Comprehensive Stroke Center
Research Focuses on Beet Juice After Stroke
Research often works with one scientist building off another's work.
It has been with a groundbreaking 2003 study about how the chemical nitrite is converted into nitric oxide in the human body to regulate blood flow and blood pressure. The study was conducted by Wake Forest University physics professor Daniel Kim-Shapiro, PhD, director of the Translational Science Center, in collaboration with lead investigator Mark Gladwin, MD, chief of the division of Pulmonary, Allergy and Critical Care Medicine and director of the Vascular Medicine Institute at the University of Pittsburgh School of Medicine.
In time, the work of Gladwin and Kim-Shapiro gave Cheryl Bushnell, MD, director of Wake Forest Baptist Health's Comprehensive Stroke Center, an idea.
Benefits of High Nitrate Diet
The work of Gladwin and Kim-Shapiro, as well as others, grew after 2003; for example, studies showed that nitric oxide derived from nitrite could improve outcomes in heart attack and pulmonary hypertension.
Bushnell was particularly interested in a 2010 follow-up study by Kim-Shapiro's multidisciplinary team from Wake Forest University and a Wake Forest School of Medicine team that included Jonathan Burdette (Radiology) and Gary Miller (Health and Exercise Science). That study showed that a high nitrate diet resulted in increased blood flow in parts of the brain for healthy elderly people.
Some study participants had been given beet juice, a high nitrate product that is converted in the mouth to nitrite and eventually to nitric oxide in places in the body where it is needed. The nitric oxide is a vasodilator, meaning it expands blood vessels, and largely targets areas in the body that are low in oxygen.
"We showed that there's increased cerebral blood flow in areas associated with cognitive decline in older adults after they drank beet juice,'' Kim-Shapiro says.
Building off that idea, Bushnell is leading a new clinical trial that offers stroke patients the potential benefits of beet juice in their recovery.
After a stroke, which kills brain cells, a certain amount of new cells form in the brain. Bushnell says she is hopeful that drinking beet juice will "actually enhance patients' recovery'' because of the way nitric oxide promotes cell growth.
Beet juice taking off?
In recent years, beet juice has gained traction for its restorative qualities. Scientists around the world have been studying the efficacy of beet juice in everything from reducing blood pressure levels to improving athletic performance. At the Summer Olympics last year in London, numerous athletes were seen drinking beet juice to promote increased blood flow.
Kim-Shapiro says beet juice seems to increase respiratory efficiency at the cellular level, which could increase exercise efficiency. Studies are ongoing.
The clinical trial for stroke that Bushnell is leading will involve 80 patients and should be completed in two years. After that, Bushnell says, the goal would be to pursue a multi-center trial.
Bushnell says she has not lacked for interest in people willing to try a small portion of beet juice daily for 30 days after suffering a stroke.
"So far, people want to do something that would potentially help them recover,'' she says. "The enthusiasm is there.''
Marketing Beet Juice
Although it could be years before beet juice is approved by the Food and Drug Administration as a product to enhance recovery from the effects of stroke, Wake Forest University has worked with a company in Florida to make bottled beet juice.
The drink has been in the works for more than three years thanks to the efforts of Wake Forest Innovations, the division that helps to commercialize and market the work of scientists and researchers. Bottles of the sweet-tasting juice, a formula developed to counter the natural bitterness of beet juice, are already available for use by Kim-Shapiro's research team. The juice is expected to be available to consumers this year.
Kim-Shapiro says people essentially see beet juice as a new type of energy drink.
Last year, he says, he gave some beet juice samples to his students in advance of exams to gauge their reaction and see if it would give them an energy boost.
They were so enthusiastic, he says, that some would come up to him and ask, "Can I have another bottle? I have another final."