Double-blind controlled dietary cross-over intervention with differentially fertilised intact lettuce leaves shows acute reduction in blood pressure in young adults, associated with faster uptake of nitrate than of phenolics.

Othman K Qadir, Chris J Seal, Ammar W Ashor, Michele Tassotti, Pedro Mena, Daniele Del Rio, Mario Siervo, Kirsten Brandt

Journal: European journal of nutrition 2022;61(8):4191-4203

PMID: 35871120

Abstract

PURPOSE

To compare acute effects on blood pressure (BP) of ingestion of visually similar lettuce with controlled high and low content of either nitrate or phenolic compounds.

METHODS

In a randomised cross-over design, 19 healthy participants (22-31 years) received 50 g of lettuce containing either 530 mg (8.4 mmol) nitrate + 11 mg (0.03 mmol) phenolic compounds (HNLP); or 3 mg nitrate (0.05 mmol) + 77 mg (0.2 mmol) phenolic compounds (LNHP), obtained by differential fertilisation. Ambulatory BP was recorded along with plasma, salivary and urinary nitrate and nitrite and plasma concentrations of cyclic guanosine monophosphate (cGMP), phenolic metabolites, Trolox equivalent antioxidant capacity (TEAC) and ferric reducing antioxidant power (FRAP).

RESULTS

Compared with LNHP, 3 h post ingestion of HNLP, plasma nitrate increased 0.31 ± (95%CI) 0.12 mM (+ 240%), and salivary nitrate 5.5 ± 1.4 mM (+ 910%); accumulated urinary nitrate excretion increased 188 ± 72 mg (+ 296%) (all P < 0.001). Systolic BP was reduced 4.9 ± 4.2 mmHg (P = 0.031) between 3 and 6 h after ingestion of HNLP compared with LNHP; systolic BP differences were negatively correlated (P = 0.004) with differences in saliva nitrate concentrations. LNHP increased plasma phenolics at 6 h, predominantly 3'-methoxycinnamic acid-4'-glucuronide (ferulic acid-4'-glucuronide), 116%, 204 ± 138 nM more than HNLP (P = 0.001); increased cGMP 14% (P = 0.019); and reduced FRAP 3.1% (P = 0.009).

CONCLUSION

The acute BP difference within 6 h of consumption matched the plasma/saliva nitrate peak, not the slower changes of plasma phenolics. This is the first double-blind controlled dietary intervention demonstrating differential effects on human physiology by consumption of an intact plant food, where compositional differences were obtained by controlling growing conditions, indicating potential opportunities for health claims relating to precision/vertical farming.

CLINICAL TRIAL REGISTRATION

The trial was retrospectively registered on ClinicalTrials.gov, with identifier NCT02701959, on March 8, 2016.

© 2022. The Author(s).

Address: Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.; Food Science and Quality Control Department, College of Agricultural Engineering Sciences, University of Sulaimani, 46001, Sulaymaniah, Kurdistan Region, Iraq.; Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.; Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.; Department of Internal Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq.; Human Nutrition Unit, Department of Food and Drugs, University of Parma, Medical School Building C, Via Volturno, 39, 43125, Parma, Italy.; Human Nutrition Unit, Department of Food and Drugs, University of Parma, Medical School Building C, Via Volturno, 39, 43125, Parma, Italy.; School of Advanced Studies on Food and Nutrition, University of Parma, Parma, Italy.; Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.; School of Life Sciences, Queen's Medical Centre, Nottingham University, Nottingham, NG7 2UH, UK.; Human Nutrition Research Centre, Population Health Sciences Institute, William Leech Building, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK. [email protected].
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