Nitrates and Vascular Disease

The Power of Nitrate-Rich Foods vs. Supplements: Heart Health the DeLand Foot and Leg Center Way

By: Dr. Jenneffer Pulapaka, DPM
DipABLM, CWSP®, DipABMSP, FACCWS, PCWC, retd. AACFAS
Medical Director
DeLand Foot and Leg Center
Podiatric Lifestyle Medicine and Wound Care Management
AAWC BOD

Welcome to the DeLand Foot and Leg Center blog! Today, we dive into an intriguing topic: the benefits of consuming nitrate-rich foods versus supplements, focusing on how our Heart Healthy Plant-Based Cookbook can help you.

Understanding Nitrates and Their Benefits
Nitrates (NO3) have garnered attention for their various health benefits, notably enhancing exercise performance and improving cardiovascular health. Nitrates convert into nitric oxide in the body, which promotes arterial dilation, improving blood flow and reducing blood pressure levels. Studies have shown that nitrates can also enhance endothelial function and suppress vascular inflammation, both crucial for heart health.

Why Nitrates Matter

Nitrates (NO3) are known to:

• Enhance Exercise Performance: Athletes have found that nitrates can improve their performance by increasing nitric oxide production in the body.
• Blood Pressure Reduction: Nitrates cause arterial dilation, allowing the smooth muscles around arteries to relax. This leads to lowered blood pressure and improved vascularity.
• Endothelial Function: Increasing nitric oxide bioavailability improves the vessel lining (endothelium) function, suppressing vascular inflammation.

Food vs. Supplements: What’s the Better Choice?
While there has been a surge in popularity for nitrate supplements such as Super Beets, it’s important to explore natural ways to incorporate nitrates into your diet. Beet and beet greens, for example, are packed with nitrates and have the added advantage of providing additional nutrients and fiber that supplements might lack. Whole foods offer a complex matrix of nutrients and compounds that supplements lack, which can enhance the absorption and efficacy of nitrates. The nitrate content in supplements can vary significantly between products and even batches. Therefore, you might not always get the nitrate boost you’re expecting. Whole vegetables provide additional fibers, vitamins, antioxidants, and other nutrients that supplements don’t.

Nitrates in the Athlete’s Diet
Research indicates that beets can improve exercise performance by enhancing nitric oxide production. However, the nitrate content in beet products varies significantly, making it challenging to standardize the dosage when using supplements.

A study published in the International Journal of Sport Nutrition and Exercise Metabolism revealed vast discrepancies in nitrate content across different beetroot juice (BRJ) products. Some BRJ supplements provide sufficient nitrates to enhance performance, but others fall short. For athletes looking to benefit from nitrates, consistency in nitrate content is essential, and achieving this through supplements alone can be unreliable.

 The Beetroot Juice Boom

There’s no denying that beetroot juice has made quite a splash, particularly among athletes. Studies, like those from Edgar J. Gallardo and Andrew R. Coggan, have shown that beetroot juice (BRJ) can elevate exercise performance by increasing nitric oxide levels. This is especially helpful for endurance, meaning you might just run that extra mile or outlast your competition on the field.

However, the nitrate content in beetroot juice can be highly variable. Gallardo and Coggan’s study revealed that there’s a striking ~50-fold range in nitrate content between different beet juice products. Such variability can make it challenging to ensure you’re getting the right amount if you’re solely relying on commercial beetroot juice.

Supplements: The Convenient Alternative?

Considering these variances in natural beet juice, some might wonder about beetroot supplements like SuperBeets or BeetElite. They can provide a more controlled and consistent intake of nitrates. Yet, as convenient as supplements can be, they come with their own set of challenges. Despite promising levels of nitrates, some products like SuperBeets might not reduce blood pressure significantly, perhaps due to lower overall nitrate doses compared to consuming whole beets.

The study also found that nitrate levels in supplements can differ drastically even within the same product across different batches. Plus, while some products like SuperBeets and BeetElite contained higher amounts of nitrite (NO2-)—a byproduct in the nitrate pathway—it’s unclear if these levels are adequate to offer consistent physiological benefits.

Real Food Over Pills: The Whole Food Advantage

While supplements can be a quick fix, there’s a compelling case for consuming whole foods high in nitrates. Beets, beet greens, arugula, and spinach, among others, are naturally rich in nitrates alongside a gamut of vitamins, minerals, and fiber. Not only are you ingesting nitrates, but you’re also benefiting from a wider nutritional profile that’s hard to replicate in a pill or powder. Eat the whole food! 

In the study by Dos Santos Baião, they suggest that frequent daily doses up to 6.0 mmol of dietary NO₃ (per Lidder, 15 oz of beets would nail the daily target, as would a really big salad of arugula) for long periods of time (≥3 weeks) are required to promote beneficial blood pressure and endothelial function effects, mainly in populations with compromised vascular responsiveness such as hypertensive, metabolic syndrome, obese and older individuals.

Dr. Jenneffer Pulapaka and Chef Hari Pulapaka, authors of “The Heart Healthy Plant-Based Cookbook,” reveal a secret weapon for a healthy heart: nitrate-rich vegetables. This book goes beyond supplements, offering a vibrant culinary adventure that nourishes your body and delights your taste buds.Chef Hari Pulapaka’s James Beard-recognized expertise guarantees not only a nutritional boost but also an explosion of flavor with every recipe.

• Natural Nitrate Powerhouses: Explore recipes featuring nature’s gift of nitrates! From the vibrant “Apple Kale Arugula, Spinach, and Grape Salad with Ginger Lime Dressing” (easily enhanced with roasted beets – page 72) to the flavorful “Beet and Cardamom Chutney” (page 230) spread this high-nitrate delight on whole-grain toast for a satisfying and healthy snack that packs a nutritious punch.
• Nitrate-Rich Greens Beyond Beets: Discover the nitrate bounty in leafy greens like arugula, spinach, and kale. Our recipes incorporate these daily essentials seamlessly, ensuring a well-rounded intake of these valuable compounds.
• More Than Just Nitrates: Whole vegetables offer a symphony of health benefits! Our recipes go beyond nitrates, providing essential fiber, vitamins, and minerals often missing in supplements.

Embrace a Heart-Healthy Future:

Skip the supplements and discover the holistic benefits of nitrate-rich foods. Learn about foods that empowers you to make delicious choices that support healthy blood pressure, vascular function, and overall well-being.

Explore more, eat well, and keep those greens coming!

Find “The Heart Healthy Plant-Based Cookbook” on Amazon or visit www.hearthealthycookbook.com.

Stay tuned to our blog for more insights and delicious recipes focused on your health and wellness!

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Thank you for choosing the DeLand Foot and Leg Center as your trusted source for health information. Let’s embark on this heart-healthy journey together!

 References: 

Gallardo EJ, Coggan AR. What’s in Your Beet Juice? Nitrate and Nitrite Content of Beet Juice Products Marketed to Athletes. Int J Sport Nutr Exerc Metab. 2019 Jul 1;29(4):345–349. doi: 10.1123/ijsnem.2018-0223. PMID: 30299195; PMCID: PMC8512783.

DeVan AE, Johnson LC, Brooks FA, Evans TD, Justice JN, Cruickshank-Quinn C, Reisdorph N, Bryan NS, McQueen MB, Santos-Parker JR, Chonchol MB, Bassett CJ, Sindler AL, Giordano T, Seals DR. Effects of sodium nitrite supplementation on vascular function and related small metabolite signatures in middle-aged and older adults. J Appl Physiol (1985). 2016 Feb 15;120(4):416-25. doi: 10.1152/japplphysiol.00879.2015. Epub 2015 Nov 25. PMID: 26607249; PMCID: PMC4754621.

Dos Santos Baião D, Vieira Teixeira da Silva D, Margaret Flosi Paschoalin V. A Narrative Review on Dietary Strategies to Provide Nitric Oxide as a Non-Drug Cardiovascular Disease Therapy: Beetroot Formulations-A Smart Nutritional Intervention. Foods. 2021 Apr 15;10(4):859. doi: 10.3390/foods10040859. PMID: 33920855; PMCID: PMC8071323.

Lidder S, Webb AJ. Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway. Br J Clin Pharmacol. 2013 Mar;75(3):677-96. doi: 10.1111/j.1365-2125.2012.04420.x. PMID: 22882425; PMCID: PMC3575935.

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