The Great Debate Around Dietary Nitrate

Ancient Chinese Medicine

《腐行诀脏腐用药法要》之"救猝死中毒开突方五首"

This ancient Dunhuang medical manuscript describes an emergency remedy for sudden collapse (possibly heart attack or poisoning). The text instructs physicians to check if the patient’s fingertips and nails turn bluish, and if so, to place a powdered mixture of alum (硝石) and realgar (雄黄, an arsenic sulfide mineral) under the tongue. Sublingual absorption was thought to “open the blockage” and revive the patient. Interestingly, this mirrors modern use of sublingual nitroglycerin to treat angina, showing a striking parallel between traditional and modern approaches to cardiovascular emergencies.

Source: Butler AR, Moffett J. In: Lo EY, Cullen C, eds. Medieval Chinese Medicine: The Dunhuang Medical Manuscripts. London, UK: Routledge; 2004.

Nobel Prize Recognition

The Nobel Prize in Physiology or Medicine 1998 recognized the discovery of nitric oxide as a signaling molecule in the cardiovascular system, revolutionizing our understanding of vascular biology.

Source: The Nobel Prize in Physiology or Medicine 1998. NobelPrize.org. Nobel Prize Outreach AB 2024. www.nobelprize.org/prizes/medicine/1998/summary/

Nitrate and the Fertilizer Revolution and Challenge

The widespread adoption of nitrogen fertilizers since the mid-20th century has transformed global agriculture, enabling unprecedented food production to support growing populations. However, this agricultural revolution has come with significant environmental costs that directly relate to nitrate concerns in food and water systems.

Research shows that globally farmers apply around 115 million tonnes of nitrogen to crops every year, with only around 35% utilized by plants, meaning 75 million tonnes of nitrogen runs off into rivers, lakes and natural environments. This excess nitrogen represents a massive environmental challenge, as it creates ecological imbalances in ecosystems and water bodies, contributing to nitrate contamination of groundwater and eutrophication of aquatic systems.

The connection between agricultural nitrogen use and dietary nitrate exposure is complex: while fertilizer runoff contaminates water supplies, it also increases nitrate concentrations in vegetables grown in nitrogen-rich soils. Understanding this agricultural-environmental-dietary nexus is crucial for developing sustainable approaches to both food security and public health.

Source: Our World in Data. Share of global excess nitrogen from croplands. ourworldindata.org/grapher/share-global-excess-nitrogen