Beetroot Juice for Interstitial Lung Disease

Recruiting at 1 trial location

Overseen By Dhillon Satvir, MSc

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Must not be taking: Prednisone

Disqualifiers: Cardiovascular, Musculoskeletal, Neurological, others

Compensation: Varies

Number of Visits: 1

Duration: 1 week

15 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether beetroot juice, high in nitrates, can enhance exercise performance in individuals with interstitial lung disease (ILD). Researchers aim to determine if this juice improves exercise capacity compared to a similar juice without nitrates. Suitable participants have ILD with specific types of lung fibrosis (scarring), stable oxygen levels, and no conditions that prevent safe exercise. The trial compares two groups: one drinks nitrate-rich beetroot juice, and the other drinks a nitrate-free version. As an unphased trial, this study offers a unique opportunity to contribute to understanding potential new benefits of beetroot juice for ILD patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you are using prednisone at more than 10 mg/day for more than two weeks within three months of the first study visit, you may not be eligible to participate.

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

Research shows that beetroot juice, rich in dietary nitrate, is generally safe. Studies have found that concentrated beetroot juice supplements are usually well-tolerated. People have used it to potentially enhance exercise performance and improve blood flow. No major reports of serious side effects exist when consumed in typical amounts.

Although the effects of beetroot juice specifically in individuals with interstitial lung disease (ILD) have not been fully studied, its safety in other groups is reassuring. For most people, drinking beetroot juice with the nitrate amount used in this study is considered safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard treatments for interstitial lung disease, which often involve corticosteroids or antifibrotic medications, the treatment under study uses concentrated beetroot juice rich in dietary nitrates. Researchers are excited about this approach because dietary nitrates can enhance blood flow and improve oxygen delivery to tissues, potentially offering a new way to alleviate symptoms. Additionally, beetroot juice is a natural, easily consumable supplement, which could make it a more accessible and appealing option for patients.

What evidence suggests that drinking nitrate-rich beetroot juice could improve exercise performance in people with interstitial lung disease?

Research has shown that drinking beetroot juice, rich in nitrates, can improve exercise performance. One study found that people with mild to moderate chronic obstructive pulmonary disease (COPD) who drank this juice daily could exercise more. Another study discovered that adding nitrates to the diet might lower blood pressure and enhance the benefits of pulmonary rehabilitation. However, when researchers combined results from eight different studies, they found no significant difference between drinking beetroot juice and a placebo. In this trial, participants will receive either a nitrate-rich beetroot juice or a nitrate-depleted placebo. Despite mixed findings, the potential to improve exercise ability remains exciting for people with interstitial lung disease. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for people with certain types of interstitial lung disease (like IPF or NSIP) who have stable oxygen levels and health in the past 6 weeks. They should be able to exercise, not have severe other diseases, no pacemakers or similar devices, and their lung function should be above a specific threshold.

Inclusion Criteria

My health condition has been stable for the last 6 weeks.

Your oxygen level is at least 92% when measured with a pulse oximeter while resting and breathing normal air.

I have been diagnosed with a specific type of lung scarring disease by a team of doctors.

Exclusion Criteria

I have a lung or other serious health condition that affects my ability to exercise or breathe.

I cannot do exercise tests due to a serious health condition.

You have a pacemaker or any metal or electronic devices inside your body.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive dietary nitrate supplementation or placebo for 1 week to assess exercise performance

1 week

1 visit (in-person) for baseline and post-treatment assessments

Follow-up

Participants are monitored for safety and effectiveness after treatment

1-2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• concentrated beetroot juice (400mg of nitrate per serving)
• concentrated beetroot juice (trace amounts of nitrate per serving)

Trial Overview The study tests if drinking beetroot juice rich in nitrate improves exercise performance compared to beetroot juice without nitrate for those with interstitial lung disease. Participants will drink one type of juice and see how it affects their ability to exercise.

How Is the Trial Designed?

Group I: Dietary nitrate supplementation Experimental Treatment 1 Intervention

The dietary nitrate supplement will be a concentrated, nitrate-rich beetroot juice (70 ml providing ∼400mg nitrate per serving)

Group II: Placebo Placebo Group 1 Intervention

The placebo will be a concentrated, nitrate-depleted beetroot juice (70 ml with trace amounts of nitrate)

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Published Research Related to This Trial

In a study involving 48 participants with type 2 diabetes, dietary nitrate supplementation from beetroot juice significantly increased plasma nitrate and nitrite levels, indicating successful absorption of the supplement.

However, despite these increases, nitrate supplementation did not reduce the oxygen cost of walking or improve performance in the 6-minute walk test, suggesting it does not enhance exercise response in individuals with type 2 diabetes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of dietary nitrate supplementation on the oxygen cost of exercise and walking performance in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled crossover trial. Shepherd, AI., Gilchrist, M., Winyard, PG., et al.[2015]

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 14-day study involving 8 subjects with mild to moderate COPD, daily consumption of nitrate-rich beetroot juice significantly increased exercise capacity, as shown by a 14.6% improvement in the incremental shuttle walk test distance.

The increase in exercise tolerance was linked to higher levels of plasma nitrate/nitrite, suggesting that dietary nitrate may enhance performance in COPD patients without affecting blood pressure or lung function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary nitrate improved exercise capacity in COPD but not blood pressure or pulmonary function: a 2 week, double-blind randomised, placebo-controlled crossover trial. Kerley, CP., James, PE., McGowan, A., et al.[2019]

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]

In a study involving nine trained apneists, acute supplementation with nitrate-rich beetroot juice did not significantly affect heart rate (HR), peripheral oxygen saturation (SpO2), or pulmonary gas exchange during submaximal static and dynamic apneas.

The results suggest that consuming beetroot juice prior to apnea exercises does not provide any physiological benefits for free divers, as there were no notable differences compared to a placebo.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of a Dietary Nitrate Supplementation in the Form of a Single Shot of Beetroot Juice on Static and Dynamic Apnea Performance. Barlow, MJ., Elia, A., Shannon, OM., et al.[2018]

In a study involving 17 chronic kidney disease (CKD) patients, supplementation with beetroot juice, which is high in dietary nitrate, significantly reduced blood pressure and renal resistive index (RRI), suggesting potential cardiovascular benefits.

The reduction in blood pressure and RRI after beetroot juice consumption may be attributed to the release of nitric oxide (NO), a vasodilator, indicating that dietary nitrate could be a useful adjunct therapy for managing hypertension in CKD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary nitrate load lowers blood pressure and renal resistive index in patients with chronic kidney disease: A pilot study. Kemmner, S., Lorenz, G., Wobst, J., 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]

Dietary nitrate supplementation from beetroot juice significantly increases plasma nitrite levels and enhances oxygen uptake kinetics during moderate-intensity exercise in hypoxia, suggesting improved efficiency in oxygen utilization.

In hypoxic conditions, nitrate supplementation also improves tolerance to severe-intensity exercise, indicating potential benefits for athletes training or competing at high altitudes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary nitrate supplementation: effects on plasma nitrite and pulmonary O2 uptake dynamics during exercise in hypoxia and normoxia. Kelly, J., Vanhatalo, A., Bailey, SJ., et al.[2022]

Citations

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

Efficacy of dietary nitrate-rich beetroot juice ... Results: A pooled analysis from eight included trials showed no significant difference between dietary nitrate-rich beetroot juice and placebo ...

2. trialx.com trialx.com/clinical-trials/listings/294596/effects-of-drinking-beetroot-juice-on-exercise-performance-in-patients-with-fibrotic-interstitial-lung-disease/

Effects of Drinking Beetroot Juice on Exercise Performance ... The purpose of this study is to determine if drinking nitrate-rich beetroot juice can improve exercise performance compared to drinking nitrate- ...

3. cdek.pharmacy.purdue.edu cdek.pharmacy.purdue.edu/trial/NCT04299945/

Trial | NCT04299945 The purpose of this study is to determine if drinking nitrate-rich beetroot juice can improve exercise performance compared to drinking nitrate-free beetroot ...

4. withpower.com withpower.com/trial/phase-lung-diseases-2020-17414

Beetroot Juice for Interstitial Lung Disease In a 14-day study involving 8 subjects with mild to moderate COPD, daily consumption of nitrate-rich beetroot juice significantly increased exercise capacity, ...

5. bmjopenrespres.bmj.com bmjopenrespres.bmj.com/content/8/1/e000948

Impact of dietary nitrate supplementation on exercise ... Conclusion Dietary nitrate supplementation may have a beneficial effect on BP and augment the effect of pulmonary rehabilitation on exercise ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8422488/

Impact of dietary nitrate supplementation on exercise ... Dietary nitrate supplementation, usually in the form of beetroot juice, may improve exercise performance and endothelial function.

7. healthresearchbc.ca healthresearchbc.ca/award/the-effects-of-dietary-nitrate-supplementation-on-exercise-tolerance-in-patients-with-fibrotic-interstitial-lung-disease/

The effects of dietary nitrate supplementation on exercise ... Using nitrate in the form of concentrated beetroot juice, a safe and commercially available dietary supplement, may improve the delivery and efficiency of ...

8. journals.physiology.org journals.physiology.org/doi/abs/10.1152/japplphysiol.00372.2013

Beetroot juice and exercise: pharmacodynamic and dose- ... Dietary supplementation with beetroot juice (BR), containing approximately 5–8 mmol inorganic nitrate (NO3−), increases plasma nitrite concentration ...