“Beet” the cold: beetroot juice supplementation improves peripheral blood flow, endothelial function, and anti-inflammatory status in individuals with Raynaud’s phenomenon

Abstract

Raynaud’s phenomenon (RP) is characterized by recurrent transient peripheral vasospasm and lower nitric oxide (NO) bioavailability in the cold. We investigated the effect of nitrate-rich beetroot juice (BJ) supplementation on 1) NO-mediated vasodilation, 2) cutaneous vascular conductance (CVC) and skin temperature (Tsk) following local cooling, and 3) systemic anti-inflammatory status. Following baseline testing, 23 individuals with RP attended four times, in a double-blind, randomized crossover design, following acute and chronic (14 days) BJ and nitrate-depleted beetroot juice (NDBJ) supplementation. Peripheral Tsk and CVC were measured during and after mild hand and foot cooling, and during transdermal delivery of acetylcholine and sodium nitroprusside. Markers of anti-inflammatory status were also measured. Plasma nitrite concentration ([nitrite]) was increased in the BJ conditions ( P < 0.001). Compared with the baseline visit, thumb CVC was greater following chronic-BJ (Δ2.0 flux/mmHg, P = 0.02) and chronic-NDBJ (Δ1.45 flux/mmHg, P = 0.01) supplementation; however, no changes in Tsk were observed ( P > 0.05). Plasma [interleukin-10] was greater, pan endothelin and systolic and diastolic blood pressure (BP) were reduced, and forearm endothelial function was improved, by both BJ and NDBJ supplementation ( P < 0.05). Acute and chronic BJ and NDBJ supplementation improved anti-inflammatory status, endothelial function and blood pressure (BP). CVC following cooling increased post chronic-BJ and chronic-NDBJ supplementation, but no effect on Tsk was observed. The key findings are that beetroot supplementation improves thumb blood flow, improves endothelial function and anti-inflammatory status, and reduces BP in people with Raynaud’s. NEW & NOTEWORTHY This is the first study to examine the effect of dietary nitrate supplementation in individuals with Raynaud’s phenomenon. The principal novel findings from this study were that both beetroot juice and nitrate-depleted beetroot juice 1) increased blood flow in the thumb following a cold challenge; 2) enhanced endothelium-dependent and -independent vasodilation in the forearm; 3) reduced systolic and diastolic blood pressure, and pan-endothelin concentration; and 4) improved inflammatory status in comparison to baseline.

Effects of Beetroot Juice Ingestion on Physical Performance in Highly Competitive Tennis Players

“…Beetroot juice consumption promotes an enhanced endurance performance in several populations of athletes [26], potentially due to improved vasodilatation, which facilitates an increase in blood flow to the exercised muscles [22,23] and stimulates a reduction in the O 2 needed during submaximal efforts [25]. However, in intermittent efforts, there is controversial evidence regarding the ergogenic effect of BJ [40,42].…”

“…After absorption in the oral cavity or the intestine, circulating NO 2 − serves as a substrate for O 2 − independent of NO generation, a process potentiated by hypoxia and acidosis conditions [20]. An increased NO presence derived from NO 3 − supplementation improves vasodilation, increasing blood flow to the muscles [21][22][23], and facilitates force production in vivo, reducing ATP cost in exercised muscles [24,25]. Hence, BJ supplementation has showed the capacity to improve endurance performance [26] and accelerate post-repeated-sprint recovery [27].…”

How to beet hypertension in pregnancy: is there more to beetroot juice than nitrate?

“…In some models, the pharmacological amelioration of endothelial dysfunction has been shown to prevent growth restriction (Sekimoto et al 2020). Supplementation with beetroot juice (either with or without nitrate) was shown to improve vascular reactivity of isolated uterine arteries in this mouse model and has also been shown to improve microvascular function in humans with Raynaud's disease (Shepherd et al 2019).…”

Beverages in Rheumatoid Arthritis: What to Prefer or to Avoid

“…Betalain pigments within nitrate-rich red beetroot have a variety of beneficial properties in inflammatory conditions including reducing oxidative stress [ 77 ]. In the rheumatic diseases, this has recently been demonstrated in Raynaud’s phenomenon (seen in appropriately a fifth of patients with RA), with marked reductions in pan-endothelin and blood pressure, as well as pro-inflammatory cytokines, on administration of beetroot juice [ 78 , 79 ]. A small cohort study of patients with RA also demonstrated significant improvements in endothelial function following two weeks of daily beetroot juice consumption [ 80 ].…”