A Nitrate-Rich Vegetable Intervention Elevates Plasma Nitrate and Nitrite Concentrations and Reduces Blood Pressure in Healthy Young Adults



      Emerging evidence suggests that increasing dietary nitrate intake may be an effective approach to reduce blood pressure. Beetroot juice is often used to supplement dietary nitrate, whereas nitrate intake levels from habitual diet are low. An increase in the habitual intake of nitrate-rich vegetables may represent an alternative to nitrate supplementation. However, the effectiveness and acceptability of a nitrate–rich-vegetables diet remain to be established.


      The aim was to investigate the effect and feasibility of two different intervention strategies to increase dietary nitrate intake, on plasma nitrate/nitrite concentrations and blood pressure.


      A randomized, crossover trial was used.


      Participants were healthy men and women (both n=15; age: 24±6 years) from the Netherlands.


      Participants were instructed to consume ∼400 mg nitrate at lunch, provided through nitrate-rich vegetables and dietary counseling, or beetroot juice supplementation. Both interventions lasted 1 week, with 1-week washout (January to April 2017).

      Main outcome

      Plasma nitrate and nitrite concentrations and resting systolic and diastolic blood pressure were measured in an overnight fasted state (before and after intervention) and ∼2.5 hours after lunch (before and throughout intervention on day 1, 4, and 7).

      Statistical analysis

      Two-factor (time × treatment) repeated-measures analyses of variance were performed.


      Mean plasma nitrate concentrations increased with both interventions, with a larger increase in beetroot juice vs nitrate-rich vegetables, both in a fasted state and ∼2.5 hours after lunch (day 1, beetroot juice: 2.31±0.56 mg/dL [373±90 μmol/L] vs nitrate-rich vegetables: 1.71±0.83 mg/dL [277±134 μmol/L]; P<0.001). Likewise, mean plasma nitrite concentrations increased with both interventions, but were higher after lunch in beetroot juice than in nitrate-rich vegetables (day 1: 2.58±1.52 μg/dL [560±331 nmol/L] vs 2.15±1.21 μg/dL [468±263 nmol/L]; P=0.020). Fasting mean systolic and diastolic blood pressure did not change, but mean systolic and diastolic blood pressure assessed ∼2.5 hours after lunch were significantly reduced throughout both intervention periods (P<0.05), with no differences between beetroot juice and nitrate-rich vegetables (day 1, systolic blood pressure: –5.1±9.5 mm Hg and diastolic blood pressure: –5.3±8.9 mm Hg).


      Short-term consumption of dietary nitrate in the form of nitrate-rich vegetables represents an effective means to increase plasma nitrate and nitrite concentrations, and reduces blood pressure to the same extent as beetroot juice supplementation.


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      C. M. T. van der Avoort is a doctoral degree candidate, Institute of Sport and Exercise Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.


      K. L. Jonvik is an associate professor, Institute of Sport and Exercise Studies HAN University of Applied Sciences, Nijmegen, The Netherlands.


      L. J. C. van Loon is a professor, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.


      J. Nyakayiru is a researcher, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.


      L. B. Verdijk is an associate professor, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.


      M. T. E. Hopman is professor, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.