Could beetroot juice be used to treat fetal growth restriction?

Dr Elizabeth Cottrell, Dr Teresa Tropea, Professor Colin Sibley, Dr Susan Greenwood, Dr Mark Wareing, Catherine Chmiel, Dr Laura Ormesher, Dr Ed Johnstone, Dr Jenny Myers

Supplementation with dietary nitrate can improve heart and blood vessel function, enhance exercise performance and increase blood flow. We've found that this could also treat fetal growth restriction.

This research project is completed

Fetal growth restriction (FGR) is when a baby’s growth in the womb slows or stops, and affects around 5% of all pregnancies. Often when this happens, there isn’t enough blood flowing across the placenta: this means the baby can’t get the food and oxygen it needs to grow. Currently, there is no treatment for FGR: early delivery is the only option. Funded by the British Heart Foundation and Central Manchester NHS Foundation Trust, researchers at the Tommy’s London centre are trying to change this.

Nitric oxide is a small molecule made throughout the body that makes our blood vessels get wider, allowing blood to flow more easily. It is particularly important in making sure enough blood flows across the placenta during pregnancy.

Too little nitric oxide has been associated with decreased blood flow in pregnancies where the baby isn’t growing normally. Recently, scientists have shown that nitrate – which we eat plenty of in green leafy vegetables and beetroot – can be “activated” in the body to increase levels of nitric oxide. Studies in non-pregnant humans and animals have shown that supplementing the diet with nitrate can improve heart and blood vessel function, lead to better exercise performance and increase blood flow.

We have recently completed a study in which pregnant women with hypertension were given either beetroot juice that contains nitrate, or a placebo (an identical juice with the nitrate removed). We found that nitrate supplementation significantly lowered blood pressure in women who were able to utilise the nitrate. Importantly, amongst the 40 women that completed the trial, 97% said they would be willing to drink beetroot juice in the future, if it would be of benefit. 

Our results suggest that a dietary nitrate supplement could be an effective regulator of blood pressure in pregnant women. Further studies are now required to confirm this finding, and to investigate the role of oral bacteria in the digestion process.

Research papers

Ormesher L, Myers JE, Chmiel C, Wareing M, Greenwood SL, Tropea T, Lundberg JO, Weitzberg E, Nihlen C, Sibley CP, Johnstone ED, Cottrell EC. Effects of dietary nitrate supplementation, from beetroot juice, on blood pressure in hypertensive pregnant women: A randomised, double-blind, placebo-controlled feasibility trial. Nitric oxide: biology and chemistry. Nov 1 2018;80:37-44. 

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This study takes place in a Tommy's centre and is funded by the British Heart Foundation and the Central Manchester NHS Foundation Trust

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