{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:46:58Z","timestamp":1782848818575,"version":"3.54.5"},"reference-count":8,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100018948","name":"Saudi Arabian Cultural Bureau","doi-asserted-by":"publisher","award":["No Applicable"],"award-info":[{"award-number":["No Applicable"]}],"id":[{"id":"10.13039\/100018948","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Moulton Medical Foundation","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"abstract":"<jats:p>\n                    Dietary nitrate (NO\u2083\n                    <jats:sup>\u2212<\/jats:sup>\n                    ) supplementation has been shown to improve vascular function and exercise capacity in chronic obstructive pulmonary disease and in pulmonary hypertension. In a double-blind, placebo-controlled crossover study in 20 patients with idiopathic pulmonary fibrosis who desaturated on exercise, endurance shuttle walk test improved by a median (IQR) difference of 31\u2009s (\u20139.5 to 100.0; (p=0.043)), following a single dose of 140 mL NO\u2083\n                    <jats:sup>\u2212<\/jats:sup>\n                    rich beetroot juice, as did brachial artery flow mediated dilatation; +4.25% (95% CI \u20130.71% to 8.45%; p=0.036), compared with following placebo NO\u2083\n                    <jats:sup>\u2212<\/jats:sup>\n                    depleted placebo juice. Longer-term studies are needed to see if these acute effects translate into sustained benefit.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN14888729\">ISRCTN14888729<\/jats:ext-link>\n                    . Registration date 14 July 2015,\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1186\/ISRCTN14888729\">https:\/\/doi.org\/10.1186\/ISRCTN14888729<\/jats:ext-link>\n                  <\/jats:p>","DOI":"10.1136\/thorax-2026-224919","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:20:40Z","timestamp":1781716840000},"page":"thorax-2026-224919","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Dietary Nitrate Supplementation on Exercise Performance in Hypoxic IPF (EDEN-OX3): a double-blind, placebo-controlled, randomised crossover study"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"isrctn14888729","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn14888729","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3070-3415","authenticated-orcid":false,"given":"Mansour S","family":"Majrshi","sequence":"first","affiliation":[{"name":"Imperial College London NHLI, London, UK"},{"name":"Royal Brompton and Harefield Hospitals, London, UK"},{"name":"King Abdulaziz University, Jeddah, Makkah Province, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK"},{"name":"Respiratory Therapy Department, Taibah University, Medina, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M","family":"George","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Perkins","sequence":"additional","affiliation":[{"name":"Imperial College London NHLI, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-3580","authenticated-orcid":false,"given":"Keir E J","family":"Philip","sequence":"additional","affiliation":[{"name":"Imperial College London NHLI, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona S","family":"Alshehri","sequence":"additional","affiliation":[{"name":"King Abdulaziz University, Jeddah, Makkah Province, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S","family":"Fenwick","sequence":"additional","affiliation":[{"name":"Imperial College London NHLI, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah S","family":"Alsulayyim","sequence":"additional","affiliation":[{"name":"Respiratory Therapy Program, Department of Nursing, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5250-660X","authenticated-orcid":false,"given":"Laura C","family":"Price","sequence":"additional","affiliation":[{"name":"National Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Foundation Trust, London, UK"},{"name":"NHLI, Imperial College London Faculty of Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael I","family":"Polkey","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals, London, UK"},{"name":"Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, 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