Abstract Background Age-associated decline in mitochondrial oxidative capacity is associated with increased risk of disease, frailty, and disability. Oral nitrite and nitrate supplementation have been demonstrated to improve mitochondrial energetics and physical function in younger adults, but effects in older adults (age ≥70 years) remain unclear. Methods Randomized, placebo controlled, double-blind, 2-arm trial with a parallel group design to examine the effect of 20 mg sodium nitrite supplements administered three times a day for 12 weeks versus placebo in older (age ≥70 years) sedentary adults. Change in muscle mitochondrial respiration (complex I and II supported maximal oxidative phosphorylation CI&II MaxOXPHOS) was the primary outcome. Platelet bioenergetics, cardiorespiratory fitness, and other physical function measures were also assessed. Results 64 adults (75.7 ± 5.7 years) completed the trial. Nitrite supplementation was not associated with improvements in skeletal muscle mitochondrial respiration, nor improvements in exercise capacity and physical function. However, platelet mitochondrial respiration changed significantly following an acute dose of oral nitrite. Notably, while nitrite levels increased 16 to 30-fold in plasma following an acute dose, levels increased only 1.6 fold in skeletal muscle. Conclusions The divergent response of skeletal muscle versus platelet mitochondrial respiration in response to nitrite supplementation suggest tissue-specific pharmacokinetics and pharmacodynamics that likely impact on the efficacy of nitrite supplementation. Results also suggest there may be age-related changes in drug delivery, metabolism, and mitochondrial responsiveness compared to nitrite/nitrate previously demonstrated in younger adults.
Forman et al. (Fri,) studied this question.