables plus a potassium nitrate supplement (300 mg). Group 3 (n = 77) consumed nitrate-rich leafy green vegetables providing 300 mg nitrate daily plus the placebo capsule. Twenty-four-hour urine samples were collected before and after the intervention. Nitrate was measured with high-pressure liquid chromatography and N-nitrosamine concentrations were quantified using ultra high-pressure liquid chromatography-tandem mass spectrometry. A paired t-test was used for statistical analyses.
resultsAs expected, urinary nitrate increased ∼5- to 6-fold in participants consuming nitrate-rich vegetables or potassium nitrate compared with those consuming potassium chloride. Total urinary excretion of N-nitrosamines was low across all groups under basal conditions (<5 μg/24 h) and did not significantly change after the intervention. A similar lack of change was observed for each of the 7 individual N-nitrosamine species measured.
conclusionsThese findings suggest that a 5-wk dietary intake of nitrate mostly exceeding the current consensus for upper limit of the acceptable daily intake (3.7 mg/kg/d), whether provided as a vegetable source or as a nitrate salt, does not increase urinary excretion of N-nitrosamines. This study was registered at clinicaltrials.gov as NCT02916615.
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