The blood pressure lowering effect of nitrate-rich beetroot juice in older people may be due to specific changes in their oral microbiome, according to the largest study of its kind.

Researchers at the University of Exeter in England conducted the study which was published in the journal Free Radical Biology and Medicine. It followed previous research that had shown a high nitrate diet can reduce blood pressure—which, in turn, can reduce the risk of heart disease.

Nitrate is crucial to the body and is consumed as a natural part of a vegetable-rich diet. When older adults drank a concentrated ‘shot’ of beetroot juice twice a day for two weeks, their blood pressure decreased – an effect not seen in a younger group used for comparison.

“Encouraging older adults to consume more nitrate-rich vegetables could have significant long term health benefits,” said study author Professor Anni Vanhatalo, of the University of Exeter.

“We know that a nitrate-rich diet has health benefits, and older people produce less of their own nitric oxide as they age.”

“The good news is that if you don’t like beetroot, there are many nitrate-rich alternatives like spinach, rocket, fennel, celery and kale.”

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The study recruited 39 adults under age 30 and 36 adults in their 60s and 70s (through the NIHR Exeter Clinical Research Facility).

In both groups, the make-up of the oral microbiome changed significantly after drinking the nitrate-rich beetroot juice, but these changes differed between the younger and older age groups.

According to Exeter News, “The new study provides evidence that this outcome was likely caused by the suppression of potentially harmful bacteria in the mouth. An imbalance between beneficial and harmful oral bacteria can decrease the conversion of nitrate (abundant in vegetable-rich diets) to nitric oxide—which is key to healthy functioning of the blood vessels, and therefore the regulation of blood pressure.”

The older age group experienced a notable decrease in the mouth bacteria Prevotella after drinking the juice, along with an increase in the growth of bacteria known to benefit health, such as Neisseria. The older group had higher average blood pressure at the start of the study, which fell after taking the nitrate-rich beetroot juice, but not after taking the placebo supplement.

“This study shows that nitrate-rich foods alter the oral microbiome in a way that could result in less inflammation, as well as a lowering of blood pressure in older people,” said co-author Professor Andy Jones.

“This paves the way for larger studies to explore the influence of lifestyle factors and biological sex in how people respond to dietary nitrate supplementation.”

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“By uncovering how dietary nitrate affects oral bacteria and blood pressure in older adults, the study opens up new opportunities for improving vascular health through nutrition,” said Dr. Lee Beniston from BBSRC, which funded the research.

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