High-nitrate salad increased plasma nitrates/nitrites and brachial artery flow-mediated dilation in postmenopausal women: A pilot study

Cardiovascular disease risk is elevated in postmenopausal women relative to men of the same age or to younger, premenopausal women. This elevated risk is closely linked to the loss of estrogen, which is a potent stimulator of the vasodilator nitric oxide. While studies have largely supported dietary nitrate supplementation (typically concentrated beetroot juice) to augment plasma nitric oxide, these studies focused mainly on improving vascular fitness of athletes or patient populations. The purpose of this controlled crossover trial was to assess the feasibility of consuming a high-nitrate, leafy green salad twice daily for 10 consecutive days versus a low-nitrate, canned vegetable control (beans, corn, or peas) on plasma nitrate/nitrite concentration and measures of cardiovascular health in postmenopausal women. We hypothesized that plasma nitrate/nitrite concentration and flow-mediated dilation would improve following the leafy green salad treatment. Ten women (52.6 ± 4.9 y; 26.4 ± 6.4 kg/m ² ) completed the two 10-day treatment periods separated by 2–3 weeks washout. The mean fasting plasma nitrate/nitrite concentration was significantly increased following the high-nitrate salad treatment compared to the control (+156% and+ 16% respectively; P = .002, effect size = 0.661). Flow-mediated dilation responded favorably to the high nitrate salad in comparison to the canned vegetable condition (+17% versus −8% respectively; P = .047, effect size = 0.407); however, there were no treatment effects on peripheral or derived central-aortic blood pressure. These data suggest that daily ingestion of nitrate-rich, leafy green salads may prove a useful strategy for improving cardiovascular health in postmenopausal women.