Impact of Lifestyle Behaviors Changes on Endothelial Function and Possible Protective Effect of Beetroot Juice
Front Nutr 2020 Oct 21;7:582210.
Covid-19 Quarantine: Impact of Lifestyle Behaviors Changes on Endothelial Function and Possible Protective Effect of Beetroot Juice
Mônica Volino-Souza 1 2, Gustavo Vieira de Oliveira 1 3, Carlos Adam Conte-Junior 1 2 3, Thiago Silveira Alvares 1 2 4
· 1Nutrition and Exercise Metabolism Research Group, Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
· 2Graduate Program in Food Science (PPGCAL), Institute of Chemistry (IQ), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro, Brazil.
· 3Nanotechnology Network, Carlos Chagas Filho Research Support Foundation of the State of Rio de Janeiro (FAPERJ), Rio de Janeiro, Brazil.
· 4Postgraduate Program in Bioactive Products and Biosciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
The current recommendation for reducing person-to-person Coronavirus 2019 (COVID-19) transmission is social distancing, including remote work and school, and home confinement. However, confinement may cause negative feelings, such as frustration, anger, boredom, and stress, in quarantined people. Furthermore, unhealthy diet and physical inactivity behaviors are commonly linked to home confinement, leading to weight gain, metabolic disorders, smoking, and exacerbated alcohol consumption. As a result, these unhealthy behaviors are typically linked to vascular endothelium damage (endothelial dysfunction), which is a first step for the development of cardiovascular disease (CVD). Given that CVD is the main cause of morbidity and mortality worldwide, attenuating the progression of endothelial dysfunction is very important for the control of CVD. Consuming vegetable rich in nitrate, such as beetroots, may be an effective way to prevent endothelial dysfunction. Several emerging studies have recommended beetroot juice in order to improve endothelial function in hypertensive, hypercholesterolemic individuals, as well as in those with CVD risk factors. Therefore, nitrate-rich vegetable consumption, such as beetroot, should be encouraged to be included in the diet during confinement from COVID-19 outbreaks in order to alleviate the potential negative effect of home confinement on cardiovascular health.
Keywords: cardiovascular disease; coronavirus; dietary nitrate; nitric oxide; vascular health.
Figure 1 The effect of lifestyle behaviors changes during COVID-19 quarantine on endothelial function. Social distancing was adopted as a way to reduce person-to-person Coronavirus 2019 transmission. However, home confinement may promote lifestyle behaviors changes as unhealthy diet and physical inactivity. Collectively, these unhealthy behaviors are associated with endothelial damage, the first step for the development of cardiovascular diseases. Since nitrate-rich beetroot juice ingestion has demonstrated positive effect on endothelial function due to its effects on nitric oxide bioavailability, its ingestion could be encouraged during COVID-19 quarantine in order to alleviate the potential negative effect of home confinement on cardiovascular health.
Figure 2 Nitrate-nitrite-nitric oxide pathway in humans. After ingestion of nitrate-rich beetroot juice, the nitrate is converted into nitrite by nitrate reductase enzymes in the oral cavity. In the stomach, due to low pH the nitrite can be converted into nitric oxide. The remaining nitrate and nitrite are absorbed from the intestine and 75% is excreted in the urine. The nitrite absorbed from intestine into blood circulation can be converted into nitric oxide in dysfunctional artery.