Acceptability and Feasibility of a 13-Week Pilot Randomised Controlled Trial Testing the Effects of Incremental Doses of Beetroot Juice in Overweight and Obese Older Adults

Abstract

Nitrate-rich food can increase nitric oxide production and improve vascular and brain functions. This study examines the feasibility of a randomised controlled trial (RCT) testing the effects of prolonged consumption of different doses of dietary nitrate (NO₃^-) in the form of beetroot juice (BJ) in overweight and obese older participants. A single-blind, four-arm parallel pilot RCT was conducted in 62 overweight and obese (30.4 ± 4 kg/m²) older participants (mean ± standard deviation (SD), 66 ± 4 years). Participants were randomized to: (1) high-NO₃^- (HN: 2 × 70 mL BJ/day) (2) medium-NO₃^- (MN: 70 mL BJ/day), (3) low-NO₃^- (LN: 70 mL BJ on alternate days) or (4) Placebo (PL: 70 mL of NO₃^--depleted BJ on alternate days), for 13 weeks. Compliance was checked by a daily log of consumed BJ, NO₃^- intake, and by measuring NO₃^- and NO₂^- concentrations in plasma, saliva, and urine samples. Fifty participants completed the study. Self-reported compliance to the interventions was >90%. There were significant positive linear relationships between NO₃^- dose and the increase in plasma and urinary NO₃^- concentration (R² = 0.71, P < 0.001 and R² = 0.46 P < 0.001, respectively), but relationships between NO₃^- dose and changes in salivary NO₃^- and NO₂^- were non-linear (R² = 0.35, P = 0.002 and R² = 0.23, P = 0.007, respectively). The results confirm the feasibility of prolonged BJ supplementation in older overweight and obese adults.