A single dose of beetroot juice improves endothelial function but not tissue oxygenation in pregnant women: a randomised clinical trial

Evaluation of 12-Week Standardized Beetroot Extract Supplementation in Older Participants: A Preliminary Study of Human Health Safety

In recent years, there has been a notable surge in the popularity of beetroot-based dietary supplements, driven by their rich nitrate composition. Several types of beetroot-based dietary supplements can be found in markets worldwide; however, ensuring the safety of dietary supplements is a crucial consideration, as there is limited evidence on their safety, especially for older populations. Therefore, the purpose of the current study was to evaluate the safety and tolerability of a nitrate-rich beetroot extract in older participants taking supplements over 12 weeks. The participants were randomly assigned to receive 20 g daily of beetroot extract or a matching placebo. The safety and tolerability of the supplementation were evaluated as the occurrence of adverse events and anthropometric, biochemical, and hemodynamic parameters were measured. No serious adverse events were reported in any group. Anthropometric, biochemical, and hemodynamic parameter changes between the baseline and the end of the study were not statistically significant in either group. However, interestingly, the group receiving beetroot extract supplementation exhibited a notable increase in plasma nitrate levels (p = 0.076, f = 0.50) and showed a decrease in insulin levels (p = 0.026, f = 0.59). In conclusion, we found that 20 g of beetroot extract supplementation for 12 weeks was safe and well tolerated in older participants.

Dissipation behaviours, residues, and health risk of six herbicides in sugar beets under field conditions

This study established a residue detection method based on the QuEChERS pre-treatment method and combined it with high-performance liquid chromatography-tandem mass spectrometry to test six herbicides (metamitron, clopyralid, desmedipham, phenmedipham, ethofumesate, and haloxyfop-p-methyl) in sugar beet plants, soil, and roots. The degradation dynamics and terminal residues of each herbicide in sugar beets were analysed. Finally, the dietary risks of various herbicides in sugar beets were evaluated based on the dietary structure of Chinese people, and the risk quotient values were below 100%. Using this detection method, all reagents exhibited good linearity (0.9724 ≤ R2 ≤ 0.9998), The limit of quantification (LOQ) ranged from 0.01 to 0.05 mg/L, the matrix effect ranged from -1.2% to -50%, the addition recovery rate ranged from 77.00% to 103.48%, and the relative standard deviation ranged from 1.61% to 16.17%; therefore, all indicators of this method met the residue detection standards. Under field conditions, the half-lives (t1/2) ranged about 0.65 ∼ 2.96 d and 0.38 ∼ 27.59 d in sugar beet plants and soil, respectively. All herbicides were easily degraded in sugar beet plants and soil (t1/2 < 30 d). The terminal residue amounts in the beet plants, soil, and roots ranged from < LOQ to 0.243 mg/kg. The dietary risk assessment of each pesticide was conducted based on the residual median of the terminal residues and the highest residual values on the edible part of the beetroot. The chronic exposure risk quotient (RQc) and acute exposure risk quotient (RQa) values were < 100%, indicating that the residue of each pesticide in beetroot posed low risks to consumers in China at the recommended dosage.

Should the non-canonical pathway of nitric oxide generation be targeted in hypertensive pregnancies?

Hypertension in pregnancy is prevalent, affecting around 10% of pregnancies worldwide, and significantly increases the risk of adverse outcomes for both mothers and their babies. Current treatment strategies for pregnant women with hypertension are limited, and new approaches for the management of hypertension in pregnancy are urgently needed. Substantial evidence from non-pregnant subjects has demonstrated the potential for dietary nitrate supplementation to increase nitric oxide (NO) bioavailability and lower blood pressure, following bioactivation via the non-canonical NO pathway. Emerging data suggest this approach may also be of benefit in pregnant women, although studies are limited. This review aims to summarise the current evidence from preclinical and clinical studies of nitrate supplementation in pregnancy, drawing on data from non-pregnant populations where appropriate and highlighting key gaps in knowledge that remain to be addressed in future trials.

Altered Oral Nitrate Reduction and Bacterial Profiles in Hypertensive Women Predict Blood Pressure Lowering Following Acute Dietary Nitrate Supplementation

BACKGROUND

The efficacy of dietary nitrate supplementation to lower blood pressure (BP) in pregnant women is highly variable. We aimed to investigate whether differences in oral microbiota profiles and oral nitrate-reducing capacity may explain interindividual differences in BP lowering following nitrate supplementation.

METHODS

Participants recruited for this study were both pregnant and nonpregnant women, with or without hypertension (n=55). Following an overnight fast, plasma, saliva, and tongue scraping samples were collected for measurement of nitrate/nitrite concentrations, oral NaR (nitrate reductase) activity, and microbiota profiling using 16S rRNA gene sequencing. Baseline BP was measured, followed by the administration of a single dose of dietary nitrate (400 mg nitrate in 70 mL beetroot juice). Post-nitrate intervention, plasma and salivary nitrate/nitrite concentrations and BP were determined 2.5 hours later.

RESULTS

Women with hypertension had significantly lower salivary nitrite concentrations (P=0.006) and reduced abundance of the nitrate-reducing taxa Veillonella(P=0.007) compared with normotensive women. Oral NaR activity was not significantly different in pregnant versus nonpregnant women (P=0.991) but tended to be lower in hypertensive compared with normotensive women (P=0.099). Oral NaR activity was associated with both baseline diastolic BP (P=0.050) and change in diastolic BP following acute nitrate intake (P=0.01, adjusted for baseline BP).

CONCLUSIONS

The abundance and activity of oral nitrate-reducing bacteria impact both baseline BP as well as the ability of dietary nitrate supplementation to lower BP. Strategies to increase oral nitrate-reducing capacity could lower BP and enhance the efficacy of dietary nitrate supplementation, in pregnancy as well as in nonpregnant adults.

REGISTRATION

URL: https://www.

CLINICALTRIALS

gov; Unique identifier: NCT03930693.

AI, Borges Jr. E. Beetroot, watermelon and ginger juice supplementation may increase the clinical outcomes of Intracytoplasmic Sperm Injection cycles

OBJECTIVE

To prove the hypothesis that beetroot, watermelon and ginger juice supplementation improves the endometrial receptivity and clinical outcomes of intracytoplasmic sperm injection (ICSI) cycles.

METHODS

This prospective randomized study enrolled 436 female patients undergoing ICSI cycles from January/2018 to June/2021, in a private university-affiliated IVF center. Female patients were randomized in a 1:3 ratio to either Control (n=109) or Supplementation Group (n=327). All patients received nutritional orientation before the beginning of the treatment. Participants in the Supplementation Group were instructed to intake a daily dose of homemade juice, prepared with fresh beetroot, watermelon and ginger, from the day of embryo transfer until the day of pregnancy test, while patients in Control Group did not follow the juice protocol. Generalized Linear Models, adjusted for potential confounders (female age, body mass index - BMI, endometrial thickness upon embryo transfer, and number of transferred embryos), followed by Bonferroni post hoc test for the comparison of means between groups, were used to investigate the impact of juice supplementation on the clinical outcomes of ICSI.

RESULTS

Patients and cycles characteristics were equally distributed among Supplementation and Control groups. Implantation rate (25.2% vs. 20.5%, p<0.001) and clinical pregnancy rate (41.0% vs. 22.0%, p=0.039) were significantly higher in the Supplementation compared to the Control group.

CONCLUSIONS

The use of beetroot, watermelon and ginger juice may be considered a promising strategy for improving clinical outcomes in assisted reproductive technology (ART), without any side effects.

The effect of microencapsulated watermelon rind (Citrullus lanatus) and beetroot (Beta vulgaris L.) ingestion on ischemia/reperfusion-induced endothelial dysfunction: a randomised clinical trial

Endothelial dysfunction is commonly associated with a cardiovascular event, such as myocardial infarction. Myocardial infarction is marked by an ischemia/reperfusion (IR) phenomenon associated with endothelial dysfunction, contributing even more to future cardiovascular events. Although the supplementation with L-citrulline and nitrate from watermelon and beetroot have been used to improve vascular function, the effect of microencapsulated watermelon rind (WR) or its co-ingestion with beetroot (WR + B) on endothelial IR injury has not been addressed. Therefore, this study aimed to investigate the effect of a single dose of WR and WR + B on IR-induced macro-and microvascular dysfunction. In a randomized, crossover, placebo-controlled study, 12 volunteers underwent macro (flow-mediated dilation) and microvascular (muscle oxygen saturation) assessment and blood collection (to measure L-citrulline, L-arginine, nitrate and nitrite) before and after 20 min of blood occlusion in WR, WR + B and placebo conditions. Prolonged ischemia induced endothelial dysfunction in the macro but not in the microvasculature. The WR and WR + B supplementation significantly restored FMD after IR injury compared to the placebo (p < 0.05). However, there was no significant difference between WR and WR + B in the macrovascular function (p > 0.05). Plasma L-citrulline, L-arginine, nitrate, and nitrite significantly increased (p > 0.05) after WR and WR + B supplementation compared to the placebo. A single dose of WR and WR + B effectively minimizes IR-induced macrovascular endothelial dysfunction in healthy individuals. Beetroot co-ingestion with watermelon did not provide an additional effect of endothelial dysfunction induced by IR (NCT04781595, March 4, 2021).

Common pregnancy complications and polyphenols intake: an overview

During pregnancy, the body undergoes a great amount of changes in order to support a healthy developing fetus. In this context, maternal dietary supplementation is widely encouraged to provide adequate nutrition for the newborn. In the past few years, studies have emerged highlighting the benefits of polyphenols intake during pregnancy. Indeed, despite differences among reports, such as experimental model, polyphenol employed, dosage and regimen of administration, there is no doubt that the ingestion of these molecules has a protective effect in relation to three pregnancy-associated diseases or conditions: preeclampsia, gestational diabetes and fetal growth restriction. In this review, we describe the effects of different polyphenols and polyphenol-rich extracts or juices on the main outcomes of these common pregnancy-associated complications, obtained in human, animal and in vitro studies. Therefore, this work provides a critical analysis of the literature, and a summary of evidences, from which future research using polyphenols can be designed and evaluated.

The effect of dietary nitrate on macro- and microvascular function: A systematic review

Previous studies have investigated the impact of dietary nitrate on vascular function due to the association between dietary nitrate ingestion and improvement in nitric oxide (NO) bioavailability. Considering that NO can present different effects through vascular beds (macro- vs. microvasculature) due to the specific characteristic (function and morphology) that each vessel exhibits, it is crucial to investigate the effect of dietary nitrate ingestion on the macro- and microvascular function to understand the effect of nitrate on vascular function. For this reason, this review aimed to evaluate the impact of dietary nitrate on macro- and microvascular function in humans. A total of 29 studies were included in the systematic review, of which 19 studies evaluated the effect of nitrate supplementation on macrovascular function, eight studies evaluated the effect on microvascular function, and two studies evaluated the impact on both macro- and microvascular function. The literature suggests that dietary nitrate ingestion seems to improve the vascular function in macrovasculature, whereas microvascular function appears to be modest. Future studies investigating the effect of nitrate ingestion on vascular function should focus on measuring macro- and microvascular function whenever possible so that the impact of nitrate-rich foods on vascular segments could be better understood.

A comprehensive review of beetroot (Beta vulgaris L.) bioactive components in the food and pharmaceutical industries

Beetroot is rich in various bioactive phytochemicals, which are beneficial for human health and exert protective effects against several disease conditions like cancer, atherosclerosis, etc. Beetroot has various therapeutic applications, including antioxidant, antibacterial, antiviral, and analgesic functions. Besides the pharmacological effects, food industries are trying to preserve beetroots or their phytochemicals using various food preservation methods, including drying and freezing, to preserve their antioxidant capacity. Beetroot is a functional food due to valuable active components such as minerals, amino acids, phenolic acid, flavonoid, betaxanthin, and betacyanin. Due to its stability, nontoxic and non-carcinogenic and nonpoisonous capabilities, beetroot has been used as an additive or preservative in food processing. Beetroot and its bioactive compounds are well reported to possess antioxidant, anti-inflammatory, antiapoptotic, antimicrobial, antiviral, etc. In this review, we provided updated details on (i) food processing, preservation and colorant methods using beetroot and its phytochemicals, (ii) synthesis and development of several nanoparticles using beetroot and its bioactive compounds against various diseases, (iii) the role of beetroot and its phytochemicals under disease conditions with molecular mechanisms. We have also discussed the role of other phytochemicals in beetroot and their health benefits. Recent technologies in food processing are also updated. We also addressed on molecular docking-assisted biological activity and screening for bioactive chemicals. Additionally, the role of betalain from different sources and its therapeutic effects have been listed. To the best of our knowledge, little or no work has been carried out on the impact of beetroot and its nanoformulation strategies for phytocompounds on antimicrobial, antiviral effects, etc. Moreover, epigenetic alterations caused by phytocompounds of beetroot under several diseases were not reported much. Thus, extensive research must be carried out to understand the molecular effects of beetroot in the near future.

Resveratrol supplementation efficiently improves endothelial health: A systematic review and meta-analysis of randomized controlled trials

We perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to quantify the effect of resveratrol supplementation on endothelial function. A comprehensive search was performed in electronic databases including PubMed, Scopus, Web of Science, and Cochrane Library up to February 2021 with no limitation in time and language. A meta-analysis of eligible studies was performed using a random-effects model to estimate the pooled effect size of flow-mediated dilation (FMD), intracellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), fibrinogen, and plasminogen activator inhibitor-1 (PAI-1). In total, 21 arms from 17 studies were included. The meta-analysis results showed that resveratrol significantly change the concentrations of FMD (WMD: 1.43%; 95% CI: 0.98 to 1.88, p < .001) and ICAM-1 (WMD: -7.09 ng/ml, 95% CI: -7.45 to -6.73, p < .001). However, VCAM-1, fibrinogen, and PAI-1 did not change significantly after resveratrol supplementation. In conclusion, the results of this study suggest that resveratrol supplementation can improve endothelial function which could be important, especially in patients with cardiovascular diseases.

A single dose of dietary nitrate supplementation protects against endothelial ischemia-reperfusion injury in early postmenopausal women

The onset of menopause and accompanying changes to ovarian hormones often precedes endothelial dysfunction in women. In particular, accelerated impairments in macrovascular and microvascular function coincide with the loss of estrogen, as does impaired endothelial responses to ischemia-reperfusion (IR) injury. In healthy, early postmenopausal women (n = 12; 3.9 ± 1.5 years since menopause) we tested the hypothesis that acute dietary nitrate (NO3-) supplementation would improve endothelial function and attenuate the magnitude of endothelial dysfunction following whole-arm IR in comparison with placebo. In this randomized, double-blind, placebo-controlled, crossover study we tested participants before and after NO3--rich (BRnitrate) and NO3--depleted (BRplacebo) beetroot juice (BR) consumption, as well as following IR injury, and 15 min after IR to assess recovery. Analyses with repeated-measures general linear models revealed a condition × time interaction for brachial artery flow-mediated dilation (FMD; P = 0.04), and no interaction effect was found for the near-infrared spectroscopy-derived reperfusion slope (P = 0.86). Follow-up analysis showed a significant decline in FMD following IR injury with BRplacebo in comparison with all other timepoints (all, P < 0.05), while this decline was not present with BRnitrate (all, P > 0.05). Our findings demonstrate that a single dose of dietary NO3- minimizes IR-induced macrovascular endothelial dysfunction in healthy, early postmenopausal women, but does not improve resting macrovascular and microvascular function. Trial registration number: NCT03644472. Novelty: In healthy, early postmenopausal women, a single dose of NO3--rich BR can protect against IR-induced endothelial dysfunction. This protection may be due to nitric oxide bioactivity during IR rather than improved endothelial function prior to the IR protocol per se.

Impact of microencapsulated watermelon (Citrullus lanatus) and beetroot (Beta vulgaris L) on storage stability of l-citrulline and dietary nitrate

The aim the current study was to developed a watermelon rind powder (WRP), watermelon pulp powder (WPP), and beetroot powder (BP), in order to compare the stability of L-citrulline and nitrate with that of watermelon rind juice (WRJ), watermelon pulp juice (WPJ), and beetroot juice (BJ), respectively. The stability was evaluated during 32 days at 25, 4 and - 20 ºC. L-arginine and L-ornithine content were also evaluated. At day 0, a significantly higher L-citrulline and L-ornithine content in WRP was observed when compared to WPP. However, a significantly lower L-arginine content in WRP was observed when compared to WPP. L-citrulline content in WRP and WRJ was stable over 32 days in all temperatures evaluated, whereas it reduced in WPP in 32 days at 25 ºC and it is reduced in in WPJ in day 16 and day 32 at 25 °C. L-arginine content in WRP and WPP was stable over 32 days in all temperatures evaluated. A reduction was observed in WRJ at day 2, 4 and 32 at 25 °C and in WPJ at day 2, 4, 8, 16 and 32 days at 25 °C. L-ornithine content in WRP and WPP was stable over 32 days in all temperatures evaluated. An increase was observed in WRJ at day 2, 4 and 32 at 25 °C and in WPJ in day 2, 4, 8, 16 and 32 at 25 °C. Nitrate content in BP was stable over 32 days in all temperatures evaluated, while nitrate content in beetroot juice was reduced in day 2 at 25 °C and day 8 at 4 °C. In conclusion, L-citrulline of the microencapsulated watermelon rind and nitrate of the microencapsulated beetroot were stable throughout storage.

Boosting nitric oxide in stress and respiratory infection: Potential relevance for asthma and COVID-19

Nitric oxide (NO) is a ubiquitous signaling molecule that is critical for supporting a plethora of processes in biological organisms. Among these, its role in the innate immune system as a first line of defense against pathogens has received less attention. In asthma, levels of exhaled NO have been utilized as a window into airway inflammation caused by allergic processes. However, respiratory infections count among the most important triggers of disease exacerbations. Among the multitude of factors that affect NO levels are psychological processes. In particular, longer lasting states of psychological stress and depression have been shown to attenuate NO production. The novel SARS-CoV-2 virus, which has caused a pandemic, and with that, sustained levels of psychological stress globally, also adversely affects NO signaling. We review evidence on the role of NO in respiratory infection, including COVID-19, and stress, and argue that boosting NO bioavailability may be beneficial in protection from infections, thus benefitting individuals who suffer from stress in asthma or SARS-CoV-2 infection.

Effect of dietary nitrate ingestion on muscular performance: a systematic review and meta-analysis of randomized controlled trials

Dietary nitrate consumption from foods such as beetroot has been associated with many physiological benefits including improvements in vascular health and exercise performance. More recently, attention has been given to the use of dietary nitrate as a nutritional strategy to optimize muscular performance during resistance exercise. Our purpose was to perform a systematic review and meta-analysis of the research literature assessing the effect of dietary nitrate ingestion on muscular strength and muscular endurance. A structured search was carried out in accordance with PRISMA guidelines and from the total included studies (n = 34 studies), 12 studies had data for both measurement of strength and muscular endurance outcomes, 14 studies had data only for muscular strength outcome, and 8 studies had data only for muscular endurance outcome. Standardized mean difference (SMD) was calculated and meta-analyses were performed by using a random-effects model. Dietary nitrate ingestion was found to result in a trivial but significant effect on muscular strength (overall SMD = 0.08, P = 0.0240). Regarding muscular endurance dietary nitrate was found to promote a small but significant effect (overall SMD = 0.31, P < 0.0001). Dosage, frequency of ingestion, training level, muscle group, or type of contraction did not affect the findings, except for a greater improvement in muscle endurance during isometric and isotonic when compared to isokinetic contractions. Dietary nitrate seems to have a positive effect on muscular strength and muscular endurance, which is mostly unaffected by dosage, frequency of ingestion, training level, muscle group, or type of contraction. However, given the trivial to small effect, further experimental research on this topic is warranted.

Covid-19 Quarantine: Impact of Lifestyle Behaviors Changes on Endothelial Function and Possible Protective Effect of Beetroot Juice

The current recommendation for reducing person-to-person Coronavirus 2019 (COVID-19) transmission is social distancing, including remote work and school, and home confinement. However, confinement may cause negative feelings, such as frustration, anger, boredom, and stress, in quarantined people. Furthermore, unhealthy diet and physical inactivity behaviors are commonly linked to home confinement, leading to weight gain, metabolic disorders, smoking, and exacerbated alcohol consumption. As a result, these unhealthy behaviors are typically linked to vascular endothelium damage (endothelial dysfunction), which is a first step for the development of cardiovascular disease (CVD). Given that CVD is the main cause of morbidity and mortality worldwide, attenuating the progression of endothelial dysfunction is very important for the control of CVD. Consuming vegetable rich in nitrate, such as beetroots, may be an effective way to prevent endothelial dysfunction. Several emerging studies have recommended beetroot juice in order to improve endothelial function in hypertensive, hypercholesterolemic individuals, as well as in those with CVD risk factors. Therefore, nitrate-rich vegetable consumption, such as beetroot, should be encouraged to be included in the diet during confinement from COVID-19 outbreaks in order to alleviate the potential negative effect of home confinement on cardiovascular health.

Acute supplementation with beetroot juice improves endothelial function in HIV-infected individuals

Human immunodeficiency virus (HIV) is associated with lower nitric oxide (NO) bioavailability and vascular dysfunction. Nitrate-rich beetroot juice (BJ) has been shown to acutely increase NO availability and vascular function in healthy and individuals at high risk for cardiovascular disease. Thus, we tested the effects of BJ ingestion on flow-mediated dilation (FMD) and pulse wave velocity (PWV) measurements in healthy and HIV-infected patients. Thirteen HIV-infected individuals (age, 36 ± 10 years) and 18 healthy (age, 27 ± 8 years) participated in the study. Individuals were submitted to vascular tests such as FMD and pulse PWV at pre (T0) and at 120 min (T120) after BJ and placebo (PLA) ingestion. The %FMD at T0 of the control group was significantly higher than the %FMD at T0 of the HIV individuals in both interventions. BJ improved the %FMD at T120 when compared with T0 in the HIV and control groups. There was no change in %FMD after PLA ingestion in the control and HIV groups. There were no differences between groups (control vs HIV), time points (T0 vs T120), and interventions (BJ vs PLA) for PWV. Our findings showed that nitrate-rich BJ ingestion acutely improved vascular function in healthy and HIV-infected patients. Clinical Trials Registry no. NCT03485248. Novelty: HIV is associated with lower NO bioavailability and vascular dysfunction. Acute supplementation with nitrate-rich BJ has been shown to acutely increases NO bioavailability. We showed for the first time that BJ acutely improves endothelial function in HIV-infected patients.

Beetroot juice lowers blood pressure and improves endothelial function in pregnant eNOS-/- mice: importance of nitrate-independent effects

KEY POINTS

Maternal hypertension is associated with increased rates of pregnancy pathologies, including fetal growth restriction, due at least in part to reductions in nitric oxide (NO) bioavailability and associated vascular dysfunction. Dietary nitrate supplementation, from beetroot juice (BRJ), has been shown to increase NO bioavailability and improve cardiovascular function in both preclinical and clinical studies. This study is the first to investigate effects of dietary nitrate supplementation in a pregnant animal model. Importantly, the effects of nitrate-containing BRJ were compared with both 'placebo' (nitrate-depleted) BRJ as well as water to control for potential nitrate-independent effects. Our data show novel, nitrate-independent effects of BRJ to lower blood pressure and improve vascular function in endothelial nitric oxide synthase knockout (eNOS^-/- ) mice. These findings suggest potential beneficial effects of BRJ supplementation in pregnancy, and emphasize the importance of accounting for nitrate-independent effects of BRJ in study design and interpretation.

ABSTRACT

Maternal hypertension is associated with adverse pregnancy outcomes, including fetal growth restriction (FGR), due in part to reductions in nitric oxide (NO) bioavailability. We hypothesized that maternal dietary nitrate administration would increase NO bioavailability to reduce systolic blood pressure (SBP), improve vascular function and increase fetal growth in pregnant endothelial NO synthase knockout (eNOS^-/- ) mice, which exhibit hypertension, endothelial dysfunction and FGR. Pregnant wildtype (WT) and eNOS^-/- mice were supplemented with nitrate-containing beetroot juice (BRJ+) from gestational day (GD) 12.5. Control mice received an equivalent dose of nitrate-depleted BRJ (BRJ-) or normal drinking water. At GD17.5, maternal SBP was measured; at GD18.5, maternal nitrate/nitrite concentrations, uterine artery (UtA) blood flow and endothelial function were assessed, and pregnancy outcomes were determined. Plasma nitrate concentrations were increased in both WT and eNOS^-/- mice supplemented with BRJ+ (P < 0.001), whereas nitrite concentrations were increased only in eNOS^-/- mice (P < 0.001). BRJ- did not alter nitrate/nitrite concentrations. SBP was lowered and UtA endothelial function was enhanced in eNOS^-/- mice supplemented with either BRJ+ or BRJ-, indicating nitrate-independent effects of BRJ. Improvements in endothelial function in eNOS^-/- mice were abrogated in the presence of 25 mm KCl, implicating enhanced EDH signalling in BRJ- treated animals. At GD18.5, eNOS^-/- fetuses were significantly smaller than WT animals (P < 0.001), but BRJ supplementation did not affect fetal weight. BRJ may be a beneficial intervention in pregnancies associated with hypertension, endothelial dysfunction and reduced NO bioavailability. Our data showing biological effects of non-nitrate components of BRJ have implications for both interpretation of previous findings and in the design of future clinical trials.

A single oral dose of beetroot-based gel does not improve muscle oxygenation parameters, but speeds up handgrip isometric strength recovery in recreational combat sports athletes

Although the effect of beetroot supplementation on exercise performance has been widely demonstrated to improve the performance of cyclists, runners, and swimmers, its effect on combat sports remains inconclusive. The present study assessed the effect of beetroot-based gel (BG) supplementation on maximal voluntary contraction (MVC), exercise time until fatigue (ETF), muscle O₂ saturation (SmO₂), and blood volume (tHb) in response to handgrip isotonic exercise (HIE) in recreational combat sport athletes. In a randomized, crossover, double-blind study, 14 combat sports athletes performed three sets of HIE (at 40% MVC) until fatigue after BG or nitrate-depleted gel (PLA) supplementation, in which forearm SmO₂ and tHb were continuously monitored using near-infrared spectroscopy. MVC was evaluated at baseline and 20 min after HIE. MVC values were analysed as the change from baseline values (ΔMVC). There was a significant increase accompanied by a large effect size in ΔMVC (p = 0.036, d = 0.94) after HIE in the BG condition compared to PLA. However, there were no changes in SmO₂ parameters (p> 0.05), tHb (p> 0.05) or ETF (p = 0.161) throughout the three sets of HIE. Additionally, a trivial to small effect size was observed in near-infrared spectroscopy (NIRS) parameters and ETF (d = ≤ 0.2 to 0.5). Therefore, a single dose of beetroot gel supplementation may be considered as a good nutritional strategy to improve strength recovery in combat sports athletes.

Is flow-mediated dilatation associated with near-infrared spectroscopy-derived magnitude of muscle O2 desaturation in healthy young and individuals at risk for cardiovascular disease?

Vascular occlusion test (VOT)-induced reactive hyperemia in brachial artery is crucial to flow-mediated dilation (FMD). Emerging studies have suggested that reactive hyperemia depends on the magnitude of the O₂ desaturation (ischemia) in downstream microvessels. Although near-infrared spectroscopy-derived tissue O₂ saturation index (TSI) has been used to assess the magnitude of ischemia, the association between FMD and the magnitude of O₂ desaturation has not been addressed. Therefore, the aim of the present study was to evaluate whether FMD correlates with the magnitude of muscle O₂ desaturation in healthy young individuals and older adults at risk for cardiovascular disease (CVD). Twenty healthy young individuals and 20 others at risk for CVD participated in the study. The magnitude of ischemic stimulus was determined by calculating the area under curve of TSI signal over 5 min of cuff occlusion period. Oxygen resaturation rate was calculated as the upslope of the TSI signal over 10 s following cuff deflation. There was no significant correlation between FMD and the magnitude of ischemic stimulus in both groups assessed (young: R = 0.327; P = 0.159 and older: R = -0.184; P = 0.436). However, a significant correlation between the magnitude of O₂ desaturation and O₂ resaturation rate in young (R = 0.555; P = 0.011) and older individuals at risk for CVD (R = 0.539; P = 0.014). In conclusion, FMD response did not correlate with the magnitude of muscle O₂ desaturation, although it seems to be partially associated with O₂ resaturation rate.

The effects of the analysis strategy on the correlation between the NIRS reperfusion measures and the FMD response

This study aimed to investigate the correlation between near-infrared spectroscopy (NIRS)-derived measures of microvascular responses using a range of different analysis and flow-mediated dilation (FMD). Additionally, we aimed to investigate whether assessing NIRS and FMD simultaneously or non-simultaneously would affect this association. Thirty-five healthy young individuals (26 ± 13 years old) participated in the study. Twenty were submitted to a simultaneous NIRS/FMD test (NIRS probe placed below the cuff during FMD test) and fifteen to a non-simultaneous FMD and NIRS intervention (NIRS test performed 20 min after FMD). NIRS-derived oxygen saturation signal (StO₂) during reperfusion was analyzed as follow: upslope of a 10 s (slope 10 s) and 30 s (slope 30 s) reperfusion window immediately following cuff deflation, time for the StO₂ to reach the pre-occlusion ₍baseline) values after cuff release (time to baseline) and to reach the peak after cuff release (time to max), difference between the minimum and maximum StO₂ value reached after cuff deflation (Magnitude) and; the total area under the reperfusion curve above the baseline value until the end of the 2 min post cuff release (AUC 2 min). There was a significant positive correlation between slope 10 s and FMD in the simultaneous (r = 0.60; p < 0.05) and non-simultaneous (r = 0.62; p < 0.05) assessments. There was no significant correlation between NIRS-derived slope 30 s, time to baseline, time to max, magnitude, and AUC 2 min and the FMD in both methods. The association between NIRS and FMD is analysis strategy dependent, regardless if assessed simultaneously or non-simultaneously.

The association between near-infrared spectroscopy assessment of microvascular reactivity and flow-mediated dilation is disrupted in individuals at high risk for cardiovascular disease

OBJECTIVE

This study aimed to evaluate the correlation between the NIRS-derived reperfusion slope and %FMD in the arm of healthy and at high risk for CVD individuals.

METHODS

Twelve healthy (24 ± 4 years) and twelve at high risk for cardiovascular disease (65 ± 11 years) individuals participated in the study. The individuals were submitted to a conduit artery FMD followed by a NIRS-VOT microvascular function test in the arm. Microvascular responsiveness was calculated as the forearm reperfusion slope, and macrovascular function was assessed as the percent of change in FMD (%FMD) of the brachial artery.

RESULTS

There was a significant correlation between reperfusion slope and %FMD (R = 0.61, P < 0.05) in the healthy group; however, no significant correlation between FMD and reperfusion slope (R = -0.21, P > 0.05) was found in individuals at high risk for CVD.

CONCLUSION

The correlation between NIRS-derived reperfusion slope and %FMD was disrupted in the arm of individuals at high risk for cardiovascular disease compared to healthy individuals. The findings of the present study reinforce the importance of examining vascular function at microvasculature and conduit artery level, especially in populations with risk factors for CVD.