Dietary nitrate improves skeletal muscle microvascular oxygenation in HIV-infected patients receiving highly active antiretroviral therapy: a randomised, double-blind, cross-over, placebo-controlled study

Br J Nutr. 2020 Dec 28;124(12):1277-1284. doi: 10.1017/S0007114520002226. Epub 2020 Jun 24.

Abstract

HIV-1 proteins and highly active antiretroviral therapy (HAART) have been associated with microvascular endothelial dysfunction. Although nitrate-rich beetroot juice (NR-BJ) consumption has been shown to improve endothelial function in clinical population, its effects in HIV-infected patients has not been addressed. We investigated the effect of a single dose of NR-BJ on muscle oxygen saturation parameters in response to a handgrip exercise in HIV-infected patients. Fifteen HIV-infected patients received NR-BJ or nitrate-depleted beetroot juice (ND-BJ) in a double-blind cross-over design. Near-IR spectroscopy was utilised to assess muscle oxygen saturation parameters during rhythmic handgrip exercise after NR-BJ or ND-BJ supplementation. A significant faster muscle oxygen desaturation rate during exercise (-7·97 (sd 5·00) v. -5·45 (3·94) %/s, P = 0·005) and muscle oxygen resaturation rate during exercise recovery (0·43 (0·24) v. 0·28 (0·24) %/s, P = 0·030) after NR-BJ ingestion was found. However, no significant difference in exercise time until fatigue was observed. Salivary nitrite and urinary nitrate concentration were analysed after NR-BJ or ND-BJ. A significant increase in salivary nitrite and urinary nitrate in NR-BJ was observed compared with ND-BJ (P < 0·05). Our findings suggest that NR-BJ consumption may acutely improve muscle oxygen saturation during exercise and exercise recovery in HIV-infected patients undergoing HAART and who are expected to present microvascular damage. Thus, future studies investigating the chronic effects of NR-BJ are warranted to delineate a better nutritional strategy based on nitrate-rich foods.

Keywords: Beetroot; HIV; Microcirculation; Muscle oxygenation.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / adverse effects*
  • Beta vulgaris*
  • Cross-Over Studies
  • Dietary Supplements
  • Double-Blind Method
  • Endothelial Cells
  • Female
  • Fruit and Vegetable Juices*
  • HIV Infections / drug therapy
  • HIV Infections / physiopathology
  • HIV Infections / virology
  • HIV-1
  • Hand Strength
  • Humans
  • Male
  • Microvessels / metabolism
  • Middle Aged
  • Muscle, Skeletal / blood supply
  • Nitrates / administration & dosage*
  • Oxygen Consumption / drug effects*
  • Treatment Outcome
  • Young Adult

Substances

  • Nitrates