Exercise plus beetroot juice boosts heart function in women planning to conceive

Beetroot juice in combination with exercise may help improve cardiovascular function in women who are planning to have children, suggests a study.

“The results of this pilot study show that beetroot juice and exercise are feasible and well tolerated interventions in potentially modifying cardiovascular parameters in women planning to conceive,” the researchers said.

“The findings support an appropriately powered study on nonpharmacological and home-based monitoring interventions on pregnancy outcomes relating to gestational hypertension,” they added.

Thirty-two women aged 18‒45 years were included in this prospective, single-site, open-label, randomized controlled trial. Participants were randomly assigned into one of four arms: exercise, beetroot juice, exercise plus beetroot juice, and no intervention for 12 weeks. Blood pressure (BP) was measured daily in the home.

Finally, the researchers measured the cardiac output (CO) and the total peripheral resistance (TPR) using bioelectrical impedance analysis.

Of the participants, 29 (91 percent) completed the study. Adherence to daily BP measurement was 81 percent while that for weight was 78 percent. Eight out of 15 (53 percent) women did not drink all the provided beetroot juice due to forgetfulness and taste. [J Hypertens 2023;42:101-108]

Exercise led to a decrease in standing TPR (‒278 dynes s cm⁻⁵; p<0.05) and an increase in standing CO (0.88 l/min; p<0.05) after 12 weeks. Exercise in combination with beetroot juice resulted in a reduction in standing diastolic BP (7 mm Hg; p<0.05) and an increase in standing CO (0.49 l/min/ p<0.05).

On the other hand, the control group demonstrated a decrease in standing TPR (313 dynes s cm^‒5) and standing diastolic BP (8 mm Hg). Weight gain was observed in all groups.

“Twelve weeks of monitoring alone in controls [showed that] exercise, beetroot juice, and particularly exercise plus beetroot juice were associated with improvements in various cardiovascular parameters in healthy women planning pregnancy,” the researchers said.

“This suggests that preconception health monitoring with lifestyle and nonpharmacological interventions are feasible and potentially effective community-based primary preventive interventions for pre-eclampsia,” they added.

Beetroot juice

In previous studies involving healthy, young participants, results showed that drinking beetroot juice reduced systolic and diastolic BP. [Front Physiol 2019;10:47; Nutr J 2012;11:106; Nutr J 2012;11:106; J Hypertens 2017;35:1353-1359]

A phase II, randomized, double-blind study also reported a sustained BP reduction (8.1/3.8 mm Hg) with dietary nitrate among hypertensive nonpregnant volunteers. [Hypertension 2015;65:320-327]

“Beetroot juice alone demonstrated no changes to cardiovascular parameters in [the current] study, most probably because of a lack of statistical power and cannot, therefore, refute that beetroot juice reduces TPR,” the researchers said. [Hypertension 2015;65:320-327]

Of note, future researchers must consider the acceptability of beetroot juice, since more than a third of participants expressed dissatisfaction with drinking beetroot juice daily. In addition, more than half of the women did not drink it at all.

“This has consequences on the validity of the trial as it has been demonstrated that a 1-week washout period from beetroot juice can reverse BP changes,” the researchers said. “Future studies should consider whether there are more palatable ways to prepare nitrate-based supplementation.” [Front Physiol 2019;10:47]