Physiological Effects of Beetroot in Athletes and Patients

Dietary Beetroot Juice - Effects in Patients with COPD: A Review

Chronic Obstructive Pulmonary Disease (COPD) exerts a severe toll on human health and the economy, with high prevalence and mortality rates. The search for bioactive components effective in the treatment of COPD has become a focal point of research. Beetroot juice, readily accessible and cost-effective, is noted for its ability to enhance athletic performance and for its preventive and therapeutic impact on hypertension. Beetroot juice is a rich source of dietary nitrates and modulates physiological processes via the nitrate-nitrite- nitric oxide pathway, exerting multiple beneficial effects such as antihypertensive, bronchodilatory, anti-inflammatory, antioxidant, hypoglycemic, and lipid-lowering actions. This paper provides a review of the existing research on the effects of beetroot juice on COPD, summarizing its potential in enhancing exercise capacity, lowering blood pressure, improving vascular function, and ameliorating sleep quality among patients with COPD. The review serves as a reference for the prospective use of beetroot juice in the symptomatic improvement of COPD, as well as in the prevention of exacerbations and associated comorbidities.

Dietary Nitrate Supplementation Does Not Alter Exercise Efficiency at High Altitude - Further Results From the Xtreme Alps Study

Introduction

Nitrate supplementation in the form of beetroot juice (BRJ) ingestion has been shown to improve exercise tolerance during acute hypoxia, but its effect on exercise physiology remains unstudied during sustained terrestrial high altitude exposure. We hypothesized that performing exercise at high altitude would lower circulating nitrate and nitrite levels and that BRJ ingestion would reverse this phenomenon while concomitantly improving key determinants of aerobic exercise performance.

Methods

Twenty seven healthy volunteers (21 male) underwent a series of exercise tests at sea level (SL, London, 75 m) and again after 5-8 days at high altitude (HA, Capanna Regina Margherita or "Margherita Hut," 4,559 m). Using a double-blind protocol, participants were randomized to consume a beetroot/fruit juice beverage (three doses per day) with high levels of nitrate (∼0.18 mmol/kg/day) or a nitrate-depleted placebo (∼11.5 μmoles/kg/day) control drink, from 3 days prior to the exercise trials until completion. Submaximal constant work rate cycle tests were performed to determine exercise efficiency and a maximal incremental ramp exercise test was undertaken to measure aerobic capacity, using breath-by-breath pulmonary gas exchange measurements throughout. Concentrations of nitrate, nitrite and nitrosation products were quantified in plasma samples collected at 5 timepoints during the constant work rate tests. Linear mixed modeling was used to analyze data.

Results

At both SL and HA, plasma nitrate concentrations were elevated in the nitrate supplementation group compared to placebo (P < 0.001) but did not change throughout increasing exercise work rate. Delta exercise efficiency was not altered by altitude exposure (P = 0.072) or nitrate supplementation (P = 0.836). V̇O₂peak decreased by 24% at high altitude (P < 0.001) and was lower in the nitrate-supplemented group at both sea level and high altitude compared to placebo (P = 0.041). Dietary nitrate supplementation did not alter other peak exercise variables or oxygen consumption at anaerobic threshold. Circulating nitrite and S-nitrosothiol levels unexpectedly rose in a few individuals right after cessation of exercise at high altitude.

Conclusion

Whilst regularly consumed during an 8 days expedition to terrestrial high altitude, nitrate supplementation did not alter exercise efficiency and other exercise physiological variables, except decreasing V̇O₂peak. These results and those of others question the practical utility of BRJ consumption during prolonged altitude exposure.

Portuguese Football Federation consensus statement 2020: nutrition and performance in football

Nutrition is an undeniable part of promoting health and performance among football (soccer) players. Nevertheless, nutritional strategies adopted in elite football can vary significantly depending on culture, habit and practical constraints and might not always be supported by scientific evidence. Therefore, a group of 28 Portuguese experts on sports nutrition, sports science and sports medicine sought to discuss current practices in the elite football landscape and review the existing evidence on nutritional strategies to be applied when supporting football players. Starting from understanding football's physical and physiological demands, five different moments were identified: preparing to play, match-day, recovery after matches, between matches and during injury or rehabilitation periods. When applicable, specificities of nutritional support to young athletes and female players were also addressed. The result is a set of practical recommendations that gathered consensus among involved experts, highlighting carbohydrates periodisation, hydration and conscious use of dietary supplements.

Effects of 7-day supplementation with escalating doses of citrulline nitrate on resting and post-exercise blood pressure and safety biomarkers in healthy men: A randomized controlled trial

We investigated the effects of 7-day supplementation with three different dosages of citrulline nitrate (CN) on blood pressure at rest and after exercise, biochemical safety markers, and self-reported outcome measures of adverse events in healthy men. 12 apparently healthy young men (age 25.9 ± 4.0 years; weight 78.6 ± 10.0 kg, height 181.0 ± 7.0 cm) volunteered to participate in this double-blind, randomized, placebo-controlled cross-over trial. The dosages of CN were 1.5 g per day (low dose), 3.0 g per day (medium dose), and 6.0 g per day (high dose). No significant differences were found for systolic and diastolic blood pressure and heart rate at rest and after exercise between varying doses of CN and placebo ( p > 0.05). In addition, hematological indices, biochemical variables, and clinical enzyme profiles were not affected by either intervention ( p > 0.05), and the type and frequency of side effects were comparable to the placebo group. Citrulline nitrate was safe and well tolerated when administered for 7 days in dosages up to 6 g per day.

Possible Effects of Beetroot Supplementation on Physical Performance Through Metabolic, Neuroendocrine, and Antioxidant Mechanisms: A Narrative Review of the Literature

Athletes often seek to use dietary supplements to increase performance during exercise. Among various supplements, much attention has been paid to beetroot in recent years. Beetroot is a source of carbohydrates, fiber, protein, minerals, and vitamins; also, it is a natural source of nitrate and associated with improved sports performance. Nitrates can the modification of skeletal muscle contractile proteins or calcium handling after translation. The time to reach the peak plasma nitrate is between 1 and 3 h after consumption of a single dose of nitrate. Nitrate is metabolized by conversion to nitrite and subsequently nitric oxide. Beetroot can have various effects on athletic performance through nitric oxide. Nitric oxide is an intracellular and extracellular messenger for regulating certain cellular functions and causes vasodilation of blood vessels and increases blood flow. Nitric oxide seems to be effective in improving athletic performance by increasing oxygen, glucose, and other nutrients for better muscle fueling. Nitric oxide plays the main role in anabolic hormones, modulates the release of several neurotransmitters and the major mediators of stress involved in the acute hypothalamic-pituitary-adrenal response to exercise. Beetroot is an important source of compounds such as ascorbic acid, carotenoids, phenolic acids, flavonoids, betaline, and highly active phenolics and has high antioxidant properties. Beetroot supplement provides an important source of dietary polyphenols and due to the many health benefits. Phytochemicals of Beetroot through signaling pathways inhibit inflammatory diseases. In this study, the mechanisms responsible for these effects were examined and the research in this regard was reviewed.

Acute Beetroot Juice Supplementation Does Not Improve Match-Play Activity in Professional Tennis Players

OBJECTIVE

Beetroot juice is a source of dietary nitrate (NO₃-) recognized as a potential ergogenic aid to enhance tolerance during endurance exercise of submaximal-to-maximal intensity. However, little is known about the effects of beetroot juice on exercise performance in intermittent sports such as tennis. The present study aimed to determine the effect of acute beetroot juice supplementation on movement patterns during a competitive tennis match in professional players.

METHODS

In a double-blind and randomized experiment, nine professional tennis players performed two experimental trials 3 h after ingesting either 70 mL of a commercially-available concentrated beetroot juice (6.4 mmol NO₃-) or placebo (0.005 mmol NO₃-). In each experimental trial, players completed a 3-set tennis match and two performance tests (i.e., serve speed and isometric handgrip strength) before and after the match. Match-play running performance was recorded using wearable GPS and accelerometer units.

RESULTS

In comparison to the placebo trial, the acute beetroot juice supplementation did not modify any match-play running performance (p = 0.178 to 0.997, d = 0.01 to 0.42). Furthermore, beetroot juice supplementation did not alter the pre-to-post match change in serve speed (p = 0.663, ηp² = 0.03) or isometric handgrip strength (p = 0.219, ηp² = 0.18).

CONCLUSIONS

The current results indicated that acute ingestion of a commercialized shot of nitrate-rich beetroot juice (70 mL containing 6.4 mmol of NO₃-) did not produce any performance benefit on tennis matchplay. Thus, acute beetroot juice supplementation seems an ergogenic aid with little value to enhance physical performance in professional tennis players.

Effectiveness of beetroot juice derived nitrates supplementation on fatigue resistance during repeated-sprints: a systematic review

In recent decades, the search for non-doping substances that enhance sports performance has increased. Ergogenic aids such as beetroot juice (BRJ) and BRJ rich in nitrates (NO₃^-) are widely used to cause physiological benefits that may lead to physical improvements. Therefore, the purpose of this systematic review was to explore the knowledge reported to date on the NO₃^- derived from BRJ intake effect on fatigue resistance during repeated sprints. A digital search was conducted following systematic review guidelines, and 18 studies met inclusion criteria from a total of 209 articles. In a third of the selected studies, the consumption of beet juice rich in NO₃^- contributes to an increase in nitrites in plasma that led to the rise in peak power, mean power, number of sprint repetitions, total work and time to task failure, and causes a decrease in fatigue index and sprints times. Some different dose has been proposed for both chronic and acute protocols. It seems that a chronic intake of ∼5-6 mmol of NO₃^- in 70 ml of BRJ, twice a day, for a minimum of 3-6 days could lead to a fatigue resistance improvement during repeated sprints. Besides, acute intake of NO₃^- 2.5-3 h before physical exertion or a dose of 250 ml/d to 500 ml/d of BRJ could lead to similar effective results. This systematic review presents some improvements (1.2-5.38%) in fatigue resistance during repeated sprints when consuming BRJ derived NO₃^-. The in-field practical meaning of these results should be explored.

The benefits and risks of beetroot juice consumption: a systematic review

Beetroot juice (BRJ) has become increasingly popular amongst athletes aiming to improve sport performances. BRJ contains high concentrations of nitrate, which can be converted into nitric oxide (NO) after consumption. NO has various functions in the human body, including a vasodilatory effect, which reduces blood pressure and increases oxygen- and nutrient delivery to various organs. These effects indicate that BRJ may have relevant applications in prevention and treatment of cardiovascular disease. Furthermore, the consumption of BRJ also has an impact on oxygen delivery to skeletal muscles, muscle efficiency, tolerance and endurance and may thus have a positive impact on sports performances. Aside from the beneficial aspects of BRJ consumption, there may also be potential health risks. Drinking BRJ may easily increase nitrate intake above the acceptable daily intake, which is known to stimulate the endogenous formation of N-nitroso compounds (NOC's), a class of compounds that is known to be carcinogenic and that may also induce several other adverse effects. Compared to studies on the beneficial effects, the amount of data and literature on the negative effects of BRJ is rather limited, and should be increased in order to perform a balanced risk assessment.