A nutritional product designed to enhance nitric oxide actvity restores endothelium-dependent function in hypercholesterolemia

A. J. Maxwell, B. E. Anderson, John P. Cooke

Research output: Contribution to journalArticlepeer-review


Background: We investigated the vascular and biochemical effects of a nutrient bar enriched with L-arginine and a combination of other nutrients known to enhance the synthesis or activity of endothelium-derived nitric oxide. Methods: Using a single-blind dose-response design, 41 individuals with hypercholesterolemia were assigned to consume 2 or 3 bars/day for 2 weeks. Each bar contains 4g of L-arginine as well as antioxidant vitamins, niacin and isoflavenoids. Flow-mediated (endothelium-dependent) and nitroglycerin-mediated (endothelium-independent) vasodilation of the brachial artery was measured using high-resolution ultrasonography before and after intervention. Results: Before 2 or 3 bar/day intervention, mean serum arginine level was 33 ± 4 μM and flow-mediated vasodilation was 5±1%(SE). After therapy, trough serum arginine level increased to 43 ± 4 μM (p < 0.0005). Concomitant with this increase, flow-mediated vasodilation improved to 17±2% (p<.0001). Nitroglycerin-mediated vasodilation also increased (19±2% before, 24±2% after, p<.05). The effects of 2 bars/day was equal to that of 3 bars/day. The effect of the intervention was greater in females than males and was independent of the degree of initial dysfunction. The intervention also lowered total serum cholesterol (269±32 before, 253±41 after, p<.05). Other lipid values as well as serum chemistries and hematology were unaffected except for a decline in uric acid levels (5.0±2mg/dl before, 4.3±2 after p<.0001) and a rise in blood urea nitrogen (15±1mg/dl before, 19±1 after). The bars were well tolerated and no significant adverse side-effects were reported. Conclusion: This study demonstrates that 2 or 3 bars/day of this nutritional therapy can reverse endothelial dysfunction in individuals with hypercholesterolemia. This intervention may have an important role in the dietary management of individuals with hypercholesterolemia.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Issue number2
StatePublished - Jan 1 1999

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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