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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether drinking beet juice can improve heart and breathing function in older adults with coronary artery disease (CAD). Participants will receive either beet juice with nitrates, which may enhance blood flow, or a nitrate-free version for comparison. The trial seeks individuals diagnosed with CAD through specific heart tests or treatments who are stable on their current medications. It is suitable for those aged 60 to 85 who have not had recent heart surgeries or events and do not smoke or engage in intense exercise. As an unphased trial, this study provides a unique opportunity to contribute to understanding potential dietary benefits for heart health.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that beetroot juice, high in nitrates, is generally safe and well-tolerated. One study found that adding beetroot juice to the diet is safe for people with peripheral artery disease (PAD), suggesting it might also be safe for those with other heart conditions, such as coronary artery disease. Another study found that this juice can help lower blood pressure in older adults. These studies reported no major safety issues. While more research is always useful, current evidence supports the safety of nitrate-rich beetroot juice for consumption. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about using beetroot juice for coronary artery disease because it introduces a natural source of nitrates, which can improve blood flow and reduce blood pressure. Unlike traditional treatments like statins or beta-blockers, nitrate-rich beetroot juice offers a dietary approach that might enhance cardiovascular health through its unique mechanism of increasing nitric oxide levels in the body. This natural method could provide a complementary or alternative option for patients seeking less conventional treatments.

What evidence suggests that this trial's treatments could be effective for coronary artery disease?

Research has shown that beetroot juice, rich in nitrates, has mixed results for heart health. Some studies suggest it can lower blood pressure, benefiting the heart. However, other studies did not find a significant effect on blood pressure or heart-related issues. One study found that it improved heart function after exercise in older women. This trial will compare the effects of nitrate-rich beetroot juice with nitrate-depleted beetroot juice. Overall, the evidence is promising but not definitive, and more research is needed to fully understand its effects on heart disease. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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 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 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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9903428/

Nitrate-rich beet juice intake on cardiovascular ... Recent meta-analyses of clinical trials have shown that NO3 consumed through beetroot juice lowers blood pressure more clearly [10, 11] than in ...

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/33745600/

Efficacy of dietary nitrate-rich beetroot juice ... Conclusion: There is no significant effect of nitrate-rich beetroot juice on cardiovascular events as systolic, diastolic blood pressure, and ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0891584924005501

Effects of increased nitrate intake from beetroot juice on ... In the present study, the decrease in the oxLDL/NOx ratio after the increased nitrate intake apparently resulted mainly from the pronounced increases in plasma ...

4. frontiersin.org frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1398108/full

Effects of short-term dietary nitrate supplementation on ... Acute and short-term beetroot juice nitrate-rich ingestion enhances cardiovascular responses following aerobic exercise in postmenopausal ...

5. nature.com nature.com/articles/s41430-022-01115-4

No effect of nitrate-rich beetroot juice on microvascular ... Beetroot juice had no effect on blood pressure or microvascular endothelial function in young and older individuals.

6. nad.com nad.com/news/beetroot-juice-lowers-blood-pressure-in-older-adults-new-study-shows

Human Trial Finds Nitrate-Enhanced Juice Lowers Blood ... A new human trial yields data showing that nitrate-rich beetroot juice alters the oral microbe composition and lowers blood pressure in older ...

7. clinicaltrials.gov clinicaltrials.gov/study/NCT05810974

The Impact of Inorganic Nitrate-rich Beetroot Juice on ... The hypothesis of the study is that the nitrate in beetroot juice will increase circulating nitric oxide that will then increase blood flow in small blood ...