The findings of this review demonstrate that dietary nitrate (NO3 −) supplementation may reduce the oxygen cost of exercise, elevate arterial and tissue oxygenation, improve muscle metabolic function, and enhance exercise capacity/performance at simulated altitude.

Current preliminary evidence from training studies conducted at simulated altitude suggests that NO3 − supplementation has no effect on performance-related adaptations, although further investigations are warranted.

Additional studies are required to confirm whether the beneficial effects of NO3 − supplementation that have been demonstrated at simulated altitude also manifest at terrestrial altitude.