Beet juice may reduce walking pain with leg artery disease

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[September 08, 2018]  By Lisa Rapaport

(Reuters Health) - Patients with peripheral artery disease who drink beet juice before walking may feel less pain from this type of exercise than people who don't, a small experiment suggests.

Peripheral artery disease (PAD) develops over time with hardening of the arteries and reduced blood and oxygen flow to the tissues and muscles in the legs. When people have PAD, walking can cause severe pain that requires them to stop and rest after very short distances because the legs don't get enough oxygen to handle the demands of even this gentle form of exercise.

Some previous research suggests that inorganic nitrate, an ingredient in beet juice, can help increase delivery of blood and oxygen to working muscles and enable muscles to use oxygen more efficiently, particularly in people who are less fit or who do high-intensity exercise.

"This makes it an attractive potential therapeutic approach for individuals with PAD who have severely limited blood/oxygen supply to the lower limbs which severely reduces their function and makes everyday tasks require a vigorous effort," said senior study author Jason David Allen of the University of Virginia in Charlottesville.

"Our early work in patients with PAD showed that a single dose of beetroot juice increased pain free walking by 18 percent when compared to a placebo juice with no inorganic nitrate," Allen said by email.

For the experiment, researchers provided 35 patients with PAD a total of 36 supervised exercise sessions over 12 weeks. For each session, participants walked on a treadmill for 30 minutes, with the speed and incline tailored to their individual abilities.

Half of the participants were randomly chosen to drink beet juice three hours prior to each workout, while the other half of the patients got a placebo drink.

By the end of the experiment, both groups could walk further in timed six minute treadmill tests than they could at the beginning. With beet juice, people increased walking distance by an average of about 53 meters. Without it, participants increased walking distance by almost 25 meters on average.

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Cramps are a common side effect of walking and other exercise in people with PAD, and this also improved for both groups. With beet juice, the time it took people to feel cramping increased by an average of 180 seconds, while without it, the time it took participants to feel leg cramps increased by an average of 59 seconds.

Even though these results suggest that beet juice might reduce pain related to exercise, it's not clear how much of the improvements in the study were due to the beet juice or because of the supervised exercise sessions, the study authors note in Circulation Research.

The study was also too small to determine if beet juice might benefit all patients with PAD.

Beet juice also isn't something doctors typically prescribe for reducing pain from walking with PAD, noted Dr. Joseph Ladapo of the David Geffen School of Medicine at the University of California Los Angeles.

"The potential benefits of beets are not yet established in mainstream medical literature," Ladapo, who wasn't involved in the study, said by email.

But there's very little downside to trying it, Ladapo said.

"The biggest downside is that a person could ingest too much sugar, which we are increasingly recognizing as being bad for your health and particularly bad for children, because it contributes to obesity, but that's about it," Ladapo said. "Otherwise, beets are a healthy, nutritious food."

SOURCE: http://bit.ly/2NoJqdY Circulation Research, online August 7, 2018.

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