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Chronic inorganic nitrate supplementation does not improve metabolic health and worsens disease progression in mice with diet-induced obesity

Chronic inorganic nitrate supplementation does not improve metabolic health and worsens disease progression in mice with diet-induced obesity
Chronic inorganic nitrate supplementation does not improve metabolic health and worsens disease progression in mice with diet-induced obesity

Inorganic nitrate (NO 3 -) has been proposed to be of therapeutic use as a dietary supplement in obesity and related conditions including the metabolic syndrome (MetS), type II diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD). Administration of NO 3 - to endothelial nitric oxide synthase-deficient mice reversed aspects of MetS; however, the impact of NO 3 - supplementation in diet-induced obesity is not well understood. Here we investigated the whole body metabolic phenotype and cardiac and hepatic metabolism in mice fed a high-fat, high-sucrose (HFHS) diet for up to 12 mo of age, supplemented with 1 mM NaNO 3 (or NaCl) in their drinking water. HFHS feeding was associated with a progressive obesogenic and diabetogenic phenotype, which was not ameliorated by NO 3 -. Furthermore, HFHS-fed mice supplemented with NO 3 - showed elevated levels of cardiac fibrosis and accelerated progression of MASLD including development of hepatocellular carcinoma in comparison with NaCl-supplemented mice. NO 3 - did not enhance mitochondrial β-oxidation capacity in any tissue assayed and did not suppress hepatic lipid accumulation, suggesting it does not prevent lipotoxicity. We conclude that NO 3 - is ineffective in preventing the metabolic consequences of an obesogenic diet and may instead be detrimental to metabolic health against the background of HFHS feeding. This is the first report of an unfavorable effect of long-term nitrate supplementation in the context of the metabolic challenges of overfeeding, warranting urgent further investigation into the mechanism of this interaction. NEW & NOTEWORTHY Inorganic nitrate has been suggested to be of therapeutic benefit in obesity-related conditions, as it increases nitric oxide bioavailability, enhances mitochondrial β-oxidation, and reverses metabolic syndrome in eNOS -/- mice. However, we here show that over 12 months nitrate was ineffective in preventing metabolic consequences in high fat, high sucrose-fed mice and worsened aspects of metabolic health, impairing cholesterol handling, increasing cardiac fibrosis, and exacerbating steatotic liver disease progression, with acceleration to hepatocellular carcinoma.

Animals, Diet, High-Fat/adverse effects, Dietary Supplements, Disease Progression, Liver/metabolism, Male, Metabolic Syndrome/metabolism, Mice, Mice, Inbred C57BL, Myocardium/metabolism, Nitrates/metabolism, Obesity/metabolism, inorganic nitrate, mitochondria, metabolic dysfunction-associated steatotic liver disease, metabolism, obesity
0193-1849
E69-E91
Sowton, Alice P
57d8a989-eec4-43ae-adc4-7730ec94e131
Holzner, Lorenz M W
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Krause, Fynn N
7275b945-73f3-4ad2-8325-55bb50a78684
Baxter, Ruby
75c8e94e-e5b0-4090-97ea-bf93c8b907fd
Mocciaro, Gabriele
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Krzyzanska, Dominika K
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Minnion, Magdalena
ab23b32b-9f8e-4876-aaf5-99cb6a725a2f
O'Brien, Katie A
548aadd1-580b-41e7-bc91-cecd0f8997fe
Harrop, Matthew C
25c1230c-ff2a-4c34-92b1-4548440391cb
Darwin, Paula M
3dbf16f6-51ac-40c5-b515-f412bf9b37d7
Thackray, Benjamin D
3740cd15-8d7a-4bdb-8ea7-2e898a2598ff
Vacca, Michele
9e4fa176-34fc-41b4-87b5-ea61a4f36fd8
Feelisch, Martin
8c1b9965-8614-4e85-b2c6-458a2e17eafd
Griffin, Julian L
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Murray, Andrew J
b4710645-e8f4-4d2e-8a31-cf341f98ed20
Sowton, Alice P
57d8a989-eec4-43ae-adc4-7730ec94e131
Holzner, Lorenz M W
ddfd801d-6fe1-48e7-a18e-a12fa0898266
Krause, Fynn N
7275b945-73f3-4ad2-8325-55bb50a78684
Baxter, Ruby
75c8e94e-e5b0-4090-97ea-bf93c8b907fd
Mocciaro, Gabriele
ae50102f-087f-453b-9397-ce280da26ec3
Krzyzanska, Dominika K
c75449de-19e7-4e4d-a467-a15a4ddaf4ad
Minnion, Magdalena
ab23b32b-9f8e-4876-aaf5-99cb6a725a2f
O'Brien, Katie A
548aadd1-580b-41e7-bc91-cecd0f8997fe
Harrop, Matthew C
25c1230c-ff2a-4c34-92b1-4548440391cb
Darwin, Paula M
3dbf16f6-51ac-40c5-b515-f412bf9b37d7
Thackray, Benjamin D
3740cd15-8d7a-4bdb-8ea7-2e898a2598ff
Vacca, Michele
9e4fa176-34fc-41b4-87b5-ea61a4f36fd8
Feelisch, Martin
8c1b9965-8614-4e85-b2c6-458a2e17eafd
Griffin, Julian L
fdfacaf4-435f-45f9-b84f-375062c94164
Murray, Andrew J
b4710645-e8f4-4d2e-8a31-cf341f98ed20

Sowton, Alice P, Holzner, Lorenz M W, Krause, Fynn N, Baxter, Ruby, Mocciaro, Gabriele, Krzyzanska, Dominika K, Minnion, Magdalena, O'Brien, Katie A, Harrop, Matthew C, Darwin, Paula M, Thackray, Benjamin D, Vacca, Michele, Feelisch, Martin, Griffin, Julian L and Murray, Andrew J (2025) Chronic inorganic nitrate supplementation does not improve metabolic health and worsens disease progression in mice with diet-induced obesity. American Journal of Physiology - Endocrinology and Metabolism, 328 (1), E69-E91. (doi:10.1152/ajpendo.00256.2024).

Record type: Article

Abstract

Inorganic nitrate (NO 3 -) has been proposed to be of therapeutic use as a dietary supplement in obesity and related conditions including the metabolic syndrome (MetS), type II diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD). Administration of NO 3 - to endothelial nitric oxide synthase-deficient mice reversed aspects of MetS; however, the impact of NO 3 - supplementation in diet-induced obesity is not well understood. Here we investigated the whole body metabolic phenotype and cardiac and hepatic metabolism in mice fed a high-fat, high-sucrose (HFHS) diet for up to 12 mo of age, supplemented with 1 mM NaNO 3 (or NaCl) in their drinking water. HFHS feeding was associated with a progressive obesogenic and diabetogenic phenotype, which was not ameliorated by NO 3 -. Furthermore, HFHS-fed mice supplemented with NO 3 - showed elevated levels of cardiac fibrosis and accelerated progression of MASLD including development of hepatocellular carcinoma in comparison with NaCl-supplemented mice. NO 3 - did not enhance mitochondrial β-oxidation capacity in any tissue assayed and did not suppress hepatic lipid accumulation, suggesting it does not prevent lipotoxicity. We conclude that NO 3 - is ineffective in preventing the metabolic consequences of an obesogenic diet and may instead be detrimental to metabolic health against the background of HFHS feeding. This is the first report of an unfavorable effect of long-term nitrate supplementation in the context of the metabolic challenges of overfeeding, warranting urgent further investigation into the mechanism of this interaction. NEW & NOTEWORTHY Inorganic nitrate has been suggested to be of therapeutic benefit in obesity-related conditions, as it increases nitric oxide bioavailability, enhances mitochondrial β-oxidation, and reverses metabolic syndrome in eNOS -/- mice. However, we here show that over 12 months nitrate was ineffective in preventing metabolic consequences in high fat, high sucrose-fed mice and worsened aspects of metabolic health, impairing cholesterol handling, increasing cardiac fibrosis, and exacerbating steatotic liver disease progression, with acceleration to hepatocellular carcinoma.

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sowton-et-al-2025-chronic-inorganic-nitrate-supplementation-does-not-improve-metabolic-health-and-worsens-disease - Version of Record
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Accepted/In Press date: 7 November 2024
e-pub ahead of print date: 9 December 2024
Published date: 1 January 2025
Keywords: Animals, Diet, High-Fat/adverse effects, Dietary Supplements, Disease Progression, Liver/metabolism, Male, Metabolic Syndrome/metabolism, Mice, Mice, Inbred C57BL, Myocardium/metabolism, Nitrates/metabolism, Obesity/metabolism, inorganic nitrate, mitochondria, metabolic dysfunction-associated steatotic liver disease, metabolism, obesity

Identifiers

Local EPrints ID: 497501
URI: http://eprints.soton.ac.uk/id/eprint/497501
ISSN: 0193-1849
PURE UUID: e73cb242-5d4f-43fc-9678-a929991114e8
ORCID for Martin Feelisch: ORCID iD orcid.org/0000-0003-2320-1158

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Date deposited: 23 Jan 2025 17:56
Last modified: 22 Aug 2025 02:06

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Contributors

Author: Alice P Sowton
Author: Lorenz M W Holzner
Author: Fynn N Krause
Author: Ruby Baxter
Author: Gabriele Mocciaro
Author: Dominika K Krzyzanska
Author: Magdalena Minnion
Author: Katie A O'Brien
Author: Matthew C Harrop
Author: Paula M Darwin
Author: Benjamin D Thackray
Author: Michele Vacca
Author: Martin Feelisch ORCID iD
Author: Julian L Griffin
Author: Andrew J Murray

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