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Grönroos R, Eggertsen R, Bernhardsson S, Praetorius Björk M. Effects of beetroot juice on blood pressure in hypertension according to European Society of Hypertension Guidelines: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:2240-2256. [PMID: 39069465 DOI: 10.1016/j.numecd.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 07/30/2024]
Abstract
AIMS It has been suggested that nitrate-rich beetroot juice (BRJ) reduces blood pressure (BP) in various populations. We aimed to investigate the effect of BRJ on BP in adults with hypertension according to the European Society of Hypertension Guidelines (clinical BP ≥ 140/≥ 90 mmHg) and whether BRJ can be considered as an adjunct to hypertension drug treatment, by conducting a meta-analysis of randomized controlled trials. DATA SYNTHESIS PubMed, SCOPUS, Medline Ovid, Cinahl, Cochrane Library and Web of Science were searched from inception until April 13, 2024 to identify randomized controlled trials of BRJ versus placebo, water, or no intake. Risk of bias was assessed using a standardized appraisal instrument from the Swedish Agency for Health Technology and Assessment of Social Services, which is based on the Cochrane risk-of-bias tool for randomized trials. The pooled BP effect size was calculated using random effects models and meta-regression. Certainty of evidence was assessed using GRADE. Eleven trials (349 patients) were included. BRJ yielded a significant reduction in clinical systolic BP compared with placebo mean difference (MD) -5.31 mmHg (95% CI -7.46, -3.16; I2 = 64%, GRADE ⊕⊕OO). There was no significant effect on clinical diastolic BP or 24-h BP outcomes, and the heterogeneity was moderate to high. CONCLUSIONS Daily ingestion of 200-800 mg of nitrate from BRJ may reduce clinical systolic BP in hypertensive individuals with no sign of development of tolerance. Certainty of evidence is low, and results should be interpreted with caution.
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Affiliation(s)
- Rebecca Grönroos
- Region Västra Götaland, Närhälsan Mölnlycke Healthcare Centre, Gothenburg, Sweden.
| | - Robert Eggertsen
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden; Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marcus Praetorius Björk
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Pinheiro VDS, Junior OJFR, Ortmann CF, Pande A, Conte-Junior CA, Alvares TS. Evaluation of 12-Week Standardized Beetroot Extract Supplementation in Older Participants: A Preliminary Study of Human Health Safety. Nutrients 2024; 16:1942. [PMID: 38931296 PMCID: PMC11206266 DOI: 10.3390/nu16121942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/14/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
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.
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Affiliation(s)
- Vivian dos Santos Pinheiro
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center, Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27971-525, RJ, Brazil; (V.d.S.P.); (O.J.F.R.J.)
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, Rio de Janeiro 21941-909, RJ, Brazil;
| | - Olavo João Frederico Ramos Junior
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center, Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27971-525, RJ, Brazil; (V.d.S.P.); (O.J.F.R.J.)
- Multicenter Postgraduate Program in Physiological Sciences, Federal University of Rio de Janeiro, Macaé 27965-045, RJ, Brazil
| | | | - Anurag Pande
- Sabinsa Corporation, 20 Lake Drive, East Windsor, NJ 08520, USA;
| | - Carlos Adam Conte-Junior
- Postgraduate Program in Food Science, Chemistry Institute, Federal University of Rio de Janeiro, Rio de Janeiro 21941-909, RJ, Brazil;
| | - Thiago Silveira Alvares
- Nutrition and Exercise Metabolism Research Group, Multidisciplinary Center, Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27971-525, RJ, Brazil; (V.d.S.P.); (O.J.F.R.J.)
- Multicenter Postgraduate Program in Physiological Sciences, Federal University of Rio de Janeiro, Macaé 27965-045, RJ, Brazil
- Multidisciplinary Center, Food and Nutrition Institute, Federal University of Rio de Janeiro, Macaé 27930-560, RJ, Brazil
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Tan L, Stagg L, Hanlon E, Li T, Fairley AM, Siervo M, Matu J, Griffiths A, Shannon OM. Associations between Vegetable Nitrate Intake and Cardiovascular Disease Risk and Mortality: A Systematic Review. Nutrients 2024; 16:1511. [PMID: 38794749 PMCID: PMC11124077 DOI: 10.3390/nu16101511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Consumption of nitrate-rich vegetables increases nitric oxide bioavailability, lowers blood pressure, and improves endothelial function. These effects could also translate into reduced cardiovascular disease (CVD) risk and mortality. This systematic review aimed to investigate the associations between habitual vegetable nitrate intake and CVD incidence and mortality. A secondary aim was to identify factors that moderate the relationship between vegetable nitrate intake and CVD incidence/mortality. Seven databases (PubMed, MEDLINE, Embase, Scopus, Web of Science, CINAHL, and APA PsycINFO) were searched from inception to 13 February 2023. Observational studies quantifying vegetable nitrate intake in participants aged 18+ years through self-reported dietary exposure and assessing incidence or mortality from CVD overall, or individual CVD subtypes, were eligible. Five studies including a total of 63,155 participants were included. There was an inverse association between vegetable nitrate intake and most reported CVD outcomes. Reported risk reductions tended to plateau at moderate intake, suggesting a possible ceiling effect. The risk of bias across all studies was low. The results of this systematic review suggest a potential role for vegetable nitrate in reducing CVD risk and mortality. Further randomised controlled trials are now required to corroborate these findings.
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Affiliation(s)
- Loucas Tan
- School of Biomedical, Nutritional & Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (L.T.); (L.S.); (E.H.); (T.L.); (A.M.F.)
| | - Libby Stagg
- School of Biomedical, Nutritional & Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (L.T.); (L.S.); (E.H.); (T.L.); (A.M.F.)
| | - Emily Hanlon
- School of Biomedical, Nutritional & Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (L.T.); (L.S.); (E.H.); (T.L.); (A.M.F.)
| | - Toby Li
- School of Biomedical, Nutritional & Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (L.T.); (L.S.); (E.H.); (T.L.); (A.M.F.)
| | - Andrea M. Fairley
- School of Biomedical, Nutritional & Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; (L.T.); (L.S.); (E.H.); (T.L.); (A.M.F.)
| | - Mario Siervo
- School of Population Health, Curtin University, Perth, WA 6845, Australia;
- Curtin Dementia Centre of Excellence, Enable Institute, Curtin University, Perth, WA 6845, Australia
| | - Jamie Matu
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK; (J.M.); (A.G.)
| | - Alex Griffiths
- School of Health, Leeds Beckett University, Leeds LS1 3HE, UK; (J.M.); (A.G.)
| | - Oliver M. Shannon
- Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
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Afrisham R, Farrokhi V, Ghanavati M, Asbaghi O, Mohammadi S, Mohammadian M, Taghvaei-Yazdeli T, Safaei-Kooyshahi S, Jadidi Y, Ashtary-Larky D. The effects of beetroot and nitrate supplementation on body composition: a GRADE-assessed systematic review and meta-analysis. Br J Nutr 2023; 130:1343-1356. [PMID: 36847169 DOI: 10.1017/s000711452300034x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
This systematic review and meta-analysis aimed to investigate the effects of beetroot (BR) or nitrate supplements on body composition indices. A systematic search was conducted for randomised controlled trials (RCT) published up to August 2022 among online databases including Scopus, PubMed/Medline, Web of Science and Embase. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCT. A total of twelve RCT met the inclusion criteria for this meta-analysis. The pooled effect size of included studies indicated that BR or nitrate supplementation did not change body weight (weighted mean differences (WMD): -0·14 kg, 95 % CI -1·22, 1·51; P = 0·836; I2 = 0 %), BMI (WMD: -0·07 kg/m2, 95 % CI -0·19,0·03; P = 0·174, I2 = 0 %), fat mass (WMD: -0·26 kg, 95 % CI -1·51, 0·98; P = 0·677, I2 = 0 %), waist circumference (WMD: -0·28 cm, 95 % CI -2·30, 1·74; P = 0·786, I2 = 0 %), body fat percentage (WMD: 0·18 %, 95 % CI -0·62, 0·99; P = 0·651, I2 = 0 %), fat-free mass (WMD: 0·31 kg, 95 % CI -0·31, 1·94; P = 0·703, I2 = 0 %) and waist-to-hip ratio (WMD: 0, 95 % CI -0·01, 0·02; P = 0·676, I2 = 0 %). Subgroup analyses based on trial duration, BR or nitrate dose, study design, baseline BMI and athletic status (athlete v. non-athlete) demonstrated similar results. Certainty of evidence across outcomes ranged from low to moderate. This meta-analysis study suggests that BR or nitrate supplements cannot efficiently ameliorate body composition indices regardless of supplement dosage, trial duration and athletic status.
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Affiliation(s)
- Reza Afrisham
- Department of Clinical Laboratory Sciences, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vida Farrokhi
- Department of Hematology, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Matin Ghanavati
- National Nutrition and Food Technology Research Institute, (Faculty of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Teheran, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shooka Mohammadi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrnaz Mohammadian
- Department of Exercise Physiology, Islamic Azad University of Ahvaz, Ahvaz, Iran
| | - Tahereh Taghvaei-Yazdeli
- Department of Hematology, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Safaei-Kooyshahi
- Department of Clinical Laboratory Sciences, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Jadidi
- Department of Clinical Laboratory Sciences, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ilori TO, Zhen A, Velani RN, Zhao R, Echouffo-Tcheugui J, Anderson CA, Waikar SS, Kengne AP. The impact of dietary and lifestyle interventions on blood pressure management in sub-Saharan Africa: a systematic review and metanalysis. J Hypertens 2023; 41:918-925. [PMID: 36928004 PMCID: PMC10158605 DOI: 10.1097/hjh.0000000000003411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Current literature is lacking a comprehensive review of data on dietary interventions in blood pressure (BP) management in sub-Saharan African countries. We assessed the association of dietary and other lifestyle interventions with BP-lowering effects in populations within sub-Saharan Africa. METHODS We performed a systematic review and random-effects meta-analysis to determine the impact of dietary and lifestyle interventions on SBP and DBP in sub-Saharan Africa. We searched the MEDLINE, EMBASE, and Web of Science databases. We included intervention studies that were randomized and nonrandomized conducted in Africans residing in sub-Saharan Africa investigating diet and other lifestyle, physical activity, weight loss, tobacco, and alcohol cessation modifications. We determined the effect of diet and other lifestyle interventions on SBP and DBP. We expressed effect size as weighted mean difference and 95% confidence interval (CI). MAIN RESULTS : We identified six studies with a total of 1412 individuals, 38% males, mean age of 52.8 years (SD = 11.5). The weighted mean difference of dietary and other lifestyle interventions on SBP and DBP was -7.33 mmHg, (95% CI: -9.90 to -4.76, P < 0.001) and -2.98 mmHg, (95% CI: -4.28 to -1.69, P < 0.001), respectively. In the metaregression analyses, the duration of the interventions did not have any effect on changes in SBP and DBP. PRINCIPAL CONCLUSION : Dietary modifications showed a beneficial overall improvement in SBP and DBP in Africans. However, aside from low-salt interventions, studies on dietary potassium, healthy dietary patterns, and lifestyle modifications have not been investigated extensively in Africans and are in critical need. In addition, researchers will need to consider the settings (rural, urban, or semiurban) and the predominant existing dietary habits while designing studies on dietary interventions in sub-Saharan Africa. PROSPERO REGISTRATION CRD42020207923.
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Affiliation(s)
- Titilayo O. Ilori
- Nephrology Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine
| | - Aileen Zhen
- Nephrology Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine
| | - Romie N. Velani
- School of Public Health, Boston University, Boston, Massachusetts
| | - Runqi Zhao
- Nephrology Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine
| | - Justin Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, John Hopkins University, Baltimore, Maryland
| | - Cheryl A.M. Anderson
- Department of Public Health, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Sushrut S. Waikar
- Nephrology Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine
| | - Andre P. Kengne
- Noncommunicable Diseases Research Unit, South African Medical Research Council, Durban and Cape Town
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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6
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Zhang Y, Zhang H, An W, Li D, Qin L. Regulatory effect of dietary nitrate on blood pressure: a meta-analysis of randomized controlled trials. Food Funct 2023; 14:1839-1850. [PMID: 36740972 DOI: 10.1039/d2fo03140j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Hypertension is the leading risk factor for global disease burden. Many clinical studies have reported that dietary inorganic nitrate can affect blood pressure. In this study, the PubMed, Embase, and Cochrane Library databases were searched for relevant literature published before December 2021 to explore the preventive and therapeutic effects of inorganic nitrate on hypertension. Two reviewers evaluated the randomized controlled trials of inorganic nitrates. This study included a total of 19 articles. The analyzed outcomes of the study were systolic, diastolic and mean arterial blood pressures as well as 24-hour ambulatory blood pressure. RevMan 5.4 was used to conduct meta-analysis. In the healthy population, inorganic nitrate lowered systolic blood pressure (-2.42 mmHg, 95% confidence intervals (CI) [-4.28, -0.57]; P = 0.01) but not diastolic blood pressure (-0.58 mmHg, 95% CI [-1.84, 0.68]; P = 0.36) or mean arterial pressure (-1.01 mmHg, 95% CI [-3.55, 1.54]; P = 0.44). However, in the hypertensive population, inorganic nitrates did not lower systolic blood pressure (-0.82 mmHg, 95% CI [-2.53, 0.90]; P = 0.35), diastolic blood pressure (-0.03 mmHg, 95% CI [-1.35, 1.30]; P = 0.97), 24-hour ambulatory systolic blood pressure (-0.22 mmHg, 95% CI [-1.50, 1.94]; P = 0.8), or 24-hour ambulatory diastolic blood pressure (-0.33 mmHg, 95% CI [-2.03, 1.37]; P = 0.7). In conclusion, inorganic nitrate can mildly reduce systolic blood pressure in healthy people, but does not have a lowering effect on blood pressure in patients with hypertension. Further research is required to obtain more definitive data and prove the link between inorganic nitrate and blood pressure.
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Affiliation(s)
- Yingrui Zhang
- Department of Oral and Maxillofacial & Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
| | - Haoyang Zhang
- Department of Oral and Maxillofacial & Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
| | - Wei An
- Department of Oral and Maxillofacial Surgery, Shanxi Provincial People's Hospital, Shuang Ta Temple Street No. 29, Taiyuan, Shanxi, 030000, China
| | - Dan Li
- Department of Oral and Maxillofacial & Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
| | - Lizheng Qin
- Department of Oral and Maxillofacial & Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Tian Tan Xi Li No.4, Beijing, 100050, China.
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Benjamim CJR, Sousa YBA, Porto AA, de Moraes Pontes YM, Tavares SS, da Silva Rodrigues G, da Silva LSL, da Silva Goncalves L, Guimaraes CS, Rebelo MA, da Silva Sobrinho AC, Tanus-Santos JE, Valenti VE, Gualano B, Bueno Júnior CR. Nitrate-rich beet juice intake on cardiovascular performance in response to exercise in postmenopausal women with arterial hypertension: study protocol for a randomized controlled trial. Trials 2023; 24:94. [PMID: 36750904 PMCID: PMC9903428 DOI: 10.1186/s13063-023-07117-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/28/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND There is no evidence of the use of beetroot juice with a previously recommended dose of nitrate (NO3) (> 300 mg) on the cardiovascular performance during and recovery following exercise in postmenopausal women with systemic arterial hypertension (SAH). METHODS We will investigate the effects of beetroot juice rich in NO3 acutely (800 mg) and during a week with daily doses (400 mg) on blood pressure, heart rate (HR), cardiac autonomic control, endothelial function, inflammatory, hormonal, and stress biomarkers oxidative stress and enzymes involved in nitric oxide synthesis and mitochondrial regulation, under resting conditions, as well as mediated by submaximal aerobic exercise sessions. Through a randomized, crossover, triple-blind, placebo-controlled clinical trial, 25 physically inactive women with SAH will undergo an acute and 1-week trial, each with two intervention protocols: (1) placebo and (2) beetroot, in which will ingest beet juice with or without NO3 in its composition with a 7-day washout interval. On collection days, exercise will be performed on a treadmill for 40 min at a speed corresponding to 65-70% of VO2peak. The collection of variables (cardiovascular, autonomic, and blood samples for molecular analyses) of the study will take place at rest (135 min after ingestion of the intervention), during exercise (40 min), and in the effort recovery stage (during 60 min) based on previously validated protocols. The collections were arranged so that the measurement of one variable does not interfere with the other and that they have adequate intervals between them. DISCUSSION The results of this research may help in the real understanding of the nutritional compounds capable of generating safety to the cardiovascular system during physical exercise, especially for women who are aging and who have cardiovascular limitations (e.g., arterial hypertension) to perform physical exercise. Therefore, our results will be able to help specific nutritional recommendations to optimize cardiovascular health. TRIAL REGISTRATION ClinicalTrials.gov NCT05384340. Registered on May 20, 2022.
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Affiliation(s)
- Cicero Jonas R. Benjamim
- grid.11899.380000 0004 1937 0722Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Yaritza Brito Alves Sousa
- grid.11899.380000 0004 1937 0722Ribeirao Preto Nursing School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Andrey Alves Porto
- grid.410543.70000 0001 2188 478XMovement Sciences, Autonomic Nervous System Center (CESNA), São Paulo State University (UNESP), Presidente Prudente, SP Brazil
| | - Yasmim Mota de Moraes Pontes
- grid.11899.380000 0004 1937 0722Ribeirao Preto School of Physical Education and Sports, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Simone Sakagute Tavares
- grid.11899.380000 0004 1937 0722Ribeirao Preto School of Physical Education and Sports, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Guilherme da Silva Rodrigues
- grid.11899.380000 0004 1937 0722Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Leonardo Santos Lopes da Silva
- grid.11899.380000 0004 1937 0722Ribeirao Preto School of Physical Education and Sports, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Leonardo da Silva Goncalves
- grid.11899.380000 0004 1937 0722Ribeirao Preto School of Physical Education and Sports, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Carolina Scoqui Guimaraes
- grid.11899.380000 0004 1937 0722Ribeirao Preto Nursing School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Macário Arosti Rebelo
- grid.411087.b0000 0001 0723 2494Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP Brazil
| | - Andressa Crystine da Silva Sobrinho
- grid.11899.380000 0004 1937 0722Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Jose E. Tanus-Santos
- grid.11899.380000 0004 1937 0722Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil
| | - Vitor Engracia Valenti
- grid.410543.70000 0001 2188 478XAutonomic Nervous System Center (CESNA), São Paulo State University (UNESP), Marília, SP Brazil
| | - Bruno Gualano
- grid.11899.380000 0004 1937 0722Applied Physiology & Nutrition Research Group, University of São Paulo, Medical School (FMUSP), São Paulo, SP Brazil
| | - Carlos Roberto Bueno Júnior
- grid.11899.380000 0004 1937 0722Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil ,grid.11899.380000 0004 1937 0722Ribeirao Preto School of Physical Education and Sports, University of São Paulo, Ribeirão Preto, SP Brazil
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8
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Mattos S, Cunha MR, Marques BC, d´El-Rei J, Baião DDS, Paschoalin VMF, Oigman W, Neves MF, Medeiros F. Acute Effects of Dietary Nitrate on Central Pressure and Endothelial Function in Hypertensive Patients: A Randomized, Placebo-Controlled Crossover Study. Arq Bras Cardiol 2022; 120:e20220209. [PMID: 36629601 PMCID: PMC9833313 DOI: 10.36660/abc.20220209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The diet's inorganic nitrate (NO3-) may provide a physiological substrate for reducing nitrate (NO2-) to NO independent of the endothelium. Studies suggest that inorganic NO3- has beneficial effects on cardiovascular health. OBJECTIVE This study evaluated the acute effects of 500 mL nitrate-rich beetroot juice (BRJ; containing 11.5mmol NO3-) on blood pressure and endothelial function in treated hypertensive patients. METHODS A randomized, placebo-controlled, crossover study was conducted in treated hypertensive patients (n=37; women=62%) who underwent clinical and nutritional evaluation and assessment of central hemodynamic parameters and microvascular reactivity. The significance level was p<0.05. RESULTS The mean age was 59±7 years, and mean systolic and diastolic blood pressures were 142±10/83±9mmHg. There was a significant increase in the subendocardial viability ratio (SEVR; 149±25 vs. 165±30%, p<0.001) and reduction in ejection duration (ED; 37±4 vs. 34±4%, p<0.001) in the beetroot phase but no significant SEVR difference in the control phase. The % increase in perfusion (155 vs. 159 %, p=0.042) was significantly increased in the beetroot phase, which was not observed in the control phase. In the beetroot phase, the change in SEVR showed a significant correlation with the change in the area under the curve of post-occlusive reactive hyperemia (AUC-PORH) (r=0.45, p=0.012). The change in ED showed a significant correlation with the post-intervention perfusion peak (r=-0.37, p=0.031) and AUC-PORH (r=-0.36, p=0.046). CONCLUSIONS The acute ingestion of BRJ by hypertensive patients resulted in an improvement of endothelial function, which was associated with higher subendocardial viability and performance in myocardial contraction.
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Affiliation(s)
- Samanta Mattos
- Departamento de Clínica MédicaUniversidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Clínica Médica – Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ – Brasil
| | - Michelle Rabello Cunha
- Departamento de Clínica MédicaUniversidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Clínica Médica – Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ – Brasil
| | - Bianca Cristina Marques
- Departamento de Clínica MédicaUniversidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Clínica Médica – Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ – Brasil
| | - Jenifer d´El-Rei
- Departamento de Clínica MédicaUniversidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Clínica Médica – Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ – Brasil
| | - Diego dos Santos Baião
- Instituto de QuímicaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilInstituto de Química – Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ – Brasil
| | - Vania M. F. Paschoalin
- Instituto de QuímicaUniversidade Federal do Rio de JaneiroRio de JaneiroRJBrasilInstituto de Química – Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ – Brasil
| | - Wille Oigman
- Departamento de Clínica MédicaUniversidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Clínica Médica – Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ – Brasil
| | - Mario Fritsch Neves
- Departamento de Clínica MédicaUniversidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilDepartamento de Clínica Médica – Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ – Brasil
| | - Fernanda Medeiros
- Escola de NutriçãoUniversidade Federal do Estado do Rio de JaneiroRio de JaneiroRJBrasilEscola de Nutrição da Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ – Brasil
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9
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Shannon OM, Allen JD, Bescos R, Burke L, Clifford T, Easton C, Gonzalez JT, Jones AM, Jonvik KL, Larsen FJ, Peeling P, Piknova B, Siervo M, Vanhatalo A, McGawley K, Porcelli S. Dietary Inorganic Nitrate as an Ergogenic Aid: An Expert Consensus Derived via the Modified Delphi Technique. Sports Med 2022; 52:2537-2558. [PMID: 35604567 PMCID: PMC9474378 DOI: 10.1007/s40279-022-01701-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2022] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Dietary inorganic nitrate is a popular nutritional supplement, which increases nitric oxide bioavailability and may improve exercise performance. Despite over a decade of research into the effects of dietary nitrate supplementation during exercise there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Moreover, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. This study aimed to address these research gaps. METHODS The modified Delphi technique was used to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via videoconferencing), the expert panel members voted on 222 statements relating to dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e. yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research. RESULTS The 12 panel members contributed to voting in all three rounds. A total of 39 statements (17.6%) reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60.4%) of the statements, and were unable to agree on the outcome of the remaining statements. CONCLUSIONS This study provides information on the current expert consensus on dietary nitrate, which may be of value to athletes, coaches, practitioners and researchers. The effects of dietary nitrate appear to be diminished in individuals with a higher aerobic fitness (peak oxygen consumption [V̇O2peak] > 60 ml/kg/min), and therefore, aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes looking to benefit from dietary nitrate supplementation should consume 8-16 mmol nitrate acutely or 4-16 mmol/day nitrate chronically (with the final dose ingested 2-4 h pre-exercise) to maximise ergogenic effects, taking into consideration that, from a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe, although the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, highlighting the need for future research in this area.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
| | - Jason D Allen
- Department of Kinesiology, School of Education and Human Development and Division of Cardiovascular Medicine, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Raul Bescos
- School of Health Professions, Faculty of Health, Plymouth Institute of Health and Care Research (PIHR), University of Plymouth, Plymouth, UK
| | - Louise Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Sciences, University of the West of Scotland, Blantyre, UK
| | - Javier T Gonzalez
- Department for Health, University of Bath, Bath, UK
- Centre for Nutrition and Exercise Metabolism, University of Bath, Bath, UK
| | - Andrew M Jones
- Sport and Health Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Kristin L Jonvik
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Filip J Larsen
- Department of Physiology, Nutrition and Biomechanics, Åstrand Laboratory, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Peter Peeling
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia
| | | | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Anni Vanhatalo
- Sport and Health Sciences, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Kerry McGawley
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Simone Porcelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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10
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Amoah I, Cairncross C, Osei EO, Yeboah JA, Cobbinah JC, Rush E. Bioactive Properties of Bread Formulated with Plant-based Functional Ingredients Before Consumption and Possible Links with Health Outcomes After Consumption- A Review. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2022; 77:329-339. [PMID: 35857200 PMCID: PMC9463282 DOI: 10.1007/s11130-022-00993-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 06/12/2023]
Abstract
Bread is a commonly consumed staple and could be a viable medium to deliver plant-based ingredients that demonstrate health effects. This review brings together published evidence on the bioactive properties of bread formulated with plant-based ingredients. Health effects associated with the consumption of bread formulated with plant-based functional ingredients was also reviewed. Bioactive properties demonstrated by the functional ingredients fruits and vegetables, legumes, nuts and tea incorporated into bread include increased phenolic and polyphenolic content, increased antioxidant activity, and extension of bread shelf-life by impairment of lipid and protein oxidation. Acute health effects reported included appetite suppression, reduced diastolic blood pressure, improvements in glycaemia, insulinaemia and satiety effect. These metabolic effects are mainly short lived and not enough for a health claim. Longer term studies or comparison of those who consume and those who do not are needed. The incorporation of plant-based functional ingredients in bread could enhance the health-promoting effects of bread.
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Affiliation(s)
- Isaac Amoah
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, 1010, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand.
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Carolyn Cairncross
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, 1010, New Zealand
| | - Emmanuel Ofori Osei
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jacqueline Afua Yeboah
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jesse Charles Cobbinah
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Elaine Rush
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, 1010, New Zealand.
- Riddet Institute, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand.
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11
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Tyler SEB, Tyler LDK. Therapeutic roles of plants for 15 hypothesised causal bases of Alzheimer's disease. NATURAL PRODUCTS AND BIOPROSPECTING 2022; 12:34. [PMID: 35996065 PMCID: PMC9395556 DOI: 10.1007/s13659-022-00354-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/15/2022] [Indexed: 05/26/2023]
Abstract
Alzheimer's disease (AD) is progressive and ultimately fatal, with current drugs failing to reverse and cure it. This study aimed to find plant species which may provide therapeutic bioactivities targeted to causal agents proposed to be driving AD. A novel toolkit methodology was employed, whereby clinical symptoms were translated into categories recognized in ethnomedicine. These categories were applied to find plant species with therapeutic effects, mined from ethnomedical surveys. Survey locations were mapped to assess how this data is at risk. Bioactivities were found of therapeutic relevance to 15 hypothesised causal bases for AD. 107 species with an ethnological report of memory improvement demonstrated therapeutic activity for all these 15 causal bases. The majority of the surveys were found to reside within biodiversity hotspots (centres of high biodiversity under threat), with loss of traditional knowledge the most common threat. Our findings suggest that the documented plants provide a large resource of AD therapeutic potential. In demonstrating bioactivities targeted to these causal bases, such plants may have the capacity to reduce or reverse AD, with promise as drug leads to target multiple AD hallmarks. However, there is a need to preserve ethnomedical knowledge, and the habitats on which this knowledge depends.
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Affiliation(s)
| | - Luke D K Tyler
- School of Natural Sciences, Bangor University, Gwynedd, UK
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12
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Thiruvengadam M, Chung IM, Samynathan R, Chandar SRH, Venkidasamy B, Sarkar T, Rebezov M, Gorelik O, Shariati MA, Simal-Gandara J. A comprehensive review of beetroot ( Beta vulgaris L.) bioactive components in the food and pharmaceutical industries. Crit Rev Food Sci Nutr 2022; 64:708-739. [PMID: 35972148 DOI: 10.1080/10408398.2022.2108367] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
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.
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Affiliation(s)
- Muthu Thiruvengadam
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul, Republic of Korea
| | - Ill-Min Chung
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul, Republic of Korea
| | | | | | - Baskar Venkidasamy
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Tanmay Sarkar
- Department of Food Processing Technology, Malda Polytechnic, West Bengal State Council of Technical Education, Government of West Bengal, Malda, India
| | - Maksim Rebezov
- Department of Scientific Advisers, V. M. Gorbatov Federal Research Center for Food Systems, Moscow, Russian Federation
- Department of Scientific Research, K.G. Razumovsky Moscow State University of Technologies and management (The First Cossack University), Moscow, Russia Federation
| | - Olga Gorelik
- Faculty of Biotechnology and Food Engineering, Ural State Agrarian University, Yekaterinburg, Russian Federation
- Ural Federal Agrarian Research Center of the Ural Branch, Russian Academy of Sciences, Yekaterinburg, Russian Federation
| | - Mohammad Ali Shariati
- Department of Scientific Research, K.G. Razumovsky Moscow State University of Technologies and management (The First Cossack University), Moscow, Russia Federation
| | - Jesus Simal-Gandara
- Universidade de Vigo, Nutrition and Bromatology Group, Analytical Chemistry and Food Science Department, Faculty of Science, Ourense, Spain
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13
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Bioactive potential of beetroot (Beta vulgaris). Food Res Int 2022; 158:111556. [DOI: 10.1016/j.foodres.2022.111556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
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14
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Lundberg JO, Weitzberg E. Nitric oxide signaling in health and disease. Cell 2022; 185:2853-2878. [DOI: 10.1016/j.cell.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 10/16/2022]
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15
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Benjamim CJR, Porto AA, Valenti VE, Sobrinho ACDS, Garner DM, Gualano B, Bueno Júnior CR. Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis. Front Nutr 2022; 9:823039. [PMID: 35369064 PMCID: PMC8965354 DOI: 10.3389/fnut.2022.823039] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Although there are a considerable number of clinical studies on nitrate (NO3) rich beetroot juice (BRJ) and hypertension, it is difficult to indicate the real effects of NO3 from BRJ on the BP of hypertensive patients because there are still no estimates of the effects of NO3 derived from BRJ on the BP of hypertension patients. Objective To clarify these effects, we developed a systematic literature review with a meta-analysis of randomized clinical trials (RCTs). Design The searches were accomplished through EMBASE, Cochrane Library, MEDLINE, CINAHL, Web of Science, and LILACS databases. The study included single or double-blinded RCTs and participants older than 18 years with hypertension [systolic BP (SBP) > 130 mmHg and diastolic BP (DBP) > 80 mmHg]. NO3 BRJ was required to be consumed in a format that possibly blinded participants/researchers. These studies should also report the SBP and DBP values (mmHg) measured before and after the treatment. Risk of Bias tools and GRADE were enforced. Results Seven studies were included (218 participants). BRJ intervention time ranged from 3 to 60 days with daily dosages of 70-250 mL of BRJ. After the intervention with NO3 from BRJ, SBP underwent significant changes (p < 0.001) of -4.95 (95% CI: -8.88; -1.01) (GRADE: ⊕⊕⊕○ Moderate), but not for DBP (p = 0.06) -0.90 mmHg (95% CI: -3.16; 1.36) (GRADE: ⊕⊕⊕○ Moderate), compared to the control group. Conclusions The NO3 derived from BRJ reduces SBP, but not DBP in patients with arterial hypertension. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269339.
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Affiliation(s)
- Cicero Jonas R. Benjamim
- Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | | | | | | | - David M. Garner
- Autonomic Nervous System Center, UNESP, Marilia, Brazil
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos Roberto Bueno Júnior
- Department of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- School of Physical Education of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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16
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Li X, Zhang W, Laden F, Curhan GC, Rimm EB, Guo X, Hart JE, Wu S. Dietary nitrate intake and vegetable consumption, ambient particulate matter, and risk of hypertension in the Nurses' Health study. ENVIRONMENT INTERNATIONAL 2022; 161:107100. [PMID: 35066305 DOI: 10.1016/j.envint.2022.107100] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Studies have suggested that dietary nitrate could lower blood pressure levels whereas ambient particulate matter (PM) may increase risk of hypertension. However, it is unknown if these exposures may modify each other. OBJECTIVES We collected information on dietary nitrate intake and vegetables consumption and estimated long-term exposures to ambient PM for women in the Nurses' Health Study. METHODS Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for risk of hypertension were calculated using Cox proportional hazards models with adjustment for potential demographic, lifestyle and dietary confounders. Interactions were assessed with multiplicative interaction terms and stratified models. RESULTS Increases in dietary nitrate intake (per 150 mg/d) and green leafy vegetables consumption (per serving/day) were both significantly associated with decreases in hypertension risk (both multivariable-adjusted HRs were 0.97, 95% CI: 0.94, 0.99). Long-term exposure to ambient PM with an aerodynamic diameter ≤ 2.5 µm (PM2.5) was associated with an increased risk of hypertension, with a multivariable-adjusted HR of hypertension of 1.06 (95% CI: 1.02, 1.11) per 10 µg/m3 increase in PM2.5. Ambient PM2.5 significantly modified the associations of dietary nitrate intake (Pinteraction = 0.02) and green leafy vegetables consumption (Pinteraction = 0.004). The associations with dietary factors were gradually weakened with increasing PM2.5: the fully-adjusted HRs for risk of hypertension were 0.94 (95% CI: 0.89, 0.99) and 0.94 (95% CI: 0.90, 0.99) for per 150 mg/d increase in nitrate intake and per serving/d increase in green leafy vegetables consumption, respectively, in the lowest PM2.5 quartile, and 1.00 (95% CI: 0.94, 1.06) and 1.02 (95% CI: 0.97, 1.08), respectively, in the highest PM2.5 quartile. CONCLUSION Our research highlights a potentially protective effect of dietary nitrate intake in the prevention of hypertension and suggests that these benefits are attenuated by increasing exposure to ambient PM2.5.
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Affiliation(s)
- Xianggui Li
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China
| | - Weidong Zhang
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Eric B Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
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17
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Lee SS, McGrattan A, Soh YC, Alawad M, Su TT, Palanisamy UD, Hussin AM, Kassim ZB, Mohd Ghazali ANB, Christa Maree Stephan B, Allotey P, Reidpath DD, Robinson L, Mohan D, Siervo M. Feasibility and Acceptability of a Dietary Intervention to Reduce Salt Intake and Increase High-Nitrate Vegetable Consumption in Malaysian Middle-Aged and Older Adults with Elevated Blood Pressure: Findings from the DePEC-Nutrition Trial. Nutrients 2022; 14:nu14030430. [PMID: 35276789 PMCID: PMC8839221 DOI: 10.3390/nu14030430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
The DePEC-Nutrition trial is a complex dietary and behavioural intervention of salt intake reduction combined with increased high-nitrate vegetable consumption among Malaysian middle-aged and older adults with elevated blood pressure. This study aimed to assess the feasibility and acceptability of the trial. Participants were recruited from the South East Asia Community Observatory (SEACO) database and randomised into one of four groups: (1) low salt; (2) high-nitrate vegetable; (3) combined high-nitrate vegetable and low salt; and (4) control. The intervention included a combination of group counselling sessions, information booklets, reinforcement videos and text messages to modify dietary behaviour. The primary outcomes evaluated were the measures of feasibility and acceptability of (1) recruitment, follow-up attendance and retention; (2) data collection procedures and clinical outcome measures; and (3) individual and combined multi-modal dietary interventions. A total of 74 participants were recruited, and the 10-month retention rate was 73%. Data collection procedures were acceptable with minimal missing data. All intervention strategies were feasible and acceptable, with group counselling being the most acceptable strategy. This study provides important insights into improving the screening process of participants, facilitating their access to the research facilities and refining the measurement protocols and dietary recommendations, which are instrumental in formulating the design of a full-scale definitive DePEC-Nutrition trial.
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Affiliation(s)
- Siew Siew Lee
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
| | - Andrea McGrattan
- School of Biomedical, Nutritional and Sports Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK;
| | - Yee Chang Soh
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
| | - Mawada Alawad
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
| | - Tin Tin Su
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
| | - Uma Devi Palanisamy
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia;
| | - Azizah Mat Hussin
- Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang 43000, Malaysia;
| | - Zaid bin Kassim
- District Health Office, Pejabat Kesihatan Daerah (PKD) Segamat, Segamat 85000, Malaysia; (Z.b.K.); (A.N.b.M.G.)
| | | | | | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur 56000, Malaysia;
| | - Daniel D. Reidpath
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 45700, Malaysia;
- International Centre for Diarrhoeal Disease Research, ICDDR, B, Dhaka 1212, Bangladesh
| | - Louise Robinson
- Population Health Science Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK;
| | - Devi Mohan
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia; (S.S.L.); (Y.C.S.); (M.A.); (T.T.S.)
- Correspondence: ; Tel.: +60-3-5515-9658
| | - Mario Siervo
- School of Life Sciences, University of Nottingham Medical School, Nottingham NG7 2UH, UK;
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18
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Siervo M, Shannon OM, Llewellyn DJ, Stephan BC, Fontana L. Mediterranean diet and cognitive function: From methodology to mechanisms of action. Free Radic Biol Med 2021; 176:105-117. [PMID: 34562607 DOI: 10.1016/j.freeradbiomed.2021.09.018] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
The traditional Mediterranean diet (MedDiet), rich in minimally processed plant foods and fish, has been widely recognized to be one of the healthiest diets. Data from multiple randomized clinical trials have demonstrated its powerful effect against oxidative stress, inflammation and the development and progression of cardiovascular disease, type 2 diabetes, and other metabolic conditions that play a crucial role in the pathogenesis of neurodegenerative diseases. The protecting effects of the MedDiet against cognitive decline have been investigated in several observational and experimental studies. Data from observational studies suggest that the MedDiet may represent an effective dietary strategy for the early prevention of dementia, although these findings require further substantiation in clinical trials which have so far produced inconclusive results. Moreover, as we discuss in this review, accumulating data emphasizes the importance of: 1) maintaining an optimal nutritional and metabolic status for the promotion of healthy cognitive aging, and 2) implementing cognition-sparing dietary and lifestyle interventions during early time-sensitive windows before the pathological cascades turn into an irreversible state. In summary, components of the MedDiet pattern, such as essential fatty acids, polyphenols and vitamins, have been associated with reduced oxidative stress and the current evidence from observational studies seems to assign to the MedDiet a beneficial role in promoting brain health; however, results from clinical trials have been inconsistent. While we advocate for longitudinal analyses and for larger and longer clinical trials to be conducted, we assert our interim support to the use of the MedDiet as a protective dietary intervention for cognitive function based on its proven cardiovascular and metabolic benefits.
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Affiliation(s)
- Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK.
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK; Alan Turing Institute, London, UK
| | - Blossom Cm Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
| | - Luigi Fontana
- Charles Perkins Center, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Department of Clinical and Experimental Sciences, Brescia University School of Medicine, Brescia, Italy
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19
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Dent MR, DeMartino AW, Tejero J, Gladwin MT. Endogenous Hemoprotein-Dependent Signaling Pathways of Nitric Oxide and Nitrite. Inorg Chem 2021; 60:15918-15940. [PMID: 34313417 PMCID: PMC9167621 DOI: 10.1021/acs.inorgchem.1c01048] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Interdisciplinary research at the interface of chemistry, physiology, and biomedicine have uncovered pivotal roles of nitric oxide (NO) as a signaling molecule that regulates vascular tone, platelet aggregation, and other pathways relevant to human health and disease. Heme is central to physiological NO signaling, serving as the active site for canonical NO biosynthesis in nitric oxide synthase (NOS) enzymes and as the highly selective NO binding site in the soluble guanylyl cyclase receptor. Outside of the primary NOS-dependent biosynthetic pathway, other hemoproteins, including hemoglobin and myoglobin, generate NO via the reduction of nitrite. This auxiliary hemoprotein reaction unlocks a "second axis" of NO signaling in which nitrite serves as a stable NO reservoir. In this Forum Article, we highlight these NO-dependent physiological pathways and examine complex chemical and biochemical reactions that govern NO and nitrite signaling in vivo. We focus on hemoprotein-dependent reaction pathways that generate and consume NO in the presence of nitrite and consider intermediate nitrogen oxides, including NO2, N2O3, and S-nitrosothiols, that may facilitate nitrite-based signaling in blood vessels and tissues. We also discuss emergent therapeutic strategies that leverage our understanding of these key reaction pathways to target NO signaling and treat a wide range of diseases.
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Affiliation(s)
- Matthew R Dent
- Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
| | - Anthony W DeMartino
- Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
| | - Jesús Tejero
- Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, United States
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
| | - Mark T Gladwin
- Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, United States
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, United States
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20
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Bahrami LS, Arabi SM, Feizy Z, Rezvani R. The effect of beetroot inorganic nitrate supplementation on cardiovascular risk factors: A systematic review and meta-regression of randomized controlled trials. Nitric Oxide 2021; 115:8-22. [PMID: 34119659 DOI: 10.1016/j.niox.2021.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/18/2021] [Accepted: 06/07/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Inorganic nitrate is one of the most effective compounds in beetroot for improving cardiovascular function due to its conversion to nitric oxide in the body. This review and meta-analysis aimed to investigate the role of beetroot inorganic nitrate supplementation on adults' cardiovascular risk factors. METHODS We conducted a systematic literature review of articles published without time limitation until November 2020 in PubMed, Embase, ISI Web of Science, Scopus, Cochrane Library, and gray literature databases. We included the original randomized clinical trials (RCTs) in which the effect of beetroot inorganic nitrate supplementation on endothelial function, arterial stiffness, and blood pressure was studied. RESULTS 43 studies were included for qualitative synthesis, out of which 27 were eligible for meta-analysis. Beetroot inorganic nitrate supplementation significantly decreased Arterial Stiffness (Pulse Wave Velocity (-0.27 m/s, p = 0.04)) and increased Endothelial function (Flow Mediated Dilation: 0.62%, p = 0.002) but did not change other parameters (p > 0.05). CONCLUSION Beetroot inorganic nitrate supplementation might have a beneficial effect on cardiovascular risk factors. Further high-quality investigations will be needed to provide sufficient evidence.
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Affiliation(s)
- Leila Sadat Bahrami
- Metabolic Syndrome Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyyed Mostafa Arabi
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran.
| | - Zahra Feizy
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX79414, USA.
| | - Reza Rezvani
- Metabolic Syndrome Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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21
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Shannon OM, Easton C, Shepherd AI, Siervo M, Bailey SJ, Clifford T. Dietary nitrate and population health: a narrative review of the translational potential of existing laboratory studies. BMC Sports Sci Med Rehabil 2021; 13:65. [PMID: 34099037 PMCID: PMC8186051 DOI: 10.1186/s13102-021-00292-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dietary inorganic nitrate (NO3-) is a polyatomic ion, which is present in large quantities in green leafy vegetables and beetroot, and has attracted considerable attention in recent years as a potential health-promoting dietary compound. Numerous small, well-controlled laboratory studies have reported beneficial health effects of inorganic NO3- consumption on blood pressure, endothelial function, cerebrovascular blood flow, cognitive function, and exercise performance. Translating the findings from small laboratory studies into 'real-world' applications requires careful consideration. MAIN BODY This article provides a brief overview of the existing empirical evidence basis for the purported health-promoting effects of dietary NO3- consumption. Key areas for future research are then proposed to evaluate whether promising findings observed in small animal and human laboratory studies can effectively translate into clinically relevant improvements in population health. These proposals include: 1) conducting large-scale, longer duration trials with hard clinical endpoints (e.g. cardiovascular disease incidence); 2) exploring the feasibility and acceptability of different strategies to facilitate a prolonged increase in dietary NO3- intake; 3) exploitation of existing cohort studies to explore associations between NO3- intake and health outcomes, a research approach allowing larger samples sizes and longer duration follow up than is feasible in randomised controlled trials; 4) identifying factors which might account for individual differences in the response to inorganic NO3- (e.g. sex, genetics, habitual diet) and could assist with targeted/personalised nutritional interventions; 5) exploring the influence of oral health and medication on the therapeutic potential of NO3- supplementation; and 6) examining potential risk of adverse events with long term high- NO3- diets. CONCLUSION The salutary effects of dietary NO3- are well established in small, well-controlled laboratory studies. Much less is known about the feasibility and efficacy of long-term dietary NO3- enrichment for promoting health, and the factors which might explain the variable responsiveness to dietary NO3- supplementation between individuals. Future research focussing on the translation of laboratory data will provide valuable insight into the potential applications of dietary NO3- supplementation to improve population health.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, Scotland, UK
| | - Anthony I Shepherd
- School of Sport, Health & Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Stephen J Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tom Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
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22
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Cowell OR, Mistry N, Deighton K, Matu J, Griffiths A, Minihane AM, Mathers JC, Shannon OM, Siervo M. Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Hypertens 2021; 39:729-739. [PMID: 33060448 DOI: 10.1097/hjh.0000000000002667] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis investigating effects of MedDiet on blood pressure in randomized controlled trials (RCTs) and associations of MedDiet with risk of hypertension in observational studies. METHODS PubMed, The Cochrane Library and EBSCOhost were searched from inception until January 2020 for studies that met the following criteria: participants aged at least 18 years, RCTs investigating effects of a MedDiet versus control on BP, observational studies exploring associations between MedDiet adherence and risk of hypertension. Random-effects meta-analyses were conducted. Meta-regression and subgroup analyses were performed for RCTs to identify potential effect moderators. RESULTS Nineteen RCTs reporting data on 4137 participants and 16 observational studies reporting data on 59 001 participants were included in the meta-analysis. MedDiet interventions reduced SBP and DBP by a mean -1.4 mmHg (95% CI: -2.40 to -0.39 mmHg, P = 0.007, I2 = 53.5%, Q = 44.7, τ2 = 1.65, df = 19) and -1.5 mmHg (95% CI: -2.74 to -0.32 mmHg, P = 0.013, I2 = 71.5%, Q = 51.6, τ2 = 4.72, df = 19) versus control, respectively. Meta-regression revealed that longer study duration and higher baseline SBP was associated with a greater decrease in BP, in response to a MedDiet (P < 0.05). In observational studies, odds of developing hypertension were 13% lower with higher versus lower MedDiet adherence (95% CI: 0.78--0.98, P = 0.017, I2 = 69.6%, Q = 41.1, τ2 = 0.03, df = 17). CONCLUSION Data suggest that MedDiet is an effective dietary strategy to aid BP control, which may contribute towards the lower risk of CVD reported with this dietary pattern. This study was registered with PROSPERO: CRD42019125073.
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Affiliation(s)
- Owen R Cowell
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Nathan Mistry
- Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire
| | | | - Jamie Matu
- School of Clinical Applied Sciences, Leeds Beckett University, Leeds
| | - Alex Griffiths
- Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds
| | - Anne Marie Minihane
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia (UEA), Norwich
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Mario Siervo
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
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23
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Tan ML, Hamid SBS. Beetroot as a Potential Functional Food for Cancer Chemoprevention, a Narrative Review. J Cancer Prev 2021; 26:1-17. [PMID: 33842401 PMCID: PMC8020175 DOI: 10.15430/jcp.2021.26.1.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 12/21/2022] Open
Abstract
Patients with cancer are prone to several debilitating side effects including fatigue, insomnia, depression and cognitive disturbances. Beetroot (Beta vulgaris L.) as a health promoting functional food may be potentially beneficial in cancer. As a source of polyphenols, flavonoids, dietary nitrates and other useful nutrients, beetroot supplementation may provide a holistic means to prevent cancer and manage undesired effects associated with chemotherapy. The main aim of this narrative review is to discuss beetroot's nutrient composition, current studies on its potential utility in chemoprevention and cancer-related fatigue or treatment-related side effects such as cardiotoxicity. This review aims to provide the current status of knowledge and to identify the related research gaps in this area. The flavonoids and polyphenolic components present in abundance in beetroot support its significant antioxidant and anti-inflammatory capacities. Most in vitro and in vivo studies have shown promising results; however, the molecular mechanisms underlying chemopreventive and chemoprotective effects of beetroot have not been completely elucidated. Although recent clinical trials have shown that beetroot supplementation improves human performance, translational studies on beetroot and its functional benefits in managing fatigue or other symptoms in patients with cancer are still lacking.
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Affiliation(s)
- Mei Lan Tan
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Malaysia
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia
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Cheng CK, Wang C, Shang W, Lau CW, Luo JY, Wang L, Huang Y. A high methionine and low folate diet alters glucose homeostasis and gut microbiome. Biochem Biophys Rep 2021; 25:100921. [PMID: 33537464 PMCID: PMC7838713 DOI: 10.1016/j.bbrep.2021.100921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/20/2022] Open
Abstract
Hyperhomocysteinemia (HHcy) is considered as a risk factor for several complications, including cardiovascular and neurological disorders. A high methionine low folate (HMLF) diet chronically causes HHcy by accumulating homocysteine in the systemic circulation. Elevated Hcy level is also associated with the incidence of diabetes mellitus. However, very few studies focus on the impact of HMLF diet on glucose homeostasis, and that on gut microbiome profile. HHcy was induced by feeding C57BL/6 mice a HMLF diet for 8 weeks. The HMLF diet feeding resulted in a progressive body weight loss, and development of slight glucose intolerance and insulin resistance in HHcy mice. Notably, the HMLF diet alters the gut microbiome profile and increases the relative abundance of porphyromonadaceae family of bacteria in HHcy mice. These findings provide new insights into the roles of dysregulated glucose homeostasis and gut flora in the pathogenesis of HHcy-related complications.
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Key Words
- 16S rRNA sequencing
- Glucose homeostasis
- Gut microbiome
- HDL, high-density lipoprotein
- HHcy, hyperhomocysteinemia
- HMLF diet
- HMLF, high methionine low folate
- Hcy, homocysteine
- Hyperhomocysteinemia
- LEfSe, linear discriminant analysis effect size
- NAFLD, non-alcoholic fatty liver disease
- NMDS, non-metric multi-dimensional scaling
- OTU, operational taxonomic unit
- PCA, principal component analysis
- Porphyromonadaceae
- SCFA, short-chain fatty acids
- TC, total cholesterol
- TG, triglyceride
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Affiliation(s)
- Chak Kwong Cheng
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chenguang Wang
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China.,Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Wenbin Shang
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Wai Lau
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jiang-Yun Luo
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Wang
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yu Huang
- School of Biomedical Sciences and Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China.,Heart and Vascular Institute and Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong SAR, China
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25
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Zhang G, Han H, Zhuge Z, Dong F, Jiang S, Wang W, Guimarães DD, Schiffer TA, Lai EY, Ribeiro Antonino Carvalho LR, Lucena RB, Braga VA, Weitzberg E, Lundberg JO, Carlstrom M. Renovascular effects of inorganic nitrate following ischemia-reperfusion of the kidney. Redox Biol 2020; 39:101836. [PMID: 33360353 PMCID: PMC7772560 DOI: 10.1016/j.redox.2020.101836] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/29/2020] [Accepted: 12/14/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Renal ischemia-reperfusion (IR) injury is a common cause of acute kidney injury (AKI), which is associated with oxidative stress and reduced nitric oxide (NO) bioactivity and increased risk of developing chronic kidney disease (CKD) and cardiovascular disease (CVD). New strategies that restore redox balance may have therapeutic implications during AKI and associated complications. AIM To investigate the therapeutic value of boosting the nitrate-nitrite-NO pathway during development of IR-induced renal and cardiovascular dysfunction. METHODS Male C57BL/6 J mice were given sodium nitrate (10 mg/kg, i. p) or vehicle 2 h prior to warm ischemia of the left kidney (45 min) followed by sodium nitrate supplementation in the drinking water (1 mmol/kg/day) for the following 2 weeks. Blood pressure and glomerular filtration rate were measured and blood and kidneys were collected and used for biochemical and histological analyses as well as renal vessel reactivity studies. Glomerular endothelial cells exposed to hypoxia-reoxygenation, with or without angiotensin II, were used for mechanistic studies. RESULTS IR was associated with reduced renal function and slightly elevated blood pressure, in combination with renal injuries, inflammation, endothelial dysfunction, increased Ang II levels and Ang II-mediated vasoreactivity, which were all ameliorated by nitrate. Moreover, treatment with nitrate (in vivo) and nitrite (in vitro) restored NO bioactivity and reduced mitochondrial oxidative stress and injuries. CONCLUSIONS Acute treatment with inorganic nitrate prior to renal ischemia may serve as a novel therapeutic approach to prevent AKI and CKD and associated risk of developing cardiovascular dysfunction.
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Affiliation(s)
- Gensheng Zhang
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Dept. of Neurobiology, Institute of Neuroscience, NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Huirong Han
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Dept. of Anesthesiology, Shandong Provincial Medicine and Health Key Laboratory of Clinical Anesthesia, Weifang Medical University, Weifang, China
| | - Zhengbing Zhuge
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Fang Dong
- Dept. of Physiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Shan Jiang
- Dept. of Physiology, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenwen Wang
- Dept. of Pathology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Drielle D Guimarães
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Tomas A Schiffer
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - En Yin Lai
- Dept. of Physiology, Zhejiang University School of Medicine, Hangzhou, China
| | | | | | - Valdir A Braga
- Dept. of Biotechnology - Federal University of Paraiba, Joao Pessoa, PB, Brazil
| | - Eddie Weitzberg
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jon O Lundberg
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Carlstrom
- Dept. of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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26
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Hoffman DJ. Use of Beetroot Juice Extract for Hypertension Treatment in Low- and Middle-Income Countries. J Nutr 2020; 150:2233-2234. [PMID: 32725193 DOI: 10.1093/jn/nxaa215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- Daniel J Hoffman
- Department of Nutritional Sciences, Program in International Nutrition; Center for Childhood Nutrition Research, New Jersey Institute for Food, Nutrition, and Health; Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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