Beet Juice Supplementation for Coronary Artery Disease

Overseen By Stephanie Lapierre, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Florida

Must not be taking: Hormone therapy

Disqualifiers: Stroke, Hypertension, Tobacco, others

Compensation: Varies

Number of Visits: Unknown

Duration: 2 weeks

24 Participants Needed

Trial Summary

What is the purpose of this trial?

Older adults with coronary artery disease (CAD) have impaired vascular and inspiratory muscle function. The objective of this study is to examine the effect of beet juice supplementation on vascular and inspiratory muscle function in older adults with CAD.

Do I need to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, it does require that participants have stable coronary artery disease on optimal medical therapy, which suggests you may need to continue your current treatment.

What data supports the effectiveness of this treatment for coronary artery disease?

Research shows that beetroot juice, which is high in nitrates, can improve cardiovascular function by increasing nitric oxide levels in the body. This has been linked to better exercise performance and lower blood pressure, which may benefit people with coronary artery disease. ^{1 2 3 4 5}

Is beet juice supplementation safe for humans?

Research shows that beet juice supplementation, which is rich in nitrates, is generally safe for humans. It has been used in studies with older adults and patients with COPD (a lung condition) without significant safety concerns, and it can help lower blood pressure and improve exercise performance. ^{1 2 6 7 8}

How does beetroot juice supplementation differ from other treatments for coronary artery disease?

Beetroot juice supplementation is unique because it is rich in nitrates, which the body converts into nitric oxide, a molecule that helps improve blood flow and reduce blood pressure. This natural approach differs from standard medications by using dietary means to enhance cardiovascular health. ^{1 2 5 7 9}

Eligibility Criteria

This trial is for adults aged 60-85 with stable coronary artery disease (CAD), confirmed by an angiogram or history of heart issues, who are on optimal medical therapy. Participants must be non-smokers, not engaged in regular aerobic exercise, and women should be postmenopausal. Those with recent heart attacks, strokes, severe lung disease, uncontrolled high blood pressure or certain infections like hepatitis B/C and HIV cannot join.

Inclusion Criteria

You have a history of heart disease based on a test showing more than half narrowing in a major heart blood vessel, a previous heart attack, or a past heart surgery to improve blood flow.

You have stable coronary artery disease and are taking the right medications for it.

You are between 60 and 85 years old.

Exclusion Criteria

Your heart's pumping ability is lower than 50%.

You have unstable chest pain.

You had a heart attack in the last 6 months.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive beet juice supplementation to assess its effect on vascular and inspiratory muscle function

2 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Nitrate depleted beetroot juice
• Nitrate rich beetroot juice

Trial Overview The study investigates the effects of beet juice supplementation on blood vessel and breathing muscle function in older adults with CAD. It compares two types of beetroot juice: one rich in nitrates and one depleted of nitrates to see which might improve these functions better.

Participant Groups

Group I: Nitrate rich beetroot juice Active Control 1 Intervention

Group II: Nitrate depleted beetroot juice Placebo Group 1 Intervention

Who Is Running the Clinical Trial?

University of Florida

Lead Sponsor

Trials

1,428

Recruited

987,000+

Findings from Research

In a study involving 15 COPD patients, acute ingestion of beetroot juice significantly improved exercise capacity, allowing patients to exercise longer at a submaximal workload compared to a placebo.

Beetroot juice also led to notable reductions in both resting and exercise-induced blood pressure, indicating potential cardiovascular benefits alongside improved exercise performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patients. Berry, MJ., Justus, NW., Hauser, JI., et al.[2018]

Ingesting beetroot juice rich in nitrate (NO3-) significantly increases plasma levels of both nitrate and nitrite (NO2-), which can positively affect cardiovascular measures like mean arterial pressure (MAP).

While both NO3- and NO2- have the potential to lower MAP, the expected reduction in systolic and diastolic blood pressure was not observed, suggesting that the role of NO2- in blood pressure regulation alongside NO3- needs further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of Nitrate and Nitrite Following Beetroot Juice Drink Consumption. Jakubcik, EM., Rutherfurd-Markwick, K., Chabert, M., et al.[2021]

In a study involving 12 healthy young African-American females, beetroot juice significantly increased plasma nitric oxide (NO) levels, which is linked to improved cardiovascular function during exercise.

The consumption of beetroot juice led to decreased oxygen consumption, systolic blood pressure, and heart rate during exercise, suggesting it may reduce cardiac workload and improve efficiency in healthy individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cardiorespiratory function associated with dietary nitrate supplementation. Bond, V., Curry, BH., Adams, RG., et al.[2021]

Betaine supplementation, whether taken acutely or chronically, does not significantly affect plasma nitrate/nitrite levels in exercise-trained men, suggesting it does not enhance nitric oxide production as previously thought.

The lack of impact on nitrate/nitrite levels indicates that the performance benefits of betaine may be due to mechanisms other than increasing nitric oxide in the body.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of betaine supplementation on plasma nitrate/nitrite in exercise-trained men. Bloomer, RJ., Farney, TM., Trepanowski, JF., et al.[2021]

In a cross-over trial with healthy middle- to older-aged adults, beetroot juice significantly increased plasma nitrate and nitrite levels after consumption, indicating its effectiveness in enhancing nitric oxide production.

Co-ingesting beetroot juice with vitamin C or whey protein did not result in significant differences in plasma nitrate and nitrite levels compared to beetroot juice alone, suggesting that these supplements do not enhance the acute response of the nitrate-nitrite-nitric oxide pathway.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Vitamin C and Protein Supplementation on Plasma Nitrate and Nitrite Response following Consumption of Beetroot Juice. Miller, GD., Nesbit, BA., Kim-Shapiro, DB., et al.[2023]

In a study involving 12 healthy older adults, dietary nitrate supplementation from concentrated beetroot juice significantly reduced resting blood pressure, with systolic pressure decreasing from 120 mmHg to 115 mmHg and diastolic pressure from 73 mmHg to 70 mmHg.

Nitrate supplementation improved the speed of oxygen uptake response during exercise, reducing the time taken to transition from rest to walking, but did not enhance overall walking performance or cognitive function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of short-term dietary nitrate supplementation on blood pressure, O2 uptake kinetics, and muscle and cognitive function in older adults. Kelly, J., Fulford, J., Vanhatalo, A., et al.[2022]

In a 12-week study with adults, those consuming beetroot juice containing 380 mg of nitrate showed a significant increase in plasma nitrite levels (273.2% change) compared to a placebo group (4.9% change).

Long-term consumption of beetroot juice effectively enhances the body's ability to convert dietary nitrate into plasma nitrate and nitrite, indicating its potential benefits for cardiovascular health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy and Variability in Plasma Nitrite Levels during Long-Term Supplementation with Nitrate Containing Beetroot Juice. Miller, GD., Collins, S., Ives, J., et al.[2023]

Chronic supplementation with beetroot juice (BRJ) for 15 days significantly lowered blood pressure and vascular resistance in 14 healthy males during both rest and exercise, indicating its potential as an effective dietary intervention for cardiovascular health.

BRJ also improved endothelial function, which may enhance oxygen delivery to muscles during exercise, allowing for longer performance before fatigue sets in.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise. Lee, JS., Stebbins, CL., Jung, E., et al.[2020]

In a study involving 15 COPD patients, dietary beetroot juice (BR) supplementation for 7 days increased plasma nitrite levels and significantly reduced diastolic blood pressure (DBP), indicating potential cardiovascular benefits.

Despite these positive effects on blood pressure and nitrite levels, BR supplementation did not improve exercise performance, as measured by the 6-minute walk test or oxygen consumption during submaximal cycling.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary beetroot juice - effects on physical performance in COPD patients: a randomized controlled crossover trial. Friis, AL., Steenholt, CB., Løkke, A., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Dietary nitrate supplementation improves exercise performance and decreases blood pressure in COPD patients. [2018]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Pharmacokinetics of Nitrate and Nitrite Following Beetroot Juice Drink Consumption. [2021]

3. Canada pubmed.ncbi.nlm.nih.gov

Cardiorespiratory function associated with dietary nitrate supplementation. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Effect of betaine supplementation on plasma nitrate/nitrite in exercise-trained men. [2021]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Effect of Vitamin C and Protein Supplementation on Plasma Nitrate and Nitrite Response following Consumption of Beetroot Juice. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Effects of short-term dietary nitrate supplementation on blood pressure, O2 uptake kinetics, and muscle and cognitive function in older adults. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Efficacy and Variability in Plasma Nitrite Levels during Long-Term Supplementation with Nitrate Containing Beetroot Juice. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Effects of chronic dietary nitrate supplementation on the hemodynamic response to dynamic exercise. [2020]

9. New Zealand pubmed.ncbi.nlm.nih.gov

Dietary beetroot juice - effects on physical performance in COPD patients: a randomized controlled crossover trial. [2018]